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Medical Forum / Diseases and Disorders / Diabetes / March 2006Homocysteine
I have been taking folic acid, vitamin B6 and B12 for almost 2 years. They were supposed to lower my homocysteine and reduce the risk of heart attack or stroke. Now they are saying they do lower the homocysteine but have little or no effect on the risk. In fact, they may increase the risk! http://Homocysteine.notlong.com I am beginning to think I would fair better if I got my health advice from South American Shaman rather than doctors. Anon I always take these types of studies--studies that try to correlate one thing with another--with a bit of skepticism, whether the study supports what I'm doing or not. Do you remember the famous Framingham study in which they concluded that coffee causes heart disease? Several years later, they recanted, realizing they hadn't controlled for smoking. Turns out many coffee drinkers are smokers. Instead of blaming the smoking, they'd erroneously blamed the coffee. While I think scientists have learned from this rather huge snafu, I always wonder what else is going on. And I always wish I had a better understanding of statistical mathematics because sometimes what is reported as a seemingly impressive percentage is not when the data is analyzed. Michelle Anon, with studies like this anyone could go nuts I have been jtaking the same three supplements for years and my homocystein levels are under 7. I think lower is better. I am not stopping the supplements. This wasnt a study with 100,000 people so how can we be sure. I will discuss it with my doctor. I suggest everyone on it does the same. Listen if there was something that cured everything, we would all live to a thousand. Something has to get us, just hope not too soon. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. :: Anon, with studies like this anyone could go nuts I have been :: jtaking the same three supplements for years and my homocystein [quoted text clipped - 4 lines] :: I will discuss it with my doctor. I suggest everyone on it does the :: same. Whenever I tried that I've always wished I hadn't bothered wasting time on it. Did you doctor really have a real conversation with you about this? :: Listen if there was something that cured everything, we would all :: live to a thousand. Something has to get us, just hope not too soon. [quoted text clipped - 5 lines] :: of Israel, two bastions of strength in a world filled with strife and :: terrorism. This post not CC'd by email On Sun, 12 Mar 2006 20:13:20 -0800, "Anon" <anon4592004@yahoo.com> wrote: >I have been taking folic acid, vitamin B6 and B12 for almost 2 years. They >were supposed to lower my homocysteine and reduce the risk of heart attack [quoted text clipped - 7 lines] > >Anon G'day G'day Anon, Elevated homocysteine has been an excellent marker for a pathological process. Homocysteine is a naturally occurring intermediate in amino acid metabolism. When the metabolism isn't normal the steady state level of homocysteine rises. There are two processes that reduce the levels of homocysteine. One converts it eventually to SAMe and the other to glutathione, both having wonderful benefits for health. At first the medical world was enamored with high dose folic acid. That worked in reducing homocysteine levels but didn't reduce morbidity. Then they added Vit B12 and B6. I'm not sure how well that has worked with morbidity and would appreciate someone coming up with the actual research on the matter rather than an internet opinion piece. Perhaps the problem is they haven't spread their net wide enough even now. The actual ingredients needed for full conversion to SAMe is TMG (trimethylglycine supported by B12, folate, B6, B2, magnesium and zinc. The pathway to glutathione requires B6, B2 and zinc. Where do we get TMG? We produce it from choline found in fish and egg yolks, prawns or from betaine found in sugar beet or beetroot grown in salty soil or beans, peas, The best foods for Vit B12 are per 100 grams. Sardine 28 mcg Oysters 15 mcg Cottage cheese 5 mcg Tuna 5 mcg Turkey, chicken 2 mcg The best foods for Vit B6 are per 100 grams. Salmon 820 mcg Trout 680 mcg Pheasant 660 mcg Turkey 470 mcg kidney beans 440 mcg Mackerel 400 mcg brussel sprouts 280 mcg The best foods for folate are per 100 grams. lentils 179 mcg endive 142 mcg chick peas 141 mcg spinach 140 mcg broccoli 130 mcg Best wishes,  SignatureQuentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin > This post not CC'd by email > On Sun, 12 Mar 2006 20:13:20 -0800, "Anon" <anon4592004@yahoo.com> [quoted text clipped - 34 lines] > (trimethylglycine supported by B12, folate, B6, B2, magnesium and > zinc. The pathway to glutathione requires B6, B2 and zinc. <snip> Thanks Quentin, this gives me some homework. In light of the findings of this study, I am interested to see the results of a similar study that I just started. Although the initial stage just finished, last month I joined a five year extension. The study is known as