Vitamin Supplementation Research Articles

Effectiveness of nutritional supplements (vitamins, minerals, omega-3, and probiotics) in preventing and treating COVID-19 and viral respiratory infections

BackgroundViral respiratory infections (VRIs) continue to be among the most common illnesses and are known to be one of the main reasons of medical consultations worldwide.COVID-19 remains a major public concern and a threat to global health. The current focus lies on the pivotal role of the human host's immunologic response in combating viral threats.This critical review aims to examine the current evidence on the potential benefit of nutritional supplements in the prevention and treatment of COVID-19 and viral respiratory infections (VRIs). MethodsThe study was performed in the Google-Scholar and PubMed databases with a main emphasis on publications between January 2000 and September 2023. Consequently, a total of 202 articles were included in this literature review, distributed as follows: 62 meta-analyses and systematic reviews, 20 randomized clinical trials, 11 clinical trials, 28 observational cohorts and 81 others. Of these, 44 % were published between 2020 and 2023. ResultsThe research indicates that Vitamin C may have a mitigating effect on VRIs, whereas a deficiency in Vitamin D might heighten susceptibility to COVID-19. Understanding the roles of Vitamins A, B, and E is hampered by limited data availability. Zinc supplementation and probiotics emerge as potential preventive measures for both COVID-19 and VRIs, with selenium and magnesium demonstrating promising results in treating VRIs. The recommendation for omega-3 fatty acid supplementation for COVID-19 treatment awaits further evidence. ConclusionCurrently, there is insufficient clinical evidence to definitively establish the efficacy of vitamin, mineral, probiotic and/or omega-3 supplementation for combating COVID-19 and VRIs.

The Effect of Vitamin D Supplementation on Thyroid Hormone Levels in Patients With Autoimmune Thyroid Disease: A Systematic Review.

Autoimmune thyroid diseases (AITDs) pose significant challenges in clinical practice, representing one of the most common endocrine abnormalities. Vitamin D deficiency has been linked as one of the contributing factors to the etiology of AITDs. This systematic review evaluates the effects of vitamin D supplementation on thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) levels in adults with AITDs. Using a PICO (population, intervention, comparison, and outcome) framework and adhering to thePreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, seven relevant studies were identified from an initial pool of 1,469 articles. The population comprised individuals with thyroid autoimmunity, as evidenced by at least one elevated positive thyroid autoimmune marker and intervention involved the supplementation of vitamin D, regardless of the dose or method of administration. All randomized clinical trials within the last 10 years, which fit the study criteria, were included. These studies showed varying results based on follow-up duration. Short-term studies (three months or less) demonstrated no significant changes in mean TSH, T3, or T4 levels compared to the control group with vitamin D supplementation. However, all of the long-term studies (greater than three months) indicated significant improvements compared to the controlin mean TSH, T3, and T4 levels. Additionally, all long-term studies that compared TSH, T3, and T4 to baseline levels revealed significant changes by the trial's end. Despite these promising findings, the review highlights limitations, including small sample sizes, short study durations, and the need for further research to establish optimal dosing and treatment duration for vitamin D in AITD management. The overall findings suggest that vitamin D supplementation may play a part in thyroid hormone regulation in AITD, particularly with prolonged administration.

Association of vitamin D with risk of warts: A retrospective and Mendelian randomization study.

