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Homocysteine Level (New Thread)
But before I do I came across the following today which is easy to read and ya never know maybe of use to someone.
WHY ARE B12 & FOLIC ACID SO IMPORTANT? These nutrients are especially critical for 2 reasons: 1 - There are so many conditions & commonly used drugs which deplete them or interfere with their absorption 2 - The deficiency of either can go undetected to cause great damage & suffering. These 2 nutrients are addressed together because when supplementing one, the other must also be supplemented, again for 2 reasons: 1 - If there is a B12 deficiency & only folic acid is taken, it can mask some of the blood changes & clues that a B12 deficiency exists. Such masking can allow progressive & irreversible damage to take place in the brain, spinal column, & peripheral nerves. Further, folic acid must be present for the proper use of B12. 2 - Many of the same factors contribute to deficiencies of these 2 nutrients. WHAT SPECIAL CONDITIONS REQUIRE ASSURED AMOUNTS OF B12 & FOLIC ACID? The only non meat foods containing B12 are eggs, blue-green algae, & nori seaweed, so vegetarians are at risk for deficiency. Those with low thyroid function have impaired B12 absorption, while those with high thyroid function have excessive loss of B12. Most with stomach /GI disturbances are at risk, whether it be from intestinal malabsorption, inflammatory diseases, chronic diarrhea, parasites, tapeworms, low stomach acid, gastrectomy, or the depletion of a protein called “intrinsic factor”, secreted in the stomach by what are called parietal cells. Intrinsic factor only exists to extract B12 from food. Auto immune illnesses can act in the stomach, to prevent production of or to bind the intrinsic factor preventing B12 absorption. Such people may have anti-parietal cell antibodies which can be easily found on a blood test. As if absorption weren’t a big enough problem, there may be defects in molecules which transport B12 from the blood to the tissue, so though serum levels look normal, the cells are deficient. There are 12 different inherited disorders which affect absorption, transport, or intracellular metabolism of B12. High mercury , lead or other heavy metals which can reduce B12 uptake in the cells. A significant percentage of my patients have metal toxicity. For more see the Metal Toxicity Newsletter. The elderly are at risk, because B12 absorption is known to decrease with age. Also they are more likely to be low in folic acid, iron, calcium, & vitamin B6 which contributes to depleted B12. They are more likely to have low stomach acid, or to be on acid blockers which impair absorption. They use more laxatives which deplete the storage of B12. Research suggests that elderly people with “normal” serum B12 levels are still metabolically deficient in B12 & often respond positively to the addition of B12. Pregnant & nursing women, as well as infants need extra amounts of B12 / folic acid Alcoholics notoriously are deficient, as well as those with anorexia, malnutrition, general illness states, or chronic stress. Those with AIDS, or asymptomatic HIV are often compromised re B12 status. This occurs at an early stage of the infection. Such low levels are associated with acceleration of the disease , while adequate B12 treatment is correlated with increased CDT4 cell counts & improved AIDS index. Studies suggest B12 deficiency may both increase susceptibility to catching the virus in the first place & promote the progression to AIDS. When HIV positive & B12 deficient the progression to AIDS will come 4 years sooner. The “poppers”, an alkyl nitrite inhalant “recreational” drug can inactivate B12. The use of “poppers” has long been associated with susceptibility to HIV infection. It is believed there is a B12 deficiency in about 50% of all AIDS cases. Those with mental, or emotional illness, or retardation may also be vulnerable to low levels. Besides helping to maintain the structural integrity of the brain & nerves, B12 & folic acid are needed for the synthesis of the essential neurotransmitters serotonin, norepinephrine, & dopamine. These are critical regulators for mood, sleep, appetite, drive, motivation, movement, cognition & numerous brain functions. Studies have shown certain people with “treatment resistant” depression responded well to folic acid treatment, which also potentiated the effect of Prozac & helped to protect against side effects. WHAT DRUGS/SUBSTANCES CAN CAUSE LOW B12 AND FOLIC ACID? Besides antacids & laxatives, other drugs they which deplete B12 are Aspirin, & the other salicylates, Tricosal, Trilisate, Arthropan; diuretics such as Bumetanide, Ethacrynic Acid, Furosemide, & Torsemide; & steroid medications. ( Be sure to check generic names on your drugs) High dose vitamin C supplementation without the addition of B12/folic acid can contribute to deficiency. Birth control pills decrease both B12 & folic acid. This is of particular significance if a woman then decides she wants to get pregnant & stops birth control pills without starting supplements. It is well know that the birth defects of spina bifida, cleft palate & lip are caused by low folic acid levels in the mother, especially in the first 6 weeks of pregnancy. A B12 deficient infant will suffer severe developmental abnormalities. Many of the same conditions which deplete B12 also decrease folic acid. The drugs which contribute to folic acid deficiency are many of those used to treat seizure disorders, such as: barbiturates, Tegretol, Depakote, Zarontin, Celontin, Primidone, Dilantin, & Fosphenytoin; many of which are also used in the psychiatric population. The whole class of non-steroidal anti-inflammatory meds such as Ibuprofen, Anaprox, Motrin, Naprosyn, Naprelan, Pamprin, Voltaren, etc deplete folic acid. Other culprits are drugs used for stomach problems & esophageal reflux, such as Pepcid, Axid, Tritec, Cimetidine & Zantec; the immune suppressants Methotrexate , Azulfidine, & steroids; Indomethacin; Viox; Aspirin & the other salicylates; Colestid; WHAT ARE THE ACTIONS & DEFICIENCY SYMPTOMS OF B12 & FOLIC ACID? Depression Mental lethargy Withdrawal Irritability Poor memory Confusion Dementia Psychosis-paranoia Insomnia Digestive disturbances Diarrhea Weakness Numbness Stiffness/spasticity Headaches Restless legs Burning feet Increased sensitivity to pain Sore tongue Lesions at corners of mouth Anemia (megaloblastic) Shortness of breath Low white blood cell count Lowered resistance to infection, decreased antibody formation Graying hair Toxemia of pregnancy Premature births Increased risk of certain birth defects Sprue Weight loss Anorexia (appetite loss) WHAT IS THE HOMOCYSTEINE CONNECTION? Those who read health articles in the general press have likely come across information about homocysteine. Homocysteine is a normal necessary substance in the body produced from the metabolism of an essential amino acid called methionine. (All amino acids are components of protein). The homocysteine, in turn, converts to a detoxifying amino acid called cysteine, a substance called ATP which is critical in producing energy in the cells, SAMe & also back to methionine. This occurs when all is working as it should be. But these conversions do not take place properly if adequate amounts of B12, Folic acid, & Pyridoxal 5 phosphate (B6) , are not present. When the homocysteine does not metabolize properly , it then accumulates to unhealthy high levels & becomes a silent formidable enemy. Elevated levels of homocysteine are associated with a greater risk for cardiovascular diseases such as heart attacks, peripheral arterial disease, strokes, venous thrombosis, & carotid artery stenosis. In fact, the homocysteine level is the strongest predictor of both overall mortality from any cause & mortality from cardiovascular causes. Cardiovascular disease accounts for 43% of all deaths in the U.S. Excess homocysteine is directly toxic & damaging to the walls of the blood vessels which helps lead to atherosclerosis. It also stimulates an inflammatory substance in the platelets called thromboxane which helps cause clots. It may also contribute to the oxidation of LDL. (Imagine how much good could be done if all cardiologists included a multivitamin mineral, B12, folic acid, extra B6, co-enzyme Q10, & policosonal in their treatment plans!) Excess homocysteine also contributes to the development of Alzheimer’s, arthritis, & diabetes. A new study in the New England Journal of Medicine involving 1092 subjects over the course of 8 years found that for every 5 micromoles /l increase of homocsyteine the risk of dementia or Alzheimer’s was increased by 40%. Homocysteine levels over 14 nearly doubled the risk of Alzheimer’s. Clearly homocysteine is not the only contributing factor to these illnesses, but plays its deadly part. Interesting other studies have shown high levels to be associated with miscarriage, which was corrected when the women were supplemented with folic acid 15mg daily & B6 750 mg daily, which are quite large doses. Another study showed levels greater than 6.3 were associated with an increased risk for cervical cancer. WHAT TESTS CAN BE DONE TO SEE IF THERE ARE DEFICIENCIES? One can get a homocysteine blood test by itself, or a panel such as the Comprehensive Cardiovascular Assessment, which contains this test as well as numerous other evaluations for cardiovascular risk. The optimal safe range for homocysteine is less than 6, the lower the better. The most exciting & informative new test which has just become available,is the Cardio Genomic Profile http://www.genovations.com. This test identifies gene variations which foretell the increased likelihood of developing cardiovascular disease. It can identify if you are at risk for the development of high homocysteine so you can really act preventatively. The test identifies your genetic risk for increased blood clotting, increased blood pressure, cholesterol imbalance, & inflammatory cardiovascular disease. It is also useful if you already know you have these problems, because it tells you how to change your genetic predisposition! You can then retest in several months to make sure mission accomplished. The test can be done at home by collecting mouth wash samples & sending in the kit. The DNA in buccal cells is analyzed. You would have to ask your Dr to order the kit. Because it is so new, insurance does not yet cover it, so if that is an issue, you might use some of the other tests mentioned here-but this is my current preference. Many Drs only order a serum B12 & serum folic acid test. If these are normal, they consider all to be fine in this arena. This is simply not true. These tests are only useful when they are low, which then indicates a substantial