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Posts Tagged ‘inflammation’

Understanding Cholesterol

Posted in common conditions, tagged , on April 11, 2010| 3 Comments »

Cholesterol is probably the most talked about health concern, and based on my experience with patients (and doctors), the least understood facet of health. Some cholesterol is considered “good”, some is considered “bad”, and by all means, we certainly don’t want high levels of it! Hmmm, is this accurate? Does it make sense that some fractions of cholesterol should be considered “bad”. Keep reading and I’ll help to explain this highly publicized, ill-understood (in my opinion) aspect of health.

So what is cholesterol anyway? Contrary to popular belief, cholesterol is not a fat, it is in fact a sterol. This is simply a technicality, but I thought it was worth mentioning. Cholesterol is vital to the cells in the body, as it makes up part of the cellular membrane allowing them to maintain permeability (the passage of substances in and out of the cell) and fluidity. Additionally, cholesterol is necessary for hormone synthesis (e.g.: estrogen, testosterone, progesterone, cortisol, etc.), bile acid synthesis (necessary for fat emulsification/digestion), and some fat-soluble vitamins. This article will focus mainly on the cardiovascular effects of cholesterol.

Roughly two-thirds of cholesterol is made in the body (liver) and the other one-third is gotten from diet (only animal foods – so don’t get duped by vegetarian products touting to be “cholesterol-free”, that’s a given). This simple fact says that the amount of cholesterol you eat has less to do with your total levels than other factors. If the amount of cholesterol you consume was truly related to your cholesterol levels, then vegans would be in the clear and not have to be concerned with their levels; but that couldn’t be further from the truth, as many vegans have higher than normal blood cholesterol levels.

The reason cholesterol gets so much press (aside from cholesterol-lowering drugs), is because a build-up of cholesterol (along with other substances) in the arteries can lead to plaque-formation and have grave consequences. If too much plaque builds up in the arteries and a clot forms, it can cut off the blood supply to the heart (leading to a heart attack) and/or the brain (leading to a stroke). So the question now is, or should be: “Why does cholesterol get deposited in the arteries?”, and “What can we do about it?”. And the answer is not simply because some of it is “bad”. Let me first discuss the difference between so-called “good” and “bad” cholesterol before I answer the question about why cholesterol deposits in the arteries.

These good and bad cholesterol markers are in fact carriers or transporters of cholesterol, not actually cholesterol. They are like buses or taxis. “Good” cholesterol, or high-density lipoproteins (HDL) are coined “good” because they circulate through the blood vessels and pick up cholesterol for transport to the liver. “Bad” cholesterol, or low-density lipoproteins (LDL) deposit cholesterol in the vessels, possibly leading to the eventual clogging of arteries. This is why it’s stressed that we need to have low blood levels of LDL’s (cholesterol depositors) and high levels of HDL’s (cholesterol retrievers, if you will). Now on to the next question. Why would cholesterol get deposited in the arteries. Is the body stupid? Is it trying to self-destruct by giving us a heart attack or stroke? In fact, it is doing the opposite, trying to keep you alive and well!

Essentially, cholesterol gets deposited in the arteries in order to help us. That’s right, not to kill us, but to help us. When the inner lining of arteries get damaged, inflammation sets in. Now realize, inflammation is a necessary part of the healing process, but when it gets out of control (essentially not remitting due to an inability and constant struggle to repair) we can run into problems. Chronic inflammation in the arteries (or anywhere for that matter) can be likened to a fire that can’t be put out. If this fire continues to spiral out of control, your arterial wall will continue to “burn” and possibly even “leak”. So here comes cholesterol to the rescue! That “bad” (LDL) “cholesterol depositor” brings cholesterol to the damaged area in order to put the fire out. Is that really “bad”? Do you really want a fire burning out of control in your arteries? So as you can see, it’s not bad at all, it’s in fact good if you ask me, and possibly if your arteries could speak up, they’d say it was good also. Next, in an optimally functioning body, the HDL’s, or “good” cholesterol will swing into action when healing has taken place, and transport the cholesterol back to the liver in order for recycling into other vital substances (i.e.: hormone synthesis and bile acid synthesis).

