vitamin-b-12 and Multiple-Sclerosis

Topics: Adult; Case-Control Studies; Disease Progression; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Multiple Sclerosis; Vitamin B 12

Current studies suggested discrepancies on the correlations between multiple sclerosis (MS) and blood levels of homocysteine (Hcy), vitamin B12 (VB12), and folate. We performed a case-control study and meta-analysis to help resolve the controversy of these lab values in Chinese patients with MS.. We recruited 80 Chinese MS patients, 86 age/sex matched neurological controls (patients with peripheral vertigo or sleep disorders), and 80 age- and sex-matched healthy controls. Serum Hcy levels were measured using flourimetric high-performance liquid chromatography, serum levels of VB12 and folate using immune assay. A literature search of PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed was conducted for case-control studies with pure Chinese populations published up to March 16, 2019. The effective size was estimated by the pooled standardized mean difference (SMD) and associated 95% confidence interval (CI).. The case-control study results suggest higher Hcy levels (mean ± SD) and frequency of hyperhomocysteinemia in the Chinese MS cases than control groups (all p < 0.001), lower for VB12 levels (mean ± SD, p = 0.043 or 0.039). No significant difference was observed for levels of folate (mean ± SD, both p > 0.05), and for frequency of folate or VB12 deficiency (all p > 0.05). Analysis of pooled SMDs and 95% CIs suggested increased Hcy levels in Chinese MS patients (SMD: 2.31, 95% CI: 1.33-3.28, p < 0.001), and in relapsing or remitting cases relative to controls (SMD: 0.94 or 0.85, 95% CI: 0.49-1.39 or 0.35-1.34, both p < 0.001). The meta-analysis results also suggested reduced VB12 levels in Chinese MS patients (SMD: -0.30, 95% CI: -0.46-0.14, p < 0.001), and in relapsing MS patients compared to controls (SMD: -0.31, 95% CI: -0.47-0.15, p < 0.001), while no statistical difference for cases in remission. No significant difference was observed for levels folate in all comparisons.. Patients with MS tend to have increased blood Hcy levels compared to controls. MS patients of Chinese origin and those in relapse may have decreased levels of VB12. Hcy and VB12 may contribute to pathogenesis of the disease, and VB12 may correlate with MS relapse.

Topics: Adult; Case-Control Studies; China; Female; Folic Acid; Homocysteine; Humans; Hyperhomocysteinemia; Male; Middle Aged; Multiple Sclerosis; Vitamin B 12

Surveys of patients with multiple sclerosis report that most are interested in modifying their diet and using supplements to potentially reduce the severity and symptoms of the disease. This review provides an updated overview of the current state of evidence for the role that vitamins and dietary supplements play in multiple sclerosis and its animal models, with an emphasis on recent studies, and addresses biological plausibility and safety issues.. Several vitamins and dietary supplements have been recently explored both in animal models and by patients with multiple sclerosis. Most human trials have been small or nonblinded, limiting their generalizability. Biotin and vitamin D are currently being tested in large randomized clinical trials. Smaller trials are ongoing or planned for other supplements such as lipoic acid and probiotics. The results of these studies may help guide clinical recommendations.. At the present time, the only vitamin with sufficient evidence to support routine supplementation for patients with multiple sclerosis is vitamin D. Vitamin deficiencies should be avoided. It is important for clinicians to know which supplements their patients are taking and to educate patients on any known efficacy data, along with any potential medication interactions and adverse effects of individual supplements. Given that dietary supplements and vitamins are not subject to the same regulatory oversight as prescription pharmaceuticals in the United States, it is recommended that vitamins and supplements be purchased from reputable manufacturers with the United States Pharmacopeia designation.

Topics: Acetylcarnitine; Animals; Ascorbic Acid; Biotin; Caffeine; Creatine; Curcumin; Dietary Supplements; Disease Models, Animal; Encephalomyelitis, Autoimmune, Experimental; Fatty Acids, Unsaturated; Folic Acid; Ginkgo biloba; Humans; Multiple Sclerosis; Niacin; Pantothenic Acid; Plant Preparations; Probiotics; Pyridoxine; Resveratrol; Riboflavin; Tea; Thiamine; Thioctic Acid; Ubiquinone; Vitamin A; Vitamin B 12; Vitamin D; Vitamin E; Vitamins

Nutrition is considered to be a possible factor in the pathogenesis of the neurological disease multiple sclerosis (MS). Nutrition intervention studies suggest that diet may be considered as a complementary treatment to control the progression of the disease; a systematic review of the literature on the influence of diet on MS was therefore conducted. The literature search was conducted by using Medlars Online International Literature (MEDLINE) via PubMed and Scopus. Forty-seven articles met the inclusion criteria. The reviewed articles assessed the relations between macro- and micronutrient intakes and MS incidence. The patients involved used alternative therapies (homeopathy), protocolized diets that included particular foods (herbal products such as grape seed extract, ginseng, blueberries, green tea, etc.), or dietary supplements such as vitamin D, carnitine, melatonin, or coenzyme Q10. Current studies suggest that high serum concentrations of vitamin D, a potent immunomodulator, may decrease the risk of MS and the risk of relapse and new lesions, while improving brain lesions and timed tandem walking. Experimental evidence suggests that serum vitamin D concentration is lower during MS relapses than in remission and is associated with a greater degree of disability [Expanded Disability Status Scale (EDSS) score >3]. The findings suggest that circulating vitamin D concentrations can be considered a biomarker of MS and supplemental vitamin D can be used therapeutically. Other studies point to a negative correlation between serum vitamin B-12 concentrations and EDSS score. Vitamin B-12 has fundamental roles in central nervous system function, especially in the methionine synthase-mediated conversion of homocysteine to methionine, which is essential for DNA and RNA synthesis. Therefore, vitamin B-12 deficiency may lead to an increase in the concentration of homocysteine. Further research is clearly necessary to determine whether treatment with vitamin B-12 supplements delays MS progression.

Topics: Diet; Dietary Supplements; Disease Progression; Humans; Multiple Sclerosis; Nutritional Status; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D; Vitamin D Deficiency; Vitamins

Multiple sclerosis (MS) is a demyelinating and disabling inflammatory disease of the central nervous system. Several factors contribute to MS pathogenesis including genetic-environmental interactions. Case-control studies suggest that there might be associations between MS and homocysteine (Hcy), vitamin B12, and folate blood levels.. To meta-analyze all available data describing associations between MS and serum or plasma Hcy, vitamin B12, and folate levels.. The PubMed, MEDLINE, and EMBASE databases were searched for eligible case-control studies published until June 2017. After data extraction, separate analyses using mainly random-effects models were conducted to test for associations between MS and vitamin B12, Hcy, or folate blood levels.. Twelve, 12, and 9 studies met the inclusion criteria for meta-analysis of MS and Hcy, vitamin B12, and folate levels, respectively. The standardized mean difference (SMD) between MS patients and controls was statistically significant for Hcy (SMD: 0.70, 95% CI: 0.06, 1.34). Stratification according to clinical pattern did not reveal significant differences between relapsing-remitting MS patients and controls (SMD: 0.30, 95% CI: -0.93, 1.54) or between secondary progressive MS patients and controls (SMD: 0.12, 95% CI: -1.65, 1.90). There were no significant differences in SMD between MS patients and healthy individuals for vitamin B12 (SMD: -0.09, 95% CI: -0.29, 0.10) or folate (SMD: -0.06, 95% CI: -0.17, 0.05).. MS patients tend to have elevated Hcy blood levels compared to healthy controls. Hcy may contribute to the pathogenesis of the disease.