The clinical strategy of oral supplementation of Vitamin D (VD) as a preventive and therapeutic measure for warts needs further exploration. The clinical data of patients with skin diseases who visited the Children's Hospital affiliated with Chongqing Medical University from February 2018 to June 2024 were collected. The serum VD levels in patients with warts (common warts, flat warts, and plantar warts) and patients with other common skin diseases (atopic dermatitis, psoriasis, alopecia areata, vitiligo, and chronic urticaria) were compared. Two-sample bidirectional Mendelian randomization (MR) analysis was performed to investigate potential causal associations between VD and warts. The average serum VD level of children with warts was 23.27±7.07ng/mL, which showed no statistically significant difference compared to children with other common skin diseases. The inverse variance weighted (IVW) method analysis indicated a positive causal relationship between VD and warts (Odds Ratio [OR]=1.86, [95% CI: 1.19-2.92], p=0.007). Sensitivity analysis did not show any indication of horizontal pleiotropy or heterogeneity. The MR-PRESSO method did not identify any outliers. The levels of serum VD in children with warts do not significantly decrease compared to children with other common skin conditions. The evidence from the MR analysis indicates a positive causal relationship between VD and warts, suggesting caution in supplementing VD for children with warts who have normal or elevated serum VD levels. Further clinical studies are needed for validation in the future.

Effects of Vitamin Supplements in a Pollen Substitute on Some Characteristics of Bee Nucleus Colonies

This study aimed to evaluate the effects of vitamin supplementation in a pollen substitute on the performance of honey bee colonies (Apis mellifera mellifera). Twenty nucleus colonies housed in Langstroth-Ruth hives were randomly selected and fed a diet consisting of corn gluten, sugar, and brewer’s yeast residuals, yielding 21.0% crude protein, 7.1% crude fat, and 1.7% crude ash. This diet was enriched with a vitamin mixture at doses of 1, 2, and 3 grams. Control group I received a sugar-water syrup (1:1, w/v), while control group II received the basic diet without vitamin supplementation. The three experimental groups were given the diet with varying amounts of the vitamin mixture. Results indicated that experimental group II demonstrated colony strength comparable to experimental group I but significantly higher than the control group by 14.6-49.4%, and 34.3% higher than experimental group III (P<0.05). Queen bee egg yield increased significantly, with control group II showing a 27.5% increase, experimental group I showing 52.1% increase, experimental group II showing 67.6% increase, and experimental group III showing 28.5% increase on July 28th. Similar trends were observed on August 28th, with respective increases of 30.2%, 32.5%, 37.4%, and 14.7% compared to control group I. Additionally, honey yields for experimental group II were significantly higher by 25.8-57.9% compared to the control groups and 46.8% higher than experimental group III (P<0.05). These findings suggest that vitamin-enriched pollen substitutes positively impact colony strength, queen bee egg laying, and honey production, underscoring the potential benefits of such supplementation in beekeeping practices.

Ultra-high dose methylcobalamin and other emerging therapies for amyotrophic lateral sclerosis.

Recent development in understanding the pathophysiology of amyotrophic lateral sclerosis (ALS) has led to increasing number of promising test drugs in the pipeline along with the existing ones. We will review these agents focusing on ultra-high dose methylcobalamin, which is pending approval in Japan. Clinical trial design best suited for ALS will also be discussed. The most recent phase 3 trial (JETALS) of ultra-high dose methylcobalamin demonstrated significant slowing of ALSFRSR changes (0.5/month), with marked reduction of serum homocysteine levels in the initial double-blind period. The post hoc analysis of the previous phase 2/3 study (E761 trial; Eisai) showed that it prolonged survival of ALS patients, if started within 1 year of onset, but the previous studies suggested its efficacy even in later stages, depending upon the rate of progression. Phase 3 trial of AMX0035 or Relyvrio on the other hand showed negative results despite the promising phase 2 data. The latter did not adjust the disease progression rate before entry. Ultra-high dose methylcobalamin is not a vitamin supplement but a novel disease-modifying therapy for ALS, and it emphasizes homocysteine as a key factor in the disease process. Clinical trial design must include entering patients early and with similar rates of progression using pretrial observation periods for meaningful results, since ALS is a chronologically heterogenous condition with similar phenotypes.

TET3 downregulation and low 5-hydroxymethylcytosine are epigenetic signatures of head and neck carcinoma.

