I do not take Centrum multivitamins, as they contain fillers and artificial coloring. I do however take Now Foods multivitamins. I doubt there is any particularly great effect from the Centrum product specifically.
Lupus Fog Treatment? Vitamin Improves Memory in Research
Finding an effective lupus fog treatment remains elusive. Yet, a 2023 study called the COcoa Supplement and Multivitamin Study Web Ancillary Study showed that taking Centrum Silver may improve memory. This study does not prove that Centrum Silver improves memory, as we never want to trust the results of just one study. However, its results are intriguing, and a larger study should be conducted. This post discusses the results of this study.
Lupus Memory Problems and Lupus Fog Treatment
Although the numbers vary from study to study, around 50% of systemic lupus erythematosus (SLE) patients have memory problems. If you want to search for medical studies on the subject, search for “cognitive dysfunction.” This is a broad medical term that includes memory problems. The lupus community often calls cognitive dysfunction “lupus fog.” Due to this, patients often ask me for a lupus fog treatment. Of course, they want an easy treatment and often ask if a vitamin improves memory. There are some interventions that research shows may help. I discuss them in the video below. Though the video is from 2014, 95% of what I talk about holds true today in June 2023.
Treatments that show the best evidence for helping memory from the video are still true today, until we discover better treatments:
- Regular moderate, aerobic exercise
- Cognitive training (commonly called brain games)
- The American Academy of Neurology recommends the above two in their Practice Guidelines for Mild Cognitive Impairment
- Anti-inflammatory diets, like the Mediterranean diet, may help
- Many of the lifestyle changes recommended in the Lupus Secrets
Vitamin Improves Memory in 2023 Study
New research can always change true knowledge. Oftentimes, the proper studies are not done to answer important questions. For example, though diets, as mentioned above, may possibly help memory, they are not proven. It is hard to force people in a research study to eat only what you want them to eat plus make 100% sure that they do. Unlike laboratory mice, we cannot cage people up in cages for a couple of years to ensure they eat only what we give them.
May 24, 2023, experts released the results of a study called the COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web) ancillary study. Brigham and Columbia University (highly acclaimed universities) did the research. They blindly randomized 3562 older adults to take either Centrum Silver (a multiple vitamin) daily or a placebo. By the way, I do not get any compensation from Centrum to mention their product. They then gave them numerous neuropsychological tests (including memory tests) over 3 years.
Those who took Centrum Silver did significantly better on a test for “immediate recall performance.” A previous large study performed in collaboration with Wake Forest University called the COSMOS-MIND study also showed that taking a multiple vitamin improves memory (the cocoa supplement did not).
Will I Recommend a Multiple Vitamin as a Lupus Fog Treatment?
In the video above, I state, “Don’t waste your money on multiple vitamins.” As of today, 6/17/23, the section on memory (mild cognitive impairment, MCI) in UpToDate states, “No medications or dietary supplements have been shown to have symptomatic or preventive benefits in patients with MCI.”
Based on these results, I will stop saying “don’t waste your money on multiple vitamins.” Instead, I will recommend taking them daily along with regular exercise and a healthy diet to help as a lupus fog treatment. I am glad that I already take Centrum Silver daily myself.
Downside of Recommending a Vitamin as a Lupus Fog Treatment
The researchers performed the above research on older adults. The doctors did not study lupus patients. Since lupus fog treatment may be different, because the causes of lupus fog are most likely different (involving abnormalities of the immune system), these results may not apply to lupus patients. However, older patients most likely have memory problems partly related to decreased brain blood flow due to hardening of the arteries, and hardening of the arteries probably also plays a key role in lupus fog, Centrum Silver may actually be a good lupus fog treatment.
A Harvard Professor says that a Vitamin Improves Memory
Dr. JoAnn Manson, Professor of Medicine at Harvard Medical School and Brigham and Women’s Hospital said, “… the finding that a daily multivitamin improved memory and slowed cognitive decline in two separate COSMOS randomized trials is exciting, suggesting that multivitamin supplementation holds promise as a safe, accessible, and affordable approach to protecting cognitive health in older adults.” As a possible reason a vitamin may work, she says, “… we know the brain requires several nutrients for optimal health, and deficiencies in one or more of these nutrients may accelerate cognitive decline. Some of the micronutrients that are known to be important for brain health include vitamin B12, thiamin, other B vitamins, lutein, magnesium, and zinc.”
For more in-depth information on memory problems in lupus and how to help in greater detail:
Read chapters 13, 38, an 39 of The Lupus Encyclopedia, edition 2
Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia.
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If you have memory problems, cognitive dysfunction, or “lupus fog” from lupus, what has your experience been? What do you recommend for other patients?
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8 Comments
- ARW
- Nardine Daniels
I am taking a Citrical +D3 that has 400 mg Calcium, and Centrum Silver Women that has 300 Mg Calcium. What is the maximum amount of calcium that a person should be taking daily? My Primary Physician mentioned that too much calcium may cause kidney stones.
- Donald Thomas, MDModerator
Nardine: This is a small amount of calcium. The worse case scenario would be someone with a history of known calcium oxalate or calcium phosphate stones. Those patients are recommended to limit their calcium intake to 1000 mg or less per day. So they should keep track of food sources as well as supplement contents. Patients without calcium stones generally do not need to worry while eating a healthy diet.
However, ask your primary care doctor as as they know your entire history better and can give you exact recommendations.Donald Thomas, MD
- Marlene Raper
Thank you Dr. Thomas for all of the helpful information you share, I am very grateful.
Several years ago I had been taking a B100 vitamin and became toxic with vit b6 so my neurologist told me not to take b6 supplements anymore. I wanted to share my experience to help others be aware that that can happen with Vit B6 and to have those levels check periodically to prevent that from happening. I do take b12 and now b2. I have SLE and have been positive for APS antibodies, over several years, I do get brain fog and for the past year and a half or so I have had a big increase of migraines with flu like symptoms.I have learned about the connection between migraines and antiphospholipid antibodies and I am wondering if you have any information on migraine treatments for APS positive lupus patients you have used for your patients going through this type of situation. I do currently take hydroxichloroquine and 81mg asprin. My neurologist prescribed verapamil which I haven’t started yet. If you know of any studies or have any info to share I would really appreciate it as having migraines so often has been very challenging.- Donald Thomas, MDModerator
Marlene: For what it is worth, I have one patient with recurrent ocular migraine and triple APLA positivity. Her migraines got much better on Benlysta (so, just one anectdotal report).
There are reports of using the blood thinner heparin for APLA-related migraine: https://academic.oup.com/qjmed/article/94/2/114/1518527
Warfarin has rarely been used: https://medicine.umich.edu/dept/intmed/what-are-aps-headaches-what-can-i-do-manage-them
However, blood thinners carry risks of bleeding. So, it should be considered a treatment of last resort.
Thanks for reading my blog and commenting.
Donald Thomas, MD
- Myung-Sin
Thank you so much for such a helpful information, Dr Thomas. I’ve been battling with lupus fog and cognitive issues for many years. I tried many things. Per your recommendation, I exercised. I recently came across Phosphatidylserine and was wondering if there is any study conducted on lupus brain fog and cognitive function. Do you have any insight on this? Thank you very much in advance.
- Donald Thomas, MDModerator
Myung-Sin: I am not sure about phosphatidylserine. However, the OTC supplement NAC may possibly help lupus disease activity, fatigue, and lupus fog:
https://www.lupusencyclopedia.com/fatigue-in-lupus-sjogrens-other-ai-diseases/
Don Thomas, MD
- Myung-Sin
Thank you very much, Dr Thomas! Wish you a Happy New Year!
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