Topics: Folic Acid; Homocysteine; Humans; Multiple Sclerosis; Vitamin B 12

A meta-analysis was conducted to assess the relationship between serum homocysteine, vitamin B(12), and folate levels in patients with multiple sclerosis (MS). The DerSimonian and Laird Q test was used to evaluate the degree of heterogeneity between studies and a funnel plot was used to assess publication bias. The pooled effect size (standardized mean difference [SMD]) between patients with MS and control patients) from a random effects model was 0.84 (95% confidence interval: 0.18, 1.49) for homocysteine and -0.25 (-0.45, -0.04) for vitamin B(12), and from a fixed effects model was 0.98 (0.80, 1.16) for homocysteine and -0.25 (-0.41, -0.09) for vitamin B(12). Both nutrients were statistically significant, but the SMD for folate was not. Patients with MS were found to have raised homocysteine levels but low B(12) levels, which might contribute to the pathogenesis of MS.

Topics: Folic Acid; Homocysteine; Humans; Multiple Sclerosis; Vitamin B 12

There are many reasons for reviewing the neurology of vitamin-B12 and folic-acid deficiencies together, including the intimate relation between the metabolism of the two vitamins, their morphologically indistinguishable megaloblastic anaemias, and their overlapping neuropsychiatric syndromes and neuropathology, including their related inborn errors of metabolism. Folates and vitamin B12 have fundamental roles in CNS function at all ages, especially the methionine-synthase mediated conversion of homocysteine to methionine, which is essential for nucleotide synthesis and genomic and non-genomic methylation. Folic acid and vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including Alzheimer's disease and vascular dementia in elderly people.

Topics: Animals; Folic Acid; Humans; Metabolic Diseases; Models, Biological; Multiple Sclerosis; Nervous System; Vitamin B 12; Vitamin B 12 Deficiency

Multiple Sclerosis (MS) and vitamin B12 deficiency share common inflammatory and neurodegenerative pathophysiological characteristics. Due to similarities in the clinical presentations and MRI findings, the differential diagnosis between vitamin B12 deficiency and MS may be difficult. Additionally, low or decreased levels of vitamin B12 have been demonstrated in MS patients. Moreover, recent studies suggest that vitamin B12, in addition to its known role as a co-factor in myelin formation, has important immunomodulatory and neurotrophic effects. These observations raise the questions of possible causal relationship between the two disorders, and suggest further studies of the need to close monitoring of vitamin B12 levels as well as the potential requirement for supplementation of vitamin B12 alone or in combination with the immunotherapies for MS patients.

Topics: Animals; Demyelinating Diseases; Humans; Models, Biological; Multiple Sclerosis; Myelin Sheath; Vitamin B 12; Vitamin B 12 Deficiency; Wound Healing

Topics: Diagnosis, Differential; Humans; Immunoglobulin G; Lyme Disease; Magnetic Resonance Imaging; Male; Methylprednisolone; Middle Aged; Multiple Sclerosis; Tomography, X-Ray Computed; Vitamin B 12

Folate and vitamin B12 are required both in the methylation of homocysteine to methionine and in the synthesis of S-adenosylmethionine. S-adenosylmethionine is involved in numerous methylation reactions involving proteins, phospholipids, DNA, and neurotransmitter metabolism. Both folate and vitamin B12 deficiency may cause similar neurologic and psychiatric disturbances including depression, dementia, and a demyelinating myelopathy. A current theory proposes that a defect in methylation processes is central to the biochemical basis of the neuropsychiatry of these vitamin deficiencies. Folate deficiency may specifically affect central monoamine metabolism and aggravate depressive disorders. In addition, the neurotoxic effects of homocysteine may also play a role in the neurologic and psychiatric disturbances that are associated with folate and vitamin B12 deficiency.

Topics: Depressive Disorder; Folic Acid; Folic Acid Deficiency; Homocysteine; Humans; Methylation; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

Multiple sclerosis (MS) is occasionally associated with vitamin B12 deficiency. Recent studies have shown an increased risk of macrocytosis, low serum and/or CSF vitamin B12 levels, raised plasma homocysteine and raised unsaturated R-binder capacity in MS. The aetiology of the vitamin B12 deficiency in MS is often uncertain and a disorder of vitamin B12 binding or transport is suspected. The nature of the association of vitamin B12 deficiency and MS is unclear but is likely to be more than coincidental. There is a remarkable similarity in the epidemiology of MS and pernicious anaemia. Vitamin B12 deficiency should always be looked for in MS. The deficiency may aggravate MS or impair recovery. There is evidence that vitamin B12 is important for myelin synthesis and integrity but further basic studies are required.

Topics: Animals; Erythrocytes; Homocysteine; Humans; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Humans; Multiple Sclerosis; Neurologic Examination; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Antiviral Agents; Demyelinating Diseases; Glutens; Humans; Immunosuppressive Agents; Linoleic Acids; Multiple Sclerosis; Palliative Care; Transfer Factor; Vitamin B 12

Topics: Chloroquine; Climate; Diet; Female; Humans; Male; Multiple Sclerosis; Pakistan; Poland; Research; Sex Factors; United Kingdom; Vitamin B 12

To determine whether combination therapy with lofepramine, L-phenylalanine, and intramuscular vitamin B-12 (the "Cari Loder regime") reduces disability in patients with multiple sclerosis.. A placebo controlled, double blind, randomised study carried out in five United Kingdom centres on outpatients with clinically definite multiple sclerosis, measurable disability on Guy's neurological disability scale (GNDS), no relapse in the preceding six months, and not on antidepressant drugs. Over 24 weeks all patients received vitamin B-12, 1 mg intramuscularly weekly, and either lofepramine 70 mg and L-phenylalanine 500 mg twice daily, or matching placebo tablets. Outcome was assessed using the GNDS, the Kurtzke expanded disability status scale; the Beck depression inventory, the Chalder fatigue scale, and the Gulick MS specific symptom scale.. 138 patients were entered, and two were lost from each group. There was no statistically significant difference between the groups at entry or at follow up. Analysis of covariance suggested that treated patients had better outcomes on four of the five scales used. Both groups showed a reduction of 2 GNDS points within the first two weeks, and when data from all time points were considered, the treated group had a significant improvement of 0.6 GNDS points from two weeks onwards.. Patients with multiple sclerosis improved by 2 GNDS points after starting vitamin B-12 injections. The addition of lofepramine and L-phenylalanine added a further 0.6 points benefit. More research is needed to confirm and explore the significance of this clinically small difference.