So why do the arteries get damaged and inflamed in the first place? It goes right back to the basics. One of the most common reasons would definitely be high blood sugar and insulin levels (really DIET and lifestyle). Other causes of arterial inflammation include, but are not limited to: food allergies and sensitivities, high levels of homocysteine, infections, and nutrient deficiencies. Additionally, high levels of stress hormones can begin a cascade of biochemical events that will eventually result in inflammation and poor blood sugar control. And last but certainly not least, we must consider environmental toxins, such as industrial pollutants, toxic chemicals and metals, and of course excessive alcohol consumption and cigarette smoking.

You see, your body is smarter than you think (or at least smarter than the drug companies think). It’s trying to survive, that is essentially it’s design. What happens when you cut yourself? Your body seals it up, and hopefully new tissue gets formed. Some cuts/wounds are worse than others, and the body forms a scar. But regardless, the body is doing the best job it can to heal. And so is your “bad” cholesterol. So if your cholesterol gets out of control, perhaps you’d be better off looking into the reasons why. If you lower your cholesterol artificially through medications, your body will again do it’s best job in trying to survive and heal the arterial damage – most likely by laying down calcium if it doesn’t have enough cholesterol. Hans Selye, the famous “stress” researcher, has shown that chronic inflammation (repair deficit) eventually leads to calcification. Then what? I guess we turn to stone.

Some people do have exceptionally high levels of cholesterol (that may need to be controlled with medication) due to genetic factors, but most people don’t. And many people have cholesterol levels that are too low! Remember, it’s absolutely necessary for the formation of other important biochemicals. This can be from overdoing cholesterol-lowering medication or supplements. And when medications or supplements aren’t being taken, I find that low cholesterol is the result of an under-functioning liver that needs to be addressed.

So high levels of cholesterol should really be seen as a symptom of another problem that’s taking place (and most definitely causing more problems than laying down arterial plaque). I’ll leave you with this. If parts of your house were constantly catching on fire and the fire department continuously came to put the fires out, would you blame the firemen as the problem and then force them away; or would you look to find out why all these fires continue to start?

I hope this article helped to give you a better understanding of the topic of cholesterol and how your body works.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Achilles tendonitis, applied kinesiology, and chiropractic

Posted in Applied Kinesiology, chiropractic, common conditions, tagged , , , on November 19, 2009| 2 Comments »

Achilles tendonitis (or inflammation of the tendon of the calf muscle) is a fairly common condition, especially among runners.

Signs or Symptoms
Pain or discomfort in the Achilles tendon with up or down movement of the ankle and foot; as in walking, running, and climbing stairs. Quite often, pain is also elicited by simply touching or applying pressure to the tendon. A decrease in range of motion will usually result due to the pain; and swelling may be noted in severe cases.

Causes
Overuse of the calf muscle as in long distance running, or running up hills can often result in Achilles tendonitis (bear in mind that overuse can sometimes mean insufficient recovery). Direct trauma to the tendon, perhaps from being kicked while playing sports may also be a cause. Poorly fitting shoes should be considered, especially if there is undue pressure being exerted on the tendon itself. Structural misalignments or abnormalities like dysfunction in the joints of the foot and ankle (including over-pronation), or a short leg can also be a cause. However, the most common cause is an over-contraction of the calf muscle which attaches to the Achilles tendon. (I’ll address this at the end of the article)

Standard Treatment
Generally, rest, ice, stretching, and anti-inflammatory medications are recommended. Other physical therapy modalities such as therapeutic ultrasound or electric muscle stimulation may be used. In some circumstances, a heel lift may be used.

Applied Kinesiology Approach
The focus of applied kinesiology treatments for any musculoskeletal complaint is proper muscle balance. In the case of Achilles tendonitis, I would consider a weakness in the muscles that act as synergists or antagonists to the calf muscle. This might explain why the calf muscle is over-contracted, or tight and shortened in the first place. Joint alignment, whether in the lower extremity, spine or pelvis should also be considered as aggravating factors, and corrected with standard chiropractic adjustments.