Ten-eleven translocases (TETs) are enzymes responsible for demethylation processes, playing a crucial role in maintaining the body's methylation balance. Dysregulation of TET expression can lead to abnormal methylation levels. Isocitrate dehydrogenases (IDH) are upstream genes involved in Kreb cycle responsible for production of α-ketoglutarate (α-KG). α-KG and vitamin C are cofactors of TET3 enzyme. There is limited data on the relationship between TET3 and its cofactor Vitamin C in head and neck carcinoma (H&NC). In this study, we have investigated the expression of the TET3 gene along with IDH1/2 genes involved in the Krebs cycle in the peripheral blood of 32H&NC patients compared to 32 healthy controls. We estimated serum levels of TET3 protein and vitamin C and 5-hydroxymethylcytosine (5-hmC) percentage in DNA isolated from EDTA blood samples. Our findings revealed that TET3 and IDH1/2 were downregulated in H&NC patients compared to healthy controls. Serum levels of TET3 and Vitamin C were low in H&NC patients compared to healthy controls. Diminished levels of percentage 5-hmC were detected in EDTA blood samples of H&NC patients compared to controls. Spearman correlation analysis revealed a significant positive correlation between TET3 levels, vitamin C levels and 5-hmC percentage. The low levels of Vitamin C are believed to contribute to decreased activity of the TET3 gene and less conversion of 5-methylcytosine (5-mC) to 5-hmC. Dietary supplementation of Vitamin C may increase TET3 activity.

Role of Micronutrient Supplementation in the Management of Hashimoto's Thyroiditis: A Review of Current Evidence and Potential Mechanisms of Action

Introduction and objective: Hashimoto's thyroiditis (HT), the most prevalent autoimmune disorder and a primary cause of hypothyroidism globally, leads to thyroid gland damage through lymphocyte infiltration. Pharmacological treatment of HT involves the use of levothyroxine, which in most cases must be taken for life. However, supplementation with micronutrients is often overlooked. Several studies have examined the impact of substances such as selenium, zinc, vitamin B12, and vitamin D on the course of Hashimoto's disease. Review methods: Review and summary of research studies available in open-source format on Google Scholar, PubMed. Abbreviated description of the state of knowledge: Supplementation with selenium, zinc, vitamin D, and B12 shows potential benefits for patients with Hashimoto's disease. Summary: Regular monitoring and tailored supplementation of selenium, zinc, vitamin D, and vitamin B12 can enhance overall health and disease management. Therefore, it is worth considering the supplementation of these micronutrients in the daily routine of patients with Hashimoto's thyroiditis. However, it should be noted that these supplements do not constitute a treatment for Hashimoto's disease and their effect cannot replace the intake of levothyroxine.

Different effects of vitamin supplementation on arsenic bioaccessibility in contaminated soils using multiple in vitro methods and their relevant mechanisms

Exposure to arsenic (As) induces adverse effects on human health. Vitamins B1, B6, and C, as indispensable micronutrients for humans, have been proven to influence the metabolism and toxicity of ingested As. To determine the effect of vitamins on health risks associated with soil exposure, As bioaccessibility in 14 soil samples using four in vitro methods of IVG, PBET, SBRC, and UBM was measured with the addition of vitamins B1, B6, and C. With vitamins B1 and B6 addition, the gastric As bioaccessibility in 14 soil samples was reduced by 1.14–3.52 and 1.14–5.02 fold, respectively, and instead an increase in the intestinal bioaccessibility was presented in some cases. Vitamin C supplementation yielded higher As bioaccessibility in the gastric (1.13–13.02 fold) and small intestinal (1.21–33.35 fold) phases, respectively. As evidenced by the X-ray absorption near-edge spectroscopy (XANES) and Fourier transform infrared spectroscopy (FTIR) analysis, arsenic dissolution was promoted by Fe-As and hindered by the formation of Al-As fractions. Soil As dissolution in the simulated gastrointestinal tract was strongly influenced by soil minerals and ingested vitamins, due to the chelation of arsenic with vitamins and soil minerals such as Fe (hydr)oxides, and Fe(III) reductive dissolution to enhance As release by vitamin C as an iron reducer. These findings will expand the knowledge of health risks of exposure to As-contaminated soils and nutritional interventions aiming at the mitigation of As toxicity.