Topics: Adolescent; Adult; Aged; Antidepressive Agents, Tricyclic; Disability Evaluation; Double-Blind Method; Drug Therapy, Combination; Fatigue; Female; Follow-Up Studies; Humans; Lofepramine; Male; Middle Aged; Multiple Sclerosis; Phenylalanine; Severity of Illness Index; Treatment Outcome; Vitamin B 12

In a randomized, placebo-controlled double-blind trial a combination of lofepramine, phenylalanine and vitamin B(12) was found to be effective in relieving the symptoms of multiple sclerosis (MS). The effect occurred within 2-4 weeks, and improved all types of symptoms in all types of MS. The combination was also effective in relieving symptoms in patients with chronic pain and chronic fatigue. We hypothesize that the action of this combined therapy may relate to activation of the noradrenergic locus coeruleus/lateral tegmentum (LC/LT) system which has the potential to influence the functioning of large areas of the brain and spinal cord.

Topics: Adrenergic Fibers; Adrenergic Uptake Inhibitors; Antidepressive Agents; Chronic Disease; Double-Blind Method; Drug Therapy, Combination; Fatigue Syndrome, Chronic; Humans; Locus Coeruleus; Lofepramine; Methylation; Multiple Sclerosis; Norepinephrine; Pain; Phenylalanine; Severity of Illness Index; Stroke; Stroke Rehabilitation; Tegmentum Mesencephali; Treatment Outcome; Vitamin B 12

Topics: Action Potentials; Adult; Anabolic Agents; Androstanes; Attention; Blood Pressure; Cerebral Hemorrhage; Clinical Trials as Topic; Depression, Chemical; Electrocardiography; Electroencephalography; Female; Folic Acid; Heart Rate; Humans; Hydroxocobalamin; Male; Middle Aged; Multiple Sclerosis; Nervous System Diseases; Niacinamide; Placebos; Psychopharmacology; Pyridoxine; Sleep; Vitamin B 12; Vitamin B Complex

Topics: Acute Disease; Adrenocorticotropic Hormone; Adult; Chronic Disease; Evoked Potentials; Extremities; Female; Folic Acid; Humans; Male; Methods; Motor Activity; Multiple Sclerosis; Neural Conduction; Peripheral Nerves; Vitamin B 12

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). Considering how vitamin B12 or cobalamin affects the immune system, especially inflammation and the formation of the myelin sheath, it appears as a complementary therapy for MS by affecting some signaling pathways. Recently diagnosed MS patients were divided into two groups (n=30). One group received interferon-beta (IFN-β or Avonex), and another received IFN-β+B12 for six months. Blood samples were taken before and after treatments.  Interleukin (IL)-10 and osteopontin (OPN) levels in the plasma were determined by the enzyme-linked immunosorbent assay (ELISA) method, and the expression of microRNA (miR)-106a, miR-299a, and miR-146a by real-time PCR. IFN-β neither changed the IL-10 plasma levels nor miR106a and miR-299a expression, but it led to a remarkable decrease in OPN concentration and enhancement in let-7c and miR-146a expression. There was a significant decrease in IL-10, OPN plasma levels, miR-106a expression, and a substantial increase in let-7c and  miR-146a expression in IFN-β+B12, treated group. There was no correlation between IL-10 and OPN with related miRNAs in the two treatment groups. Our study indicated that B12 could be a complementary treatment in MS that may influence the disease improvement.

Topics: Humans; Interferon-beta; Interleukin-10; MicroRNAs; Multiple Sclerosis; Osteopontin; Vitamin B 12; Vitamin B Complex

The association between homocysteine and risk of multiple sclerosis (MS) remains unclear. We implemented a two-sample Mendelian randomization (MR) analysis to comprehensively investigate the causal relationships between circulating homocysteine, vitamin B12 (VitB12), and folate levels and MS with data from large-scale genome-wide association studies. MR results demonstrated an inverse association between genetically predicted higher circulating homocysteine levels (per 1 standard deviation (SD) increase) and risk of MS (OR 0.78, 95% CI 0.64-0.94, p = 0.0106). No significant causal relationships between genetically determined higher VitB12 and folate levels and MS were observed. Further studies are warranted to elucidate the potential mechanisms.

Topics: Folic Acid; Genome-Wide Association Study; Homocysteine; Humans; Mendelian Randomization Analysis; Multiple Sclerosis; Vitamin B 12

Cobalamin (vitamin B

Topics: Aged; Antibodies, Monoclonal, Humanized; Cervical Cord; Diagnostic Errors; Female; Humans; Immunologic Factors; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Hyperhomocysteinemia, vitamin B12 and folate deficiency have been linked to cognitive dysfunction in multiple sclerosis (MS) patients.. This study aimed to investigate the relation of serum homocysteine (Hcy), vitamin B12 and folate to cognitive functions in MS patients.. Forty-five MS patients and twenty matched healthy controls were included. Subjects were submitted to cognitive assessment using a selected psychometric battery and measurement of serum levels of homocysteine, B12 and folic acid.. MS patients showed significant worse performance in cognitive scales compared to controls (P  ≤ 0.05). Serum homocysteine, vitamin B12 and folate showed no significant difference between patients and controls (P  > 0.05). Serum homocysteine was negatively correlated with total score of Addenbrooke's Cognitive Examination (ACE), paced auditory serial addition test and controlled oral word association test scores. Serum vitamin B12 was positively correlated with ACE language, visuospatial and total scores and negatively correlated with trail making B score. Serum folate was significantly positively correlated with ACE language and total scores. Homocysteine was the only significant predictor for cognitive impairment in MS patients.. Serum homocysteine may play a role in cognitive dysfunction in MS patients.

Topics: Adult; Brain; Case-Control Studies; Cognition Disorders; Female; Folic Acid; Homocysteine; Humans; Linear Models; Magnetic Resonance Imaging; Male; Multiple Sclerosis; Psychometrics; Statistics, Nonparametric; Vitamin B 12

The pathogenesis of multiple sclerosis (MS) begins with an infection by a bacterium from the class of bacteria that produce and utilize adenosylcobalamin (AdoCbl) and possess an adenosyl transferase enzyme (ATR); these bacteria are the exogenous antigens that cause MS. Human ATR is homologous to bacterial ATR and B cells produce anti-ATR antibodies as an autoimmune response thereby reducing the concentration of ATR and thus limiting production of AdoCbl, one of the two bioactive forms of vitamin B12. The next step in MS pathogenesis is a period of subclinical AdoCbl deficiency over a period of many years resulting in production of odd-carbon-number fatty acids that are incorporated into myelin rendering it antigenic. The next step in MS pathogenesis is breach of the blood brain barrier thereby introducing leukocytes into the brain's blood supply resulting in T cell attack of antigenic myelin. All epidemiological clusters are regions wherein the major agricultural products are legumes that produce a high percentage of odd-carbon-number fatty acids and contain symbiotic rhizobia type bacteria in root nodules and in the soil. This novel etiological hypothesis is called "multiple sclerosis due to adenosylcobalamin deficiency" (MS-AdoCbl). Creation of realistic animal models based on the MS-AdoCbl hypothesis is presented. Methods for testing predictions made by the MS-AdoCbl hypothesis are described.

