Optimization of folic acid, vitamin B(12), and vitamin B(6) supplements in pediatric patients with sickle cell disease

American Journal of Hematology
F P L van der DijsF A J Muskiet

Abstract

Using homocysteine as a functional marker, we determined optimal folic acid, vitamin B(12), and vitamin B(6) dosages in 21 pediatric sickle cell disease (SCD) patients (11 HbSS, 10 HbSC; 7-16 years). Daily supplements of folic acid (400, 700, or 1,000 microg), vitamin B(12) (1, 3, or 5 U.S. 1989 RDA), and vitamin B(6) (1 or 3 U.S. 1989 RDA) were gradually increased in an 82-week dose-escalation study. Blood was taken at 9 occasions for measurements of erythrocyte (RBC) and serum folate, plasma vitamin B(12), whole-blood vitamin B(6), and plasma homocysteine. Augmentation of folic acid from 700 to 1,000 microg and vitamin B(12) from 3 to 5 RDA did not further decrease homocysteine. Percentages of patients exhibiting significant individual homocysteine decreases amounted to 43% (folic acid from 0 to 400 microg, vitamins B(12) and B(6) from 0 to 1 RDA), 14% (folic acid from 400 to 700 microg), 24% (vitamin B(12) from 1 to 3 RDA), and 18% (vitamin B(6) from 1 to 3 RDA ). The lowest plasma homocysteine at 82 weeks was 5.9 +/- 2.2 micromol/L. Patients with HbSS had higher RBC folate than HbSC. The entire group exhibited an inverse relation between RBC folate and hemoglobin. We conclude that RBC folate is less valuable for folate stat...Continue Reading

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Citations

Jul 29, 2004·Current Treatment Options in Neurology·Fenella J. Kirkham, Michael R. DeBaun
May 5, 2007·Nature Clinical Practice. Neurology·Fenella J Kirkham
Nov 25, 2003·Current Opinion in Pediatrics·Fenella J Kirkham
Aug 30, 2008·Annals of Tropical Paediatrics·A-W M Al-SaqladiB J Brabin
May 26, 2016·Brazilian Oral Research·Shirlene Barbosa Pimentel FerreiraAntônio Paulino Ribeiro
Jul 8, 2017·Critical Reviews in Food Science and Nutrition·Agartha Ohemeng, Isaac Boadu
Oct 23, 2008·IUBMB Life·Nissar Ahmad WaniJyotdeep Kaur
Apr 21, 2020·British Journal of Haematology·Sandra L SamarronRalph Green
Nov 13, 2020·Journal of Blood Medicine·George O AdjeiJorgen A L Kurtzhals

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