Prevalence and risk factors of osteopenia and osteoporosis among postmenopausal women: A cross-sectional study from Jordan.

Our aim was to predict the prevalence of osteopenia and osteoporosis and their associated risk factors among postmenopausal women from Jordan. In this cross-sectional study, a total of 368 postmenopausal women were recruited from King Abdullah University Hospital (KAUH) in the North of Jordan between September 2022 and April 2023. Bone mineral density (BMD) was measured using a dual-energy X-ray absorptiometry scan. T-score was used for osteoporosis diagnosis in accordance with the International Society for Clinical Densitometry (ISCD) guidelines. Data about sociodemographic and lifestyle variables were collected using face-to-face interviews. Medical records were used to retrieve participants' BMD information. Predictors of osteoporosis were identified using logistic regression. Prevalence of osteoporosis was 40.5%, while 44.6% of participants were diagnosed with osteopenia. The lumbar spine had the highest frequency of osteoporosis (30.4%), while the left femoral neck had the highest prevalence of osteopenia (46.3%). Postmenopausal women's age (p-value=.024), and history of chronic diseases (p-value=.038) were significant factors associated with increased osteoporosis risk. Postmenopausal women from Jordan had high prevalence of osteoporosis and osteopenia. It is therefore necessary to target risk factors leading to osteoporosis and to improve patients' lifestyles through patient education. Healthcare systems should consider early screening approaches for osteoporosis at the age of menopause and thereafter. Supplements of calcium and vitamin D may be routinely considered for this age group depending on their serum levels.

Long-term prevalence of vitamin deficiencies after bariatric surgery: a meta-analysis.

Bariatric surgery can lead to short-mid-term vitamin deficiencies, but the long-term vitamin deficiencies is unclear. This study aimed to conduct a meta-analysis regarding the long-term prevalence (≥ 5years) of vitamin deficiencies after bariatric surgery. We searched the EMBASE, PubMed, and CENTRAL databases for clinical studies until June 2023. Meta-analysis, sensitivity, subgroup, and meta-regression analyses were performed. This meta-analysis included 54 articles with follow-up duration ranging from 5 to 17years. The most prevalent vitamin deficiencies after surgery were vitamin D (35.8%), followed by vitamin E (16.5%), vitamin A (13.4%), vitamin K (9.6%), and vitamin B12 (8.5%). Subgroup analyses showed that the prevalence of vitamin A and folate deficiencies increased with the follow-up time. Roux-en-Y gastric bypass had a higher rate of vitamin B12 deficiency than sleeve gastrectomy and biliopancreatic diversion with duodenal switch (BPD-DS). Studies conducted in Europe had higher vitamin A deficiency (25.8%) than in America (0.8%); Asian studies had more vitamin B12 but less vitamin D deficiency than European and American studies. Meta-regression analysis displayed that publication year, study design, preoperative age, BMI, and quality assessment score were not associated with vitamin A, B12, D, and folate deficiencies rate. A high prevalence of vitamin deficiencies was found after bariatric surgery in the long-term follow-up, especially vitamin D, E, A, K, and B12. The variation in study regions, surgical procedures, and follow-up time are associated with different postoperative vitamin deficiencies; it is necessary to develop more targeted vitamin supplement programs.

Current treatment for male infertility: an umbrella review of systematic reviews and meta-analyses.