Topics: Adenosine Triphosphate; Animals; Autoimmunity; B-Lymphocytes; Blood-Brain Barrier; Cobamides; Disease Models, Animal; Fatty Acids; Humans; Male; Methionine Adenosyltransferase; Mice; Models, Biological; Multiple Sclerosis; Rhizobium; T-Lymphocytes; Vitamin B 12

We have previously demonstrated that multiple sclerosis (MS) patients have abnormal cerebrospinal fluid (CSF) levels of the key myelin-related molecules cobalamin (Cbl), epidermal growth factor (EGF), and normal cellular prions (PrP(C)s), thus confirming that some CSF abnormalities may be co-responsible for remyelination failure. We determined the levels of these three molecules in post-mortem spinal cord (SC) samples taken from MS patients and control patients. The control SC samples, almost all of which came from non-neurological patients, did not show any microscopic lesions of any type. All of the samples were supplied by the U.K. MS Tissue Bank. The Cbl, EGF, and PrP(C) levels were determined using enzyme-linked immunosorbent assays. The SC total homocysteine level was determined using a competitive immunoenzymatic assay. CSF samples, taken from a further group of MS patients, were used for the assay of holo-transcobalamin (holo-TC) levels. The Cbl, EGF, and PrP(C) levels were significantly decreased in MS SCs in comparison with controls and, paradoxically, the decreased Cbl levels were associated with decreased SC levels of homocysteine, a biochemical marker of Cbl deficiency. The trends of EGF and PrP(C) levels paralleled those previously found in CSF, whereas that of Cbl was the opposite. There was no significant difference in CSF holo-TC levels between the MS patients and the controls. Given that we have previously demonstrated that Cbl positively regulates central nervous system EGF levels, it is conceivable that the low EGF levels in the MS SC may be causally related to a local decrease in Cbl levels. Only PrP(C) levels were invariably decreased in both the SC and CSF regardless of the clinical course of the disease. These findings suggest that the simultaneous lack of Cbl, EGF, and PrP(C)s may greatly hamper the remyelination process in MS patients, because they are key molecules of the machinery for remyelination.

Topics: Adult; Aged; Aged, 80 and over; Epidermal Growth Factor; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Prions; Severity of Illness Index; Spinal Cord; Vitamin B 12; White Matter; Young Adult

Optic neuritis (ON) is closely linked to multiple sclerosis (MS). It may, however, also be associated to a range of autoimmune or infectious diseases. The purpose of this study was to assess the differential diagnoses in patients with suspected ON. In this retrospective study, we reviewed the files of all patients referred to the Clinic of Optic Neuritis, Glostrup Hospital, University of Copenhagen, Denmark, between January 2000 and November 2011. All patients were referred by ophthalmologists with possible ON. Patients diagnosed with MS prior to referral were excluded from the study. A total of 643 patients were included in the study. Apart from ON, the most frequent diagnoses were tumors (n = 15), ischemic or hypertensive neuropathies (n = 13), and retinal or choroid disorders (n = 9). Six patients were diagnosed with neuromyelitis optica. Rarer causes of visual loss were infections (n = 5), giant cell arteritis (n = 4), sarcoidosis (n = 3), thyrotoxicosis (n = 2), and hereditary or toxic neuropathies (n = 2). Nine percent of patients referred to the Clinic of Optic Neuritis had symptoms caused by medical, neurosurgical or ophthalmic disorders, and 0.9 % of our patients had NMO. Though most of these conditions are rare, it is of importance to keep them in mind upon encountering patients with symptoms of ON.

Topics: Adolescent; Adult; Aquaporin 4; Autoantibodies; Blood Cell Count; Blood Sedimentation; C-Reactive Protein; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Male; Middle Aged; Multiple Sclerosis; Optic Neuritis; Retrospective Studies; Thyrotropin; Vitamin B 12; Young Adult

We have previously demonstrated that the concentration of normal prion proteins (PrP(C)) is increased in the serum and cerebrospinal fluid (CSF) of rats deficient in vitamin B(12) (cobalamin, Cbl). In this study, we investigated whether similar increases also occur in the serum and CSF of patients deficient in Cbl (Cbl-D), and whether the increase in serum levels can be corrected by Cbl therapy. The study involved two sample populations. The first consisted of 45 patients (13 patients with pernicious anemia [PA], 19 with other forms of anemia, and 13 healthy controls); and the second, 68 patients (five with subacute combined degeneration [SCD], 18 with amyotrophic lateral sclerosis, 22 with multiple sclerosis [MS], and 23 neurological controls). Serum PrP(C) levels were measured using an enzyme-linked-immunosorbent-assay before as well as after Cbl therapy. The mean serum PrP(C) levels in patients with PA were significantly higher than those of the controls (p=0.0017) but normalized after Cbl therapy; there was no significant change in the patients with other forms of anemia. Mean CSF PrP(C) levels in the patients with SCD were significantly higher than in the neurological controls (p<0.03). The serum and CSF PrP(C) levels of patients with PA and those with SCD were correlated significantly with serum (p=0.004) and CSF (p=0.0018) Cbl levels. In patients with MS, CSF PrP(C) concentrations were significantly lower than those of the controls regardless of their CSF Cbl levels. We found a correlation between Cbl and PrP(C) levels in the serum and CSF of Cbl-D patients, which suggests that Cbl may regulate the PrP(C) levels in the serum and CSF in humans.

Topics: Adult; Amyotrophic Lateral Sclerosis; Analysis of Variance; beta-Thalassemia; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Neurologic Examination; Prions; Statistics as Topic; Subacute Combined Degeneration; Vitamin B 12; Vitamin B Complex

Topics: Adult; Anaphylaxis; Humans; Hydroxocobalamin; Male; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

The incidence of seizures is generally accepted to be greater in patients with multiple sclerosis (MS) than in the general population, and rarely, MS can initially present as seizure. To present a case report of seizure as the initial symptom of MS, to quantify the occurrence of seizures among MS patients, and to classify patients according to when seizures occur relative to onset of MS. The medical history of patients presenting with MS and seizure in our clinic was examined. In addition, 25 scientific papers were reviewed and the number and characteristics of patients with MS and seizure recorded. Data from the literature review and from our own clinical series were combined and examined. Of the MS patients, 1.95% experienced seizures at any time during life. Patients experiencing seizures before MS diagnosis were classified into three categories: (a) 25 (7.3% of patients with MS and seizures) with seizure as the initial presentation of MS; (b) 27 (7.9%) with seizures appearing with other signs and symptoms of MS; and (c) 68 (20%) with seizures occurring years or an unknown period of time before MS onset. Seizure occurring as a symptom of MS relapse was found in 29 patients. The prevalence of seizures among MS patients was higher than that in the general population, indicating a relationship between seizures and MS. Seizures occurred before MS diagnosis in a small percentage of patients.