FAVORIT, and is studying a similar combination of vitamins in a smaller sub-group of patients than those in the general population, which the study just released in the N.E.J.M. covered. FAVORIT covers only renal transplant patients, who are at greater risk than the general population for cardiovascular morbidity. The prospective study of renal patients in Australia that preceded FAVORIT indicated that: "After adjustment for several important risk factors, elevated tHcy levels (>/=12 micromol/L) were associated with 2.44 times the mortality risk of patients with normal tHcy levels" "Similarly, elevated tHcy levels were associated with 1.63 times increased risk of kidney allograft loss" Fasting Plasma Total Homocysteine Levels and Mortality and Allograft Loss in Kidney Transplant Recipients: A Prospective Study Winkelmayer WC, Kramar R, Curhan GC, et al Journal of the American Society of Nephrology. 2005;16(1):255-260 Whether I get the placebo or 1 of 2 doses of vitamins, hopefully the study will show that at least some people get some benefit in reducing homocysteine levels. http://www.niddk.nih.gov/patient/favorit/favorit.htm Dennis (Type 2, Kidney Transplant 1995) This post not CC'd by email On Tue, 14 Mar 2006 21:58:37 -0500, Dennis R <dennis.rekuta@sympatico.ca> wrote: >Thanks Quentin, this gives me some homework. In light of the findings of >this study, I am interested to see the results of a similar study that I [quoted text clipped - 25 lines] > >Dennis (Type 2, Kidney Transplant 1995) G'day G'day Dennis, Thank you for posting. The pharmacology associated with homocysteine is in its infancy so it is important not to let negative results discourage further research. Homocysteine appears as a marker in so many pathological conditions it seems that time will show it is important to deal with it. My guess is that in time we discover WHAT ELSE must be done get the benefits of lowering homocysteine. Best wishes, SignatureQuentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin > Homocysteine appears as a marker in so many pathological conditions it > seems that time will show it is important to deal with it. My guess > is that in time we discover WHAT ELSE must be done get the benefits of > lowering homocysteine. But it may also be that high homocysteine levels are *not* the problem, just an indicator of the problem, and lowering the homocysteine levels will not deal with the underlying problem. In any case, there seems to be precious little downside to taking the B supplements, so there's no harm to doing it, it just might not be helping as much as we hoped. Chak SignatureI would like at least one political party in this country to be willing to say that sex is fun and an important part of being human. --PZ Myers, http://scienceblogs.com/pharyngula/ This post not CC'd by email On 15 Mar 2006 19:38:41 GMT, Chakolate <chakolateDeathToSpammers@gmail.com> wrote: >> Homocysteine appears as a marker in so many pathological conditions it >> seems that time will show it is important to deal with it. My guess [quoted text clipped - 4 lines] >just an indicator of the problem, and lowering the homocysteine levels >will not deal with the underlying problem. G'day G'day Chakolate, Indeed it could turn out that high homocysteine is not a problem. Personally I doubt that this is true. The steady state for homocysteine is normally low. In a host of pathological conditions the levels are high. Put simply it is like the situation in Sicily where a little town wins the state lottery TWICE. Once could be coincidence. Twice stretches that coincidence. There is a deep suspicion that some form of rigging occurred. We don't know how but coincidence doesn't seem like the most likely answer. My apologies if my explanation isn't very clear. It does seem as though homocysteine isn't the problem. What I'm saying is that it is problematic BUT there is another as yet hidden part of the jigsaw puzzle that has to found before intervention will work. Why am I so obstinate in this matter? Well New Zealand is a young country in geological terms. The soils are notorious for being deficient in TRACE elements as well as some major and minor elements. Clover didn't thrive in some areas due to a shortage of molybdenum. Cattle didn't thrive in some areas due to shortage of cobalt. These were trace elements. Sometimes adding fertilizer worked because they accidentally added sufficient of the trace elements. Sometimes they didn't. It was very hit and miss. It was easy to think the soils didn't need calcium because they didn't respond to it. People could have though calcium was only a marker for plant health and that intervention with lime (calcium carbonate) was not beneficial for clover growth. And they would have been wrong. All the time the clover was unable to utilised the calcium because it was molybdenum deficient. >In any case, there seems to be precious little downside to taking the B >supplements, so there's no harm to doing it, it just might not be helping >as much as we hoped. IMHO there could