The Angry Grandma

Or why old folks get angry as they age and what can be done about it

Type in ANGRY GRANDMA in your web browser and you come up with a YouTube star simply named ANGRY GRANDMA.  She reportedly has been featured on YouTube by her grandson since 2013 and viewed 39 million times.  She comedically talks a lot of cuss words, so I won’t provide the direct links.  But in real life a lot of grandkids report their grandmothers and grandfathers are more than just cranky, they are a-n-g-r-e-e.  That means more than ornery.  Often the very reason these elderly family members have been institutionalized is because they are so combative.  About 6% of nursing home patients are classified as combative.  But there are a lot more than that.

Anger interspersed with mental depression is commonly observed in nursing home patients. One reason for their anger is that they have been placed in a nursing facility and they want to go back home.  They simply medically sedate these people in nursing facilities, they haven’t a clue how to manage them beyond Xanax.

According to surveys, around two-thirds of nursing home patients are on sedatives, which have terrible side effects.  Among side effects of these drugs are insomnia, poor balance, slurred speech, dizziness, irritability, amnesia, the very reasons why they were institutionalized in the first place.  These sedatives also induce shallow respirations and poor lung expansion to the point where life-threatening pneumonia develops.  Eldercide by another name.  Nothing like culling the population of these helpless but feisty seniors.  Doctor Yourself: Natur... Andrew W. Saul Best Price: $15.00 Buy New $18.21 (as of 10:15 EST - Details)

They are said to be agitated, which means they exhibit aggression, shouting, and sometimes disinhibition.  But these behavioral problems are not due to a drug deficiency, which is the way it is addressed by modern medicine.

There is a cadre of doctors, pharmacists and nursing homes that, for profit reasons, want to make sure your loved ones never become sane and are never discharged.  Keeping the beds full is the unstated goal.

These drugs aren’t meant to be used long term as they increase the risk for accidents, falls, broken hips and worse.  Polypharmacy (too many drugs) is all too common.

The average age these drugs are first prescribed is 78 years of age.

Family members are often exasperated in dealing with an angry loved one.

Here is what one young daughter had to say about her angry mom:

“My mother threatens me all the time. It’s exhausting and it makes me sick. I don’t know what to do. My mom is only 60 and may live for another 20 years. I refuse to deal with her before I’ve even had a chance to have a life.”

What’s going on inside grandma and grandpa’s brain that makes them so angry?

Over-simple answer:  there is a homocysteine storm in their brain.

What is homocysteine?

The rise and fall of Dr. Kilmer McCully

Homocysteine (ho-mow-sis-ta-een) is what Dr. Kilmer McCully had linked to many disorders of aging including heart disease as well as mental issues.  In May of 1997 Dr. McCully’s book THE HOMOCYSTEINE REVOLUTION: MEDICINE FOR THE NEW MILENNIUM was published.  For years Dr. McCully was almost a lone voice in homocysteine research said a New York Times article.  Of course, Big Pharma didn’t like the conclusion of his studies.  Big Pharma was promoting cholesterol control as the paradigm of modern medicine.

Forget the Dr. McCully had found the narrowing of arteries in carotid (neck) arteries that facilitate delivery of oxygen to the brain are narrowed (called carotid artery stenosis) due to elevated homocysteine.  The higher the blood serum levels of homocysteine the greater the risk for narrowing of carotid (neck) arteries.

Elevated homocysteine is a result of a deficiency of vitamins B6, B12, B9 (folate or folic acid) and betaine.

Homocysteine is a sulfur-based amino acid internally produced in the body from the metabolism of methionine. Methionine is largely consumed from animal sources like meat, eggs and milk.  B vitamins break down homocysteine into harmless waste products.

Let’s get back to answering the question of why grandma is angry.  High homocysteine blood levels are associated with hostility and anger.

Outbreaks of anger and hostility have been found to precede bouts of mental depression, but not vice versa.

Type A personality, characterized by being more likely to be angry or impulsive, is associated with heart disease.  But the underlying cause for this trait may be high blood plasma levels of homocysteine.  Patients with high anger scores and higher blood levels of homocysteine are more likely to undergo invasive cardiac procedures.  Adults with the lowest anger control exhibit higher risk for fatal and non-fatal heart disease.

Not only does homocysteine adversely affect blood circulation to the brain, it is linked with brain shrinkage.  And homocysteine was linked with a weakening of the blood-brain (BB) barrier over a decade ago.

This protective BB barrier blocks toxins, pathogenic germs and other inflammatory factors including albumin from entering the brain.  Only recently has it been shown that albumin, a normal volumizing protein in the blood circulation, is then allowed to enter the brain where it wreaks inflammatory havoc and creates a memory-impairing brain fog.

An alarming study published in 2004 reported that many meat/dairy-eating men develop elevated homocysteine levels in middle age and begin to exhibit impaired memory and a decline in brain volume ahead of women.  But at that time, doctors kept beating the cholesterol drum.  Everybody knows about cholesterol and statin drugs.  Homo-what do you call it?  Few are as familiar with homocysteine as they are cholesterol.

What else has been going on with B vitamins?

Something very big has been going on with B vitamins in the past three decades that demands mentioning.  This writer has to momentarily drift away from the main theme of this report, vitamin deficiency-induced anger, to inform readers that something very important was going on in the B-vitamin world at the time Dr. McCully introduced homocysteine as a disease-causing protein three decades ago.

After years of foot dragging, folic acid was fortified in food beginning in 1998, but not because it lowers elevated homocysteine levels but because of birth defects (spina bifida and anencephaly). From 1998 forward folic acid was fortified in foods.  Thereafter these birth defects steeply declined.

