Gary Wilbur’s wife, Sheila, tried her best to be helpful. He knew she loved him, and he knew that was why she was constantly on his back about his health, his food, and his exercise habits. This was because no matter how hard Gary tried, he could not stick to the sensible diet they both knew could spare him from heart disease. He would start each day with a healthful bowl of cereal and fruit and feast on baked potatoes and grilled chicken for lunch, but by dinnertime, his heart-smart enthusiasm had waned.
Gary would ultimately submit to nightly cravings for a juicy steak, or salty fries, and it drove his spouse wild with fear. Sheila loved Gary so much that she refused to take any chances with his health, especially with all she had read in the papers about the dangers of heart disease, and she eventually forbade him to eat any fats, or oils. With bread, Gary and Sheila ate margarine, but butter never touched their lips. Similarly, low-fat dessert treats were allowed sparingly in the house, but real ice-cream and cake were mere childhood memories. Sheila thought all was well with this new diet, until she found some crumpled wrappers of Big Macs and Whoppers stashed in the garage. Enraged, she turned to me to take her side.
“Gary is killing himself, and he doesn’t even realise it,” Sheila fumed to me in my office. “He’s a smart man, he knows that fat and oil will destroy his arteries, and still he downs junk-food like there’s no tomorrow.”
Sheila was making a mistake that is all too common in America. In her crusade against heart disease, she had failed to identify the real culprit. Although too much saturated and unhealthy, hydrogenated fats can clog arteries, everyone needs a small amount of good fat in their diets to stay healthy. Her ‘no fat, no oil’ campaign was a little too strict. Meanwhile, the ‘low-fat’ substitutes she was using may actually have been more lethal than their high-fat alternatives. Margarine, while lower in saturated fat than butter, contains trans-saturated fats, which have recently been deemed even worse for heart disease than butter’s saturated fats. Also, Gary ate a lot of breads and carbohydrates as part of his low-fat regimen, and too many carbohydrates were depriving him of the nutrients and vitamins that only fruits and vegetables yield.
I asked Gary if he would submit to some tests, to alleviate his wife’s anxiety. He agreed, hoping to prove to Sheila that he was in tiptop shape. Gary’s cholesterol levels were admirably low. His homocysteine levels, however, were shooting through the roof. While a normal level of homocysteine falls below 12, Gary was at 25. Clearly, despite the lack of fat in his diet, he was at serious risk of heart disease, probably because of a vitamin deficiency. Besides, your body turns about half of the ‘no fat’ carbohydrates in breads, pastas, potatoes, cereals, and other starches into fat, anyway. Gary was eating death on a roll.
It may seem impossibly simple, but I gave Gary supplements of folate and B vitamins to take daily. I also instructed him to eat less carbohydrates and greater amounts of varied fruits and vegetables. That’s all. In four weeks, his homocysteine levels were hovering around 12, low enough to satisfy even Sheila. Granted, this is no promise that Gary will not succumb to heart disease. And, while high levels of homocysteine have been widely recognised as a major risk factor for arteriosclerosis, it remains to be seen whether lowering these levels will reduce risk of stroke.
The best way to use the knowledge of homocysteine is to keep levels low, preventing them from rising dangerously. By just altering his diet, Gary was able to do his best to protect himself against heart disease — much to his loving wife’s relief.
Helen’s Case
Helen Smythe was alarmed when, at sixty-two, she awoke one morning without feeling in her lower extremities. A housewife and mother of three grown children, Helen had settled down to a quiet life of watching TV with her husband, Frank, throwing Tupperware parties, and volunteering for Mothers Against Drunk Driving. One morning, however, when she tried to get out of bed, she literally fell to the floor because she could not stand on her feet. It was as if, she told me later, her legs could not support her body. Her lower half was completely numb and tingly from that point on, and she could only move around by hobbling and shuffling, since she could barely feel where her feet were and where they were stepping.
I suspected that she had adult-onset diabetes, because it ran in her family, and one common symptom of the disease is peripheral neuropathy, which would explain her numb legs. After a number of tests, I saw that, indeed, her blood glucose was a moderately high 132. Her homocysteine levels were high at 20. High homocysteine may be a marker of heart disease, but it has also been found in diabetics with neuropathy. Vitamin B12 has been shown to reduce homocysteine levels in diabetic patients experiencing neuropathies.
The clear answer for treatment, I knew, was a heavy dose of the B vitamins. I prescribed 25mg of B6; 1,000mcg of B12; and 800mcg of folic acid. I added garlic pills — garlic has been shown to lower cholesterol and blood sugar — and, I suggested a low carbohydrate diet to help keep her diabetes under control. I also gave her a substance called chromium picolinate, which helps reduce insulin resistance. Finally, I added phosphatidyl serine and acetyl-L-carnitine to the mix, since both not only improve alertness and mental clarity, but also may alleviate peripheral neuropathies. An exercise regimen of daily walking and stretching would also stimulate Helen’s circulation and help decrease her blood sugar levels. Six months later, Helen walked back into my office with firm strides and a big smile on her face.
Homocysteine & Stroke: The Hidden Connection
Joseph Conley had always loved to eat, but even more, he had loved to cook. When he was a young boy, he would help his mother peel potatoes; when he was in high school, he persuaded the principal to let him take home economics instead of auto shop. It was only fitting that he eventually became a successful chef. Whipping up delicacies at an upscale New York brasserie, Joseph was surrounded with mouth-watering roast beef, tender salmon filets, and creamy cheesecake all day. He had long known, however, that eating everything he cooked would make him fatter than the hams he carved up, not to mention a walking heart attack candidate. As a result, he was very careful about ‘just tasting’ the savoury entrees and rich sauces he concocted. He also checked his cholesterol and triglyceride levels frequently.
Unfortunately, despite Joseph’s dietary diligence, he discovered that his triglyceride levels were extremely high. He was worried and confused. He stayed away from fatty foods, yet over the next few years several relatives of his died of strokes, and as the years went on, Joseph worried that he would be next.
In frustration, and fearful of heart disease, Joseph tried every method advertised to help prevent the condition and experimented with every diet he could find. He went to health spas that fed him rabbit food and infinitely tiny portions of grilled chicken. But, it was not enough, for at the age of forty-four, Joseph had a stroke, which left him helpless for a time. Although he recovered quite quickly, Joseph emerged from the experience even more scared and angry because of what had happened. Hadn’t he taken all the proper health precautions? How could he prevent this from happening again? Was there something that his doctors hadn’t seen, something they could have easily repaired that they all missed?
Joseph came to me for a fresh opinion, and an answer. As he recounted his ordeal for me, one simple word came to mind: homocysteine. Exercise and healthful food are good steps to take to prevent heart disease, or any disease for that matter, but his blood tests did show high levels of homocysteine. I immediately instructed him to supplement his already nutritious diet with vitamin B12, B6, and folic acid. Within weeks, his homocysteine levels had begun to fall. Granted, we cannot be sure if this precaution will rule out any possibility of his having another stroke in the future — but, vitamins may be the key to keeping his heart beating.