Topics: Adult; Anticonvulsants; Brain; Electroencephalography; Epilepsy, Tonic-Clonic; Female; Humans; Levetiracetam; Magnetic Resonance Imaging; Multiple Sclerosis; Piracetam; Seizures; Vitamin B 12; Vitamin B 6; Vitamins

We investigated whether the physiological regulation of cerebrospinal fluid (CSF) levels of tumor necrosis factor (TNF)-alpha, epidermal growth factor (EGF), and nerve growth factor (NGF) by cobalamin (Cbl) that is observed in rat and human central nervous system (CNS) is retained in the CSF of patients with multiple sclerosis (MS). The study involved 158 MS patients grouped on the basis of the different clinical courses (relapsing-remitting (RR), secondary-progressive (SP), and primary-progressive (PP)), and 76 gender- and age-matched control patients with other non-inflammatory and non-neoplastic neurological diseases. The MS patients were therapy-free at the time of lumbar puncture. CSF Cbl and EGF were blindly measured by means of radioimmunoassays, and CSF TNF-alpha, and NGF by means of highly sensitive enzyme-linked immunosorbent assays. Serum EGF was also measured in 38 of the MS patients and 20 healthy controls. CSF Cbl levels were significantly higher (RR patients 27.9+/-9.7 pg/ml, p<0.0001 vs. C; SP patients 25.4+/-8 pg/ml, p<0.02 vs. C), and CSF TNF-alpha and EGF levels significantly lower in the patients with the RR (TNF-alpha 28.3+/-23.4 x 10(-3) pg/ml, p<0.0001 vs. C; EGF 129.9+/-44.8 pg/ml, p<0.02 vs. C) or SP (TNF-alpha 20.5+/-20.5 x 10(-3) pg/ml, p<0.001 vs. C; EGF 116.5+/-24.8 pg/ml, p<0.05 vs. C) clinical course than in controls (Cbl 21+/-4.6 pg/ml; TNF-alpha 75.6+/-34.7 x 10(-3) pg/ml; EGF 170.2+/-54.8 pg/ml). There were no differences in CSF NGF or serum EGF levels between any of the MS clinical courses and controls. Our results indicate that: (a) the positive Cbl-mediated regulation of myelino- and oligodendrocyte-trophic EGF is lost in the CSF of RR- or SP-MS patients; (b) the decrease in EGF levels in the CSF may be one factor impeding CNS remyelination in MS; and (c) the PP clinical course may have different pathogenetic mechanism(s) also on the basis of the molecules investigated in this study.

Topics: Adult; Aged; Epidermal Growth Factor; Female; Gene Expression Regulation; Humans; Male; Middle Aged; Multiple Sclerosis; Radioimmunoassay; Retrospective Studies; Statistics, Nonparametric; Tumor Necrosis Factor-alpha; Vitamin B 12; Vitamin B Complex

Patients with multiple sclerosis (MS) may have low serum vitamin B12 and folate levels and high levels of homocysteine. We aimed to evaluate serum vitamin B12, folate, homocysteine, mean corpuscular volume (MCV), hemoglobin (Hb), and hematocrit (Hct) levels in patients with MS. We examined the relationship between these parameters and age, sex, disease type, age at onset, disease duration, Expanded Disability Status Score, immunoglobulin G (IgG) index, oligoclonal band presence, visual evoked potentials (VEP) and posterior tibial somatosensory evoked potentials (SEP). These parameters were evaluated in 35 patients during an acute attack and compared to data collected from 30 healthy individuals (control subjects). Serum vitamin B12, folate, homocysteine, Hb, and Hct levels and MCV were low in a proportion of patients with MS (20%, 14.3%, 20%, 6.7%, 3.3% and 10% respectively), whereas only vitamin B12 and folate levels were low in only 3.3% of the control subjects. Homocysteine levels were high in 20% of patients with MS but were within normal limits in the control group. Elevated Hct levels were significantly correlated (p<0.05) with prolonged posterior tibial SEP P1 and P2 latencies compared to the control subjects. Patients with MS who had prolonged VEP and posterior tibial SEP P1 and P2 latencies also had lower vitamin B12 levels compared to patients with normal latencies. Thus, we found a significant relationship between MS and vitamin B12 deficiency, and also demonstrated a relationship between vitamin B12 deficiency, VEP and posterior tibial SEP in MS.

Topics: Adult; Disability Evaluation; Evoked Potentials, Somatosensory; Evoked Potentials, Visual; Female; Folic Acid; Hematocrit; Hemoglobins; Homocysteine; Humans; Immunoglobulin G; Male; Middle Aged; Multiple Sclerosis; Oligoclonal Bands; Retrospective Studies; Vitamin B 12; Young Adult

Some subjects with multiple sclerosis (MS) present with low blood iron parameters. Anecdotal reports and a single patient study suggest that iron supplementation may be beneficial in these subjects. Myelin is regenerated continually, but prerequisites for this process are iron and a functional folate-vitamin B12-methylation pathway. The aim of this study was to determine iron status, folate and homocysteine in MS subjects, and to evaluate the effect on MS symptoms if deficiencies were addressed.. In relapsing-remitting MS subjects, serum iron concentration correlated significantly with age at diagnosis (r=0.49; p=0.008). In Caucasian female MS subjects, serum iron and ferritin concentrations were significantly lower than in matched controls. In a 6-month pilot study, 12 subjects taking a regimen of nutritional supplements designed to promote myelin regeneration, improved significantly neurologically as measured by the Kurzke EDSS (Total Score means 3.50 to 2.45, 29.9%; p=0.021). These were significantly improved (p=0.002) compared to 6 control group patients taking multivitamins (Kurzke Score increased by 13.9% from 4.83 to 5.50). Both groups had significantly reduced homocysteine concentrations at 6 months, suggesting that methylation is necessary but not sufficient for myelin regeneration.

