Hamilton NEW ZEALAND
Biomedical Therapies for Optimum Health
Hamilton NEW ZEALAND
Biomedical Therapies for Optimum Health
is a remarkable example of medical sleuthing, discovery, solutions, acclaim, establishment, rejection and decades later 'rediscovery'. Then rejection again in favour of drugs. An all too common situation in the medical industry.
Protein in the body is made up of many different amino acids, like carriages of a train. Some amino acids we can make and others we depend on getting them from diet - they are the 'essential' amino acids. Homocysteine is an amino acid we can make. It is found in that part of body chemistry called the 'methionine cycle' where methionine (another amino acid) is converted into SAMe. SAMe is most valuable as it 'donates' methyl groups, called methylation, a crucial necessity for many aspects of cell regulation. SAMe itself is a very useful treatment supplement in its own right. However, when the methionine cycle is not working properly, perhaps because of toxins, gene expression problems then homocysteine builds up. Lack of adequate methylation occurs in many disorders from arthritis, depression, liver disease to even Downs Syndrome.
noted the 1933 landmark case of young 8 year old boy who died from atheroma-blocked arteries. Then another case in 1965 of a 9 year old girl who had a newly discovered disease called 'homocysteinuria' where large amounts of a normal amino acid was found in the urine and blood - causing mental retardation and other problems. It turned out that it was her uncle who was that 8 year old boy and homocysteine was a common factor.
By 1965 McCulley submitted his research paper suggesting the link between homocysteine and atheroma in children. There were three types of homocysteinuria, all concerning problems converting homocysteine to methionine...leading to a toxic protein buildup of homocysteine. Three common vitamins were needed yet they were either deficient or not being processed properly - B6, B12 and Folic acid. Simple stuff, it seemed.
At the time this caused great excitement in the medical research community. His discovery was being confirmed in other centres. There was also research showing a link with homocysteine in adult onset atheroma too. Could it be the cause of heart disease? Groundbreaking news. But McCulley also proposed through his research that 'cure' was possible by treating with relatively high doses of one or combinations of folic acid, B6 and B12. Perhaps this was to be his big mistake, he should have found a drug cure.....
However, the cholesterol causation theory was deeply entrenched, and had been since the early 1900's. Puzzling was the fact that a great proportion of heart victims had normal cholesterols! Still, there was a link between high cholesterol and advanced atherosclerosis, that cant be denied. But other more powerful factors seemed to be at play.
Policy decisions were made at the highest level that the way forward was to back the 'cholesterol cause' as the key to prevent and treat heart disease. McCully's work was pushed aside as was he personally. His career of 28 years at Harvard University was over.
Pharmaceutical industries then worked frantically to discover or improve lipid (fat) lowering drugs - and to this day. Sure, they have their place and can be very effective in lowering your cholelsterol (lipid lowering drugs are covered elsewhere).
The cholesterol theory had failed also. Heart disease dropped dramatically in the 60's after an escalation in the 20 years before that. But there were no changes in population cholesterol profiles. Another problem with the theory was the lack of correlation between dietary fat and LDL levels. There have been vast numbers of trials since to try and establish causative factors. There are many. Indeed, as the western population has gone 'low fat' and high carbs and sugar, it has grown obese and heart disease is rampant and victims younger. Some doctors myself included have always maintained its the "sugar not the fat."
It turns out that homocysteine is linked to several diseases including atheroma, stroke, Alzheimers, depression and many others possibly.
Homocysteine has been 'rediscovered' 20 years later. Its "an atherogenic determinate that promotes oxidant
stress, inflammation, endothelial dysfunction and cell proliferation" according to the New England Journal of Medicine. In simple terms, its very
bad for you when elevated in your blood.
In fact elevated homocysteine is even worse for stroke risk. Homocysteine oxidises LDL (becomes biologically rancid and harmful).
Just to show how much we dont want homocysteine to be a problem (remembering that the treatment is a few dollars worth of vitamins),
a recent editorial was published by the NEJM to conclude that "modest lowering of the homocysteine did not reduce heart attack
risk of those with existing vascular (artery) disease". in conclusion, doctors and patients, there was "no clinical benefit
in the use of folic acid, B6 or B12 in patients with established heart disease".
How come, after all those painstaking years of research which showed that as levels climbed up above 7 micromols/L, the incidence
of strokes and heart atttacks went up? In fact as it got above 11 the risk of stroke increased by 74%!
About to be published in Cardiology 2007 is a study showing that there is a 2.5 factor increase in coronary events (heart attack) in people with existing heart disease and homocyteine level above average levels.
In 1992 a study of physicians with no history of heart disease and highly elevated homocysteine showed a 300% increase in heart attacks over a 5 year period.
Previous studies appeared to show that keeping homocysteine under 7 was the safest approach. Certainly under 9 at least because from 9-15 there was a doubling of risk of dying of a heart attack; and from 15 up nearly 6.5 times the risk.
The NEJM reported the 2 new studies from which they drew their latest conclusions of 'no use'. Carefully looking at their study design shows that they reduced the homocysteine in one study from 12.2 to only 9.7 average over 2 years and the other study, 13 to only 9.6 over three years. No wonder it wasnt effective! One could ask in their defence though why there wasnt at least a small drop in death rate? This is perhaps answered by noting that to participate in the study each had to have pre-existing vascular disease or heart attacks. So it was a very unhealthy group. In addition, the trial ran for 2 and 3 years only; the subjects had a lifetime of disease. To cap it off, if a subjject had a heart attack even after taking just one vitamin pill, it was classed as a statistic or failure.
Conventional blood test normal levels are said to be:
In conclusion, I would currently put my money on reducing homocysteine to under the 7-9 range based on accumulated scientific data
versus 2 only recently reported negative studies which may not be well designed enough to refute known data.
Especially so because the treatment is safe vitamins; uses natural body repair mechanisms and is simply Folic acid and/or B12 and/or
B6. Just cents a day.
Homocysteine reduction |
|
|---|---|
| Folic Acid | 4000mcg to 8000mcg daily |
| Vitamin B6 | 100 to 200mg daily |
| Vit B12 | 1-3 mg daily |
| TMG (Triimethyl glycine) | 2-4gms daily |
| Zinc | 30-60mg daily |
| SAMe | 400mg 1-4 daily |
| N-actyl-cysteine NAC | 600mg 1 - 2 times daily away from food |
This protocol should be done under the supervision of Dr. Reeder at the clinic. Not all the above supplements may be necessary initially. Sometimes injectable vitamins are required for difficult cases.