The most common cause I see is inhibited muscles in the lower leg (known as the peronei). This tends to be the primary reason for a tight calf muscle. In addition, nutritional factors may need to be considered. And, as always, a specific treatment plan for each individual is recommended.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

Source: International College of Applied Kinesiology

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Bursitis

Posted in common conditions, remedies, tagged , , , , on November 12, 2009| 6 Comments »

imagesA bursa is fluid-filled sac that acts as a cushion; and lies between a tendon (or muscle) and bone, which allows for virtually “frictionless” movement between these structures. When a bursa gets inflamed, it can lose it’s ability to create a smooth gliding surface and become irritated. The result will be pain (sharp or dull) and decreased range of motion. The pain can occur with or without movement. Bursitis (inflammation of a bursa) is a relatively common condition that I see in patients.

There are several ways a bursitis can occur. The most common would be due to structural imbalances and faulty calcium metabolism. Typically I see these two occur together. An infected bursa will also get inflamed, but that is much more rare, though still usually treatable with conservative, non-invasive methods. There are bursa all over the body, so to speak, but the common ones that get inflamed are in the shoulder, “hip” (outside of the upper thigh), and spine.

Treatment directed towards balancing the muscles, tendons, ligaments, joints, and sometimes even skin will resolve the structural imbalances. Because “everything is connected”, it’s not uncommon for muscle and joint dysfunction in one part of the body to result in a bursitis in another. For example, the most common structural reason for “hip”, or trochanteric bursitis is excessive foot pronation (or “flat feet”). [the (greater) trochanter is bony eminence on the upper, outer part of the femur, or thigh bone] A bursitis of the shoulder can be caused by neck, TMJ, or pelvic dysfunction, and sometimes even foot dysfunction. Bursitis in the spine can occur for any number of reasons including postural distortions (due to muscle dysfunction) and spinal, pelvic or extremity structural imbalances.

When a bursitis is the result of faulty calcium metabolism, nutritional supplements are almost always indicated. Keep in mind that structural imbalances will almost always accompany a calcific bursitis. Therefore, treatment should be directed towards correcting both issues. The reason a bursa gets calcified may be two-fold. First, anything that is chronically inflamed will usually begin to calcify. Second, calcium won’t be directed properly if there is a nutrient imbalance. I’ll discuss calcium metabolism in relation to bursitis in this article. Click here if you are interested in reading my article about inflammation.

Typically the person with a calcific bursitis will have stiffness upon waking and feel better after movement. This type of pain pattern will usually be the case with any type of “calcific pain”. As far as nutrients go, the main ones to consider are vitamin D and essential fatty acids or EFA’s (usually omega-3’s). This is because the problem usually begins with an excess amount of blood calcium that gets deposited in the bursa instead of the bone. Vitamin D raises blood calcium levels by absorbing it from food (or supplements) in the digestive tract, or by extracting it from bone. [Having calcium taken up from the bones is never a good idea as it can lead to osteoporosis.] Omega-3 fatty acids (or oils) will take calcium out of the blood and deposit it in the bones. The problem arises when there is an excess amount of vitamin D, or a lack of EFA’s; either of which can cause excess levels of calcium in the blood. The former is less likely, unless you’ve spent a fair amount of time in the sun or supplement excessively.

The next factor that plays a role is when the body is overly alkaline. This will cause any excess blood calcium, assuming there is an insufficient amount of EFA’s to drive it into the bone, to precipitate into the tissues, bursae in this case. So the solution is two-fold. Adequate amounts of EFA’s and an environment that is NOT overly alkaline. The remedy would be to make sure you get adequate amounts of EFA’s and possibly supplement with an acidic type of calcium. I often use both with great success.

Keep in mind that you will not always have a calcific bursitis show up on an x-ray for there to be a calcium metabolism problem. If it does show on an x-ray, the problem is quite chronic. Fortunately, in my experience with patients, bursitis (calcific or not) is usually something that resolves completely with conservative care.

There are many other potential calcium metabolizing nutrients that may be necessary, with the most common being magnesium and vitamin B6. Lastly, if these don’t work, one needs to consider further complicating factors including: infections, digestion, general pH balance, and chemicals that may be affecting calcium metabolism.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Digestive disorders and the 4 R’s

Posted in common conditions, tagged , , , , on September 29, 2009| 8 Comments »

The phrase: “Death begins in the colon”, coined by Nobel Prize winner professor Elie Metchnikoff, is a well known one; at least amongst my peers and I. I’m not sure who originally coined the 4 R’s approach to digestive disorders, but it is certainly a great way to help someone gain optimal digestive health. The 4 R’s are: 1) Remove. 2) Replace, 3) Re-inoculate, 4) Repair. I’ll discuss each individually.

