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The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 3:02 pm
by Julie G
I warmly invite everyone to take the time to actually listen to the top homocysteine/AD researchers; David Smith (Oxford) & Helga Refsum (University of Oslo) provide the evidence linking elevated homocysteine with dementia. Martha & I were lucky enough to hear them speak last spring in NYC. They make a very compelling case for tracking and tweaking homocysteine as needed to prevent and/or halt brain atrophy and cognitive decline. Their information was not considered controversial or fringe in any way by the top AD researchers and clinicians in the world. Please see my notes from the meeting here. Their talks are actually quite entertaining and...motivating ;).

Here's a link to Dr. Smith’s talk & graphics:
http://www.nyas.org/MediaPlayer.aspx?mi ... dc3fb81558

Here’s a link to Dr. Refsum’s talk & graphics:
http://www.nyas.org/MediaPlayer.aspx?mi ... 8875d97723

Per these top researchers, the following supplements below provide the starting place for addressing elevated homocysteine (>7 or 8 µmol/ for our high risk population.) This works for most people, not all as Susan will soon share with us in an upcoming Wiki entry. Tracking & tweaking individual B levels gets a lot more tricky and is sometimes necessary. Additionally, we have evidence that higher levels (above current reference ranges) of various B vitamins are sometimes necessary to get the homocysteine lowering effect.

-1 mg cobalamin
-800 mcg of folate/5-methyltetrahydrofolate or 5-MTHF
-20 mg of B-6/pyridoxal 5’ phosphate

To my knowledge there is no B vitamin complex that provides this combination at these levels. Please share if you’ve found one. TMG can be added if this protocol is unsuccessful. It’s also important to keep in mind that this trifecta of Bs is more likely to benefit those with an adequate Omega-3 Index (DHA being more important than EPA) per recent evidence from Smith & Refsum. This information may be very relevant for vegans with high homocysteine.

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 4:17 pm
by BeKindToYourMind
Hi Juliegee. Thanks for this information. I'd like to check out the presentations, but the links didn't work for me.

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 4:17 pm
by circular
Hi Julie, Thanks, I've added them to the biomarker spreadsheet.

FYI the links don't work.

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 4:22 pm
by RichardS
For what it's worth, I routinely tested around 11 for homocysteine. After 6 weeks on 1/day of the Kirkland (Costco) Super B-Complex with electrolytes, I was down to 10, another 2 months after increasing to 2/day, my homocysteine was down to 8. I don't know my MTHFR status. The Kirkland version is 3-4 cents/pill.

Vit C 200mg
Thiamin (B-1) 100mg
Riboflavin (B-2) 20mg
Niacin 25mg
Vit B-6 3mg
Folic Acid 400mcg
Vit B-12 100mcg
Biotin 300mcg
Pantothenic Acid 5.5mg
Sodium 90mg
Potassium 30mg

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 4:31 pm
by Julie G
Sorry, I fixed the links. Hopefully they work now. Nice, Richard! Proof that a multi can work... if you double it ;). My guess is that everyone's response on that will be different...

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 4:36 pm
by apod
FWIW, I usually take 1/d of the Seeking Health Active B12 w/ L-5-MTHF supplements, usually timed around a meal rich in protein (probably doesn't matter?) This supplies 800mcg of folate as Quatrefolic (6S)-5-methyltetrahydrofolate glucosamine salt and 1,000mcg of B12 as methylcobalamin and adenosylcobalamin. I have the homozygous C677T mutation + homozygous MTRR A66G mutation + homozygous MTRR A664A, among a few other homozygous / heterozygous methylation quirks. Lately, I also take a Pantethine B5, usually timed around a meal rich in fat, and I toss in the occasional nicotinamide riboside (I've read B3 might increase homocysteine?) I cycle creatine monohydrate @5g/d (taking a few weeks off when I run out), usually consumed post-workout with a protein-rich meal. I'm thinking I might add in a small amount of B6 before bed as a sort of ZMA stack, which might further lower homocysteine? I'm curious about TMG supplementation, but I've read this can increase cholesterol and raise TMAO, promoting atherosclerosis?

Last I checked, while consuming 80-100g of protein per day (~1.8g/d of methionine) with my current B + Creatine regimen, my fasting homocysteine measured 7.4 μmol/L.

It looks like the reference values for men are different than those for women (higher levels in men), although they both target a similar therapeutic level, just under 7:
https://en.wikipedia.org/wiki/Homocyste ... ine_levels

Dr. Sinatra writes that an optimal level might be around 7-10 μmol/L with low homocysteine levels being potentially as dangerous as high levels via elevated sulfate levels. http://www.drsinatra.com/the-ideal-homo ... ac-health/

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 5:03 pm
by Stavia
I believe the doses are arbitrary and one should chose something affordable then work towards a target and tweak.
I don't believe it needs to be as accurate as an acid-base titration lol.

I take Thorne 5-MTHF 1mg and Thorne P5P 33.8mg for no good reason apart from they match. And the good reason is they are my particular allergens free.
I take 1000mcg methylcobalamin Natural Factors because its also my particular allergen free, not expensive, tastes yummy and a pretty pink. And there wasn't a matching Thorne one. (OCD anyone? I'm not usually actually, just quite tidy and organised lol)

My homocysteine dropped from 11 to 7. So I guess if it's not broken, don't fret?

Julie thanks for the reminder. I'd sorted mine and moved on so it wasn't in my head anymore. Thanks also for the reminder that omega3s are likely players in the positive benefits of this intervention.

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 5:10 pm
by Stavia
My hubby's homocysteine is 11 as well but he won't take multiple tabs. Refuses. So I settled on Thorne methyl guard plus.
Its riboflavin 30mg (guess it won't harm lol), P5P 15mg, 5MTHF 1mg, methylcobalamin 1mg and betaine 0.6gm. Its the best I could find in one tablet from iHerb.
I'll recheck in 3 months.
He's likely apoe3/3 - our son is 3/4 and there is no AD in his long-lived ancestors.
But his dad had 2x MIs and he had a 6th nerve palsy probably microvascular event so he is on a small dose statin now. (5mg rosuvastatin and he prolly forgets 2 nights a week so I'm pretty relaxed about it). His apoB has dropped from 120ish to 50ish.

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 5:21 pm
by ABrain4Me
After 6 months on 1,000 mcg methyl- B12 and 800mcg methy-folate, my homocysteine only went from 11 to 10.

I was just told to take 5,000 mcg per day of methyl- B12 and continue same dosage of methyl folate, retest in 6 months and if homocysteine is not <7, add TMG.

I am heterozygous for MTHFR c677t.

Re: The Homocysteine/AD connection

Posted: Wed Jun 22, 2016 5:41 pm
by Thx4thegenes
Juliegee, unfortunately I still couldn't open the links. :?