Folate, homocysteine and methionine loading in patients on carbamazepine

Apeland, Terje; Mansoor, M. A.; Strandjord, R. E.; Vefring, Hege K.; Kristensen, Ole

doi:10.1034/j.1600-0404.2001.103005294.x

Cited by 35 publications

(27 citation statements)

References 31 publications

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“…Folate deficiency is mainly caused by inadequate intake or excessive cooking of vegetables, certain medicaments (Zimmerman et al, 1987;Morgan et al, 1998;Apeland et al, 2001) and intestinal malabsorption.Vitamin B 6 deficiency is not uncommon in the elderly (Haller et al, 1991), mostly due to reduced intake (Bates et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial

et al. 2003

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Objectives: To investigate, in an elderly population: (1) the effects of oral B-vitamin therapy on P-tHcys, S-MMA and Hb/MCV, (2) the appropriate decision limit for 'high' metabolite concentrations and (3) the estimated prevalence of vitamin B 12 /folate deficiency on the basis of different decision limits. Design: Double-blind placebo-controlled intervention study. Setting: Outpatient clinic. Subjects: A total of 209 community-dwelling subjects, median age 76 y (range 70-93) y. Intervention: Four months of oral daily supplementation with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B 6 . Results: High P-tHcys was found in 64% of men and 45% of women, high S-MMA in 11% of both. Vitamin B 12 deficiency was observed in 7.2% and folate deficiency in 11% of all subjects. Health-related upper reference limits for the metabolites at the start were higher than the laboratory's upper reference limits. The latter were, however, similar to those of the vitamin replete group. There was a significant decrease in P-tHcys (Po0.001) and S-MMA (P ¼ 0.009) after 4 months of vitamin treatment. In a multivariate analysis, the P-Hcys change correlated positively with baseline P-tHcys and inversely with baseline P-folate and transferrin saturation (Fe/TIBC ratio). The S-MMA change correlated with baseline S-MMA and inversely with baseline vitamin B 12 and age. Conclusions: Suboptimal vitamin status is an important cause of elevated P-tHcys and S-MMA in apparently healthy elderly subjects. Oral B-vitamin therapy is an effective and convenient way to normalise P-tHcys and S-MMA. Sponsorship: SupportFRecip AB.

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Section: Introductionmentioning

confidence: 99%

Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial

et al. 2003

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“…Some antiepileptic drugs have been shown to cause hyperhomocysteinemia by decreasing serum folate levels [1,[4][5][6]. Karabiber et al found significantly lower serum folate levels and higher homocysteine levels in CBZ group compared to the control group [1].…”

Section: Discussionmentioning

confidence: 99%

“…Karabiber et al found significantly lower serum folate levels and higher homocysteine levels in CBZ group compared to the control group [1]. Apeland et al have observed a decrease in folic acid levels and an increase in homocysteine levels in 42 adult patients taking CBZ as monotherapy [5]. Vitamin B12 levels have been shown to change according to the antiepileptic medication used [1,17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Folic acid and vitamin B12 are required for the conversion of homocysteine to methionine. Serum folic acid and vitamin B12 levels may be influenced by antiepileptic drug usage [1][2][3][4][5][6]. Some antiepileptic drugs have been reported to decrease serum thyroxine levels; however the patients have remained clinically euthyroid [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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The effects of oxcarbazepine treatment on vitamin B12 and folate levels, thyroid functions, sex hormones, and bone mineral density in epileptic patients

et al. 2009

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AbstractThe aim of this study was to evaluate vitamin B12 and folate levels, thyroid functions, sex hormones and bone mineral density in idiopathic epileptic patients taking oxcarbazepine as monotherapy. Newly diagnosed pediatric patients with idiopathic partial epilepsy taking oxcarbazepine (OXC) as monotherapy were enrolled in this study. The pre-treatment and 6 months post-treatment values of vitamin B12, folate, thyroid functions, sex hormones, and bone mineral density (BMD) were obtained from all patients. A total of 32 patients (22 (68.8%) males and 10 (31.2%) females) were included in this study. The mean age was 7.4 ± 3.2 years (range: 2–14 years). There were no significant differences between the pre-treatment and 6 months post-treatment values of vitamin B12, folate, thyroid functions, sex hormones, and BMD. However, the 6 month post-treatment sex hormone binding globulin (SHBG) values (159.92 ± 48.14 nmol/L) were significantly higher than the pre-treatment values (137.88 ± 43.12 nmol/L) (p=0.009). We found that OCX treatment in children did not have an effect on serum folate and vitamin B12 levels, thyroid functions, sex hormones and BMD but caused increased SHBG. Over time, the increase in serum SHBG levels may lead to diminished bioactivity of sex steroids, and thus to reduced fertility. The further studies are needed to demonstrate the clinical importance of increased SHBG levels.

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“…Patients on antiepileptic drugs (AEDs) frequently have low serum folate and high plasma total homocysteine (tHcy) (1)(2)(3)(4). This metabolic disturbance has been implicated in an increased rate of cardiovascular disease, fetal malformations, dementia, and neuropsychiatric symptoms among patients on AEDs (5)(6)(7).…”

mentioning

confidence: 99%

Fasting and Post-Methionine Loading Concentrations of Homocysteine, Vitamin B2, and Vitamin B6 in Patients on Antiepileptic Drugs

Apeland¹,

Mansoor²,

Pentieva³

et al. 2003

Clinical Chemistry

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Folate, homocysteine and methionine loading in patients on carbamazepine

Abstract: CBZ therapy may be associated with low folate and high p-tHcy levels.

Cited by 35 publications

References 31 publications

Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial

Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial

The effects of oxcarbazepine treatment on vitamin B12 and folate levels, thyroid functions, sex hormones, and bone mineral density in epileptic patients

Fasting and Post-Methionine Loading Concentrations of Homocysteine, Vitamin B2, and Vitamin B6 in Patients on Antiepileptic Drugs

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