deficiency. Numerous studies have shown a positive response to treatment with B12/folic acid, when the blood levels were normal. The amount in the blood tells nothing about transport to, uptake, or utilization by the cells. A useful indirect measurement of B12 deficiency is the urine or blood methyl malonic acid test. When this substance is elevated, there is a B12 deficiency. A complete blood count (CBC) can be useful in those people who manifest blood changes, but not all do. In fact, one can be sufficiently low to exhibit neurological damage without showing any blood cell changes. Again, when there is overt anemia of what is called the megaloblastic or macrocytic type, there is likely a B12/folic acid problem. But it is useful to look for more subtle signs such as low normal total number of red blood cells, large red blood cells(high normal MCV) , low normal total number of white blood cells, low normal platelets, or low normal neutrophils ( a type of white blood cell). There is a good blood test called the Functional Intracellular Analysis. WHAT FORMS OF B12/FOLIC ACID ARE BEST TO TAKE? Vitamin B12 comes in several chemical forms & folic acid in two forms. The most common & least expensive B12 is cyanocobalamin. This is fine to use for basic supplementation. And plain folic acid is fine for a basic program. There are also the methyl-, hydroxy-, & adenosyl- cobalamin forms of B12 which are more expensive & previously have been less available. Dietary or supplemental cyanocobalamin converts in the body to the other forms listed here, especially Methylcobalamin (MeCb). Folic acid must be present for this conversion to take place. The folic acid must be in the coenzyme form called L- 5 methyl tetrahydrofolate. A properly functioning body would have converted regular dietary or supplemental folic acid to this coenzyme form. When there are diseases, sometimes the folic acid does not convert properly, & one would have to supplement with the L-5 methyl tetrahydrofolate instead. The methyl cobalamin (MeCb) is the most active form of B12 in the body, especially in the brain & nervous system. There is the belief the MeCb has some therapeutic applications not as well achieved by other forms of B12. MeCb is also utilized more efficiently & has better tissue retention. For this reason much of the recent research has been done using this MeCb. Some of the research uses the injectable, some the sublingual form. When possible, I suggest a combination of the 2 when one is treating a significant health problem. At the risk of going on interminably, can’t help but think some would like examples of when to use these supplements in higher doses, so WHAT ARE EXAMPLES OF WHEN YOU WOULD USE HIGHER THERAPEUTIC DOSES? . Those with: Pernicious anemia, an inherited defect in the absorption of B12, or with any anemia associated with large red blood cells. High levels of MeCb are needed to regenerate nerve cells & the covering of the long nerves, called myelin sheath. MeCb also protects against neurotoxicity. Thus those with a variety of neurological disorders may respond well. In studies on Bells Palsy (a painful condition the facial nerve), patients treated with 1.5-6 mg MeCb daily recovered in an average time of 1.95 weeks. Those treated with the usually prescribed steroids took an average of 9.6 weeks to recover. Parkinson’s patients. Oral MeCb helped to delay the progression of Parkinson’s & to maintain a longer benefit from Sinemet (a drug for Parkinson’s) Those with ALS (Lou Gehrigs Disease), Multiple Sclerosis(doses up to 60 mg/d for this) Muscular Dystrophy, Peripheral Neuropathy, restless legs, neurological aging, dementia, depression, psychosis, mood swings. Infertile men treated with 1.5-6mg daily experienced a 38 % increase in sperm count & 50% increase in sperm motility. Those with chronic fatigue, fibromyalgia, burstitis. Those with immune disorders of any kind. Those with asthma. Those with liver disorders. Women with abnormal PAP smears. Those with sleep/wake cycle disorders, or those with excessive sleepiness. Those with a family history of colon cancer. Those with vitiligo. Those with chronic myelogenous leukemia have overall increased cobalamin levels, but a decreased proportion of methylcobalamin compared to normals. The lower the proportion of MeCb, the worse the prognosis, the higher the proportion the better the prognosis. ( Also MeCb improved the survival time in leukemic mice). The form used in the above research varied between injectable & sublingual, but all was with methylcobalamin. All was in the dose range of 1-6 mg daily. Remember these vitamins are usually listed as micrograms, so would take 1000 mcg to make 1 mg. Research doses of folic acid have ranged from 1-20 mg/daily. until next time, Peace, Love & Health... Priscilla Slagle M.D. http://www.thewayup.com/newsletters/041502.htm |
Lots of very good information there. One note: please do not anyone depend on algae or seaweed for their B12.
In fact, what one might get is B12 anologues that are measured in a B12 test but that are unusable. rose |
Forgot to mention: Stomach acid breaks B12 out of food.
Then intrinsic factor escorts the B12 it to the ileum. :)
rose |
seems like I am not going away ---- yet!
Quote:
One other question please has to do with bleeding gums....... is this a know symptom of B12 deficiency? Would that be a B12 problemo or a Folic problemo? of possibly both in your estimation? Should I move these questions to a new link.... or will thy normally be found by other's Rose. Thanks again oops that was more than one added question - arghhhh always bad at math:winky: |
Wow, that was a great article on homocysteine. I found out a few weeks ago my level was too high and was told by the hematologist to take a vitamin with folic acid, b12 and b6. I'm hoping this may be the solution to my problem with major depression for the past year or so. I was diagnosed with factor v leiden (blood clot gene) in August which was why I went to the hematologist in the 1st place. My fingernails, just as in Clare's picture have been bluish around the cuticle, my moons have disappeared. I have been cold to the point I had my heater on in my office while everyone had the air on. And sore tongue? My tongue would look as if it were peeling. And I would get bumps on it that hurt that I couldn't eat anything. And people (including my doctor) don't believe you when you tell them what is bothering you. I feel as if I have been dismissed so many times. Thank you for the article and hopefully with the vitamins I can finally get myself back in order.
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:) you are welcome I enjoy finding things and learning.
You are fortunate that a doctor actually checked your Hcy level.... U in the USA? I am in Ozzy land and down here it is still NOT a usual blood test..... I had to ask my GP and agree to pay for it myself........ I should get the results back next week along with the MMA results. I am hoping they will show that I do actually have problems with my B12/metabolism. I am not familiar with the disorder you have...... but hopefully your doc will keep a close eye on your other readings. Nice to have met you :grouphug: |
Hello to Clare in Ozzy land
Hi Clare,
Nice to meet you as well. Yes, I am in the US. Factor V Leiden is a blood clot mutation gene which increases your risks of developing blood clots. The reason why I was tested for it was because my brother tested positive for it after my father passed away suddenly from a pulmonary embolism in May. Since then another brother has tested positive. I went to a hematologist and he ran another series of tests one of which was the homocysteine level. (This is not a normal bloodtest here either. I never heard of it before.) This came back high which he said was an indicator my blood was forming bloodclots and an early warning sign of heart disease. He told me to start taking folic acid, b12, and b6 which I could get from taking vitamins. He said that should help. I have to go back in 3 months. I also have a problem with my thyroid. Did you ever have yours tested? Good luck with your test results. I hope the doctors find some solutions for you! Take care of yourself! |
homocysteine
You sure are fortunate to have a doctor who checked it. More are, but it amazing how many still don't.
I hope the doc specified that you take at least 1000 mcg B12. I hope also that the vitamins get you down into the lower half of normal for homocysteine. That is desireable. I don't know about the gums specifically, but I do know that low B12 can cause abnormal bleeding. Of course other things can too, even failure to floss. :eek: I hope you will get copies of all test results. No one will be willing to spend the time exploring patterns, etc., that you will. And it is surprising how many docs fail to give important information to patients, and amazing to me that some even falsely represent the results. :( I would pay special attention to nutrients, in addition to paying close attention to what the doc finds. It does sound like you have a nutrient deficiency, whatever else may or may not be going on. rose |
Sorry, answering questions out of order and jumbled together!
Many doctors here have never heard of homocysteine. :rolleyes:
Probably should begin a new thread :). rose |
Homocysteine Level (New Thread)
Thank you Rose. The hematologist tested the homocysteine as part of a series of bloodwork. If I went to my primary doctor it would not have been something she normally would have checked. The main thing they told me to take was folic acid, followed by the b12 and b6. I got copies of the bloodwork but it is all foreign to me. It doesn't specifically state folic acid or b12 levels, however it does say to lower homocysteine levels to take supplements of folic acid, b12 and b6. (My level was 16.1)
As I mentioned in a previous post, I have had problems like Clare where I get very cold and my fingernails look blackish/blue near the cuticle. I thought it was my thyroid (my doctor has had to lower my medication twice since April, then added/stopped a supplement). But now I am thinking it is all related to the homocysteine levels. Only time will tell. I am going to check out your website. Thank you for your information. Take care! |
to rose
Hi Rose
Thank you! I responded on a new thread being this one was getting so long. |
hi towie
thanks for starting a separate thread for this discussion :) I have moved 10 posts on the subject from the other thread and merged them in here |
To Rose again
I just read your website about B12. Very interesting. Sore tongue, depression. It is something I need to investigate further. Thank you
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Homocysteine Reduction
Thanks for the new thread.....
