According to a new study published in this month's issue of the Journal of the American Dietetic Association, compared with healthy women, those with rheumatoid arthritis are deficient in vitamin B6 and have elevated levels of homocysteine, an amino acid that's been linked to heart attacks and strokes.
The vitamin B6 deficit appears to be the result of altered metabolism, not reduced dietary intake. The results also indicate that as vitamin B6 levels drop and homocysteine levels rise, disability status worsens.
Numerous reports have shown that rheumatoid arthritis patients are at risk for early death from cardiovascular disease. The reason for the elevated risk, however, is unclear since there is evidence that traditional cardiovascular risk factors, such as high cholesterol levels, are no more common in arthritis patients than in healthy individuals.
Elevated homocysteine levels also increase the risk of cardiovascular disease.
Findings from several studies have indicated that homocysteine metabolism is altered with rheumatoid arthritis, which may in turn relate to changes in how vitamin B6 is processed. Typically as vitamin B6 levels fall, homocysteine levels increase.
The present findings, derived from a study of 18 patients and 33 healthy subjects, indicate that dietary levels of B vitamins are not decreased in rheumatoid arthritis patients, yet they still show a deficit of vitamin B6. Rheumatoid arthritis was also associated with increased levels of homocysteine. Levels of total cholesterol and "bad" LDL cholesterol were actually lower in patients with arthritis than in healthy individuals.
Individuals with rheumatoid arthritis may need to get more B vitamins through diet, supplements, or fortified foods. Foods that are especially high in vitamin B6 are meat, fish, poultry, legumes, non-citrus fruits, fortified cereals, and soy products.
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