Advice that pregnant women take folic acid supplements was effective but nearly a quarter of sexually active fertile women (22.8%) still did not have sufficient blood levels of B9 to prevent birth defects, so food fortification was mandated.  Fortification prevented ~1300 birth defects annually.  Another report says folic acid food fortification reduced birth defects by 614-767 cases annually at a savings of $299-603 million a year.

But even universal food fortification has not totally eradicated this abnormality.  Mothers on low carbohydrate diets have ~30% increase in their offspring experiencing a birth defect.  Folic acid is fortified in flour.  Bread is a common carbohydrate.

Over two decades of safe food fortification has now led researchers to advocate for abandonment of a “tolerable (safe) upper intake level” (1000 micrograms/1 milligram) of folic acid.

Even with food fortification, about a quarter of the U.S. population has suboptimal red blood cell folate concentrations (2017 report).  Vitamin supplementation is still recommended for women of child-bearing age.

In four short years after food fortification bean health authorities reported that the percentage of Americans who consumed insufficient amounts of folic acid decreased from 48.6% to 7.0% from before to after food fortification while the prevalence of insufficient vitamin B9 intake among vitamin supplement users was always less than 1% both before and after food fortification began.

The stated reason why the Food & Drug Administration drug its feet for many years before it finally mandated vitamin B9 supplementation is that folate/folic acid can mask a vitamin B12 deficiency.  Only recently has it been shown that a shortage of vitamin B12 is also associated with birth defects.

Disease investigators report there are birth defects that are not responsive to folic acid.  Animals deficient in another B-family nutrient, inositol, prevents spinal and cranial defects in offspring.  Coffee beans and coffee as a hot beverage depletes inositol via inhibition of absorption.  Heavy coffee consumption may raise blood levels of homocysteine.

Researchers conclude inositol should also be provided to prevent B-vitamin related birth defects.  In fact, the remaining folic acid-resistant cases of spina bifida are believed to be explained by inositol deficiency.

A form of inositol (myo-inositol) is abundant in grains (bran), nuts and fruits.  Americans consume ~ 1 gram (1000 milligrams) of inositol per day.  All major brain chemicals (neurotransmitters like dopamine, serotonin, acetylcholine) use inositol in their brain signaling.  So now you realize this report goes full circle from brain/behavior problems to birth defects and back.

Health habits and elevated homocysteine

Smoking, alcohol intake, advancing age, and low vitamin B12 blood levels are strongly associated with anger attacks.  Tobacco and alcohol are major vitamin blockers.  Smoking tobacco increases homocysteine blood levels, apparently via  depletion of folic acid and vitamin B12.

Excessive alcohol intake excites a homocysteine storm in the brain.  That is what induces a hangover among binge drinkers.  Alcohol consumption lowers B vitamin blood levels and increases homocysteine.

A decline in stomach acid secretion further induces many vitamin deficiencies in older adults.  Highly acidic betaine, a common dietary component, directly reduces homocysteine levels in the brainRelatively low dose of supplemental betaine (1500 milligrams) has been found to significantly reduce blood plasma homocysteine levels.

Men and women

In one study of 60-70-year old women, 17.4% had high homocysteine levels.  The lowest blood levels of folate (B9) had 23% higher homocysteine levels.

In another study the prevalence of high homocysteine levels (more than 15 micromole/liter of blood serum) was found to 23.4% in elderly males and 11.2% for elderly females.  A combination of a folate/folic acid and vitamin B12 deficiency increases risk for high homocysteine by 3 times!

Another study shows high homocysteine levels are correlated with hostility and anger only among men.

Now is there any wonder why there is an army of angry senior adults housed up in nursing facilities?

Children too!

The relationship between anger, hostility and aggression and nutrients is not limited to the elderly.  It is estimated 1 in 20 children and adults exhibit these behaviors.  Analysis links inositol (as inositol triphosphate or IP3) with relevant expression of angry temperament.

Primary factors

Most of the variability in blood plasma homocysteine levels is explained by five factors: (1)advancing age, (2) folic acid/folate levels, (3) albumin, (4) use of diuretics that wash out B vitamins, (5) and failure to clear creatinine via the kidneys.  But what about vitamin B12 deficiency that is masked by folic acid?

Further investigation reveals the two key nutrient deficiencies associated with high homocysteine blood plasma levels are folic acid/folate and vitamin B12, which are predominately problems found in aged adults.

Zinc too

Low circulating zinc levels are also associated with the incidence of birth defects.  Low zinc levels are now associated with anger levels in women.  How to Live Longer and... Pauling, Linus Best Price: $3.99 Buy New $11.70 (as of 04:15 EST - Details)

A study published in the European Journal of Clinical Nutrition reveals zinc supplementation reduces anger and mental depression in young women.

Zinc and multivitamins with zinc are associated with a reduction in anger-hostility scores.

Other nutrients

There are other nutrients that help curb high homocysteine levels.

Hydrogen sulfide gas, produced by garlic molecules, is an antidote against high homocysteine levels.

Supplemental vitamin D and sunshine may be a therapeutic strategy to counter homocysteine in the brain.

Vitamin C is an independent factor in elevated homocysteine.

Resveratrol, the red wine molecule, is reported to decrease homocysteine levels.

Advice

Take a multivitamin with B vitamins, zinc, vitamins C & D, and maybe extra inositol if a coffee drinker.

Don’t become a crotchety old fart.  If your loved ones are on the angry side and don’t like taking vitamins, sneak them into a glass of tomato juice or their food.  B vitamins taste terrible, so if you have to covertly add them to your foods or beverages, make sure they mask the bitter taste of B vitamins.  Take your vitamins, or else!