We are members of Life Extesion Foundation, and have always found their information to be of the finest quality and moderately easy to read. Thought I would pass this stuff along as we are on a learning curve together. Will give more information on Kilmer McCulley (Doc) in a diffrent post. LONG READ .... personally I found it worthwhile. http://www.lef.org/LEFCMS/aspx/Print...x?CmsID=113982 Homocysteine Reduction How Much Is Safe? Updated: 01/20/2006 Since its discovery in 1932, homocysteine's journey into mainstream medicine has been rocky. For the first 36 years after its discovery, little was understood about it. Then in 1968 a Harvard researcher named Dr. Kilmer McCully noticed that children with genetically elevated homocysteine levels experienced heart disease similar to the heart disease found in middle-aged patients. He proposed that homocysteine might be an independent risk factor for heart disease. Like many medical pioneers, McCully’s proposal concerning homocysteine was met with scorn. McCully's homocysteine theory has since been proven beyond a doubt: people with elevated homocysteine levels are more likely to have strokes, Alzheimer's disease and dementia, kidney disease, diseases of the eye, erectile dysfunction, and, especially, heart disease (De Bree A et al 2002). Conventional medicine, however, has still been slow to react to this news. Even today, the message on homocysteine from major mainstream medical groups is murky. Not so for the Life Extension Foundation, which has been alert to the dangers of elevated homocysteine levels since 1981. In that year, the Foundation published an article suggesting that people take aggressive action to lower their homocysteine levels (Life Extension Foundation 1981). It took conventional medicine another 15 years to catch up, when studies first appeared in major medical journals advocating the use of supplements, especially the B vitamins, to lower homocysteine levels. Scientists have worked hard to understand why our homocysteine level increases throughout life, and how that impacts our health. Homocysteine level is affected by a number of influences, including lifestyle, dietary choices, and genetics. As we age, our ability to absorb nutrients decreases. As a result, less of the important B vitamins are available to help metabolize homocysteine. Homocysteine level is also increased by certain pharmaceuticals, an aging metabolism, smoking, drinking too much alcohol or coffee, lack of exercise, obesity, and stress. There are various interpretations of how much homocysteine is dangerous. The Life Extension Foundation prefers an aggressive stance: based on numerous published studies, we advocate relatively low homocysteine levels to help lower risk of disease. By ages 40 to 42, mean homocysteine levels are about 11 micromoles per liter (µmol/L) in men and 9 µmol/L in women. Even homocysteine levels this low has been associated with disease. The Life Extension Foundation recommends homocysteine level between 7 µmol/L and 8 µmol/L. For the vast majority of people, a high homocysteine level is related to the gradual breakdown of the body’s ability to metabolize homocysteine. However, some people have a high homocysteine level because of a rare genetic defect. This condition, called homocystinuria, is associated with developmental delays, osteoporosis, diseases of the eye, stroke, and severe heart disease that can occur at a young age Now that you know some of the conditions associated with high homocysteine levels, we will discuss in detail its effects and how to lower this disease marker. What You Have Learned So Far An elevated homocysteine level is linked to heart attack and atherosclerosis. Other diseases and conditions—including vascular disease, diseases of the eye, stroke, Alzheimer's disease and dementia, erectile dysfunction, and poor outcome in pregnancy—have also been associated with having elevated homocysteine. Homocysteine level rises as we age, along with the incidence of diseases associated with this elevation. The Life Extension Foundation prefers an aggressive stance on homocysteine, striving for a level between 7 µmol/L and 8 µmol/L. Homocysteine and Heart Disease: A Clear Connection The evidence is clear that having an elevated homocysteine level is an independent risk factor for heart disease. One large study conducted among physicians who had no history of heart disease showed that having a highly elevated homocysteine level was associated with a more than 3-fold increase in the risk of heart attack over a 5-year period (Stampfer MJ et al 1992). Homocysteine has a number of direct effects on the arteries that help explain its association with heart disease. It causes thickening of the intima, or inner wall of the arteries. And it encourages blood platelets to accumulate, which may lead to the formation of blood clots (Harker LA et al 1976). In animal studies, homocysteine has been shown to affect the production of nitric oxide, a substance that causes arteries to relax and blood flow to increase (Stuhlinger MC et al 2001). Having an elevated homocysteine level has been associated with: First and second heart attacks (Al-Obaidi MK et al 2000; Matetzky S et al 2003) Coronary artery disease (Nygard O et al 1997) Total cardiovascular mortality (Anderson JL et al 2000) Adverse outcomes after coronary balloon angioplasty (Schnyder G et al 2002) Heart failure (Vasan RS et al 2003) In 1999, the American Heart Association recognized the role of homocysteine in atherosclerosis when it issued an advisory statement emphasizing the importance of reducing homocysteine blood levels and of screening people who are at high risk (Malinow MR et al 1999). The New England Journal of Medicine (Oakley GP 1998) and the Journal of the American Medical Association (Tucker KL et al 1996) suggested that vitamin supplements could be used to lower homocysteine levels. Testing Homocysteine Levels Homocysteine levels are measured directly in the blood. An acceptable level of homocysteine depends partly on your age and gender. It is clear, however, that our homocysteine level rises as we age and that (above a certain level) homocysteine is dangerous. Conventional medicine classifies homocysteine levels as follows: Normal—5 to 15 µmol/L Moderate—16 to 30 µmol/L Intermediate—31 to 100 µmol/L Severe—Above 100 µmol/L However, because of the evidence linking homocysteine to heart disease (even at relatively low levels), the Life Extension Foundation recommends that people try to keep their homocysteine level between 7 µmol/L and 8 µmol/L. A homocysteine level over 12 µmol/L should be treated aggressively. One study found that each 3-µmol/L increase in homocysteine caused a significant increase in the risk of having a heart attack (Verhoef P et al 1996). Homocysteine: What Is It? Homocysteine is an intermediary amino acid; its role in the body is complex, but very important. Homocysteine is a necessary byproduct of a healthy metabolism. Homocysteine is produced as part of the methionine cycle, in which methionine is converted to S-adenosylmethionine (SAMe). SAMe is valuable because of its ability to donate methyl groups during chemical reactions throughout the body. Homocysteine is synthesized when SAMe donates its methyl group. In scientific terms, this means the SAMe has been methylated (lost a methyl group). Methylation is crucial to the health of our cells and tissues by regulating gene expression, protein function, and RNA metabolism. The methionine cycle is responsible for the creation of all the homocysteine in the body. Most of the resulting homocysteine is bound to plasma and considered stored, or inactive. It may be released into the bloodstream as free homocysteine in response to adverse changes in the body's biochemistry. Thus, high levels of homocysteine are linked to specific health problems. There is also evidence that homocysteine itself causes damage to the cells within blood vessels. Homocysteine in the bloodstream is metabolized through two principal pathways. It may be remethylated back into methionine through a process that involves folic acid (folate) and vitamin B12. This is called the remethylation pathway and is responsible for consuming most of the body's free homocysteine. The remethylation pathway creates more SAMe to support healthy methylation. (Some organs, namely the kidney and liver, are able to remethylate homocysteine directly back into SAMe, but only a fraction of homocysteine is processed in this way.) Alternatively, some of the excess homocysteine may be used to create cysteine, which is then converted into glutathione. Glutathione is an important and powerful antioxidant. The conversion of homocysteine into glutathione may be accelerated when the body is under oxidative stress. This second process is called the transsulfuration pathway because it produces sulfate byproducts that are flushed from the body in urine. The transsulfuration pathway depends on vitamin B6 to work properly. There are many reasons free homocysteine levels might rise in the blood. We may be suffering from oxidative damage because of a shortage of glutathione, or our methylation capacity may be decreased, which affects our cells' ability to grow, differentiate, and function properly. Homocysteine: Linked to Diseases of Aging Although homocysteine's association with heart disease attracts the most attention, researchers are continually learning more about its effect on other diseases and conditions. So far, elevated homocysteine levels have been linked to the following disorders or diseases: Stroke—Homocysteine's effect on the arteries that supply the brain with blood (carotid arteries) is similar to its effect on the arteries in the heart. One study that analyzed 1077 people found that overall risk of "silent stroke" or other risk factors for a stroke were strongly associated with elevated homocysteine levels (Vermeer SE et al 2003). Larger, more focused studies are underway. Vascular disease—There is evidence that homocysteine combines with low-density lipoprotein (LDL) cholesterol and contributes to the creation of plaque inside artery walls (McCully KS 1996). Some forms of homocysteine have been shown to damage the inner walls of blood vessels directly (Jakubowski H 2003). Homocysteine has also been implicated in the formation of blood clots, which can cause a heart attack, stroke, or peripheral vascular disease. Liver disease—Elevated homocysteine and low levels of SAMe are linked to liver toxicity and