1) Remove – This refers to removing food allergens, sugar (in most forms), alcohol, artificial sweeteners and colors, and perhaps even gluten from the diet. Additionally, “removal” of pathogens such as: (an overgrowth of) yeast, parasites, harmful bacteria, viruses, protozoa, etc. is part of the “remove” step. This can be accomplished through the making healthy food choices and taking specific nutritional and/or herbal formulas.

2) Replace – This refers to “replacing”, really adding the biochemicals (via dietary supplements) necessary to digest food. For example, one may need digestive enzymes (to break down fat, carbohydrates, and protein) and/or hydrochloric acid to help with digestion of protein in the stomach, among other important reasons.

3) Re-inoculate – This step involves adding beneficial flora (or gut bacteria) in the form of dietary supplements. This helps to ensure the “good” and “bad” bacteria in the digestive tract is balanced in a healthy way. Often, there will be an overgrowth of organisms (those mentioned in step 2), that necessitates “re-inoculation” of good bacteria into the intestines. There are purportedly about 500 different species of bacteria residing in the gut. The common ones you’ve probably heard of are acidophilus and bifidus. These bacteria perform so many important functions that the topic deserves an article of its own.

4) Repair – This refers to repairing the structural integrity of the stomach and digestive tract. The digestive lining is easily irritated, especially from food allergens and foreign (natural or artificial) chemicals. The small intestine lining specifically tends to lose its integrity easily and can result in a condition known as “leaky gut syndrome”. This is when the cells that create the barrier against food getting into the bloodstream become damaged, thus allowing large undigested food particles (and chemicals) to be released systemically. As a result, the body can mount an immune response in reaction to these “foreign” and undigested chemicals causing a whole host of symptoms, especially allergic reactions leading to systemic inflammation. There are a variety of remedies that address this situation.

In my experience each individual does not necessarily need to go through all of these steps in order to feel better. However, implementing at least one (usually 2-3) can be the difference between success and failure. Changing the diet alone is usually not sufficient enough to feel and function better, especially if the condition is chronic.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Food Allergies and Sensitivities

Posted in common conditions, food, tagged , , on September 8, 2009| 7 Comments »

I find that roughly 50% of my patient’s conditions stem from the foods they eat. Think about it. Other than an obvious injury or emotional stressor, there really is not much else other than food that will cause problems. Many people and doctors think genetic factors are the cause of their problem, but genetic limitations can almost always be overcome through lifestyle. Other causative factors in health conditions may stem from chemical exposure. However, if you are eating well, your body will be able to cope much better assuming the chemical is not present in large amounts over a long (or short) period of time. If you are interested in general dietary guidelines, click here. This article will focus on food allergies/sensitivities specifically. And I may use the terms interchangeably, though technically, there is a difference.

I don’t want to go too in-depth between the differences of an allergy and sensitivity. Essentially, the body’s response differs in that it involves different areas of the immune system being activated depending on if you are truly allergic as compared to sensitive (or intolerant). And it is not uncommon for blood tests to completely miss a sensitivity (as opposed to an outright allergy) that may be the cause for your major health concern. Additionally, the body can respond to a food via a lectin reaction. Please read more about lectins here, as they are beyond the scope of this article. Just know for now that they are in some foods (especially grains) that can potentially cause cell damage and conditions just as allergies and sensitivities do. By the way, those who experience this are the “classic” patients who come back with normal blood tests and no explanation for their symptoms.

There really is no limit to the symptoms or conditions that can be caused or exacerbated by foods. The most common symptoms that I see in patients are: fatigue, digestive complaints or abdominal pain, “foggy-headedness”, chronic pain/arthritis, skin rashes (including eczema and psoriasis), inability to lose weight, headaches or migraines, phlegm in the throat, itchy and watery eyes, sneezing “attacks”, yeast infections, irritable bowel syndrome, ADHD (often caused or exacerbated by food additives), fibromyalgia, sinus problems, sleeping difficulties, elevated cholesterol, mood changes, asthma, and hypertension (high blood pressure). [A quick aside to hypertension and foods. It is not uncommon to have normal blood pressure and then experience low blood pressure after removing an offending food. Presumably, the body was releasing too many stress hormones (i.e.: adrenaline/epinephrine) which raised the blood pressure to begin with.] One of the most common musculoskeletal conditions I see as a result of food sensitivities is knee pain. Patients have even showed me how arthritic their knees were on an x-ray; however, after they avoid the foods we discovered as being a problem, the pain often “disappears”. [Anything can cause anything, and an x-ray is only one measurement. A doctor should not simply make assumptions based on what appears “obvious”.]

