AboutJ.P. Saleeby, MD Expertise Will ONLY answer questions on Longevity & Nutrition Medicine. Please limit your questions to these fields of medicine. I will send any other questions to the question pool.
This forum does not allow for the diagnosis and treatment of illness, so please don't ask questions in that regard.
Experience Medical School: Medical College of Georgia (Augusta, GA class of 1991)
Post Graduate Training: ECU school of Medicine (Greenville, NC)
16 years in Emergency Medicine, Urgent Care and Occupational Medicine.
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Licensed in states of GA, NC, SC and VA.
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Former Medical Director and Founder of the Saleeby Longevity Institute a clinical practice and research center in integrative (CAM,Allopathic Medicine (1999 to 2004).
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Founder of Vita Sanus, Inc. Manufacturer & Distributer of Vita Sanus Nutraceuticals and Skin Care products (www.vitasanus.com) Sold in 2006.
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Adjunct Professor in Graduate School of Nursing Georgia Southern University (2002-2006).
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Author of "Wonder Herbs: A Guide to Three Adaptogens" available for sale at www.xlibris.com/wonderherbs or signed copies at www.saleeby.net
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Medical Director of the Emergency Department at Marlboro Park Hospital, Bennettsville, SC (2006-Present)
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Appointed to Medical Advisory Board for Aerobic & Fitness Association of America (AFAA) 2007-present
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Appointed to Medical Advisory Board for Beach Body (Product Partners) 2008-present
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Worked as chief formulator for supplement companies: Vita Sanus Nutraceuticals (Longevity Pack & entire line), SSN's PreGame Formulas for Golf and Tennis, AdapTx Labs' CardioFactor & PreFight, BeachBody's Shakeology consultant, Parhelion Labs' Oviun BioPharma sub-fertility formula.
Question Hi J.P.
I am your typical yuppie boomer trying to stay young. In spite of eating well, taking tons of supplements, working out, etc., I have recently been diagnosed with hypertension, on top of the G.E.R.D. and 'metabolic syndrome'.
In my research I have come across homocysteine, which seems to be implicated in a lot of these 'getting older issues'.
What are your thoughts on this?
I recently began taking a supplement called Betaine for my G.E.R.D. and it has helped. More research led me to 'TMG'. a form of betaine, which reduces homocysteine levels.If you belive the hype-EVERYTHING is hyped on the net-its a cure all. This high homocysteine level thing however seems to have medical backing.
Thanks for your thoughts.
Answer Van,
Traditionally hyperhomocysteinemia is treated with Vit. B6, B12 and folic acid and this should still be the mainstay of therapy.
Betaine Lowers Homocysteine Levels
Betaine aka trimethylglycine (TMG) , a vitamin-like compound that occurs naturally in the body and in some foods, can lower blood levels of homocysteine, reports a study in the Journal of Nutrition (2003;133:4125–8). Because keeping homocysteine levels low appears to reduce the risk of heart disease, increasing one’s intake of betaine may help keep the heart healthy.
The body produces homocysteine when it metabolizes the amino acid methionine. There is evidence that homocysteine is a toxic molecule, capable of causing damage to arteries and possibly promoting the development of osteoporosis. The body has two major ways of ridding itself of homocysteine: (1) converting it back to methionine, or (2) breaking it down further into other compounds. These metabolic pathways require three vitamins to work: folic acid, vitamin B6, and vitamin B12. A growing body of evidence indicates that supplementing with these vitamins not only can lower homocysteine levels, but may also prevent or even reverse hardening of the arteries (atherosclerosis).
Betaine has also been shown to reduce homocysteine levels, but the 6 grams per day used in the various studies was relatively large; a normal diet contains considerably less betaine, typically 0.5 to 2 grams per day. The new study was designed to determine whether betaine in amounts found in an average diet would have an effect on homocysteine levels.
Nineteen healthy volunteers received daily supplements of either 1.5, 3, or 6 grams of betaine or a placebo for six weeks, in two divided doses per day. Compared with the placebo, each dose of betaine produced a significant reduction in the homocysteine concentration, averaging 12, 15, and 20% for the 1.5-, 3-, and 6-gram doses, respectively. The results of previous studies have suggested that lowering homocysteine levels by 12% (which was achieved with the 1.5-gram dose) would reduce the risk of cardiovascular disease by approximately 5 to 8%. Therefore, consuming a diet high in betaine would be expected to decrease the risk of heart disease.