cirrhosis (Martinez-Chantar ML et al 2002; Ventura P et al 2005). Homocysteine likely contributes to liver damage, leading to the formation of fibrin, clots, and vascular complications (de la Vega MJ et al 2001). Kidney disease—The kidneys filter, reabsorb, and metabolize amino acids, including homocysteine. In kidney failure, homocysteine levels rise due to improper kidney filtration (Friedman AN et al 2001). Folic acid, trimethylglycine (TMG; also known as betaine), and vitamins B6 and B12 reduce homocysteine in people with kidney failure. High doses of folic acid can normalize homocysteine levels. Once kidney failure occurs, folic acid is much less effective, and high doses of vitamin B12 are required to help normalize homocysteine levels (Righetti M et al 2004). Thyroid conditions—Elevated homocysteine levels may contribute to accelerated heart disease among people who have hypothyroidism (Morris MS et al 2001). Alzheimer’s disease and dementia—High levels of homocysteine indicate impaired methylation in the brain. Individuals with Alzheimer's disease have been shown to have elevated homocysteine levels (Joosten E et al 1997; McCaddon A et al 1998). Depression—Depression has been linked to low levels of folic acid in women (Ramos MI et al 2004). Low folic acid levels have been shown to decrease the effectiveness of the antidepressant fluoxetine (Prozac®) (Fava M et al 1997), and vitamin B6 may alleviate depression (Hvas AM et al 2004). Deficiencies in these vitamins are also closely associated with high homocysteine levels. Erectile dysfunction—Homocysteine has been shown to reduce the production of nitric oxide. Nitric oxide causes blood vessels to relax, increasing blood flow to organs and tissues. Folic acid and vitamin B12 may help lower homocysteine levels. In one case study, a man with erectile dysfunction, who also had a genetic defect that causes elevated homocysteine levels, did not initially respond to treatment with sildenafil (Viagra®). However, after treatment with 5000 micrograms (mcg) of folic acid and 1000 mcg of vitamin B12, his erectile dysfunction was successfully treated with sildenafil (Lombardo F et al 2004). Diseases of the eye—Homocysteine's ability to damage blood vessels also has implications for the tiny blood vessels in the eye. Elevated homocysteine levels are associated with serious eye conditions, including glaucoma and macular degeneration. A study showed that homocysteine levels of 11.6 µmol/L were the average concentrations in patients who had central retinal vein occlusion; the average level was 9.5 µmol/L in control subjects (Vine AK 2000). Why Homocysteine Levels Rise Homocysteine levels are responsive to a wide range of influences. They rise naturally as we age. Genes also play a large role in the body's metabolism of homocysteine. However, there are many lifestyle factors that can also cause homocysteine levels to rise. For instance, excessive coffee and alcohol consumption have been shown to increase homocysteine levels (De Bree A et al 2002). Dietary choices affect homocysteine levels. Eating foods that contain large amounts of methionine, such as red meat and chicken, has been shown to increase blood levels of homocysteine. Similarly, low intake of foods rich in vitamin B, such as green leafy vegetables, may also increase homocysteine levels (Devlin TM 2002). In addition, the following pharmaceuticals are associated with elevated homocysteine levels: Fenofibrate—Used in the treatment of high cholesterol (Dierkes J et al 1999). Niacin—Used in the treatment of lipid management (e.g. Cholesterol & Lipoprotein (a)). Metformin—Used to treat diabetes (Carlsen SM et al 1997). Antiepileptic drugs—Used to control seizures (Schwaninger MC et al 1999). Levodopa—Used to manage Parkinson's disease (Muller T et al 1999). Methotrexate—Used to treat cancer, psoriasis, arthritis, and lupus (Haagsma CJ et al 1999). The Life Extension Foundation Approach to Hyperhomocysteinemia In general, there are two strategies used to lower homocysteine: increase the rate at which it is metabolized by the body, or prevent excess homocysteine from being formed in the first place. It also makes sense to address the damage caused by an elevated homocysteine level and any underlying conditions that may be contributing to the condition. The Life Extension Foundation's approach to lowering homocysteine relies on several principles: Directly addressing high homocysteine levels by increasing metabolization of homocysteine. Nutrients that increase metabolization of homocysteine fall into two categories: those that increase the remethylation of homocysteine back into SAMe, and those that act along the transsulfuration pathway to remove excess homocysteine from the body. Routine blood testing to monitor homocysteine levels. This should include genetic testing to check for abnormalities. Slight genetic defects in as few as two enzymes may cause moderate hyperhomocysteinemia. As mentioned previously in this chapter, the most serious form of hyperhomocysteinemia (homocystinuria) is caused by an extremely rare genetic disorder. Addressing the damage directly caused by homocysteine. This may mean supplementing with antioxidants and other nutrients to reduce damage caused by homocysteine. Managing underlying conditions—including high blood pressure, coronary artery disease, diabetes, and hypothyroidism—that are associated with a high homocysteine level. Fortunately, homocysteine levels are responsive to dietary supplements, and it is possible for even moderate or high levels to be brought under control. The B Vitamins: A Powerful Weapon Management of hyperhomocysteinemia begins with folic acid, vitamin B6, and vitamin B12. To varying degrees, folic acid and vitamin B12 increase the remethylation of homocysteine back into SAMe. Vitamin B6 is necessary for the conversion of homocysteine into glutathione along the transsulfuration pathway. (For safety information on vitamin B6, see the Safety Caveats section at the end of this chapter.) The following studies have shown a rapid and dramatic decrease in homocysteine levels caused by folic acid and some B vitamins: In 1996, the Food and Drug Administration (FDA) mandated that cereal-grain flour products be fortified with folic acid. Modest but significant decreases in homocysteine levels followed (Jacques PF et al 1999; Anderson JL et al 2004). One set of patients with a history of myocardial infarction or unstable angina was given 2000 mcg of folic acid daily. Another group of patients with the same conditions received only 200 mcg. The higher dosage significantly reduced total homocysteine levels (Neal B et al 2002). Daily supplementation with 350 mcg of folic acid for 17 weeks reduced serum homocysteine levels by nearly 20 percent, enough to reduce the risk of vascular disease (Venn BJ et al 2002). Folic acid and vitamins B6 and B12 reduced homocysteine levels, restored endothelial function, and reduced arterial plaque (Spence JD et al 2001). Middle-aged to elderly men and women with initially modest to significantly elevated homocysteine levels (>8 µmol/L) who took a multivitamin and mineral supplement for 56 days had significantly higher vitamin B and lower homocysteine levels when retested. Plasma folic acid and vitamin B12 concentrations rose by 42 percent and 14 percent, respectively, while homocysteine concentrations fell 10 percent (McKay DL et al 2000). Another B vitamin, vitamin B2, is also involved in remethylation pathways in the body (Devlin TM 2001). -------------------------------------------------------------------------------- Homocysteine Reduction TMG and Zinc: Bringing Homocysteine Under Control Other nutrients that encourage the remethylation of homocysteine include TMG and zinc, both of which enhance the action of B vitamins. TMG operates along a different pathway than the B vitamins. In fact, some individuals who have a severely elevated homocysteine level respond only to TMG because its activity is limited to the liver and kidneys. To decrease a severely elevated homocysteine level, repeated high doses of TMG must be taken throughout the day. One small study found that TMG supplementation taken concurrently with vitamin B6 and folic acid significantly reduced homocysteine (Dudman NP et al 1996). Zinc acts in concert with vitamin B6 to promote remethylation of homocysteine to methionine. Zinc is also needed for the conversion of homocysteine to cysteine and glutathione. (For safety information on zinc, see the Safety Caveats section at the end of this chapter.) For More Information To learn more about the conditions associated with hyperhomocysteinemia, see the following chapters: Congestive Heart Failure Atherosclerosis Managing High Blood Pressure Diabetes Thyroid Disorders Removing Excess Homocysteine While the remethylation pathway recycles homocysteine back into methionine, the transsulfuration pathway removes it. In the transsulfuration pathway, homocysteine is condensed with serine to form cystathionine, which is converted into cysteine. In turn, cysteine is converted into glutathione, taurine, and sulfate waste products that are flushed from the body in urine. All of these reactions occur with the help of vitamin B6. Besides vitamin B6, other nutrients that strengthen the transsulfuration of homocysteine include: SAMe—SAMe is derived directly from methionine. Its job is to provide methyl groups for reactions throughout the body, including the methylation of nucleic acids (RNA and DNA), proteins, and structures throughout the brain. SAMe is the precursor to such nutrients as creatine, glutathione, taurine, L-carnitine, and melatonin and can be found in almost every tissue in the body. It has been studied in the treatment of depression, schizophrenia, demyelination diseases, liver disease, dementia, arthritis, and other conditions. It is also necessary for normal circadian rhythms. High doses of SAMe, 1600 milligrams (mg) daily, increased phosphocreatine levels in the human brain (Silveri MM et al 2003), indicating that SAMe is important in forming creatine. Although SAMe is part of the methionine cycle, taking supplemental SAMe does not increase the production of homocysteine (Devlin TM 2001). It does, however, encourage the conversion of homocysteine to cysteine and glutathione (Devlin TM 2001), thus lowering homocysteine levels. (For safety information on SAMe, see the Safety Caveats section at the end of this chapter.) Selenium—The trace mineral selenium is necessary for the antioxidant