This umbrella review aimed to summarize and provide a general evaluation of the effectiveness of current treatments for male infertility and assess the quality of evidence and possible biases. An umbrella review of systematic reviews and meta-analyses available in PubMed, Web of Science, and Scopus, covering studies published up to October 2023, was conducted. Sperm concentration, morphology, and motility were used as endpoints to evaluate the effectiveness of the treatments. Of 2998 studies, 18 published meta-analyses were extracted, yielding 90 summary effects on sperm concentration (n = 36), sperm morphology (n = 26), and sperm motility (n = 28) on 28 interventions. None of the meta-analyses were classified as having low methodological quality, whereas 12 (66.7%) and 6 (33.3%) had high and moderate quality, respectively. Of the 90 summary effects, none were rated high-evidence quality, whereas 53.3% (n = 48), 25.6% (n = 23), and 21.1% (n = 19) were rated moderate, low, and very low, respectively. Significant improvements in sperm concentration, morphology, and motility were observed with pharmacological interventions (N-acetyl-cysteine, antioxidant therapy, aromatase inhibitors, selective estrogen receptor modulators, hormones, supplements, and alpha-lipoic acid) and nonpharmacological interventions (varicocele repair and redo varicocelectomy). In addition, vitamin supplementation had no significant positive effects on sperm concentration, motility, or morphology. Treatments for male infertility are increasingly diverse; however, the current evidence is poor because of the limited number of patients. Further well-designed studies on single treatment and high-quality meta-analysis of intertreatment comparisons are recommended.

Can vitamin supplementation improve quality of life and disease severity in patients with rheumatoid arthritis, or is physical activity enough?

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and progressive joint destruction, significantly impacting quality of life. While conventional treatments focus on managing symptoms and slowing disease progression through pharmacological means, the potential role of complementary therapies like vitamin supplementation or increased physical activity has garnered increasing interest. Aim of the Study: This narrative review explores the existing literature on the efficacy and mechanisms of various vitamins in the management of RA. By synthesizing current research findings, we aim to provide a comprehensive overview of how vitamin supplementation might influence RA outcomes, offering insights into potential integrative approaches to enhance patient care. Methods and Materials: A thorough search was conducted using PubMed and Google Scholar, focusing on literature published in the past five years. Vitamins with potential impacts on RA progression were identified and paired with the term "Rheumatoid Arthritis" to collect data on their influence on the disease's incidence and management, as well as the mechanisms involved. Additionally, references from selected articles were reviewed and included in the analysis. This method ensured a comprehensive evaluation of the current evidence regarding vitamin supplementation in RA treatment. Similarly, studies on the impact of physical activity on RA were also reviewed. Results: The influence of physical activity on serum inflammatory markers in RA patients was limited. Vitamin D supplementation significantly reduced disease activity, alleviated pain, and mitigated methotrexate-related side effects, especially in patients with baseline vitamin D deficiency or lower serum levels. In contrast, other vitamins have not exhibited the same positive effects. These findings underscore the need for continued research to optimize the role of various vitamins in managing RA effectively.

COVID-19-Associated Cerebellitis: A Case Report and Rehabilitation Outcome.

The COVID-19 pandemic has brought attention to neurological complications, including cerebellitis, characterized by inflammation of the cerebellum. Despite its rare occurrence, cerebellitis has been associated with COVID-19 infection, albeit the pathogenic mechanisms remain unclear. We present the case of a 22-year-old male with acute onset ataxia and dysarthria during a SARS-CoV-2 infection. Diagnostic evaluations ruled out other causes, confirming cerebellitis. Treatment included steroid therapy, vitamin supplementation, physiotherapy, and intravenous immunoglobulins. Rehabilitation focused on enhancing balance, coordination, and daily activities. The patient showed significant improvement in functional abilities, with increased autonomy in daily activities and improved ambulation. Despite persistent mild symptoms, the multidisciplinary rehabilitation approach led to remarkable progress. This case underscores the importance of recognizing and managing neurological complications, such as cerebellitis, in COVID-19 patients. A comprehensive approach combining medical treatment and rehabilitation is essential for optimizing outcomes. Further research is needed to elucidate the pathogenesis and optimal management strategies for such complications.

