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Life Extension Magazine

LE Magazine November 2003

Startling New Findings About Homocysteine

Life Extension has consistently found that taking very large doses of folic acid does not lower homocysteine much more than moderate folic acid intakes. When members present with stubbornly high homocysteine levels, we have seen significant reductions when the dose of vitamin B6 and/or TMG is increased, but not when folic acid intake is increased. If homocysteine levels remain high despite higher intakes of TMG and B6, there is now the option of taking a weekly 1-mg vitamin B12 shot or trying very high sublingual doses of vitamin B12.

AMA Takes One Step Backward

Since 1990, the Journal of the American Medical Association (JAMA) has published dozens of articles documenting the cardiovascular dangers of homocysteine, C-reactive protein, and fibrinogen.

Three new articles published in JAMA advise doctors to take the easy way out in helping patients to reduce heart attack risk. The consensus of these articles is that while homocysteine and other cardiovascular blood markers contribute to heart attacks, physicians should concentrate prevention efforts on controlling the following four areas:

Cigarette Smoking
High Cholesterol
Hypertension
Diabetes

JAMA suggests that doctors go back to knowledge that is 30 years old in an effort to better reduce heart attack risk today.
Of course people shouldn’t smoke. One reason is that cigarette smoking boosts homocysteine levels in the blood. The trouble is that doctors have only minimal control over their patients’ smoking habits.

Hypertension can be better controlled if physicians made a greater effort. The August 2003 Life Extension magazine describes what doctors are not doing to optimally control blood pressure. Controlling hypertension better, however, does not mean that the proven dangers of homocysteine should be ignored.

Diabetes is an absolute cardiac risk factor, but conventional medicine focuses too much on treating hyperglycemia (high blood glucose) and not enough on suppressing excess insulin levels. Type II diabetics suffer from hyperinsulinemia (excess blood insulin) years before hyperglycemia manifests. During this period when the pancreas is secreting too much insulin, severe damage is being inflicted on the arterial wall, the eyes, kidneys, nerves, etc. (Refer to the Diabetes protocol in the 2003 edition of Disease Prevention and Treatment for complete information about lowering excess serum insulin.) Preventing diabetic vascular complications should include—not exclude—aggressive steps to lower homocysteine.

High cholesterol is only one of many heart attack risk factors that can be identified in the blood. Published studies indicate that other blood markers (such as C-reactive protein and homocysteine) may be more dangerous than high cholesterol.

The American Medical Association has proclaimed that doctors should focus on only four areas of heart attack prevention. This edict is a loud and clear signal that people who are truly concerned about their risk of heart attack should take matters into their own hands and follow a program that keeps ALL the known cardiac risk factors—including homocysteine—in safe ranges.

Why Homocysteine Blood Testing Is So Crucial
It has become clear that homocysteine levels increase with age and with the onset of degenerative disease. A spike in homocysteine not only accelerates damage to the arterial wall and neurons, but also increases the risk of sudden death heart attack or stroke.

As humans age, they sometimes need to increase their intake of homocysteine-lowering nutrients because their natural detoxification systems are no longer adequate.

It is not possible to “guess” what one’s homocysteine levels may be. The only way to maintain safe ranges of homocysteine is to have your blood tested, follow the appropriate homocysteine-lowering program, and then retest your blood 30-90 days later to make sure you have reduced homocysteine to a safe range (below 7-8 µmol/L). Any other approach is the equivalent of throwing darts with your eyes blindfolded.

Medicare Will Not Pay for Homocysteine Blood Testing
Based on the fact that those with lower homocysteine have a reduced risk of disease, you would think that Medicare would mandate annual homocysteine blood testing in order to lower its outlays for expensive procedures such as coronary bypass surgery and nursing home care.

Instead, Medicare classifies homocysteine as a “non-covered” test. We were told that Medicare always refuses to pay for the test because it considers the test “not medically reasonable and necessary.”

The homocysteine blood test is FDA approved and the scientific literature conclusively links elevated homocysteine to increased risk of disease in the elderly. Yet Medicare denies payment for it. We believe that these kinds of illogical rules will accelerate Medicare’s collapse into insolvency in the not-too-distant future.

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