activity of glutathione, which is converted from homocysteine. Selenium deficiency has been shown to increase oxidative damage in animals. By boosting selenium levels, you can raise your level of glutathione and help lower your homocysteine level (Devlin TM 2002). N-acetyl-cysteine—Consuming N-acetyl-cysteine may reduce homocysteine levels by encouraging the production of cysteine, which is critical to the conversion of homocysteine to glutathione. By increasing the production of cysteine, it may be possible to boost the amount of homocysteine converted into glutathione. Cysteine—Like N-acetyl-cysteine, cysteine supplementation may prevent the release of stored homocysteine into the bloodstream. The Life Extension Foundation favors maintaining an adequate level of cysteine to maintain normal glutathione levels. Inhibiting the Formation of Homocysteine Not all the homocysteine created is released directly into the bloodstream as free homocysteine. In fact, less than 1 percent of the homocysteine in the blood is free. The majority, about 98 to 99 percent, is bound to proteins in the blood and considered stored. This store of homocysteine may be released in response to decreased methylation or oxidative damage, or in response to other influences. Nutrients that have been shown to inhibit the release of homocysteine include: Creatine—Somewhere between 50 and 90 percent of the SAMe required by the body goes into the production of creatine (Devlin TM 2001; Finkelstein JD et al 1984; Lee H et al 1998; Silveri MM et al 2003; Stead LM et al 2001). Supplementation with creatine diminishes the need for SAMe, reduces formation of homocysteine, and the need for homocysteine remethylation. In animal studies, supplementation with creatine for 2 weeks reduced homocysteine levels by 25 percent (Stead LM et al 2001). Choline-producing nutrients—SAMe is involved in the production of choline. By taking choline-producing nutrients, your body produces less SAMe, which reduces the amount of homocysteine needed. Choline-producing nutrients include cytidine diphosphate (CDP) choline, lecithin, alpha-glycerylphosphorylcholine, and choline chloride. Life Extension Foundation Recommendations It is important to begin your homocysteine-lowering program by working with a qualified physician and taking the necessary blood tests to evaluate your risk. To help lower your homocysteine level, the Life Extension Foundation suggests: Folic acid—4000 to 8000 mcg daily Vitamin B12—1 to 2 mg daily Vitamin B6—100 to 200 mg daily SAMe—400 mg two to four times daily TMG—2 to 4 grams daily Zinc—30 to 90 mg daily CDP choline—250 to 500 mg daily. Alternatively, you can use 1 to 3 teaspoons of liquid choline chloride daily mixed with 2 ounces of juice, 1 tablespoon of pure lecithin granules daily, or 250 mg of a-GPC daily. Micronized creatine—500 mg (in capsule form) four to eight times daily N-acetyl-cysteine—600 mg (in capsule form) one to two times daily on an empty stomach If this protocol is not successful at lowering homocysteine level, a weekly 1-mg vitamin B12 injection may be necessary (this requires a prescription). Hyperhomocysteine Safety Caveats An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include: Creatine Do not take creatine if you have diabetes, kidney failure, a kidney disorder such as nephrotic syndrome, or are otherwise at risk of having a kidney disorder. If you take creatine, have your serum creatinine level monitored frequently. Creatine can cause muscle cramping, muscle strains, and gastrointestinal symptoms such as nausea and diarrhea. Folic acid Consult your doctor before taking folic acid if you have a vitamin B12 deficiency. Daily doses of more than 1 milligram of folic acid can precipitate or exacerbate the neurological damage caused by a vitamin B12 deficiency. NAC NAC clearance is reduced in people who have chronic liver disease. Do not take NAC if you have a history of kidney stones (particularly cystine stones). NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to detect diabetes. Consult your doctor before taking NAC if you have a history of peptic ulcer disease. Mucolytic agents may disrupt the gastric mucosal barrier. NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such as nausea and diarrhea. Phosphatidylcholine Phosphatidylcholine can cause increased salivation, a metallic taste, headache, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea SAMe Consult your doctor before taking SAMe if you have bipolar disorder. See your doctor frequently if you take SAMe and you have bipolar disorder. Consult your doctor before taking SAMe if you take antidepressants. See your doctor frequently if you take SAMe in place of or in addition to antidepressants. Consult your doctor before taking SAMe if you have cancer. Nucleic acid methylation patterns may change in people who have cancer and take SAMe. Do not take SAMe if you are undergoing gene therapy. SAMe can cause anxiety, hyperactive muscle movement, insomnia, hypomania, and gastrointestinal symptoms such as nausea and diarrhea Trimethylglycine (betaine) Do not take trimethylglycine (betaine) if you have gastritis, gastroesophageal reflux disease (GERD), or peptic ulcer disease. Vitamin B6 Do not take 5 milligrams or more of vitamin B6 daily if you are being treated with levodopa, unless you are taking carbidopa at the same time. Vitamin B12 (cyanocobalamin) Do not take cyanocobalamin if you have Leber's optic atrophy. Zinc High doses of zinc (above 30 milligrams daily) can cause adverse reactions. Zinc can cause a metallic taste, headache, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea. High doses of zinc can lead to copper deficiency and hypochromic microcytic anemia secondary to zinc-induced copper deficiency. High doses of zinc may suppress the immune system. |
Further update and reading on Homocysteine levels
Again this is from Life Extension Foundation, of which we are members:
LE Magazine October 2006 Homocysteine as a Risk Factor for Disease By Laura J. Ninger, ELS Since 1990, the National Library of Medicine has posted thousands of scientific studies showing that homocysteine is a significant risk factor for disease.1 These published reports discuss the lethal illnesses associated with excess homocysteine, how elevations in blood homocysteine levels result in incremental increases in disease risks, the mechanisms by which homocysteine exerts its multiple pathological effects, and methods to reduce toxic homocysteine levels in the body. Elevated homocysteine levels may be caused by B-vitamin deficiency, genetic factors, increasing age, kidney impairment, or other factors. Homocysteine overload increases the risk of disease in healthy people and magnifies adverse effects in those with pre-existing conditions. Since 1981, the Life Extension Foundation has published hundreds of pages of text describing the dangers of excess homocysteine in the blood. What follows is a brief chronological review of landmark studies published in major medical journals that describe specific disease risks associated with excess homocysteine. 1990 Cardiovascular Disease: Researchers found that men with premature coronary artery disease (who averaged 50 years of age) had significantly higher homocysteine levels than healthy men. Scientists thus determined that high levels of homocysteine are an independent risk factor for premature coronary atherosclerosis in men.1 1991 Early-Onset Vascular Disease: Higher levels of homocysteine raise the risk of premature cardiovascular disease affecting the heart, brain, and peripheral blood vessels. In subjects who developed cardiovascular disease before the age of 55, elevated blood levels of homocysteine were found in 42% of patients with cerebrovascular disease, 30% with coronary vascular disease, and 28% with peripheral vascular disease—but not in any of the healthy control subjects. People with elevated homocysteine had three times the risk of cardiovascular disease compared to healthy individuals.2 Cardiovascular Disease Progression: Patients with blocked arteries in the lower body or brain were found to have significantly higher homocysteine levels than healthy individuals. In addition, patients with high homocysteine (versus normal levels) had significantly faster progression of lower-extremity vascular disease and coronary artery disease.3 1992 Heart Attack: In a large study, men who had markedly higher homocysteine levels had over three times the risk of heart attack compared to men with lower homocysteine values.4 Stroke: Elevated homocysteine levels were independently associated with all types of stroke (ischemic, hemorrhagic, and embolic). Stroke survivors were more likely to demonstrate elevated homocysteine levels (40%) than healthy individuals (6%).5 1993 Blood Clotting: High homocysteine levels have been linked with increased blood-clotting tendency. In the laboratory, homocysteine increased the activity of a blood-clotting factor in human cells by 25-100%, and this negative effect increased with rising homocysteine concentrations.6 In a similar study, homocysteine decreased the production of a substance that helps prevent blood clots by 65%.7 1994 Early-Onset Coronary Artery Disease: Noting that high homocysteine raises the risk of early-onset coronary artery disease, scientists proposed that boosting plasma folate concentration may help reduce homocysteine levels and decrease coronary artery disease risk.8 1995 Atherosclerosis: In elderly adults, dangerous narrowing of the arteries that direct blood to the brain was more than twice as common in those with higher homocysteine levels (greater than 14.4 μmol/L) than in those with low levels (less than 9.1 μmol/L).9 Another study found that individuals with high homocysteine were much more likely to have atherosclerosis (72%) than those with normal homocysteine (44%).10 In patients already at risk for atherosclerosis because of high lipid levels, elevated homocysteine further increased the risk by nearly three times.10 Coronary Artery Disease: High homocysteine was found to be an independent risk factor for coronary artery disease among healthy people. Each 4-μmol/L increase in homocysteine level increased risk by 32%.11 Birth Defects: Abnormal homocysteine metabolism may be associated with birth defects that affect the coverings of the nervous system (neural tube defects).12 Elevated homocysteine levels have been found in the amniotic fluid of fetuses with neural tube defects and in blood samples of women