Topics: Adult; Anti-Inflammatory Agents; Black People; Dietary Fats; Dietary Supplements; Female; Folic Acid; Homocysteine; Humans; Interferons; Iron; Magnetic Resonance Imaging; Male; Methylation; Multiple Sclerosis; Nutritional Status; Patient Compliance; Pilot Projects; Prednisone; Vitamin B 12; White People

Free radical-mediated peroxidation of biological molecules, especially of lipids, is implicated in the pathogenesis of a number of diseases like multiple sclerosis. Low concentration of antioxidant vitamins: beta carotene, retinol, alpha tocopherol and ascorbic acid have been observed in serum or cerebrospinal fluid of multiple sclerosis patients. On the basis of these observations, we studied the potential lipoprotein oxidation and total antioxidant capacity in the pathogenesis of multiple sclerosis. Lipoprotein oxidizability for plasma in vitro, serum levels of autoantibodies against oxidized low-density lipoproteins, plasma total homocysteine levels with vitamin B12 and folate, and plasma total antioxidant capacity were measured in twenty four patients with multiple sclerosis and twenty four healthy sex- and age-matched person as control. In multiple sclerosis patients during an attack, a significant increase in both in vitro lipid oxidizability for plasma and in the levels of autoantibodies against oxidized low-density lipoproteins, and a strong decrease in plasma total antioxidant capacity were detected. Plasma total homocysteine levels were significantly higher in multiple sclerosis patients whose plasma vitamin B12 and folate levels were lower but not statistically significant, than controls. The present study indicates that lipoprotein oxidation may be important factor in the course of multiple sclerosis and in vitro measurements of plasma oxidation kinetics as an indication for lipoprotein oxidation might be useful as an additional tool for the clinical diagnosis of multiple sclerosis.

Topics: Adult; Antioxidants; Autoantibodies; Chromans; Female; Folic Acid; Homocysteine; Humans; Lipid Peroxidation; Lipoproteins; Lipoproteins, LDL; Male; Multiple Sclerosis; Oxidation-Reduction; Oxidative Stress; Vitamin B 12; Vitamin E

The aim of this study was to evaluate if multiple sclerosis (MS) is associated with vitamin B12 (cobalamin) deficiency.. We measured serum vitamin B12, plasma folate, serum methylmalonic acid (MMA), plasma homocysteine (tHcy) and also cerebrospinal fluid (CSF) MMA and tHcy in 72 patients with MS and 23 controls.. The mean plasma tHcy level was significantly increased in MS patients (11.6 micromol/L) compared with controls (7.4 micromol/L) (P = 0.002). Seven patients showed low serum vitamin B12 levels but only one of them had concomitant high plasma tHcy. None of them showed high serum MMA. Plasma or blood folate levels did not differ between MS patients and controls. We found no significant differences in mean values or frequency of pathological tests of serum B12, serum MMA, mean corpuscular volume (MCV), haemoglobin concentration, CSF tHcy or CSF MMA between patients and healthy subjects. There were no correlations between CSF and serum/plasma levels of MMA or tHcy. Serum vitamin B12, serum MMA, plasma tHcy, CSF Hcy or CSF MMA were not correlated to disability status, activity of disease, duration of disease or age.. The relevance of the increased mean value of plasma tHcy thus seems uncertain and does not indicate functional vitamin B12 deficiency. We can not, however, exclude the possibility of a genetically induced dysfunction of the homocysteine metabolism relevant for the development of neuroinflammation/degeneration. Our findings indicate that, regardless of a significant increase in plasma tHcy in MS patients, the MS disease is not generally associated with vitamin B12 deficiency since we did not find any other factors indicating vitamin B12 deficiency. Analysis of CSF MMA and CSF tHcy, which probably reflects the brain vitamin B12 status better than serum, are not warranted in MS. We conclude that B12 deficiency, in general, is not associated with MS.

Topics: Adult; Aged; Aged, 80 and over; Female; Homocysteine; Humans; Male; Methylmalonic Acid; Middle Aged; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Antidepressive Agents, Tricyclic; Drug Therapy, Combination; Exercise Therapy; Humans; Lofepramine; Multiple Sclerosis; Phenylalanine; Self Care; Vitamin B 12

Topics: Blood-Brain Barrier; Humans; Immunosuppressive Agents; Multiple Sclerosis; Vitamin B 12

Topics: Adult; Anesthetics, Inhalation; Demyelinating Autoimmune Diseases, CNS; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Multiple Sclerosis; Nitrous Oxide; Paresthesia; Postoperative Complications; Vitamin B 12; Vitamin B 12 Deficiency

To determine the frequency of serum cobalamin (Cbl) deficiency and to clarify the biologic importance of low screening Cbl levels in patients with multiple sclerosis (MS) and idiopathic myelopathy (MYL).. A significant association between Cbl metabolism and MS has been postulated based on the observations that patients with MS have lower serum Cbl levels, higher unsaturated Cbl binding capacities, and a higher prevalence of macrocytosis than do normal controls. Whether such observations have biologic importance as documented by abnormal accumulation of metabolites that would result from Cbl deficiency has not yet been determined.. Serum Cbl and folate levels were determined in 208 consecutively evaluated patients seen in an outpatient MS clinic setting during a 7-month period. Necessary blood samples were obtained for 165 of these patients. One hundred twenty-five patients had clinically definite MS, 31 had clinically probable MS, and nine had MYL. Serum methylmalonic acid (MMA) and homocysteine (HCY) concentrations, which rise in biologically severe Cbl deficiency, were subsequently determined in all patients whose Cbl levels were lower than 301 pg/mL.. A Cbl level lower than 301 was found in 32 of 156 patients with either clinically definite MS or clinically probable MS but in none of the patients with MYL. Elevated MMA or HCY levels were found in seven of 32 patients with either clinically definite MS or clinically probable MS, six of whom had an elevated HCY level and one of whom had elevated HCY and MMA levels.. Despite the observation that 32 (19.4%) of 165 of these patients with MS and MYL had screening Cbl levels less than 301 pg/mL, only seven (4.2%) of 165 had elevated MMA or HCY levels. The frequency of biologically severe Cbl deficiency in these patients with MS and MYL was very low.

Topics: Adult; Homocysteine; Humans; Methylmalonic Acid; Middle Aged; Multiple Sclerosis; Muscular Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Serum vitamin B12 levels and unsaturated vitamin B12 binding capacities were measured in 24 patients with multiple sclerosis (MS), 73 patients with other neurological disorders and 21 healthy subjects. There was no decrease in the vitamin B12 levels, however, a significant decrease in the unsaturated vitamin B12 binding capacities was observed in patients with MS when compared with other groups. A massive dose of methyl vitamin B12 (60 mg every day for 6 months) was administered to 6 patients with chronic progressive MS, a disease which usually had a morbid prognosis and widespread demyelination in the central nervous system. Although the motor disability did not improve clinically, the abnormalities in both the visual and brainstem auditory evoked potentials improved more frequently during the therapy than in the pre-treatment period. We therefore consider that a massive dose methyl vitamin B12 therapy may be useful as an adjunct to immunosuppressive treatment for chronic progressive MS.

Topics: Adult; Afferent Pathways; Chronic Disease; Drug Evaluation; Evoked Potentials; Female; Humans; Male; Middle Aged; Motor Neurons; Multiple Sclerosis; Muscular Diseases; Nervous System Diseases; Vitamin B 12

The authors present a case of dietary vitamin B12 deficiency in a patient with multiple sclerosis. A simple schemata for evaluating patients for vitamin B12 deficiency is included as a clinical aid for physicians.