OK, now for the major foods out there that result in allergic/sensitivity/lectin reactions. Wheat, corn, dairy, and soy are the most common by far. One of my mentors, Dr. Tim Francis claims that everyone is sensitive to these four, but in varying degrees. However, he still has ALL of his patients avoid them. The next most common in no particular order are eggs, citrus fruits, beef, peanuts, chocolate, fish and tree nuts (almonds, pecans, walnuts, etc.). Let’s not forget gluten, contained in the following foods: wheat (and foods and drinks made from it), barley, rye, spelt, kamut, oats (through cross-contamination only), triticale, and farro. Don’t forget beer, whiskey, and scotch usually. Gluten is one of the most common “problem-causing” food ingredients that gets missed time and time again on blood tests.

There are some more “advanced” lab tests rather than standard blood analysis. One great test is known as the ALCAT Test. One problem I have with some tests, even the advanced ones, is that a person often comes back sensitive to 50 or more foods. If that’s the case, you have other problems going on that need to be addressed (probably first and foremost). Restricting yourself of 50+ foods must sound a bit ridiculous to you as well. When I see that, I look to a gut problem (most often leaky gut syndrome) and/or a weakened immune system.

One way to determine if a specific food is causing you a problem is to simply avoid it. The time-frame may vary between individuals though. For example, the food may cause symptoms minutes after you eat it or even a week (more rarely) after you eat it; this is known as a delayed-onset reaction. Remember, even though food sensitivities may be a problem, you may not notice a change in symptoms if you only avoid one at a time if you actually have 2 or more sensitivities causing the same symptom.

One more thing. It’s very common to crave the foods you are sensitive to. Unfortunately, I could not find solid references to back this up. Some say it occurs because of withdrawl symptoms that may follow; similar to drug addiction. Frankly, I’ve never see withdrawl symptoms (caffeine is a different story and not usually an allergy). The second reason I’ve been told seems more likely. It’s that the body responds by increasing the output of stress hormones, which may give the person a “boost” of energy causing them to quickly feel better, thus continuing to reach for that food. Regardless, one of the most common things I here from patients after identifying an offending food is: “But I love…” or, “I eat that all the time”. This concept of allergy and craving is worth paying attention to.

Please keep this in mind also! Food allergies, sensitivities, and lectin reactions are by far one of the most common causes of chronic (often undetected) inflammation. And specific inflammatory markers in the blood may not pick this up.

I choose to use applied kinesiology muscle testing most of the time when I suspect foods may be causing a problem. I don’t diagnose food allergies, sensitivities, or lectin reactions; I simply see how your nervous system responds.

Come back soon to learn more about potential problems with some more specific foods we enjoy most, like avocado, banana….

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Natural remedies for inflammation

Posted in common conditions, food, remedies, tagged , , , , , , , , on September 7, 2009| 4 Comments »

The word inflammation comes from the Latin word inflamatio, which translates into: “to set on fire”. It is a term that describes the biological response to an injury or protection from a microbe. Essentially, this “injury” can only come from about 5 things: 1) physical trauma (e.g.: ankle sprain, etc.); 2) allergic reactions; 3) infections; 4) chemical toxins (e.g.: toxic metals, environmental chemicals. etc.) and 5) ionizing and UV radiation (e.g.: x-ray, sunlight, etc.). The”hallmarks” of inflammation are a change to the micro-circulation and build-up of inflammatory cells in the damaged area. The five key signs of inflammation are pain, redness, edema (or swelling), heat, and loss of use. You may not have all five, but in the most extreme case they all exist. These five signs are generated by the biochemicals which respond to any sort of tissue damage.

