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Vitamin B Supplements Can Lower Your Risk of Stroke

November 26th, 2013

by Jessica Amtower, PharmD student

Vitamin B supplements have been known for their many uses. For example, some B vitamins help cells burn fats and glucose for energy, while others help make neurotransmitters like serotonin.1 To get as much benefit as possible, it’s recommended that you need all of the B’s, but they are still beneficial alone. Some B vitamins have previously been noted to possibly lower the risk of stroke. According to the CDC, strokes are the leading cause of death in the United States, killing nearly 130,000 Americans each year—that’s 1 of every 18 deaths.2

CNN recently published an article stating that Vitamin B supplements could potentially help reduce the risk of a stroke.  The study promoting this information was published in the journal Neurology, where researches conducted a meta-analyses from the results of 14 clinical trials involving 54, 913 participants.3 The study concluded that patients taking a vitamin B supplement had a 7% reduced risk of stroke compared to those who were taking a supplement. This reduced risk of stroke was due to lowered homocysteine levels in the blood, which are associated with hardening and narrowing of the arteries as well as increased risk of heart attacks, strokes, and blood clot formation.4 Several meta-analyses have been published since 2010 looking at the effects of therapy to lower homocysteine levels with B vitamin supplementation on vascular disease risk. However, this new study included studies that were omitted from previous reports and adopted stricter inclusion criteria.5

According to an author of the study, Xu Yuming of Zhengzhou, University in Zhengzhou, China, previous studies have conflicting findings regarding the use of vitamin B supplements and stroke or heart attack.6 He states, “Some studies have even suggested that the supplements may increase the risk of these events.” While it was found that participants had a reduced risk of stroke, the supplements did not reduce the severity of the strokes or the risk of death.6 Scientists have admitted that more research needs to be done in the area, but many stroke specialists still feel this is a positive step forward.

Dr. Teshamae Monteith, an assistant professor of clinical neurology at the University of Miami School of Medicine says, “I think this is an exciting study, because we need more treatments for stroke. I believe safe options are necessary, but I don’t think people should start ingesting large amounts of Vitamin B to avoid strokes.” In light of the article background and information regarding supplements and stroke, I would agree with Dr. Monteith in that this is a step in the right direction, but we shouldn’t just start recommending it constantly. Although there is plenty of scientific literature stating that B vitamin supplementation for homocysteine reduction significantly reduced stroke events4, more research is required to solidify these findings. After further research on vitamin B supplements, I would personally recommend them. Vitamin B supplements are beneficial for health issues such as stress, anxiety, depression, dementia, Alzheimer’s disease as well as many others.6 According to the USDA, many Americans don’t get enough B vitamins, as deficiencies in folic acid, B12 and B6 are especially common.1 Many Americans are unaware of these deficiencies only because they are not currently presented in a physical ailment. B vitamin supplements are more helpful than most realize, and aren’t going to cause harm. Water-soluble B’s are found to be very safe. Patients should always check with their primary care physician before adding a dietary supplement to their medication regimens.

When searching for limitations within the research, it was rather difficult to find anything. Typically, with meta-analyses you would look for limitations such as sample size, study methods, or exclusion/inclusion criteria. This study had a rather large sample size of over 54,000 participants, ruling this out as being a possible limitation. The inclusion/exclusion criteria were very broad to include studies where vitamin B was shown effective and studies where it wasn’t. The only thing I can seem to find as a limitation is that B vitamin supplement has yet to be defined as a standard of care when dealing with reduction of the risk of stroke. Practitioners are unaware of any benefit due to it not being a standard of care.

With this newly discovered research, many patients are going to be asking questions about the safety and effectiveness of B vitamin supplements. If these supplements were to truly reduce the risk of stroke, would you take them on a regular basis? As a student pharmacist, and current intern, would you feel comfortable recommending this to patients?