Topics: Adult; Clinical Protocols; Decision Trees; Feeding and Eating Disorders; Humans; Male; Medical History Taking; Multiple Sclerosis; Psychotherapy; Vitamin B 12; Vitamin B 12 Deficiency

Twenty-one patients (15 women, 6 men) with definite multiple sclerosis (MS) were treated with 1000 mg intravenous methylprednisolone-succinate (MP) daily for 10 days. Before MP treatment there was a negative correlation (r = 0.59, P = 0.0084) between serum vitamin B12 and progression rate, defined as the ratio of the score on Kurtzke's Expanded Disability Status Scale and disease duration. A significant decrease was demonstrated in the cerebrospinal fluid (CSF) and serum levels of folate and in the CSF level of vitamin B12 after MP treatment. The decrease in serum B12 was not statistically significant. After MP treatment all median levels of vitamin B12 and folate were below the reference medians. We hypothesize that low or reduced vitamin B12/folate levels found in MS patients may be related to previous corticosteroid treatments. Otherwise a more causal relationship between low vitamin B12/folate and MS cannot be excluded. Further studies may be required to clarify the vitamin B12 and folate metabolism in patients with MS.

Topics: Adult; Female; Folic Acid; Folic Acid Deficiency; Humans; Injections, Intravenous; Male; Methylation; Methylprednisolone Hemisuccinate; Middle Aged; Multiple Sclerosis; Myelin Sheath; Vitamin B 12; Vitamin B 12 Deficiency

We have previously described 10 patients with multiple sclerosis (MS) and unusual vitamin B12 deficiency. We have therefore studied vitamin B12 metabolism in 29 consecutive cases of MS, 17 neurological controls, and 31 normal subjects. Patients with MS had significantly lower serum vitamin B12 levels and significantly higher unsaturated R-binder capacities than neurological and normal controls, and they were significantly macrocytic compared with normal controls. Nine patients with MS had serum vitamin B12 levels less than 147 pmol/L and, in the absence of anemia, this subgroup was significantly macrocytic and had significantly lower red blood cell folate levels than neurological and normal controls. Nine patients with MS had raised plasma unsaturated R-binder capacities, including three patients with very high values. There is a significant association between MS and disturbed vitamin B12 metabolism. Vitamin B12 deficiency should always be looked for in patients with MS. The cause of the vitamin B12 disorder and the nature of the overlap with MS deserve further investigation. Coexisting vitamin B12 deficiency might aggravate MS or impair recovery from MS.

Topics: Adult; Aged; Erythrocytes; Female; Folic Acid; Hemoglobins; Humans; Male; Middle Aged; Multiple Sclerosis; Vitamin B 12

We describe 10 patients with a previously unreported, to our knowledge, association of multiple sclerosis and unusual vitamin B12 deficiency. The clinical features and the age at presentation were typical of multiple sclerosis, with eight cases occurring before age 40 years, which is a rare age for vitamin B12 deficiency. Nine patients had hematologic abnormalities, but only two were anemic. All six patients examined had low erythrocyte cobalamin levels. Only two patients had pernicious anemia; in the remaining patients the vitamin B12 deficiency was unexplained. A vitamin B12 binding and/or transport is suspected. The nature of the association of multiple sclerosis and vitamin B12 deficiency is unclear but is likely to be more than coincidental. Further studies of vitamin B12 metabolism, binding, and transport in multiple sclerosis are indicated, as these cases may offer a clue to the understanding of a still mysterious neurologic disorder.

Topics: Adult; Anemia, Pernicious; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Erythrocytes, Abnormal; Female; Folic Acid; Humans; Male; Multiple Sclerosis; Vitamin B 12

Topics: Anemia, Pernicious; Female; Humans; Middle Aged; Multiple Sclerosis; Vitamin B 12; Vitamin B 12 Deficiency

Vitamin B12 and folate concentrations were measured in serum and cerebrospinal fluid (CSF) in 293 neurological patients. Serum and CSF vitamin B12 concentrations showed a positive correlation. In individual patients CSF B12 concentrations varied considerably for a given serum concentration. The median serum vitamin B12 concentration of the Alzheimer's type dementia group was significantly lower compared with that of a control group. Lower median CSF vitamin B12 concentrations were found in groups of patients with multiple sclerosis and Alzheimer's type dementia. Five patients with heterogeneous clinical pictures had unexplained low serum and CSF B12 concentrations without macrocytosis. Two patients had very high serum B12 and low-normal CSF concentrations which could be explained by a blood-brain barrier transport defect. Serum and CSF folate concentrations did not show significant differences between the various groups.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Blood-Brain Barrier; Central Nervous System Diseases; Child; Female; Folic Acid; Humans; Male; Middle Aged; Multiple Sclerosis; Neurologic Examination; Reference Values; Retrospective Studies; Vitamin B 12

Twenty-seven patients with multiple sclerosis had mild but significant macrocytosis when compared with an individually matched neurological control group and the normal laboratory reference range. The cause of the macrocytosis is unknown, but our recent clinical observations implicate a possible disturbance in vitamin B12 metabolism, binding or transport.

Topics: Adolescent; Adult; Female; Hematologic Diseases; Humans; Male; Middle Aged; Multiple Sclerosis; Retrospective Studies; Vitamin B 12

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Adult; Diagnosis, Differential; Female; Homocystinuria; Humans; Methylmalonic Acid; Methylmalonyl-CoA Mutase; Multiple Sclerosis; Mutation; Nervous System Diseases; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Diagnosis, Differential; Humans; Male; Middle Aged; Multiple Sclerosis; Nervous System Diseases; Transcobalamins; Vitamin B 12

The contribution of VEP, CT and oligoclonal bands (OB) to the diagnosis of MS was studied in a group of 213 hospitalized patients. Whereas the diagnostic values of VEP and OB were both in the same range, the combination of both methods increased the proportion of cases with "definite MS" from 58 to 75%, whereas CT did not contribute significantly to diagnostic ascertainment. Vitamin B12 absorption was less than 10% in 27% of cases. A slight tendency towards increased serum IgG and IgM levels was found, and the rheumatoid factor was demonstrated in 6% of cases.

Topics: Adolescent; Adult; Aged; Atrophy; Brain; Electroencephalography; Evaluation Studies as Topic; Evoked Potentials, Visual; Female; Humans; Immunoglobulins; Male; Middle Aged; Multiple Sclerosis; Thyroid Hormones; Tomography, X-Ray Computed; Vitamin B 12

Topics: Humans; Linoleic Acid; Linoleic Acids; Multiple Sclerosis; Vitamin B 12

Malabsorption tests were studied in 52 patients with multiple sclerosis. The stools were examined microscopically for fat and undigested meat fibers and were found to be abnormal in 41.6 and 40.9% respectively. Abnormally low five hour excretion of d-xylose was demonstrated in 26.6% cases. Malabsorption of Vitamin B12 was found in 11.9% cases. The jejunal mucosa was examined histologically and by tissue immune technic including viral studies. Histology showed normal mucosa in all except seven patients in whom an increased inflammatory infiltrate was present. Fluorescent antibody studies revealed the presence of measles virus antigen in all patients and immunofluorescent studies showed a variable degree of immune reaction in the majority of cases. The significance of these findings in the pathogenesis of multiple sclerosis is discussed.