The biochemicals released are designed to help heal the damage that has taken place. They help clean up the debris from the damaged cells, bring more blood to the area to restore new growth, and improve the drainage. There is much controversy over when to “artificially” (through ice, nutrients, or medication) reduce inflammation. However, it’s generally accepted that acute (24-72 hours) inflammation is necessary to begin the healing process. Inflammation (that is one or all of the five key signs) that persists for longer than this time (that is sub-acute or chronic) may indicate an inability to repair properly; appropriately coined a “cumulative repair deficit” by Dr. Stuart White. Therefore, intervention in the sub-acute or chronic stages is usually necessary and certainly desired by the patient.

Let’s now discuss some natural ways to deal with chronic inflammation, considering that it is normal to have inflammation in the acute (and sometimes sub-acute) time-frames. First and foremost, the source(s) of inflammation needs to be avoided. For example, exposure to food allergies/sensitivities, chemicals, toxic metals, radiation, etc.. Additionally, if the inflammation is the result of a structural impediment, you may need muscle and joint re-balancing done by a doctor. If the source is not avoided or addressed, you are simply “painting over the rust” and dealing with symptoms as opposed to the cause.

The main natural remedy to alleviate inflammation would be Omega-3 fatty acids. I’ve often used Omega-6 fatty acids also; particularly gamma linoleic acid or GLA (found in black currant seed, evening primrose oil, and borage oil) with great success in patients that have chronic musculoskeletal inflammation. Generally speaking though, most people have too many Omega-6 fats compared to 3’s in their diet; so Omega 3’s are generally recommended more often. Omega 3’s are best found in fish and krill oil. Flax oil does contain Omega 3’s, however, many biochemical steps need to occur before they are converted into to EPA (the anti-inflammatory substance). And very often, these steps can be disrupted through faulty sugar metabolism, alcohol, and trans-fats. As a result, it’s quite possible that you’ll never achieve the potential anti-inflammatory effects you are looking for. Fish and krill oil on the other hand need no conversion, as they actually contain EPA. I do not recommend that you eat fish unless you absolutely know it’s “clean”, click here to read why.

Other natural anti-inflammatory compounds include turmeric, resveratrol, ginger, quercetin, garlic, onion, boswellia, rosemary, vitamins C + E, and should also be considered. However, keep in mind that no one ever has an “herb-deficiency”. Therefore, make sure you’ve covered your nutritional bases first; that is essential Omega-3 fatty acids and vitamins C +E at a minimum. There may be other natural anti-inflammatory compounds as well, but the ones I mentioned should be more than enough.

Additionally, don’t forget that you need certain nutrients to rebuild the damage that has occurred from the inflammation. For this, think about rebuilding collagen, the most abundant connective tissue in the body. Therefore make to sure you have a sufficient amount of protein and vitamin C (the most basic nutrients) to build collagen. Some other nutrients for collagen formation would include: zinc, manganese, iron, vitamin A, sulphur, copper, and perhaps others indirectly.

In conclusion, it’s usually not apparent when you have chronic inflammation. The 5 key signs more often accompany acute inflammation and often are not observed with chronic inflammation if you don’t have pain or some sort of loss of function. This is especially true when there is inflammation in the arteries, which can lead to hardening of the arteries and ultimately cardiovascular disease. I most commonly see chronic inflammation as a result of poor dietary choices, environmental chemicals (and metals), and sub-clinical infections. Inflammation was the topic of a front-page article in Time Magazine titled “Inflammation: The Secret Killer”. It mentions the links between chronic inflammation and heart attacks, cancer, Alzheimer’s, and other diseases. So make sure you are getting anti-inflammatory compounds on a daily basis, through diet and/or supplements.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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High cholesterol? What about high homocysteine???

Posted in common conditions, remedies, tagged , , , , , , , on September 3, 2009| 3 Comments »

These days cholesterol still gets all the attention when it comes to heart disease. In fact, I think way too much attention. There are other, often better predictors of heart disease than standard cholesterol tests. And these are routinely missed, even when the patient’s (and doctor’s) motive is to assess the potential risk of future cardiovascular events. I’ll talk about one very important one of those risk factors now. It is an amino acid called homocysteine.