carrying fetuses with these birth defects.12,13 Folic acid supplements may help prevent such birth defects by correcting high homocysteine levels.12,13 1996 Pediatric Atherosclerosis: In boys and girls aged 10-19, elevated homocysteine levels were significantly associated with atherosclerosis in the carotid arteries, which supply the brain with blood. This suggests that homocysteine levels correlate with atherosclerosis, even as early as in the second decade of life.14 Cardiovascular Disease: In another pediatric study, homocysteine levels were significantly higher among children who had a male relative who died prematurely (under 55 years of age) of heart attack. Nutritional modifications may help reduce cardiovascular risk in children with a family history of heart disease.15 Coronary Artery Disease: Scientists discovered that one of the causes of elevated homocysteine levels is a particular genetic mutation, and that people with this mutation had a significantly higher risk of premature coronary heart disease.16 Birth Defects: Scientists again noted that homocysteine levels are significantly higher in women with fetuses that have neural tube birth defects than in those with healthy fetuses, further supporting the theory that folic acid supplementation may help prevent birth defects by improving homocysteine metabolism.17 1997 Atherosclerosis: Scientists found that elevated homocysteine was just as serious a risk factor for atherosclerosis as smoking or high lipid levels, and that it dramatically aggravated the risk associated with smoking or high blood pressure.18 In one study, every 5-μmol/L increase in homocysteine level led to a 30% increased risk of severe atherosclerosis.19 In addition, researchers found that people with higher levels of homocysteine had more blocked arteries than people with lower homocysteine levels.19 Death from Coronary Artery Disease: Higher homocysteine levels strongly predict mortality risk in people with coronary heart disease. People with homocysteine levels above 15 μmol/L had a 25% mortality rate over four years, compared to only 4% for those who had homocysteine levels below 9 μmol/L. Death rates rose dramatically as homocysteine levels rose from 9 to 20 μmol/L.20 1998 Cardiovascular Disease and Stroke: High levels of homocysteine increase the risk of diseased arteries of the extremities, heart, and brain.21,22 One study suggested that every 5-μmol/L increase in homocysteine level increases the risk of peripheral vascular disease by 44%, coronary artery disease by 25%, cerebrovascular disease by 24%, and any cardiovascular disease by 39%.21 In people who have type II diabetes or impaired glucose tolerance, elevated homocysteine poses even greater dangers to the cardiovascular system.21 In one study, elderly men with high homocysteine had almost twice the risk of heart attack and more than four times the risk of stroke, as well as six times the risk of fatal stroke.23 Ischemic Heart Disease: Men with higher homocysteine levels were up to three times more likely to die of ischemic heart disease—caused by a diminished supply of blood and oxygen to the heart muscle—than those who had lower levels. This correlation was so strong that scientists proposed that elevated homocysteine might actually cause heart disease, rather than simply be a risk factor for it.24 1999 Cardiovascular Disease: Homocysteine damages endothelial cells, promotes blood clots, and supports free radical damage.25 Homocysteine is associated with risks in both adults and children. In fact, healthy children with higher homocysteine levels were more likely to have increased blood pressure compared to their peers with normal homocysteine. These children have a higher risk for future cardiovascular disease.26 Testing blood homocysteine levels in children may help to identify those with a high level of heart disease risk, so that preventive strategies can be started as soon as possible.26 Colon Cancer: Women with higher homocysteine had a higher risk of colorectal cancer than women with lower levels. Those with the highest homocysteine levels had a more than 70% higher colorectal cancer risk than those with the lowest values. This led scientists to suggest that vitamin supplementation strategies to lower homocysteine levels might also decrease colorectal cancer risk.27 Birth Defects: Because high homocysteine levels are associated with both neural tube birth defects and heart disease, scientists proposed that disturbances in homocysteine breakdown might underlie both conditions. By supporting homocysteine breakdown, folic acid supplements might help prevent birth defects as well as heart disease.28 2000 Atherosclerosis: Elevated homocysteine is associated with an increased risk of atherosclerosis, heart attack, and heart disease mortality.29 Elevated homocysteine levels are strongly associated with severe atherosclerosis in one of the body’s main blood vessels, the aorta.30 Kidney and Heart Disease: In patients with early- or end-stage kidney disease, elevated homocysteine is an independent predictor of cardiovascular disease.31 Cervical Cancer: Elevated homocysteine levels may increase the risk of cervical cancer. One study found that women who had a precursor to cervical cancer had higher homocysteine levels than healthy subjects. High homocysteine also increased the cervical cancer risk associated with smoking, having several previous births, and infection with a virus associated with cervical cancer. Elevated homocysteine increases the risk of cervical tissue changes that can lead to cancer, and enhances the effects of other risk factors.32 Depression: Scientists noted that 52% of patients with severe depression had elevated homocysteine levels, as well as decreased levels of folate and impaired metabolism of certain neurotransmitters. A significant correlation between elevated homocysteine and decreased folate concentrations was noted in depressed people. Scientists thus proposed that measuring homocysteine levels may help identify people with depression, and that homocysteine-lowering therapies might elevate mood.33 Pregnancy Complications: Elevated homocysteine levels may increase the risk of several complications of pregnancy. In a large study, scientists found that pregnant women with the highest homocysteine levels had an increased risk of premature births, low-birth-weight infants, and stillbirths.34 2001 Alzheimer’s Disease: Elevated homocysteine levels may contribute to cognitive decline and Alzheimer’s disease.35,36 In healthy older adults, high homocysteine was associated with poorer cognitive function and faster cognitive decline over the course of five years.36 Although scientists do not know whether homocysteine causes cognitive decline or Alzheimer’s, they have noted that high homocysteine correlates with the progression and severity of these conditions.35 Invasive Cervical Cancer: Homocysteine may increase the risk for cervical cancer. Researchers found that women with elevated homocysteine levels were two to three times more likely to have invasive cervical cancer.37 Coronary Artery Disease: Since 1998, grain products in the United States have been fortified with folic acid to promote good health. By lowering homocysteine levels, grain fortification could reduce heart attacks and heart disease deaths by 8% in women and 13% in men. This strategy may save several hundred thousand lives and several billion dollars in health care costs over the course of 10 years, according to one analysis.38 Blood Clots: One study found that when homocysteine levels are high, the risk of dangerous blood clots (deep vein thrombosis) more than doubled. Blood clots are potentially lethal, since they can lead to heart attack or stroke.39 Overall Mortality: Elevated homocysteine increases the risk of death due to cancer and other causes. A 2001 study showed that each 5-μmol/L increase in homocysteine was associated with a 26% increase in cancer deaths, a 49% increase in all-cause mortality, a 50% increase in cardiovascular deaths, and a 104% increase in deaths not due to cancer or cardiovascular disease. Managing homocysteine levels may thus be crucial to prolonging life and preventing death from numerous health conditions.40 Continued on Page 2 of 2 -------------------------------------------------------------------------------- LE Magazine October 2006 Homocysteine as a Risk Factor for Disease By Laura J. Ninger, ELS 2002 Alzheimer’s Disease: Rising levels of homocysteine could be an early warning signal of impending dementia and Alzheimer’s in elderly men and women. High homocysteine (greater than 14 μmol/L) almost doubled the risk of Alzheimer’s disease, suggesting a possible cause-and-effect relationship between homocysteine and Alzhiemer’s.41 Cardiovascular Disease: High homocysteine levels make the cardiovascular risks of smoking even more dangerous. In one study, smokers with high homocysteine levels had 12 times the risk of cardiovascular disease compared to nonsmokers with normal homocysteine.42 Ischemic Heart Disease and Stroke: Lowering homocysteine levels may decrease the risk of heart disease and stroke.43-45 Studies have suggested that lowering one’s homocysteine level by 3 μmol/L could decrease the risk of ischemic heart disease by 11-16%, while decreasing the risk of stroke by 19-24%.43,44 2003 Dementia: Because elevated homocysteine plays a role in stroke and Alzheimer’s disease—two major causes of dementia—researchers proposed that dietary supplementation to normalize homocysteine levels could reduce rates of dementia.46 Cognitive Impairment: Healthy people who wish to maintain their cognitive function should monitor their homocysteine levels. Over the course of six years, healthy individuals with high homocysteine levels at the study’s onset had much poorer scores on word-learning tests than their counterparts with low homocysteine levels.47 Inflammatory Bowel Disease: High levels of homocysteine in the colon and blood may predispose individuals to two inflammatory bowel diseases: ulcerative colitis and Crohn’s disease. Homocysteine levels were significantly elevated in the colons of patients with inflammatory bowel diseases compared to healthy subjects.48 Ischemic Heart Disease and Stroke: People with high homocysteine levels have a much greater risk of ischemic heart disease and stroke.49 In patients with coronary heart disease, those with the highest homocysteine levels had an almost fivefold greater risk of stroke.50 Some research