Epilepsy, medications, heart disease, and dietary strategies

In recent years, researchers have identified that elevated homocysteine levels are associated with cardiovascular risk. This compound builds up in the blood when it cannot be converted into methionine. Two important nutrients, folate, and vitamin B-12, are important in this chemical reaction; when deficient, homocysteine can accumulate and cause problems.

For people with epilepsy, this is important to know, as some common epilepsy medications can decrease folate and vitamin B-12 levels, and in turn increasing cardiovascular risk.

In a recent study, children receiving carbamazapine (Tegretol) and valproate(Depakote) had statistically lower folate and higher homocysteine levels than children without epilepsy who were not on these medications.

There are several strategies you might consider if your child needs to be on these medications:

1. Give your child a daily multivitamin supplement containing folate and vitamin B-12.
2. Know your dietary sources of folate and include them in your family's meals on a regular basis: fortified cereal, sunflower seeds, dried beans and peas, and leafy greens.
3. Know your dietary sources of vitamin B-12 and include them in your family's meals on a regular basis, namely meat and dairy products.
4. Consider using a fish oil supplement. Their omega-3 fatty acids have shown promise in helping to control seizures. Using the supplement may not eliminate the need for the medication, but it may reduce the necessary dose and therefore reduce the associated side effects.
5. Limit the use of pro-inflammatory fats and oils, as they reduce the effectiveness of omega-3 fatty acids. They're easy to remember: any oil, alone or in food, beginning with the letters "S" or "C". The only exception to this is canola oil.

Vurucu S, Demirkaya E, Kul M, Unay B, Gul D, Akin R, Gokçay E. Evaluation of the relationship between C677T variants of methylenetetrahydrofolate reductase gene and hyperhomocysteinemia in children receiving antiepileptic drug therapy.Prog Neuropsychopharmacol Biol Psychiatry. 2008 Jan 28