Daily supplementation with 5 mg of folic acid, 0.4 mg of hydroxycobalamin, and 50 mg of pyridoxine reduces homocysteine levels in patients with venous thrombosis as well as in healthy control subjects, according to the results of a study conducted in The Netherlands. Researchers report that, within 8 weeks, the multivitamin reduced homocysteine levels by approximately 30%, compared with the placebo, in both patients and control subjects. Interestingly, the vitamins also moderately reduced homocysteine in subjects whose initial homocysteine and vitamin levels were normal. This observation raises the question of 'normal' homocysteine and vitamin levels.

Arterioscler Thromb Vasc Biol March 1998;18:356-361.

COMMENT: Homocysteine is a frequently overlooked risk factor for heart disease. I had a patient last week whose 46 year old brother just had a heart attack and her dad died earlier from a heart attack. When she asked the hospital staff if homocysteine levels were done on her brother, they had no idea what she was talking about. It is sad that some of this information takes such a long time to be transferred to the medical community at large. Homocysteine is such a simple cardiac risk factor to reverse. Just a bit of folic acid and B12 and some pyridoxine (B6) will easily correct this problem. More than likely, the reason it is not being heavily promoted is that no company stands to earn significant profit from its promotion. Indeed, a sad commentary on the current state of our health care system.