well be a downside to taking even harmless supplements like the B group vitamins. The doses in supplements are often high and not necessarily well balanced. As a general rule if one goes for getting B group vitamins from food one is likely to get benefits from substances one didn't even know existed. How many people have thought about their choline intake this week? Was it adequate? >Chak Best wishes, SignatureQuentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin >How many people have thought about their choline intake this week? >Was it adequate? I have to admit, I'd never heard of it until reading your post! It does look important though. By luck, I'm getting plenty, judging by the list of foods high in it: soybeans, egg yolk, butter, peanuts, potatoes, cauliflower, lentils, oats, sesame seeds and flax seeds. I don't eat potatoes, and very rarely eat oats, but the rest are staples of my diet. > Elevated homocysteine has been an excellent marker for a > pathological process. Homocysteine is a naturally occurring > intermediate in amino acid metabolism. When the metabolism isn't > normal .... [snip more good stuff] Quentin, this is a good example of the sort of post that I enjoy and consider valuable but which I suspect would unfortunately cause most bookstore browsers to return an item to the shelf. I hope I'm wrong. SignatureWes Groleau ----------- I've been framed! ... http://www.useit.com/alertbox/9612.html This post not CC'd by email On Wed, 15 Mar 2006 04:15:36 GMT, Wes Groleau <groleau+news@freeshell.org> wrote: >> Elevated homocysteine has been an excellent marker for a >> pathological process. Homocysteine is a naturally occurring [quoted text clipped - 5 lines] >unfortunately cause most bookstore browsers to return an >item to the shelf. I hope I'm wrong. G'day G'day Wes, The book has to be written because there are people like yourself who have intelligence and deserve to have the needs of that intelligence met. The world has a surfeit of dumbed down books on nutrition. IMHO it is time for something better. Best wishes, SignatureQuentin Grady ^ ^ / New Zealand, >#,#< [ / \ /\ "... and the blind dog was leading." http://homepages.paradise.net.nz/quentin > The book has to be written because there are people like yourself who > have intelligence and deserve to have the needs of that intelligence > met. The world has a surfeit of dumbed down books on nutrition. > IMHO it is time for something better. Ah, well then, I vote for more stuff like that. Sometimes, I remember you ventured into a bit of metaphor (for example, I remember something about the racing form) that adds a little entertainment value. That helps folks like me who have a short attention span (aka A.D.D.). On the other hand, the excessively intellectual might think it "corny." SignatureWes Groleau Don't get even -- get odd! :: I have been taking folic acid, vitamin B6 and B12 for almost 2 :: years. They were supposed to lower my homocysteine and reduce the [quoted text clipped - 6 lines] :: I am beginning to think I would fair better if I got my health :: advice from South American Shaman rather than doctors. Which doctor did you get homocysteine advice from? > I have been taking folic acid, vitamin B6 and B12 for almost 2 years. They > were supposed to lower my homocysteine and reduce the risk of heart attack [quoted text clipped - 5 lines] > I am beginning to think I would fair better if I got my health advice from > South American Shaman rather than doctors. A Medscape CME: subscription to Medscape is free and they have a good reputation concerning spamming and other use of e-mail addresses. B12, B6, and Folic Acid May Not Reduce Cardiovascular Events http://www.medscape.com/viewarticle/527591_print "March 15, 2006 — Vitamin supplementation with B12, B6, and folic acid does not reduce cardiovascular events, according to the results of 2 large randomized studies reported in the March 12 Early Release issue of The New England Journal of Medicine. One study suggests a trend toward harm from this combination. The editorialist suggests that other means to reduce homocysteine may still be beneficial, but that we should no longer recommend vitamin therapy. ... Compared with the placebo group, fewer patients in the active treatment group had a stroke (RR, 0.75; 95% CI, 0.59 - 0.97), but more patients in the active treatment group were hospitalized for unstable angina (RR, 1.24; 95% CI, 1.04 - 1.49)." There was less risk (RR = 0.75) for strokes but more risk of unstable angina (RR = 1.25). Angina results from shortage of blood supply or oxygen to the heart muscles. Keep in mind that many foods in the US are now supplemented with folate, i.e., cereal, bread, etc., so would there be really a true placebo in the US. Is it possible to get an unbiased study since folate is supplemented in foods? The New England Journal of Medicine is highly thought of and is peer reviewed. The news relase from Anon source and Medscape seem to be the same. Frank |
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