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BEYOND CHOLESTEROL ......
AN AMINO ACID CALLED HOMOCYSTEINE MAY BE AS CLOSELY
LINKED TO HEART DISEASE--AND EASIER TO TREAT
BY JEFFREY KLUGER
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- Between 1992 and 1996, 64 men and women in Norway quietly died. Their
passing was noted by their families but otherwise was largely unremarked. All
the deceased, after all, suffered from heart disease, and many had undergone
bypass surgery. Deaths like these are not the stuff of headlines.
Last week, however, the dead Norwegians made the evening news. What all of
them had in common, in addition to sickly hearts and premature deaths, was
elevated levels of an amino acid called homocysteine. The patients were part
of a study, published in the current issue of the New England Journal of
Medicine, that shows an almost lockstep correlation between high homocysteine
levels and coronary-disease mortality. And that paper follows more than 50
less publicized studies since 1992 suggesting similar connections.
What makes this research so compelling is that unlike cholesterol, which
everyone knows is associated with coronary problems but can often be treated
only by medication and a rigid diet, homocysteine appears to respond to
nothing more demanding than eating more vegetables and taking a few more
vitamins. Homocysteine is certainly not the lone gunman of heart disease, but
the studies strongly suggest that it's at least a co-conspirator--and one that
patients can do something about. "This is very convincing," says Dr. Jacob
Selhub of Tufts University in Boston. "Homocysteine appears to be a risk
factor for heart disease."
To a few doctors, homocysteine is nothing new. As long ago as 1969, Harvard
physician Kilmer McCully--now with the Veterans Administration Hospital in
Providence, R.I.--was studying the unusual case of an eight-year-old boy who
had died of a stroke. McCully found that the boy's bloodstream was fairly
awash in excess homocysteine and that his arteries had the sclerotic look of
an elderly man's.
Ordinarily pretty harmless stuff, homocysteine is used by the body to help
manufacture proteins and carry out cellular metabolism. Too much of it,
however, appears to cause blood platelets to clump together and vascular walls
to begin to break down. In older patients, a lifetime of this damage may give
arteries the scarred and thickened texture that provides circulating
cholesterol with a place to stick and grow. In the young boy, accelerated
homocysteine production caused by a genetic defect apparently led to
accelerated damage. In both instances, however, McCully points to the same
chemical culprit. "The underlying cause of heart disease," he says, "is an
imbalance in the system that controls homocysteine levels."
Superficially, at least, the New England Journal paper appears to confirm
this. The study, conducted at Haukeland University Hospital in Bergen, Norway,
surveyed 587 people with a history of heart trouble. The 64 who died during
the course of the research were among those with the highest levels of
homocysteine in their blood. Overall, the research suggested, people with
elevated homocysteine are 4 1/2 times as likely to die of heart disease as
those with normal levels.
No one knows for certain what causes some individuals and not others to
overproduce homocysteine. But the evidence points to a shortage of vitamin B6,
vitamin B12 and folic acid, all of which work to convert the amino acid into a
molecular form the body can use. The answer for people concerned about cardiac
health would seem to be for them to keep their intake of the protective
vitamins high. The Harvard Health Letter has recommended increasing
consumption of a range of foods--including leafy green vegetables, beans,
peas, grains and certain meats and dairy foods--to keep homocysteine in check.
Many researchers agree. "Don't wait for the Messiah," says Selhub. "Start
eating more vitamin-rich vegetables now. If you can't, take vitamin
supplements."
Not everyone is sold on such a simple prescription. Even if homocysteine is
behind some cases of heart disease, it's unlikely to be behind them all, and
there's no guarantee that managing the amino acid will decrease the risk of
cardiac trouble. Regardless of circulating homocysteine levels, smoking and
obesity will still ravage the cardiovascular system, and a poor diet will
still choke the blood with fats. Cardiologist Roger Blumenthal of Johns
Hopkins University estimates the share of all cardiac cases attributable to
homocysteine at fewer than 1 in 5.
What's more, even for patients whose illnesses are caused by elevated amino
acids, diet may not be much of a cure. Scientists know cholesterol levels in
the blood fluctuate within a limited range; when people eat less fat, the
liver simply manufactures more. It's not yet known whether there is a similar
set point for homocysteine. "People are jumping the gun if they think they can
just take vitamins and skip the traditional health measures like exercising
and eating a low-fat diet," says Blumenthal. "All the evidence has yet to come
in." Nonetheless, in a field of medicine in which the bad news often surpasses
the good, the evidence that came in last week was encouraging indeed.
- Methyl Guard by Thorne Research
METHYL-GUARD
CARDIOVASCULAR SUPPORT
COGNITIVE SUPPORT
Another Thorne Research innovation,
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Each
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Vitamin B6.... 6.8mg
Folate.... 400.0mcg
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Pure Betaine.... 600.0mg
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SF787 / 180
Dosage:
2 capsules tid
WARNING: If pregnant, consult your health
care practitioner before using this, or any other product.
Thorne
Research
A Professional Line of
highly researched products
Ownership by Thorne
Research of all trademarks of Thorne Research products
is hereby acknowledged. Thorne Research trademarks are
used by permission. All rights reserved.
Recommendations for
dosage and proper use of these products,
must be given by your licensed health care practitioner.
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