B Vitamins Harmful? B Real!

(Originally Posted March 24, 2006)
The April 13, 2006 New England Journal of Medicine will carry two articles in which investigators conclude that B-vitamins are of no value in preventing heart disease and may, in fact, be harmful. Once again, it is important to look beyond the headlines.

Both studies, which were released at www.nejm.orgon March 12th, were done on people who already had advanced cardiovascular disease at entry. All had a history of at least one heart attack, and many had a history of stroke or peripheral vascular disease as well. About half of the people in each group were still smoking, and about 40 % were diabetic. Nearly all were on multiple drugs - aspirin, beta-blockers, statins, ACE inhibitors, calcium-channel blockers, diuretics, warfarin, and diabetic drugs.

The baseline and end homocysteine levels are revealing (and what I suspected). In the Hope-2 trial the baseline homocysteine levels were 12.2 in both groups. This was lowered to 9.7 in the vitamin group, still well above the generally regarded as safe level of 7.2. In the Norvit trial the baseline was 13.2 and dropped to 9.5 in the treatment group.

The studies will be loudly trumpeted as conclusive proof that B-vitamins are of no benefit and are dangerous for people who have had a heart attack. However, anyone who thinks that lowering homocysteine to non-safe levels is going to significantly impact the outcome of these "sickest of the sick" must be living a rich fantasy life.

The authors assume a graded response to homocysteine - that a 10 % drop should result in a corresponding reduction in heart attack rates. But is this necessarily true, especially in the face of pre-existing disease?

Suppose a levee is designed to prevent flooding, provided that the water depth does not exceed 7 feet. What will happen if the water rises to 12 1/2 or 13 feet? The levee will overflow and surrounding property will be damaged. If the water level drops to 9 1/2 feet, what will happen? The levee will continue to overflow and property will continue to be damaged.

That is precisely what the Vitamin B studies demonstrate. Lowering homocysteine to unsafe levels does little, if anything, to stop the damage being done to arteries.

Having said that, an accompanying editorial draws a particularly interesting conclusion:

"What, then, can we conclude from the results of these trials? Clearly, folic acid, vitamin B12, and vitamin B6 are not the therapeutic solution expected, and they do not provide a preventive benefit in patients with mild hyperhomocysteinemia . . . we should consider alternative approaches to reducing homocysteine concentrations, perhaps with new methods of enhancing the conversion of homocysteine to cysteine in the liver or enhancing the urinary excretion of the amino acid."

The studies, therefore, are a resounding endorsement of the importance of not only lowering homocysteine levels to a safe range, but using a comprehensive approach in doing so. This is precisely what I had in mind when I created HCY Formula, which addresses both homocysteine conversion by the liver and homocysteine excretion by the kidneys. It is not surprising that nearly all of those using the product are bringing their homocysteine levels into a safe range.

For more on the significance of homocysteine see my article Homocysteine, Repair, and Maintenance

Dale H. Peterson, M.D.

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