Homocysteine was discovered by a man named Dr. Kilmer McCully. He is a Harvard Medical School graduate; and discovered this amino acid was responsible for arteriosclerosis (or hardening of the arteries) while researching a rare condition called homocysteinuria, forty years ago. He was researching two cases where an eight year-old child and and a two-month old child both had arteriosclerosis. Through further research he eventually made a connection between homocysteine and arteriosclerosis. Unfortunately though, when he first voiced this discovery, he was shunned by just about every medical professional. In 1976, the (“new”) chairman at Harvard said the “elders” at the school “felt” he had not proved his theory; and unless he could get grant money he would lose his position. They went as far putting his lab in the basement so he would have no contact with others, and then he decided to leave. For the next 27 months he could not find a single position in North America that would allow him to continue his research. McCully was later told that Harvard and Massachusetts General Hospital did not want to be associated with his work, because it did not go along with the conventional wisdom that cholesterol and fats caused heart disease. You can read more about that story in an interview with McCully here. By the way, one main reason that he was discredited might be because one of the most common ways to treat excess homocysteine levels is through nutritional supplements.

Anyhow, homocysteine is naturally produced in the body through the necessary breakdown of the essential amino acid, methionine. However, just because it is naturally produced does not mean that it is benign. An article in the Journal of the American Medical Association concluded this: “An increased plasma total homocysteine level confers an independent risk of vascular disease similar to that of smoking or hyperlipidemia” (or high blood lipids/fats). There are many more studies in existence that speak of the risk of high homocysteine levels in relation to (cardio)vascular disease so I won’t bore you with repeating this information.

Homocysteine causes several problems. For instance, it can oxidize cholesterol (making it harmful to blood vessels), cause scarring inside the lining of blood vessels, and increase blood clotting. Essentially, high levels of homocysteine will ultimately damage cells and the walls of the blood vessels. As a result, cholesterol will get deposited in the arteries in an attempt to “patch” up the damage. That is why cholesterol can “cause” cardiovascular events such as heart attacks and strokes. Also, this damage can lead to peripheral arterial disease, usually in the legs and feet, which in a worst case scenario can eventually result in the need for amputation like in diabetics. So does cholesterol really “cause” vascular problems? Well, that can be argued, but it is really the body’s attempt to heal. Hmmm, I guess cholesterol is not so bad to begin with. I will talk about that in another article. By the way, there are many causes of blood vessel damage.

High homocysteine levels have been implicated in coranary artery disease, heart attack, stroke, deep vein thrombosis, rheumatoid arthritis, osteoporosis, Alzheimer’s disease and more.

So what’s the solution? Some fancy well-marketed drug? No, B-vitamins of course! That’s right vitamins B6, B12, and folic acid (in addition to other biochemicals) will metabolize homocysteine properly and prevent high levels in the bloodstream. Folic acid and B12 will recycle homocysteine back into methionine and B6 will convert it down to cystathionine (and then hopefully down into cysteine and sulfate). So if these vitamins lower homocysteine levels, then a deficiency in them can cause high blood levels. McCully also reports other causes such as imbalances in thyroid and “female” hormones, in addition to kidney problems.

Please don’t get me wrong, many doctors are aware of homocysteine, but not enough in my opinion. I have seen blood tests from patients with known peripheral artery disease and cardiovascular complications without reporting their homocysteine levels. Also, some patients show me their blood tests with normal cholesterol levels (but no homocysteine); and report that their doctor has told them they don’t need to be concerned with heart disease. Also, look at a recent blood test of your own and (depending on the lab) you may find that they claim to determine your heart disease risk factor based on cholesterol levels alone.

One more thing, measuring homocysteine can also be used to find out if you have a deficiency in these B-vitamins. Again, there could be other causes, but it’s as simple as doing a follow-up test after supplementation for a few months.

PS: One common sign I have discovered in patients, which stems from high homocysteine (perhaps B-vitamin deficiency) is easy bruising. Bruising is basically damage to blood vessels. This is true even in those who “should” be bruising like some of the professional aerial acrobats (or intense athletes) I work with; but it’s also common in people who are not extremely active. The flip side to easy bruising would therefore also mean an inability to heal the vessels as well. And interestingly your body will not produce collagen (a main component of blood vessels and other structures) properly if your homocysteine levels are too high. But that concept, along with the other necessary nutrients to make proper collagen is for another discussion. Now don’t go trying to judge your homocysteine levels based on if you bruise easily or not; that’s just one observation I’ve made working with patients. It is worth asking your doctor to run this test – and remember those B-vitamins are necessary for a lot more functions than homocysteine metabolism.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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