Role of Supplements in Epilepsy
In people with epilepsy, there is increased nutritional risk because of altered nutrient needs, drug-nutrient interactions, and sometimes nutritional deficiency due to seizures, metabolic disorders or diarrhea (side effect of AED used).
Nutrient needs may be altered as a result of the long-term medication therapy use in epilepsy. Disorders of vitamin D, calcium, and bone metabolism result when the anticonvulsants phenytoin and/or phenobarbital are used for an extended period of time.
Metabolic disease that results in an inability to properly utilize a particular nutrient in the body, such as a vitamin or an amino acid can sometime give rise to seizure. About 20 to 80 different metabolic disorders that are most commonly associated with seizures. Seizures associated with metabolic disorders usually begin soon after birth and rarely start after age six.
Seizures can also be caused by nutritional deficiency. Research suggests that shortages of magnesium, thiamin, vitamin B6 and zinc have been reported to be associated with seizures in some individuals while a manganese deficiency in pregnant women may result in the birth of epileptic children. These nutrients, among numerous others, are needed for normal chemical reactions in the brain.
Nutritional support for people with seizure disorders, then, involves correcting metabolic problems and nutritional deficiencies. In some cases, it may also involve taking larger amounts of certain nutrients to help protect against drug-related damage and possibly against damage caused by the seizures themselves.
A number of nutrients have proven useful in helping to prevent seizures. Many doctors recommend a multivitamin/mineral supplement for their patients with epilepsy. However, most cases of epilepsy are not treated with supplements although it proves to be successful for some.
IMPORTANT: DO note that these supplements are meant to provide optimum nutritional support, not to be treatments in and of themselves. It is important to work with a doctor knowledgeable in nutrition, especially if you are giving nutritional supplements to children.
| Supplements | Dosage Information |
| Folic acid | No more than 2,500 micrograms for children ages 5-15 400-5,000 micrograms for adults 1,600 micrograms for women of childbearing age on anti-epilepstic drugs 3,000 micrograms for women on anti-epileptic drugs who are planning to become pregnant, taken for 3 months before stopping birth control (requires a prescription) |
| Selenium | 50-150 micrograms for children / 50-200 micrograms for adults |
| Vitamin E (d-alpha-tocopherol acetate) | 400 international units for children ages 3 and over (d-alpha-tocopherol acetate) / 400-600 international units for adults (d-alpha-tocopherol acetate) |
| Plus a multivitamin/mineral supplement containing the Daily Values of all essential vitamins and minerals | |
Vitamin E
It is believe that vitamin E could be helpful for some kinds of seizures. In children, whose seizures initially could not be controlled by medication, seizure frequency was found to decrease in 60-100% of the children when they took 400 international units of d-alpha-tocopherol acetate per day for three months in addition to their regular medication. Animals given vitamin E are more resistant to seizures induced by pressurized oxygen, iron and certain chemicals. And clinical studies show that people taking anti-epileptic drugs have reduced blood levels of vitamin E.
Vitamin E apparently has no direct anti-epileptic action but act as a scavenger and take up free radicals protecting the membranes of brain cells in some forms of epilepsy such as post-traumatic seizures. In animals, seizures can be induced by chemicals (e.g. ferrous chloride) that produce free radicals.
It is safe and effective even in children as young as age three. Nutrition experts say that infants under age one should not be given more than 50 international units daily. Most adults can safely take up to 600 international units without problems. It is important not to take more than this amount daily without medical supervision. No adverse side effects was associated and if vitamin E is effective the benefits will be apparent in about three months. In some cases, under medical supervision, it may be possible to reduce the dosages of some seizure drugs.
Selenium
The mineral selenium is another nutrient, which act as scavenger for free radicals, having antioxidant properties and also appears to help control seizures in some children. It was found that some children with severe, uncontrollable seizures and repeated infections have low blood levels of glutathione peroxidase, a selenium-dependent antioxidant enzyme.
Giving 50 to 150 micrograms of selenium a day to children significantly reduces their seizures. Metabolic problem that prevents usage of selenium properly may be the reason behind it. Children's needs can vary greatly depending on the amount of deficiency they have, and giving too much selenium could be detrimental to their health.
For adults with epilepsy, experts who use nutritional therapy recommend 50 to 200 micrograms of selenium daily to control seizures. A dosage of more than 100 micrograms daily of selenium requires medical supervision. However, It is possible that one can get more selenium from foods if lots of garlic, onions, whole grains, mushrooms, broccoli, cabbage and fish are included in meals.