suggests that lowering homocysteine by 25% may lead to an 11% decrease in ischemic heart disease risk and a 20% decrease in stroke risk.49 2004 Aneurysm: One of the most dangerous manifestations of cardiovascular disease is aortic aneurysm, a bulging of the body’s largest artery that can lead to rupture, a potentially fatal surgical emergency. Researchers found that 68% of adults with abdominal aortic aneurysm had elevated homocysteine levels, compared to only 6% of unaffected individuals. Patients with aneurysm had an average homocysteine level of 19.4 μmol/L, compared to 10.9 μmol/L among unaffected adults.51 Cardiovascular Disease: About half of all deaths occur because of cardiovascular disease, and elevated homocysteine may contribute to 10% of cardiovascular disease cases and deaths.52 Cardiovascular disease risk grows as homocysteine increases, and the risk is especially high in people with high blood pressure, diabetes, or high lipid levels.52 Homocysteine damages blood vessels, promotes blood clotting, and generates oxidative stress.52 Some experts estimate that lowering homocysteine could prevent 25% of cardiovascular events,52 and some recommend that all individuals at risk for heart disease should be treated regardless of their baseline homocysteine values.53 Homocysteine poses risks to men, women, and children, and particularly to people with underlying illnesses.54-56 Cognitive Impairment: High levels of homocysteine are associated with detrimental changes in the nervous system that can be detected using radiological imaging57 or clinical assessments.58 In one study, people with the highest homocysteine levels had lower scores on cognitive function tests. High homocysteine levels were also associated with a 4.3 times higher risk of dementia and a 3.7 times greater risk of Alzheimer’s disease.58 Osteoporosis: Elevated homocysteine levels may increase the risk of osteoporotic fractures in older men and women.59,60 In one report, the risk of hip fracture increased with rising levels of homocysteine in both sexes.59 Men with the highest levels had about four times the risk of fracture as men with the lowest levels, and women with the highest values had twice the risk as those with the lowest levels.59 Lowering homocysteine levels using nutritional strategies may thus help protect bone health.59 2005 Alzheimer’s Disease: Rising levels of homocysteine may predict impending cognitive decline and Alzheimer’s disease.61,62 In one study, high levels of homocysteine were associated with worse cognitive function, and elevated homocysteine predicted more severe cognitive decline during seven years of follow-up.61 Moreover, elevated homocysteine was associated with a three times higher risk of Alzheimer’s disease and a 2.6 times higher risk of mild cognitive impairment, which typically precedes more severe dementia.62 Aneurysm: People who have high homocysteine levels may have an eightfold greater risk of abdominal aortic aneurysm. When an aneurysm ruptures, fatal bleeding can occur unless the patient receives prompt surgical care.63 Atherosclerosis: Elevated homocysteine may speed the progression of atherosclerosis. One study showed that atherosclerosis progressed by 35% annually for patients with high homocysteine levels (greater than or equal to 12 μmol/L), but by only 17% per year in people with lower levels (less than 12 μmol/L).64 Cardiovascular Disease: When researchers followed healthy men for 10 years, they noticed that the men with the highest homocysteine levels had nearly twice the risk of cardiovascular disease death.65 Homocysteine was even more dangerous in smokers and in men with high cholesterol.65 In healthy women, increased homocysteine levels were associated with decreased oxygen uptake, indicating poorer cardiovascular fitness.66 Cognitive Impairment: Homocysteine may interfere with healthy mental function.67-69 In one report, healthy elderly people with high homocysteine levels experienced more dramatic cognitive decline over six years than did their counterparts with lower homocysteine levels.68 One study suggested that homocysteine may prematurely age the brain. A rise in homocysteine was equivalent to an extra 4.2 years of age on cognitive performance tests. Homocysteine might thus be a modifiable cause of cognitive decline.69 Depression: Depression and high homocysteine appear to be closely related. In people aged 60-64, a higher homocysteine level was associated with a higher prevalence of depression.70 Macular Degeneration: Homocysteine may damage eye health and threaten visual function. In fact, scientists found that patients with age-related macular degeneration had significantly higher homocysteine levels than healthy subjects.71,72 Bipolar Disorder: Homocysteine may be associated with bipolar (manic depressive) disorder. One study showed that young men with bipolar disorder had much higher homocysteine levels than healthy subjects, and homocysteine levels were highest in those with progression of the disease.73 Osteoporosis: Elevated homocysteine may adversely affect bone health and fracture risk.74 In healthy adults, high homocysteine was associated with 3.8 times the risk of fracture in men and 2.8 times the risk in women.75 Scientists believe that elevated homocysteine could be a clinical sign of osteoporosis related to nutritional deficiencies.74 High homocysteine may especially increase the risk of fractures in people suffering from underlying illnesses, such as Parkinson’s disease or a history of stroke.76,77 Schizophrenia: Some scientists believe that schizophrenia begins even before birth. Pregnant women with high levels of homocysteine were found to be more likely to have children who later developed schizophrenia. Researchers believe this may be one more reason why pregnant women should take steps to correct elevated homocysteine levels.78 Stroke: Over the course of 10 years, men with high homocysteine levels had nearly three times the risk of stroke as men with low levels of homocysteine. High serum folate levels, however, were associated with protection against stroke.79 2006 Coronary Artery Disease: People with elevated levels of homocysteine were found to have more calcification of the coronary arteries than people with lower homocysteine values. Coronary artery calcification is a measure of the severity of coronary artery disease.80 Kidney Disease: Patients with chronic kidney disease were found to have significantly higher levels of homocysteine than healthy people. In fact, 89% of these patients had homocysteine levels greater than 14 μmol/L, which may increase their risk of developing many other diseases.81 Macular Degeneration: Patients with age-related macular degeneration, a common cause of visual loss, were found to have higher homocysteine levels than healthy subjects. Levels above 12 μmol/L particularly increased the risk of macular degeneration. High homocysteine level may thus be an independent risk factor for age-related macular degeneration.82 Osteoporosis: Women with high homocysteine levels were found to have significantly lower bone mineral density in the hip than control subjects. In fact, the risk of low bone density was 96% higher among women with high homocysteine (greater than 15 μmol/L) compared to women with lower homocysteine (less than 9 μmol/L). Homocysteine may be a modifiable risk factor for osteoporosis in women.83 Schizophrenia: Homocysteine levels are extremely high in many patients with schizophrenia. When these individuals used vitamins to decrease homocysteine, their symptoms of schizophrenia lessened.84 Conclusion Elevated homocysteine levels have now been correlated with a wide array of illnesses, including heart disease, stroke, osteoporosis, depression, schizophrenia, macular degeneration, cervical cancer, and birth defects. Fortunately, those seeking to safeguard their health and longevity can readily modulate elevated homocysteine levels using nutritional therapies such as vitamins B6 and B12, folic acid, and trimethylglycine.85 These important nutritional strategies may help you avert the wide array of diseases that have been found to accompany excessive levels of homocysteine. http://www.lef.org/LEFCMS/aspx/Print...x?CmsID=114366 |
KILMER MCCULLY - Doctor
Searching for information about Homocysteine you will inevitably come up with the name of doc Klimer McCully.... I truly believe history will show him to be correct with what he discovered..... eon's ago:
http://www.newhope.com/nutritionscie...9/dialogue.cfm Kilmer McCully, M.D., Connects Homocysteine and Heart Disease http://www.lef.org/magazine/mag97/nov-cover97.html Thirty years ago colleagues scoffed at his idea that homocysteine causes heart disease. New data proves McCully was right all along. This interview could change the way you view America's No. 1 killer disease. The Fall and Rise Of Kilmer McCully http://query.nytimes.com/gst/fullpag...5BC0A961958260 Folic Acid: The Forgotten Nutrient That Will Keep You Alive And Kicking Into Your 90s http://www.thehealthierlife.co.uk/ar...olic-acid.html The Homocysteine Revolution: An interview with Dr. Kilmer McCully http://www.drpasswater.com/nutrition...ocysteine.html This is slightly different.... but I BELIEVE valuable too http://www.homocysteine.com/ Now, with the recent publication of Dr. Kilmer S. McCully's book entitled "The Homocysteine Revolution", the time has come to reveal the truth about atherosclerosis and arteriosclerosis, heart disease and stroke. The time is here to present the other half of the story, the story that until most recently, had been discarded, stuffed into the background and hidden by the elite medical academicians and pharmaceutical companies because of lack of monetary profit. Through this internet web site, information will flow, in an attempt to directly educate the public about homocysteine's "widow-maker" toxicity against the heart. http://www.westonaprice.org/bookrevi...ocysteine.html The Homocysteine Revolution - BOOK REVIEW by Sally Fallon of WAP - Weston A Price Foundation...... remember now not everyone is going to say wonderful things about KM....... what Sally Fallon says about Hcy and Doc KM findings are great tho! OK enuff from me for now I did NOT intend to take over this thread or to swamp you with information.... I am sorry. Cheer's :grouphug: |
Sorry I have so little time. I love LE. Most of their information is years to decades ahead of many publications and sites (and doctors) that should be a lot better than they are.
