A high concentration of homocysteine in the blood appears to be a risk factor for heart disease. Even mildly elevated homocysteine levels are associated with an increased risk of death from any cause.

The first study showed that even subjects with mildly to moderately elevated homocysteine levels had a 30% to 50% higher risk of death than those with the lowest levels.

The second study examined published studies on homocysteine levels and cardiovascular disease and found that the evidence reviewed supports a positive association between plasma homocysteine level and risk for cardiovascular disease.

Annals of Internal Medicine September 7, 1999;131:321-330, 363-375, 387-388.

COMMENT: Previous studies have shown that supplements of folic acid, vitamin B6 and vitamin B12 can lower high homocysteine levels.  Seven randomized, controlled studies that are now under way or in development to "scientifically prove" that this is a beneficial and safe recommendation.

Folks, do we need to wait ten years for researchers to tell us that it seems wise to take a few B vitamins to lower a clearly established risk factor for heart disease? Unfortunately, the test for homocysteine is expensive, nearly $100 in many labs. The cost of the test would provide enough treatment for years for most people.

So, my recommendation is to have your levels checked if you have good insurance for lab coverage. If you do not and are at high risk for heart disease, consider taking some folic acid, B12 and B6. It is important to remember that B12 is one large molecule and, as a result of that, it is poorly absorbed orally.

The ideal route of administration would be through an IM injection. A previous newsletter describes how one can use DMSO to apply it transdermally. There are also inhaled prescription versions of B12, but they are hyper expensive. If one does not have any of the above routes open to them, the next best option would be to use sublingual (under the tongue) versions available at most health food stores.

However, let us never forget that whole foods are tremendous sources of most B vitamins. Folic acid is found in green leafy vegetables and legumes.  Vitamin B-6 is found in poultry and fish. One would have to include animal products for B12 though as there are no great plant sources of this vitamin. Vitamin B12 deficiency is one of the most common problems I see with patients who are vegetarians.

Eating seven servings of vegetables and some fruit each day, along with moderate consumption of meat and dairy products should provide adequate amounts of these B vitamins to reduce all but genetically deranged homocysteine levels.