Folic Acid
Deficiency of folate (the naturally occurring form of folic acid and a form of vitamin B complex ) can be caused by some anti-epileptic drugs sometimes leading to abnormalities in red blood cell formation. Folate deficiency can also lead to serious birth defects called neural tube defects which happen very early in the pregnancy, often before a woman knows she is pregnant.
It is therefore advisable any woman of childbearing age who is taking anti-epileptic drugs should also take 1,600 micrograms of folic acid a day. And any woman taking anti-epileptic drugs and planning to become pregnant should take three milligrams (3,000 micrograms) of folic acid every day for three months before she stops using birth control. Such high amount of folic acid requires a prescription supplement. A few doctors recommend up to 5,000 micrograms a day for adults. Others taking anti-epileptic drugs should take 400 micrograms which is the amount of folic acid found in ordinary multivitamin/mineral supplements. Some experts say that children ages 5 to 15 may safely take up to 2,500 micrograms daily under doctor's recommendation.
Make sure that you are under a doctor's supervision when taking more than 400 micrograms, because high amounts of folic acid can mask the symptoms of vitamin B12 deficiency such as pernicious anemia.
Other nutritional supplements that may be useful in epilepsy.
| SUPPLEMENTS | AVERAGE DOSAGE | COMMENTS |
| L-Taurine & L-tyrosine (amino-acids) | 500mg three times a day | Important for proper brain function. |
| Magnesium ( Magnesium Chloride) | 700 mg taken between meals on an empty stomach with apple cider vinegar or betaine HCL. | Use magnesium chloride (an excellent source of magnesium) |
| Vitamin B6 ( Pyridoxine ) | 100-600 mg daily in divided doses under supervision. | All B vitamins are extremely important in the central nervous system. |
| Vitamin B12 | 200 mcg. dissolved under the tongue twice daily, on an empty stomach. | |
| Calcium | 1500mg daily | Important in normal nerve transmission. |
| Vitamin B complex with extra vitamin B6 and vitamin B12 and folic acid and pantothenic acid and niacin |
50mg daily | Important in nerve transmission. Injections of vitamin B complex under doctor's supervision may be necessary |
| Zinc | 50-80mg daily | Valuable in RNA/DNA synthesis |
| DMG (Gluconic from DaVinci Labe) | 50 mg under the tongue in the morning and at night | Stimulates immune response |
| Germanium | 200mg daily | Improves cellular oxidation. |
| Chromium (GTF ) | 200mcg daily | Important in cerebral sugar metabolism. Picolinate form is effective. |
| Kelp or alfafa | 5 tablets daily | For necessary mineral balance. |
| Proteolytic enzymes and digestive enzymes | Take between meals | |
| Raw thymus concentrate and thyroid extract | As directed on label. | Both the thymus and thyroid are important in proper brain function. |
| Vitamin A | 25,000 IU daily. | An important antioxidant that aids in protecting brain function. |
| Vitamin C plus bioflavoids | 2000-7000mg daily in divided doses. | Vital to functioning of adrenal gland, which is the anti-stress gland. |
In addition to the above Supplements,
Herbs like Pricky Ash, Uncaria rhynchophylla, Clove, Piperine (black pepper as folk remedy), Anise, Valerian, Star Anise, GoldenSeal, and Jujube (folk remedy), is said to have anti-seizure effects.
Eat soured milk products like yogurt and kefir. Drink juices made from green vegetables, peas, green beans, seaweed, beets, carrots, and red grapes. Include raw nuts, seeds, chard, beet tops, soybeans, green leafy vegetables, eggs raw milk, and raw cheese.
Eat small meals, don't drink a lot of liquids at once, and take two tablespoons of olive oil daily (believe to reduce response to stress).
Aluminum toxicity and lead poisoning may associate with seizure. Large amount should be avoided.
Literature reivew reveals 11 plant oils to cause convulsions (eucalyptus, fennel, hyssop, pennyroyal, rosemary, sage, savin, tansy, thuja, turpentine, and wormwood) related to their content of highly reactive monoterpene ketones
Herbs like Borage, Evening Primrose Oil, Hops, Anise (higher dose than recommended), Ephedrine, Bearberry, and Western Red Cedar should not be used in epilepsy.
ALWAYS check with your physician or pharmacist before combining prescription or over the counter drugs with your prescribed anti-seizure medications.
Posted on 9th May 2001
References:
1. Vitawise.com
2. HerbMed.org
3. Nutrition in comprehensive program planning for persons with developmental disabilities J Am Diet Assoc. 1997;97:189-193.
4. Pyridoxine-dependent seizures in an older child. J Child Neurol 1999 Oct;14(10):687-90
5. Oxidative stress and antioxidants in epilepsy. Clin Chim Acta 2001 Jan;303(1-2):19-24