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Body Systems | Children with Sickle Cell Disease Need More B Vitamins

Children with Sickle Cell Disease Need More B Vitamins

April 18, 2002—Based on the results of a newly published clinical trial in the American Journal of Hematology, new recommendations have been made regarding optimal B vitamin intake for children with sickle cell disease.1

Prior research has suggested that children with sickle cell disease require supplementation with folic acid, vitamin B6, and vitamin B12.2 3 4 5 This new study is the first to try to identify the optimal intake amount for each vitamin.

Researchers administered gradually increasing amounts of folic acid, vitamin B12, and vitamin B6 to 21 children with sickle cell disease. Blood samples were regularly taken to determine the lowest intake level of each vitamin that would provide the maximum lowering of homocysteine, a metabolic by-product that builds up in people with B vitamin deficiency.

The optimal intake level of folic acid was found to be 700 mcg per day. Optimal amounts of vitamins B12 and B6 were three times the Recommended Dietary Allowance (RDA). This translates to 4.2 to 6.0 mcg per day for vitamin B12 and 4.2 to 6.0 mg per day for vitamin B6, depending on the age and sex of the child.

To simplify their findings, the authors made a general recommendation for all children with sickle cell disease, regardless of age or sex. They suggest 1 mg of folic acid, 6 mcg of vitamin B12, and 6 mg of vitamin B6 per day. These levels are far below the levels that have been associated with adverse effects. (For example, nerve damage has been reported in some adults consuming 500 mg or more of vitamin B6 per day.6)

Sickle cell disease, also called sickle cell anemia, is an inherited disorder characterized by defective manufacture of the oxygen-carrying protein (hemoglobin) in blood cells. It affects approximately 72,000 people in the U.S., primarily African American children.

Currently, the benefits of reducing homocysteine in children with sickle cell disease remain theoretical. The researchers suggest that by reducing homocysteine levels they will protect the cells that line blood vessels from damage. By protecting the vessels, they theorize that they could reduce the incidence of painful crisis, an extremely debilitating episode of pain that occurs commonly in people with sickle cell disease.

While more research is needed to support this theory, supplementation with B vitamins appears to be a useful treatment for children with sickle cell disease.


1. van der Dijs FP, Fokkema MR, Dijck-Brouwer J, et al. Optimization of folic acid, vitamin B12, and vitamin B6 supplements in pediatric patients with sickle cell disease. Am J Hematol 2002;69:239–46.
2. van der Dijs FP, Schnog JJ, Brouwer DA, et al. Elevated homocysteine levels indicate suboptimal folate status in pediatric sickle cell patients. Am J Hematol 1998;59:192–8.
3. Natta CL, Reynolds RD. Apparent vitamin B6 deficiency in sickle cell anemia. Am J Clin Nutr 1984;40:235–9.
4. al-Momen AK. Diminished vitamin B12 levels in patients with severe sickle cell disease. J Intern Med 1995;237:551–5.
5. Lowenthal EA, Mayo MS, Cornwell PE, Thornley-Brown D. Homocysteine elevation in sickle cell disease. J Am Coll Nutr 2000;19:608-12.
6. Gaby AR. The safe use of vitamin B6. J Nutr Med 1990;1:153–7.

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Matt Brignall, ND, is in practice at the Seattle Cancer Treatment and Wellness Center and at the Evergreen Integrative Medicine Clinic in Kirkland, WA. He specializes in integrative treatment of cancer. He is a contributor to Healthnotes and Healthnotes Newswire.

Copyright © 2002 Healthnotes, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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