Over-the-counter cosmeceuticals: Exploring usage patterns and attitudes among Indians

Objectives: The study’s objectives were to find the prevalence of over-the-counter (OTC) usage of skin, nail, and hair care products and to understand the knowledge, attitudes, and practices (KAPs) of the Indian population presenting to a non-dermatology outpatient department (OPD) for various indications concerning this usage. Materials and Methods: This was a cross-sectional questionnaire-based study, conducted over a year, in which 668 consenting Indians aged 18–60 years, representing various socioeconomic backgrounds were surveyed through Google Forms regarding the OTC cosmeceutical usage in a non-dermatology OPD. Results: This KAP study was conducted on 668 participants, of whom the majority were middle-aged males (481 [72.01%]), with a diverse socioeconomic range, with the upper-middle class making up the largest segment (264 [39.52%]). Allopathy was the primary treatment choice for 347 (51.95%) of participants, with 566 (84.73%) preferring professional healthcare over self-medication. Social media was a significant source of skincare information, with Google Ads (279 [41.8%]) and Instagram (84 [12.6%]) being popular platforms. While doctors’ advice influenced 270 (40.4%) of participants in their skincare choices, word-of-mouth played a role, with 251 (37.57%) agreeing it was helpful. OTC usage was found to vary by socioeconomic class and treatment type. Oral OTC products were preferred for skin health, especially in the upper class, while fairness creams were more common among the lower class. Conclusion: Despite the growing reliance on social media for skincare information, traditional sources such as word-of-mouth and TV still hold sway, indicating a mix of modern and conventional influences. The frequency and type of OTC product usage varied across socioeconomic classes, with oral products like vitamin supplements leading in the upper class and fairness creams leading in the lower class, reflecting the societal pressure for a fair complexion in this subset.

Metabolomics and Biochemical Benefits of Multivitamin and Multimineral Supplementation in Healthy Individuals: A Pilot Study.

Scientific evidence regarding the effectiveness of vitamin and mineral supplements in healthy individuals remains scarce. In a randomized, double-blind study, 30 healthy individuals were assigned to receive a single daily dose of multivitamin and multimineral supplementation or a double daily dose for 30 days. Before and after the intake, an untargeted metabolomics assay for serum metabolites was conducted by hydrophilic interaction liquid chromatography-mass spectrometry, and clinical assessments of peripheral blood samples were performed. A paired t-test for metabolic analysis, adjusted using the false discovery rate (FDR) and p-value correction method (rate of change > 2 and FDR < 0.05), the Shapiro-Wilk test, Student's t-test, and the Mann-Whitney U test were applied depending on the variable, with a 5% significance level. An impact on oxidative stress was observed, with a significant reduction in homocysteine levels and an increment of pyridoxic acid (vitamin B6). The effect on energy metabolism was shown by a significant increase in diverse metabolites, such as linoleoylcarnitine. Serum iron and calcium levels were also impacted. Overall, we observed a nutritional balance compatible with a good state of health. In conclusion, beneficial effects on adult health were demonstrated in relation to oxidative stress, energy metabolism, and nutritional balance.