References

  1. Challem J. The Benefits of B Vitamins. In Whole Living: Body and Soul in Balance. http://www.wholeliving.com/134086/benefits-b-vitamins. Published 2005. Accessed November 15,2013.
  2. CDC. Stroke Facts and Statistics. Center for Disease Control and Prevention. http://www.cdc.gov/stroke/facts_statistics.htm. Published October 16, 2012. Accessed November 15, 2013.
  3. Wadas-Willingham V. Vitamin B may lower stroke risk. CNN Health. http://thechart.blogs.cnn.com/2013/09/19/vitamin-b-may-lower-stroke-risk/. Published September 19, 2013. Accessed November 15, 2013.
  4. Yan J., et al. Vitamin B supplementation, homocysteine levels, and the risk of cerebrovascular disease: A meta-analysis. Neurology. September 18, 2013; 81(15):1298-1307. Doi: 10.1212/WNL.0b013e3182a823cc.
  5. Anderson P. Vitamin B Supplements May Lower Stroke Risk. Medscape: Medical Students. http://www.medscape.com/viewarticle/811260. Published September 18, 2013. Accessed November 15, 2013.
  6. Whiteman H. Vitamin B may reduce risk of stroke. Medical News Today. http://www.medicalnewstoday.com/articles/266247.php. Published September 20, 2013. Accessed November 15, 2013.

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4 Responses to “Vitamin B Supplements Can Lower Your Risk of Stroke”

  1. Mike Pelyhes Says:

    The use of vitamin B to help lower strokes, sounds pretty good if further evidence can be gathered to promote it’s use. However, the article isn’t clear on specifically what forms of vitamin B are helpful, several are pointed out as potentially being harmful. A greater explanation of this would be nice. Without further research I can’t find myself likely to recommend it at this point. The study mentioned in the article isn’t linked, and doesn’t event have a title given. And, while this might be stereotyping I am reluctant to accept a Chinese study without being able to evaluate the research myself. A number of high profile reports have come out about fraud in Chinese publications. (http://www.nytimes.com/2010/10/07/world/asia/07fraud.html?pagewanted=all&_r=0 and http://www.economist.com/news/china/21586845-flawed-system-judging-research-leading-academic-fraud-looks-good-paper) One revelation even halted GlaxoSmithKline drug trials this past summer (http://www.thetimes.co.uk/tto/business/industries/health/article3788766.ece) Correspondingly, I’m skeptical of a study that I can’t view personally without a $30.00 fee to the journal of Neurology. I would like to see additional meta analyses confirm the results of this study before I would recommend vitamin B myself. If additional evidence comes out I would still stress to patients that they don’t need to bombard their body with vitamin B. While toxicity is rare with most forms of vitamin B, I feel it is important that the patient understands that at a certain point they are either excreting the product or increasing their chances of toxicity.

  2. Danielle Eaton Says:

    The use of vitamin B to reduce the incidence of stroke is certainly an interesting concept and one that should be of particular significance to pharmacists and pharmacy interns. If a doctor recommends that a patient start taking a natural supplement or vitamin, the pharmacist is usually the last healthcare professional the patient comes into contact with before purchasing the product. Therefore, the person who could potentially have the most impact on how the patient takes the supplement or which supplement they choose is the pharmacist. This makes knowing the current research about these supplements crucial to allow for the best possible patient care. The strengths of the meta-analysis mentioned give the findings good validity and generalizability, but I also see some flaws that would make me as a future pharmacist hesitant to recommend vitamin B supplementation. First of all this article does not mention which B vitamin was used, and there are several different forms. One in particular, B6 can be toxic in high doses and result in severe neuropathy. This is where I would have liked to see more in-depth research done on specific types of the B vitamins and the effects they have on the incidence of stroke. Additional evidence would be necessary for me to recommend this product for use to lower the risk of stroke.

  3. Joseph Newman Says:

    This is a very interesting concept, I think that it is great that researchers are looking into new ways to prevent strokes, especially with how many deaths are a result of strokes. I don’t think I would recommend Vitamin B supplements for that purpose, at least not yet. There needs to be a lot more research done before I would recommend it to patients. I think I would be more interested in finding out what methods for preventing stroke exist today, and how Vitamin B compares to what is already out there. It is very important to understand the research and stay up to date, especially since articles like the one you mentioned often pop up on yahoo, or on facebook and social media. It is important that we be able to answer questions given to us by these people. Overall, the study you provided looks like a very well done study, summarizing lots of research about the topic, but I would be hesitant to recommend it until there is further research done on the subject.

  4. Jessica Davis Says:

    I agree with Joe. I like the fact that they are researching ways to prevent stroke and from this study it shows that it is somewhat effective, but I would want more evidence to support this before I would recommend this to a patient. Although if a patient had read this article and came in asking about this, I would tel them that there isn’t much research on this topic but it’s not going to hurt if they want to take a B vitamin everyday. This is a major health issue and any research on the prevention of stroke due to any vitamin or medication seems like a step in the right direction.

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