Major food sources of betaine include whole wheat, wheat germ, wheat bran, spinach, and beets. Whole wheat contains substantially more betaine than refined-grain products from which most of the germ and bran have been removed. Reports that eating whole grains is associated with a lower risk of heart disease might be explained in part by the high concentration of betaine in whole grains. Betaine is also available as a nutritional supplement, both as pure betaine and as betaine hydrochloride. The latter is used primarily to provide hydrochloric acid for people whose stomachs do not produce enough acid for normal digestion. People who do not have low stomach acid (hypochlorhydria) might develop heartburn if they take betaine hydrochloride; those people would likely fare better with pure betaine.
source: Alan R. Gaby, MD article for Bastyr University.
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For many people, the daily intake of 500 mg of TMG, 800 mcg of folic acid, 1000 mcg of vitamin B12, 250 mg of choline, 250 mg of inositol, 30 mg of zinc, and 100 mg of vitamin B6 will keep homocysteine levels in a safe range. But the only way to really know is to have your blood tested to make sure your homocysteine levels are under 7. If homocysteine levels are too high, then up to 6 grams of TMG may be needed along with higher amounts of other remethylation cofactors. Some people with cystathione-B synthase deficiencies will require 500 mg a day or more of vitamin B6 to reduce homocysteine to a safe level. For the prevention of cardiovascular disease, you would want your homocysteine blood level to be under 7. For the prevention of aging, some people have suggested that an even lower level is desirable, but more research needs to be done before any scientific conclusions can be reached.
A Life Extension article (July, 1997), sites these cases of people with problems in these pathways. “People with these disorders frequently die of cardiovascular disease before reaching adulthood. In one case history report, a 16-year-old Japanese girl was unable to walk with or without support, and had severe peripheral neuropathy, muscle weakness and convulsions. Her vascular system was on the verge of collapse. B6 or B12 didn't help. Folic acid lowered homocysteine, but didn't improve her symptoms. Two months after adding TMG to the regimen, her homocysteine level dropped and she was able to walk with support. Seventeen months later, she was free from convulsions and able to walk normally again.
This case history demonstrates the seesaw relationship between homocysteine and SAM. The girls SAM levels went from undetectable to near normal after the first two months of treatment while her homocysteine levels fell dramatically. If these nutrients can overcome a genetic disorder, consider how powerful they can be in reducing the risks associated with elevated homocysteine in the general population. Some people who have been taking this homocysteine lowering nutrient combination for more than a decade reported many benefits including fewer colds, more energy, increased endurance and lower blood sugar levels.”
Homocysteine is Not a New Story
Also from the Life Extension article – “The homocysteine theory of cardiovascular risk was first tested and published by Dr. Kilmer McCully in 1969, but, with everyone focusing on cholesterol at that time, his findings were ignored. Finally, almost 30 years later, the word is out on homocysteine. In addition to NBC Nightly News with Tom Brokaw, articles have been published in Newsweek, The Wall Street Journal, The Los Angeles Times, Prevention magazine and more.”
Homocysteine levels rise as people age. Therefore, any anti-aging program must take homocysteine level control into consideration. Lowering homocysteine has benefits beyond heart protection. When the blood supply to the heart is blocked, a heart attack results. When blood to the brain is blocked, a stroke results. If the penile artery is occluded, impotence results. Blockages in the extremeties results in intermittent claudication or pain in the affected extremity.
Homocysteines relationship to heart disease may explain some things that cholesterol never could. These B vitamins and homocysteine are so interrelated that homocysteine levels could be used to assess vitamin status. This could explain the increase in heart disease which has occurred in women over the past two decades which coincides with the use of birth control pills. Birth control pills deplete vitamin B6 and raise homocysteine levels. Smoking, a known risk factor for heart disease, also depletes vitamin B6 and smokers generally have low levels of folio acid and vitamin B12...all needed for homocysteine metabolism. Its not surprising that the statistics linking smoking to heart disease are similar to those linking high homocysteine levels to heart disease.(l)
The homocysteine story may explain some of the increases in heart disease that the cholesterol scare never could. We also know now that things like taking birth control bills and smoking deprive the body of vitamin B6 (and also B12 and folic acid in smoking). These both add to the risk of heart attack and it may be because of the effect on the homocysteine nutrients that they pose risk.
source: Dr. Deb Baker's writings
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