Homocysteine Lowering Hopeless?

It looks as if lowering homocysteine levels by taking folic acid and vitamins B6 and B12 is a waste of time. The theory, which is fairly well founded, is that elevated homocysteine is associated with cardiovascular disease, leading to heart attacks and stroke. However, effective lowering of homocysteine levels with vitamins failed, in two studies, to reduce what counts – the number of heart attacks, strokes, and cardiac deaths. The studies are reported in the New England Journal of Medicine, along with an editorial that tries to puzzle through their unexpected outcomes.

There are several possible explanations. One of the vitamins given might itself have an adverse effect on the cardiovascular system, canceling out any benefit from lowered homocysteine. Or, homocysteine itself is not a ‘marker’ for cardiovascular disease or involved in its genesis, but merely a coincidental byproduct of some step in the process. The editorialist is not prepared to abandon the prominent role of homocysteine in the disease process, and suggests we should examine alternative ways of lowering its level, as folic acid and vitamins B6 and B12 are clearly of no use.

The results af these studies should not be taken as reason to shun these vitamins, The foods that contain them – leafy green vegetables, legumes, fruits, and grains, not to mention fortified cereals – are clearly beneficial to health in many ways.