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Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report

BACKGROUND: Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus (DM) and hypertension. Supplementing food with L-methylfolate and vitamin D theoretically may improve diabetic and hypertensive retinopathy, however,...

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Autores principales: Wang, Jianhua, Brown, Craig, Shi, Ce, Townsend, Justin, Gameiro, Giovana Rosa, Wang, Peng, Jiang, Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643316/
https://www.ncbi.nlm.nih.gov/pubmed/31363484
http://dx.doi.org/10.1186/s40662-019-0147-0
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author Wang, Jianhua
Brown, Craig
Shi, Ce
Townsend, Justin
Gameiro, Giovana Rosa
Wang, Peng
Jiang, Hong
author_facet Wang, Jianhua
Brown, Craig
Shi, Ce
Townsend, Justin
Gameiro, Giovana Rosa
Wang, Peng
Jiang, Hong
author_sort Wang, Jianhua
collection PubMed
description BACKGROUND: Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus (DM) and hypertension. Supplementing food with L-methylfolate and vitamin D theoretically may improve diabetic and hypertensive retinopathy, however, the outcome of these nutritional approaches has not been fully examined. A retrospective case review was done of cases of retinopathy reversal in patients on Ocufolin™ and a similar nonprescription multivitamin, Eyefolate™. In this study, they were administered L-methylfolate (2.7 mg and 3.0 mg, respectively) and vitamin D3 (4500 IU each). These dosages are significantly above the RDA but well below levels associated with toxicity. CASE PRESENTATION: Seven patients had nonproliferative diabetic retinopathy (NPDR) and some of them had hypertension. One patient had only hypertensive retinopathy. All patients were instructed to take Ocufolin™ medical food as a food supplement. Baseline genetic testing for MTHFR polymorphisms was conducted. Fundus photography was used to document the fundus condition of the enrolled eyes in 8 NPDR patients at the initial and follow-up visits. Microaneurysms (MA) and exudates were observed to be improved in some trial patients. All subjects had one or more MTHFR polymorphisms. All had diabetic retinopathy, hypertensive retinopathy, or both. MAs were resolved, and exudates were decreased in 8/8 cases after taking the medical food. Retinal edema was found in 2/8 cases and improved or resolved in both cases after taking the medical food or the supplement. The best corrected visual activity was stable or improved in 8/8 cases. CONCLUSION: We report a series of diabetic and hypertensive retinopathy cases with MTHFR polymorphisms and the improvement of retinal microvasculature (mainly MAs) in serial fundus photography after taking a medical food or supplement containing L-methylfolate and vitamin D. It appears that the use of nutritional supplements and medical foods containing L-methylfolate and vitamin D may be effective in facilitating the improvement of diabetic and hypertensive retinopathy.
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spelling pubmed-66433162019-07-30 Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report Wang, Jianhua Brown, Craig Shi, Ce Townsend, Justin Gameiro, Giovana Rosa Wang, Peng Jiang, Hong Eye Vis (Lond) Case Report BACKGROUND: Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus (DM) and hypertension. Supplementing food with L-methylfolate and vitamin D theoretically may improve diabetic and hypertensive retinopathy, however, the outcome of these nutritional approaches has not been fully examined. A retrospective case review was done of cases of retinopathy reversal in patients on Ocufolin™ and a similar nonprescription multivitamin, Eyefolate™. In this study, they were administered L-methylfolate (2.7 mg and 3.0 mg, respectively) and vitamin D3 (4500 IU each). These dosages are significantly above the RDA but well below levels associated with toxicity. CASE PRESENTATION: Seven patients had nonproliferative diabetic retinopathy (NPDR) and some of them had hypertension. One patient had only hypertensive retinopathy. All patients were instructed to take Ocufolin™ medical food as a food supplement. Baseline genetic testing for MTHFR polymorphisms was conducted. Fundus photography was used to document the fundus condition of the enrolled eyes in 8 NPDR patients at the initial and follow-up visits. Microaneurysms (MA) and exudates were observed to be improved in some trial patients. All subjects had one or more MTHFR polymorphisms. All had diabetic retinopathy, hypertensive retinopathy, or both. MAs were resolved, and exudates were decreased in 8/8 cases after taking the medical food. Retinal edema was found in 2/8 cases and improved or resolved in both cases after taking the medical food or the supplement. The best corrected visual activity was stable or improved in 8/8 cases. CONCLUSION: We report a series of diabetic and hypertensive retinopathy cases with MTHFR polymorphisms and the improvement of retinal microvasculature (mainly MAs) in serial fundus photography after taking a medical food or supplement containing L-methylfolate and vitamin D. It appears that the use of nutritional supplements and medical foods containing L-methylfolate and vitamin D may be effective in facilitating the improvement of diabetic and hypertensive retinopathy. BioMed Central 2019-07-22 /pmc/articles/PMC6643316/ /pubmed/31363484 http://dx.doi.org/10.1186/s40662-019-0147-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Wang, Jianhua
Brown, Craig
Shi, Ce
Townsend, Justin
Gameiro, Giovana Rosa
Wang, Peng
Jiang, Hong
Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report
title Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report
title_full Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report
title_fullStr Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report
title_full_unstemmed Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report
title_short Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report
title_sort improving diabetic and hypertensive retinopathy with a medical food containing l-methylfolate: a preliminary report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643316/
https://www.ncbi.nlm.nih.gov/pubmed/31363484
http://dx.doi.org/10.1186/s40662-019-0147-0
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