Topics: Adult; Aged; Antigens, Viral; Feces; Female; Humans; Intestinal Absorption; Intestinal Mucosa; Intestine, Small; Jejunum; Lipid Metabolism; Male; Measles virus; Middle Aged; Multiple Sclerosis; Vitamin B 12; Xylose

Topics: Antilymphocyte Serum; Azathioprine; Europe; Humans; Immunosuppression Therapy; Japan; Linoleic Acids; Linolenic Acids; Multiple Sclerosis; United States; Vitamin B 12

Topics: Adult; Female; Gastric Acidity Determination; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Multiple Sclerosis; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Alkaline Phosphatase; Bile; Blood Proteins; Carcinoma; Cerebrospinal Fluid Proteins; Chemistry, Clinical; Gastric Juice; Humans; Immunoglobulins; Intrinsic Factor; Isoelectric Focusing; Isoenzymes; Kidney Cortex; Kidney Medulla; Kidney Neoplasms; Methods; Multiple Sclerosis; Nephrotic Syndrome; Nerve Tissue Proteins; Proteinuria; Vitamin B 12

Topics: Adult; Age Factors; Aged; Analgesics; Carbamazepine; Ethanol; Female; Follow-Up Studies; Humans; Hypertension; Male; Middle Aged; Minnesota; Multiple Sclerosis; Neoplasms; Phenytoin; Sex Factors; Trigeminal Neuralgia; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Pernicious; Costs and Cost Analysis; Drug Prescriptions; England; Herpes Zoster; Humans; Multiple Sclerosis; Statistics as Topic; Vitamin B 12; Wales

Topics: Adult; Ascorbic Acid; Blood Circulation; Blood Coagulation; Diet Therapy; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Niacinamide; Pyridoxine; Thiamine; Vitamin A; Vitamin B 12; Vitamin E; Vitamins

Topics: Aged; Family Practice; Fatigue; Feeding and Eating Disorders; Female; Herpes Zoster; Humans; Male; Multiple Sclerosis; Pregnancy; Vitamin B 12

Topics: Atrophy; Brain Diseases; Humans; Multiple Sclerosis; Spinal Cord Diseases; Vitamin B 12

Topics: Adult; Female; Humans; Middle Aged; Multiple Sclerosis; Prochlorperazine; Vitamin B 12

Topics: Anemia, Pernicious; Arteriosclerosis; Cobalt Isotopes; Computers; Humans; Multiple Sclerosis; Polycythemia Vera; Radiometry; Statistics as Topic; Time Factors; Vitamin B 12

Topics: Adolescent; Adrenocorticotropic Hormone; Anticonvulsants; Carisoprodol; Czechoslovakia; Humans; Male; Multiple Sclerosis; Muscle Relaxants, Central; Piperidines; Propiophenones; Rest; Vasodilator Agents; Vitamin B 12; Vitamin B Complex

Topics: Adolescent; Adult; Female; Humans; Immunization, Passive; Immunotherapy; Male; Middle Aged; Multiple Sclerosis; Vitamin B 12

Topics: Anemia, Pernicious; Chronic Disease; Cobalt Isotopes; Glycoproteins; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Multiple Sclerosis; Polycythemia; Vitamin B 12

Topics: Adrenal Cortex Hormones; Biomedical Research; Double-Blind Method; Drug Therapy; Humans; Methylprednisolone; Multiple Sclerosis; Vitamin B 12

There are several claims that B(12) concentrations in serum and cerebrospinal fluid are grossly abnormal in multiple sclerosis, but results are conflicting. This paper reports measurements of these concentrations in 40 serum samples and 23 samples of lumbar cerebrospinal fluid from cases of multiple sclerosis, and in appropriate controls, using Euglena gracilis, z strain. The serum concentrations were found to be normal; the mean concentration in cerebrospinal fluid was slightly reduced, but all values were within the control range. In both control samples and samples from cases of multiple sclerosis, the B(12) concentration in lumbar cerebrospinal fluid was correlated with the concentration in serum. There was no correlation between B(12) concentration and total protein in cerebrospinal fluid.A number of estimations of serum B(12) were also made with Lactobacillus leichmannii, after extraction in the presence and absence of cyanide. These showed a difference between cases of multiple sclerosis and controls, one interpretation of which might be that the serum in multiple sclerosis contains an abnormally low concentration of hydroxocobalamin.

Topics: Blood; Blood Chemical Analysis; Cerebrospinal Fluid; Humans; Multiple Sclerosis; Vitamin B 12

Topics: Adrenocorticotropic Hormone; Biomedical Research; Drug Therapy; Fluprednisolone; Humans; Methylprednisolone; Multiple Sclerosis; Nervous System; Nervous System Physiological Phenomena; Neurologic Examination; Research; Vitamin B 12

Topics: Adolescent; Adult; Blood; Cyanides; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Smoking; Thiocyanates; Urine; Vitamin B 12

Topics: Biomedical Research; Blood Chemical Analysis; Central Nervous System Diseases; Cerebrospinal Fluid; Humans; Multiple Sclerosis; Sclerosis; Vitamin B 12

Topics: Blood Chemical Analysis; Cerebrospinal Fluid; Humans; Multiple Sclerosis; Spectrophotometry; Vitamin B 12

Topics: Corrinoids; Drug Therapy; Hematinics; Humans; Injections; Lumbosacral Region; Multiple Sclerosis; Spinal Cord; Vitamin B 12

Topics: Adenine Nucleotides; Herpes Zoster; Humans; Multiple Sclerosis; Nervous System Diseases; Neuralgia; Neuritis; Pyridoxine; Thiamine; Vitamin B 12; Vitamins

Topics: Biochemical Phenomena; Corrinoids; Hematinics; Humans; Intestinal Absorption; Multiple Sclerosis; Serum; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Multiple Sclerosis; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Diagnosis, Differential; Erythropoiesis; Humans; Intrinsic Factor; Multiple Sclerosis; Paraparesis, Spastic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Corrinoids; Humans; Immune Sera; Immunization, Passive; Multiple Sclerosis; Muscle Relaxants, Central; Vitamin B 12; Vitamin B Complex

Topics: Corrinoids; Dimercaprol; Hematinics; Humans; Multiple Sclerosis; Sclerosis; Tetraethylammonium; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Multiple Sclerosis; Sclerosis; Vitamin B 12