The effect of vitamin B12 and folic acid supplementation on serum homocysteine

Ehsan Nozari, Saied Ghavamzadeh, Nazanin Razazian

The level of homocysteine ​​in plasma and the state of megaloblastic anemia are two factors that can affect the quality of life of patients with multiple sclerosis (MS). We conducted this study to determine the effect of vitamin B12 and folic acid supplementation on serum homocysteine, megaloblastic anemia status, and quality of life in MS patients. A total of 50 relapsing-remitting multiple sclerosis (RRMS) patients included in this study were divided into 2 groups. The vitamin group received a 5 mg folic acid tablet per day and 3 injection doses of vitamin B12 (1,000 mcg) and the other group received placebo and normal saline injection (same doses). Quality of life was measured using the Multiple Sclerosis Quality of Life Questionnaire-54 (MSQOL-54). A fully automated fluorescence polarization immunoassay was used to measure serum homocysteine, vitamin B12, and folate. A blood test with a complete blood count was performed to determine the anemia status. The mean homocysteine ​​level decreased by 2.49 ± 0.39 µmol / L (p = 0.001), hemoglobin increased from 11.24 ± 1.54 to 13.12 ± 1.05 g / dL (p = 0.001 ) and the mean corpuscular volume decreased from 95.50 ± 6.65 to 89.64 ± 4.24 in the vitamin group (p = 0.001). There was a significant improvement in the mental field of quality of life in the placebo group (37.46 ± 19.01 to 50.98 ± 21.64; p = 0.001), while the physical and mental fields of quality of life Life significantly improved in the vitamin group (40.38 ± 15.07 to 59.21 ± 12.32 and 29.58 ± 15.99 to 51.68 ± 18.22, respectively; p = 0.001). The decrease in the serum homocysteine ​​level and the improvement of the anemia status with vitamin B12 and folic acid supplements reveal the potential role of these two vitamins in improving the quality of life of MS patients.