A Comparative Study Evaluating the Effectiveness of Folate-Based B Vitamin Intervention on Cognitive Function of Older Adults under Mandatory Folic Acid Fortification Policy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The policies regarding the mandatory fortification of food with folic acid (FA) may impact the effectiveness of folate-based B vitamin treatment on cognitive function in older adults. We critically and systematically review the literature to assess whether food fortification policies affect folate-based B vitamin treatment efficacy on cognition function in older adults. Electronic databases, including PubMed, Web of Science, and CNKI, were searched for "Cognitive Function", "Folate", and "Older Adults". The study had specific criteria for inclusion, which were as follows: (1) the studies should initially have randomized controlled trials that were conducted on older adults aged 60 or above; (2) the studies must assess the relationship between folate status and cognitive performance; and (3) the studies should clarify the policies regarding food fortification with FA. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Two reviewers independently extracted all the data, and any discrepancies were resolved by consensus. All the data collected were compiled, compared, and analyzed critically. Random effects models were used to assess the effects of interventions. The systematic review included fifty-one articles involving 42,768 participants. Of these, the 23 articles were included in the meta-analysis. The meta-analysis on the effects of folate-based B vitamin supplementation on cognitive function showed a significant overall impact (Z = 3.84; p = 0.0001; SMD, 0.18; 95% CI, 0.09, 0.28). Further analysis revealed that FA food fortification policies were not implemented in countries where folate-based B vitamin supplementation improved cognitive impairment in older adults (Z = 3.75; p = 0.0002; SMD, 0.27; 95% CI, 0.13, 0.40). However, the FA intervention did not have significant outcomes in areas where FA food fortification policies were mandatory (Z = 0.75; p = 0.45; SMD, 0.03; 95% CI, -0.06, 0.13). Supplementing with oral folic acid, alone or in combination, has been linked to improved cognitive performance in older adults. While mandatory FA fortification has the improved folic acid status, additional folate-based B vitamin supplements do not appear to influence cognitive function.

Supplementation of vitamin E as an addition to a commercial renal diet does not prolong survival of cats with chronic kidney disease

BackgroundThe aim of this double-blind, placebo-controlled study was to investigate the effect of vitamin E supplementation as an addition to a commercial renal diet on survival time of cats with different stages of chronic kidney disease (CKD). In addition, we were interested whether vitamin E supplementation affects selected oxidative stress and clinical parameters. Thirty-four cats with CKD and 38 healthy cats were included in the study. Cats with CKD were classified according to the IRIS Guidelines; seven in IRIS stage 1, 15 in IRIS stage 2, five in IRIS stage 3 and seven in IRIS stage 4. Cats with CKD were treated according to IRIS Guidelines. Cats with CKD were randomly assigned to receive vitamin E (100 IU/cat/day) or placebo (mineral oil) for 24 weeks in addition to standard therapy. Plasma malondialdehyde (MDA) and protein carbonyl (PC) concentrations, DNA damage of peripheral lymphocytes and plasma vitamin E concentrations were measured at baseline and four, eight, 16 and 24 weeks thereafter. Routine laboratory analyses and assessment of clinical signs were performed at each visit.ResultsVitamin E supplementation had no effect on the survival time and did not reduce the severity of clinical signs. Before vitamin E supplementation, no significant differences in vitamin E, MDA and PC concentrations were found between healthy and CKD cats. However, plasma MDA concentration was statistically significantly higher (p = 0.043) in cats with early CKD (IRIS stages 1 and 2) than in cats with advanced CKD (IRIS stages 3 and 4). Additionally, DNA damage was statistically significantly higher in healthy cats (p ≤ 0.001) than in CKD cats. Plasma vitamin E concentrations increased statistically significantly in the vitamin E group compared to the placebo group four (p = 0.013) and eight (p = 0.017) weeks after the start of vitamin E supplementation. During the study and after 24 weeks of vitamin E supplementation, plasma MDA and PC concentrations and DNA damage remained similar to pre-supplementation levels in both the placebo and vitamin E groups.ConclusionsVitamin E supplementation as an addition to standard therapy does not prolong survival in feline CKD.

