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HOMOCYSTEINE -
PART OF THE RIDDLE
by Lynn Hinderliter, CN, LDN

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In 1997  I was privileged to meet a gentleman who had just written a book about cardiovascular disease called TMG Breakthrough - Methylation, Homocysteine and Nutrition that I found most impressive. His name is Paul Frankel, and he is a brilliant young mathematical biologist who has published many articles in peer-reviewed medical journals and research journals. I want to tell you about some of his conclusions, many of which are based on the research Dr. Craig Cooney has been doing research on methylation since 1979.

First of all , Frankel points out that it is somewhat illogical to implicate so many different factors in heart disease: fatty diets, cholesterol, triglycerides, blood pressure, smoking, etc. etc. Even when combined, these causes account for less than half of all deaths from heart disease, which indicates there must be some underlying cause, perhaps related to all of these. The factor he implicates is high levels of homocysteine in the body.

Homocysteine is a toxic amino acid, which is normally well controlled through the liver with the help of B vitamains which convert it to non-toxic amino acids, among them Methionine. But when these paths are blocked, or unavailable, homocysteine builds up in body tissues. When given to test animals, it "rapidly induces the initial stages of arteriosclerosis , (whereas) cholesterol's effects are not apparent. "

 Many studies have shown a correlation between high homocysteine levels (a fasting level over 15 umols per liter is considered high) and heart disease and stroke, including a study of 405 patients which found that those suffering from coronary artery disease had higher levels than the healthy subjects, and a study which concluded that 68 patients suffering strokes had higher mean concentrations than 31 healthy controls.

In December 2002, two diametrically opposed studies were published:  one purporting to show that there is no connection between homocysteine levels and cardiovascular risk ,  the other, that elevated homocysteine levels are implicated in deep vein thrombosis, ischemic heart disease, and stroke.  So the controversy continues. You can access them here:
http://bmj.bmjjournals.com/cgi/eletters/325/7374/1202 

Research is also showing that high homocysteine levels are complicit  in the development of osteoporosis, stimulating bone breakdown and resorbtion rather than bone building.  http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=18067447&ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

The good news is that homocysteine levels can be lowered naturally, drugs are not required. Dr. Frankel's research concentrates on an approach called methylation, which involves donating a methyl group to homocysteine, a process which converts it to the harmless amino acid Methionine. The substance he uses is called TMG, or Trimethylglycine. (Interestingly, when it has donated its methyl group to homocysteine, what is left is DMG, Dimethylglycine, also known as B15, a substance which is a high energy producer). This is available as a new supplement, and he also recommends combining it with other methyl donor supplements, whose effectiveness has already been shown in previous research on homocysteine levels, and these are folic acid, B6 and B12. There are combinations of the 3 available to help those at risk from high homocysteine levels. Interestingly, a 1999 study published in the Journ. of Lab. and Clin Med., 134:238-243, showed that the loop diuretic furosemide, commonly used to treat heart failure, can double the usual rate of excretion  of B1.  A deficiency of this B vitamin can be a risk factor for heart failure.

Dr. Broda Barnes is well known in the alternative community as an expert on thyroid problems, and his book published in 1976 called "Solved: the Riddle of Heart Attacks" pointed out the connection between thyroid and heart attacks.  We know now that an underactive thyroid affects the absorption of B vitamins, the deficiencies of which in turn raise homocysteine levels. 

Normalizing thyroid function may protect the heart - http://illness.altmedangel.com/hypothy.htm

Many of you will now have learned about homocysteine, and I certainly don't want to miss a chance to say "I told you so"! Or, as the Russians used to put it "Ve Vere there first!" This is, therefore, a reprint (with some revisions) of an article first printed in our local paper in April of 1997. It may also be of interest you to know, that certain pharmaceutical companies  lost a major battle attempting, with the help of the FDA, to have  TriMethylGlycine declared a drug, when it is obviously a food supplement.  It is apparently so effective that they want to be able to patent it, which would have the effect of making it very expensive.

Frankel also advises dietary changes, noting that the Standard American Diet ( aptly abbreviated S.A.D) which is high in protein, fats, processed foods, frozen and canned foods both increases our production of homocysteine, and decreases our body's ability to remove it from the system. Smoking, and oral contraceptives also adversely affect these processes. On the other hand, a diet high in unprocessed foods , low in the "bad" fats, low in protein and high in fruits and vegetables can increase methyl donors and lower homocysteine.

Protection against heart disease is, according to Dr. Frankel, not the only benefit of lowering homocysteine levels: methylation also plays a role in protecting DNA, and therefore is a line of defense against cancer: loss of methyl groups from the DNA leads to "inappropriate gene expression, which is implicated in certain cancers. The idea us that DNA methylation can prevent cancer-causing genes from being activated".

Methylation is also involved in the production of S-Adenosylmethionine, or SAM-e, a substance that is widely used in Europe to counter depression. An U.C.L.A veteran's study conducted with 15 patients with major depression found that after being treated with SAM-e for 15 days, their index for depression improved by 50%, with no side effect noted.

At the 2000 meeting of the American Association for the Advancement of Science, I was amused to read that while many said that taking vitamins and supplements for high levels of homocysteine was a good idea, others considered it too early to do anything about the amino acid except in extreme cases. 

However, based on the fact that high levels of homocysteine are more common in people with cardiovascular problems, including stroke, the Doctor representing the Oregon Regional Primate Center  made no bones about the fact that both he and his wife practice prevention.  Since testing to confirm the presence of high levels is expensive, this makes sense to me.  Incidentally, Ms. Howard of the American Heart Association put the number of people with high levels of homocysteine at 5% of the American population.  I don't know how she came up with this figure, but I suspect it is far too low.

High homocysteine levels are now suspect in osteoporosis, which is not a surprise, given the connection between pH, methylation and homocysteine.

The study's authors state:
 "An increased homocysteine level appears to be a strong and independent risk factor for osteoporotic fractures in older men and women,"  while recommending that this risk be confirmed in other large population studies. "Proof of a causal relationship between increased homocysteine levels and bone disease could be established by intervention studies aimed at lowering the serum homocysteine level. Whereas randomized, controlled trials have shown that folic acid–based vitamin supplements can effectively reduce homocysteine levels and reduce the rate of coronary restenosis, additional studies are needed to assess whether the use of such therapy will reduce the risk of fracture."


Here is the full report at MedScape - http://www.medscape.com/viewarticle/477554?rss

Increased methylation in our bodies is obviously to be desired, and the road map Dr. Frankel gives us in his book is: avoid smoking, eating processed foods, high fat diets, birth control pills, high protein diets. Concentrate on green leafy vegetables and legumes and unprocessed foods. Take methyl donor supplements such as Folic Acid, B12, B6, TMG, and choline. These strategies will lower homocysteine levels, and therefore eliminate what he considers the main risk factor for heart attacks and strokes, as well as possibly depression and Alzheimer's disease. Some recent research is suggesting that children with ADD/ADHD have high levels of homocysteine.   Outlined above is an  approach that is both simple and effective, contributing greatly to our overall health, and lowering some seriously threatening health risks. 

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Keywords: homocysteine heart disease, natural control homocysteine, b vitamins homocysteine, methylation homocysteine, tmg homocysteine, the vitamin lady writes about homocysteine, homocysteine osteoporosis, natural control homocysteine

A meta analysis of Homocysteine and Cardiovascular Disease - http://www.healthandage.com/PHome/gm=20!gid2=2213

Homocysteine, dementia and Alzheimer's - http://content.nejm.org/cgi/content/short/346/7/476

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