Homocysteine – New Assessments for Cholesterol

heartI thought it would be good to deal with the latest in cholesterol management. At one point, the Parkersburg News ran an article on the health page titled “Hearts Beware Of Plaque” which sparked my curiosity. This article mentions how plaque is the problem when dealing with cardiovascular disease. It did not mention how homocysteine is a consideration when doing cholesterol assessments. This article will attempt to fill in the blanks from that article.

What is homocysteine and how does it affect the build up of plaque in the arteries? Homocysteine is not sold in stores or cannot be found in foods. It is a product of metabolism; meaning, it is made in the body like cholesterol. To keep it simple, homocysteine is manufactured from an amino acid found in meat called methionine. When the body digests and metabolizes methionine, it produces homocysteine before being converted into other products. The problem arises when the body cannot convert homocysteine. The critical B vitamins (B6, B12) and folic acid, choline and betaine are instrumental in converting homocysteine. The standard American diet is deficient in B vitamins. Because of over processing of food, many of us do not get adequate amounts of these nutrients to be helpful to this problem. To put it simply – when homocysteine levels get too high because certain B vitamins are too low, plaquing becomes a problem.

Let’s look at how elevated homocysteine can contribute to cardiovascular disease. When this situation occurs, elevated homocysteine damages the blood vessel wall. This sets the stage for an increase in the formation of fibrous tissue and calcium deposits on the inside of the artery. When the blood vessels feeding the heart are damaged, this is called coronary artery disease. When the vessels to the brain are affected, this becomes a potential for a stroke. When it affects the hands and legs, it is called peripheral artery disease.

The issue of homocysteine is not new to science. Research into this began back in 1933 when an article appeared in The New England Journal of Medicine about an 8-year old boy who died from a stroke. Autopsy showed that the boy had arteriosclerosis that was usually seen in the elderly. Later, Kilmer S. McCully, MD, became interested in the homocysteine connection when an Irish researcher noted that retarded children were dying of advanced heart disease and stroke before reaching puberty. This sparked DR McCully to begin studying. In 1969 Dr. McCully presented his work in the American Journal of Pathology, but he was not taken seriously. Since then much more research has been conducted, and to date there have been over 1,500 published studies on homocysteine in medical journals. In an article published in 1995 by the Journal of the American Medical Association, again researchers urged Americans to increase their intake of folic acid as a preventive measure against heart disease. The researchers further stated the following:

  • 30% to 40% of people with cardiovascular disease and peripheral artery disease have high levels of homocysteine.
  • 30% of elderly men and women have elevated homocysteine levels.
  • 25% of middle-aged men are deficient in vitamin B6, 56% in B12, and 59% in folic acid.

It is estimated that 40% of heart attacks in the United States may be caused by elevated levels of homocysteine. Current medical testing has mostly centered on elevated cholesterol as the problem. However, it is interesting to note that 80% of heart attacks occur in men with normal cholesterol levels. Our current assessment of cholesterol looks at the overall cholesterol in relation to the two-lipo proteins called HDL (high density lipo-protein) otherwise good cholesterol and LDL (low density lipo-protein) or bad cholesterol. Another factor being assessed is the level of triglycerides. A triglyceride is a fat storage molecule that comes from animal products and refined sugars. When it is elevated along with elevated cholesterol, the cardiovascular risk factor goes up.

Several recent studies indicate that one of the prime targets of free radicals is LDL cholesterol. Oxidized and non-oxidized LDL cholesterol has been implicated in artery damage. Homocysteine may also cause this oxidation of LDL. Anti-oxidant vitamins of vitamin C, E and beta-carotene have shown promise in preventing this from happening. Another type of lipo-protein is called LP(A), and it is considered another marker for elevated risk to cardiovascular disease. Dr. Mathias Rath a world-renowned cardiovascular researcher explained that LP (A) is produced in the body due to low levels of vitamin C and E that are instrumental in repair process when arteries are damaged by free radicals. LP(A) is like double stick tape. If the repair process of the vessel wall is incomplete the LP(A) fills in the damaged areas. Being like double stick tape it catches cholesterol as it passes by and may lead to a build-up of plaque that can block arteries.

Are there tests for LP(A) and homocysteine? Testing has been developed along with the lipid profile of a standard blood test. At the present time it is not the norm for this to be checked, but you would need to ask your health care practitioner to have it checked.

The average person has extremely small amounts of homocysteine. For every 1,000 molecules of cholesterol, there is generally one molecule of homocysteine. Researchers are currently trying to establish safe levels. At the moment, it is assumed that the normal range is between 4.9 and 11.7 micromoles per liter of blood. Of course, there are different levels based on age and gender. Anything over 14 micromoles is considered damaging.

According to Dr. McCully dosages of the B vitamins should be within these ranges. B6- 4 -4.3 mcg, b 12 5 – 15 mcg, folic acid 400 mcg taken on a daily basis. Most B complex vitamins are adequate to take care of this potential problem with homocysteine.

As with any health condition it is important to research when considering any therapy. Consult with your health care practitioner.

For more information read The Homocysteine Revolution by Dr. Kilmer McCully or Homocysteine: The New ” Cholesterol” by Jack Challem and Victoria Dolby.

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