I did not read all of that just now, but this jumped out at me. Quote:
Make sure you do not have a B12 deficiency. And continue to make sure by taking it! rose |
Sorry I have so little time. I love LE. Most of their information is years to decades ahead of many publications and sites (and doctors) that should be a lot better than they are.
I did not read all of that just now, but this jumped out at me. Quote:
Make sure you do not have a B12 deficiency. And continue to make sure by taking it! rose |
Wow, what an eye opener!
Thank you for all of the information. I still have to read all of the links, but just the information here is enough to get you thinking. I have had problems for the past year and a half and thought it was just me but now I am thinking it may have been caused by my homocysteine levels. Major depression is just one thing I have been dealing with. I will continue to take the vitamins as I was told by my hematologist and hopefully I can get my levels to normal and get my life back in order.
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My 2 cents here on Methyl B12.
2 Attachment(s)
I don't know if any of you recall back in August 2004 I'd posted my pleas' for help on the PN board....was before the big BT crash.
Rose helped me understand that I may be B12 deficient, but all the Neuro's and other specilist I'd been seen by told me I was in fact normal ranges for all my vits and mins....sadly 232 b12 level was/is considered normal....and was never given an MM HS levels done for true B12 levels. How could someone on some web site here know more than a medical doctor! Well....by experience AND reading!...one can learn just as a doctor does/can! But I was dying or seriously considering "ending it all" as I was suffering and I mean suffering! My prayer to God each nite "Heal me or kill me!"...just get it over with God! I truely wanted to die, but how does one do that when don't have the energy to jump off a bridge! Beisdes, the water here in Oregon is freezing cold and muddy looking...so forget that! But seriously...I had died several times from a ruptured aneurism that kept leaking in my intestines... actually is called an AVM= Arteriovenous Malformation. You're born with them, usually the brain...mine was intestinal. I also had Crohns disease...or so was told... Thats gone as well, thanks to going Gluten Free back in April...my gut pains are gone, no more diarreah and pain! I'm cured!... THANKS to the many GF'r pro's here on these forums. Back to my B12....I'd suffered severe anemia...hem 5.1 hgb and 15% hematacrit (oxygene level) I was half dead, went around like this nearly 3 years, getting transfusions every 2 weeks. That nightmare didn't kill me, but the B12 nearly finished the job. I never do anything half way...so guess is reason I'm still alive. I'd gotten the revolutionary pill camera, got stuck and batteries died before leaving my stomach. It got stuck where my small instense were so diseased, at the Terminal Illeum... they removed nearly 3 feet, then searched remainder of intestines. Thats when they found the baseball sized AVM further up my intesines removed 6 inches there.... So NOW I'm missing several feet of small intestines and some of what was left was very diseased, unable to absorb even water!... yes it was THAT bad!...and well DUH!.. The ONLY place your body absorbs B12 is in small intestines OR under your tongue! Is because B12 molecules are large, once inside your body, need to bind to something in order to convert, if low or lacking that...forget it! Is useless...just like the little B12 dots I'd taken...didn't work, usless! Why all the doctors who saw me failed to give me standard protocol, B12 injections to one who'd had bowel surgery and OR intestinal diseases such as Crohns or C-sprue....is MAJOR DUH! ...they'd only reached their level of incompetantcy, then refered elswhere! Well, duh! Duh DUH! Was like a sick joke...the entire saga is maddening and I'd like to sue if I could! Its as stupid as one ER doc refused to do basic lab work on me, sent me home saying was a panic attack when fact was I was missing 2/3 of my blood, was NOT a panic attack, was severe anemia from bleeding to death!...that doc received a well deserved black mark against her record! Once AVM was removed, was the end of my anemia! But...I continued my downhill crash...like a jet liner at full throttle, some times nose up, sometimes down. I drank an green energy drink someone got me into...MLM ploy....but did the trick asi its loaded with Hawaiin Spirilina.... a source of B12 (not good!) I had Neuropathy from head to toe, muscle twitching, weakness, burning, total loss of balance, burning lips.... But not a single Neuro picked up on the clues...I mean DUH!... She drinks this stuff= enough energy to flush the toilet! Doesn't drink it...bedridden! This went on over half year. My husband hired in home health care services to help me personal grooming as I was too fatigued to change my own underware.. I am dead serious when I say this...I couldn't even flush the toilet let alone wipe my own butt! I couldn't even chew or swallow either I was that fatigued! My spinal cord hurt like electric flash down my spine when put my chin to chest. I was so mentally out of it...but if I drank that green stuff, I'd have a few hours of sanity.. .enough to google search from my bed with a laptop, to find the cause of PN, Right away Rose advised me to take Methyl B12...within weeks I was out of bed.... This was Sept 3, 2004 when took my first B12 sublingual tab. In Oct 25 I think, same year...they repeated my EMG an NC test...now was back to normal...was moderate level of PN back in June! I did not have a single injection of anything! except all those blood transfusions over those years of anemia.... All my healing and B12 help had been soley via Methyl B12 sublingual tabs by Jarrow brand. I was told I should try the cyno injections as the doctors telling me this is best...hmmm! But if so...then why on earth did I "enjoy" such a near miraculous turn around in my health just by taking the sublingual tabs? From what I've learned so far...the Methyl suglingual is far superior to the Cyano injections.... there are many, but for this one reason alone...storage! Why take a weekly or monthly injection, when can have a daily source of B12. You only need 3mg a day anyway! And if you don't store, which is obvios, afterall, why did you become deficient in the first place! One egg or glass of milk alone has enough B12 for half year IF your body stores it! I've met lots of older ladies...they all tell me they can't wait to go in for their B12 shots...so can have some energy. Thats when I tell them about the Methyl sublingual form, teach them what I know and get off the shots!... no good reason to have the low's in-between shots! I've read what the Mayo and Harvard trained Neurologist are saying about the Methyl B12... if my doctors argue these facts...I just simply ask... "Do you want to argue with Mayo trained Neuro PLUS proven facts in my EMG and NC test alone is all proof I need to know the Methyl has been a lifeline to me and Rose has beeb a godsend to many! I wouldn't be writting any of this here had I not found BT and Rose hadn't answered my cries for help...I'd be taking a well needed dirt nap the bottom side of the soil! Those are the facts! If one wants to get a shot of Cyna...they should continue their practice...but if they really want to heal... then start taking the Methyl B12 every day!...early on, twice a day in the begining... and yes...the repairs your body is making from the damages done while being deficient is often weird and scarey... all the more reasons to take it...and NEVER STOP! It only last a short period of time before the repairs are made if possible. Never let this stop you or else you may never know what irreversable damages your body may experience...needlessly! My EMG and NC test are proof alone that the Methyl B12 works very well! And in such a short time too. I was amazed how quickly I got my energy back...10 days! Soley on Methyl B12, think was taking the 5K mcg day, but not sure. Wish those lost post would miraculously show up one day! Blessings to all, Cheryl PS....I'm still missing my moons in my index finger... I do think there's something to this...but one can still have full moons in all their fingers and still be deficient... there's a difference between tissue and serum levels in many vits and mins.... so isn't a good "gold standard" but I'd seriously think about taking the B12 if my moons were missing for sure! Can't hurt! I think for this reason alone one shouldn't feel confident that all is well if their moons are full and in place! PSS...Do I look sick here?! No way...full of life and back to living once again. I was able to take a watercolor painting class...so I did this painting for my pain doctor...he put it in the waiting room for all to see...is called "Finding beauty amongst the Ruins"...is what he does! __________________ |
My father had a stroke about 2 years ago. The doctor new enough to check his hcy levels, and of course they were high. He only told my father to take folic acid and b6. I told him to take the b12 as well. Thats when he told me that he has had tingling feet and many other symptoms for at least 15 years. Even when he told this to the doc he did not think it was a big deal (and his b12 level was around 302). So doctors can know somthing about hcy levels casusing strokes or heart disease but are clueless about b12.
Funny you should mention bleeding gums. Every now and then I break a blood vessle in the second toe of my left foot and the middle finger in my left hand, just from squeezing somthing too hard. I also broke a blood vessel in my left ear twice. Around 2 weeks ago I felt like there was somthing stuck on my tooth. It was a blood clot! Very gross. I had a clotting test done. I have never heard back from the hemo. about it, but when I called to ask fro copies the nurse said there was nothing to worry about. |
Cheryl,
No, I don't think there's anything to the moons theory, other than the fact that B12 deficiency can affect people in many ways and there may be some for whom that is a factor. Moons or no moons, if one has other symptoms I think B12 is an excellent idea. Regarding storage, one can store perfectly and still become deficient. That is why people who have good stores and store well can take years to become deficient. If someone with excellent stores begins malabsorbing severely they will get no B12 at all unless they take very large doses or shots. After a few to several years they will be severely depleted if not treated with those very large doses or shots. rose |
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