Managing Normal Tension Glaucoma with Dietary Folate

Normal-Tension Glaucoma (NTG) is the most prevalent form of glaucoma among individuals in Asian countries. While lowering intraocular pressure (IOP) remains the standard of care, this approach is insufficient for most NTG patients. Recent evidence documents the role of ischemia and oxidative stress as critical factors affecting the optic nerve in NTG. Consequently, addressing these factors has been recommended as a neuroprotective strategy. While conventional treatment strategies primarily target the reduction of IOP, this yields limited efficacy and eventual blindness in many NTG cases. Recent studies document another crucial parameter: Retinal Venous Pressure (RVP). Elevated RVP impedes retinal perfusion, resulting in oxidative stress and localized ischemia, and exacerbating optic nerve damage in NTG. Elevated RVP also appears to be a contributing factor in small vessel ischemia associated with diabetic retinopathy and macular degeneration. The underlying cause of elevated RVP is small vessel endotheliopathy, which may result from alterations in methylation and B-vitamin metabolism, leading to changed microcirculation. This metabolic disruption can arise from dietary inadequacies, malabsorption, or genetic polymorphisms affecting the methylation pathways. Restoring plasma levels of folate and B-12 can be achieved through supplementation with natural forms of these vitamins, specifically L-methylfolate, and methylcobalamin. Unlike oxidized folate (folic acid), which must be enzymatically converted to methylfolate to penetrate the blood-retinal barrier, L-methylfolate can be directly utilized. Excess unmetabolized folic acid can impede methyl folate absorption into the retina, underscoring the necessity of using methyl folate for effective supplementation. We propose integrating RVP screening into NTG risk assessments and consider a targeted vitamin supplement, such as Ocufolin®, as a viable adjunct approach to manage elevated RVP and potentially mitigate NTG progression.

Complementary and Alternative Medicine for Autism - A Systematic Review.

Complementary and Alternative Medicine (CAM) is a therapeutic option currently used by autistic people with continued interest and uptake. There remains limited evidence regarding the efficacy of CAM use in autism. The aim of this systematic review is to comprehensively review published clinical trials to explore the efficacy of CAM in autism. A systematic literature review of available research published from June 2013 to March 2023 was conducted. Our literature search identified 1826 eligible citations, and duplications removed (n = 694) with 102 articles eligible for title/abstract screening. After full text review, 39 studies were included. The results of this systematic review identified that for autistic people, vitamin and mineral supplements may only be of benefit if there is a deficiency. The results also found that the main interventions used were dietary interventions and nutraceuticals, including targeted supplements, vitamins and minerals, omega 3s and prebiotics, probiotics and digestive enzymes. The evidence does not support some of the most frequently utilised dietary interventions, such as a Gluten Free Casein Free (GFCF) diet, and the use of targeted nutraceutical supplements may be of benefit, but more conclusive research is still required to direct safe and effective treatment.

Combination therapy enhances efficacy and overcomes toxicity of metal-based anti-diabetic agent.

Metal-based therapeutic agents are limited by the required concentration of metal-based agents. Hereby, we determined if combination with 17β-oestradiol (E2) could reduce such levels and the therapy still be effective in type 2 diabetes mellitus (T2DM). The metal-based agent (vanadyl acetylacetonate [VAC])- 17β-oestradiol (E2) combination is administered using the membrane-permeable graphene quantum dots (GQD), the vehicle, to form the active GQD-E2-VAC complexes, which was characterized by fluorescence spectra, infrared spectra and X-ray photoelectron spectroscopy. In db/db type 2 diabetic mice, the anti-diabetic effects of GQD-E2-VAC complexes were evaluated using blood glucose levels, oral glucose tolerance test (OGTT), serum insulin levels, homeostasis model assessment (homeostasis model assessment of insulin resistance [HOMA-IR] and homeostasis model assessment of β-cell function [HOMA-β]), histochemical assays and western blot. In diabetic mice, GQD-E2-VAC complex had comprehensive anti-diabetic effects, including control of hyperglycaemia, improved insulin sensitivity, correction of hyperinsulinaemia and prevention of β-cell loss. Co-regulation of thioredoxin interacting protein (TXNIP) activation by the combination of metal complex and 17β-oestradiol contributed to the enhanced anti-diabetic effects. Furthermore, a potent mitochondrial protective antioxidant, coniferaldehyde, significantly potentiates the protective effects of GQD-E2-VAC complexes. A metal complex-E2 combinatorial approach achieved simultaneously the protection of β cells and insulin enhancement at an unprecedented low dose, similar to the daily intake of dietary metals in vitamin supplements. This study demonstrates the positive effects of combination and multi-modal therapies towards type 2 diabetes treatment.