Atherosclerosis

Ball and stick model of the homocysteine molecule (L-isomer). (Photo credit: Wikipedia)

In 1969, McCully presented the first findings on a relationship between elevated homocysteine levels and atherosclerosis based on autopsies of individuals with abnormally high homocysteine concentrations due to rare metabolic defects. Since then, more than 20 controlled, cross-sectional and prospective studies of over 2,000 subjects have added mounting evidence that even mildly elevated homocysteine levels in the normal range can double and triple cardiovascular disease, including heart attack and stroke. Several recent studies published between 1992 and 1995 show that increasing homocysteine levels is related to increased risk levels for carotid artery disease and heart disease.

How does homocysteine contribute to cardiovascular disease? Animal studies show that increased homocysteine levels can cause vascular lesions (a Phase 4 toxicity effect) in as little as three months. Still, in Phase 4, homocysteine may be directly toxic to the delicate endothelial cells that line all healthy blood vessels, preventing these cells from relaxing and producing toxic oxides of nitrogen. As the condition degenerates into Phase 3, homocysteine may then cause the proliferation of smooth muscle cells, which is an important part of plaque formation.

In Phase 2, homocysteine can trigger thrombus formation via thrombomodulin and activation of protein C, causing rapid deterioration in function, as with stroke and heart attack.

This elevation of homocysteine can be prevented in most cases by simply taking in a good level of the B vitamins, especially folate, B6 and B12. The higher your intake of folate, the lower your homocysteine level. At least 400 mcg of folate is needed daily to maintain low homocysteine levels. Thus about 40% of the American population is not getting enough folate. Sadly, the RDA for folate has recently been reduced from 400 mcg to 200 mcg. In the Framingham Heart Study, 21% of the population had levels of homocysteine associated with a three-fold increase in cardiovascular risk. The table below shows the SAD (Standard American Diet) state of today’s diet for the three B vitamins shown to prevent homocysteine formation and thus atherosclerosis.

Average Dietary Intake of Americans Over Age 50

Folic Acid Vitamin B6 Vitamin B12

59% of RDA 76% of RDA 55% of RDA

The methionine metabolism pathway. DHF, dihydrofolate; dSAM, decarboxylated S-adenosylmethionine; hCys, homocysteine; ME, methyl group; MetTR-1-P, 5-methylthioribose-1-phosphate; MT, methyltransferase; MTA, methylthioadenosine; MTHF, methylenetetrahydrofolate; SAH, S-adenosyl-L-homocysteine; SAM, S-adenosyl methionine; SUB, substrate. (Photo credit: Wikipedia)

The diagram summarizes the key metabolic pathways in homocysteine metabolism. It shows how the B vitamins play a key role, when present in the diet, or dietary supplementation at adequate levels, in preventing increased homocysteine levels associated with atherosclerosis.

Homocysteine Metabolism

Methionine (sulfur-bearing amino acid)

S-Adenosyl Methionine

Homocysteine (regenerated to Methionine using B12 and methyl group from methyl-THFA)

Cystathione (using B6)

Folate, the most commonly deficient vitamin, is methylated to methyl-THFA. Remission Foundation recommends TMG (Trimethylglycine) to enhance the methylation processes of the body, including recycling homocysteine to SAMe, which elevates mood, reverses atherosclerosis, and prevents cancer.[see print document for diagram and footnotes]

Many other natural factors in atherosclerosis prevention and therapies have been studied and reported as potentially beneficial in the scientific literature, including:

• Alfalfa (in Shields Up)
• Arginine (from vegetable protein) (in Star Gold)
• Artichoke
• Berberine (found in goldenseal as well as in Berberis species like Oregon Grape root)
• Beans
• Betaine (Vitamin B14) (in Star Gold and Stamina Plus)
• Bilberry (in Maxogenol)
• Brewer’s yeast (RNA & DNA non-allergenic extract from yeast is in Energessence)
• Bromelain (from pineapple) (in Star Gold and Digestzymes): inhibit platelet aggregation and break down atherosclerotic plaque.
• Calcium up to about 1000 mg to 1500 mg daily (in Structural Integrity)
• Cayenne (Capsicum in Stamina Plus and Capsicum): prevents thrombus formation and platelet aggregation; lowers cholesterol.
• Charcoal is taken up to about 10 grams three times daily (in Food Tolerance)
• Chromium 200 mcg taken 1 to 2 times daily (in GTF Chromium Picolinate and Star Gold)
• Citrin (from the Garcinia cambogia fruit) (in Weight Less)
• Coenzyme A (Vitamin B8) which is derived from pantethine (see below) (in Stamina Plus)
• Coenzyme Q is taken up to about 30 mg daily in divided doses (in Natural Resources A-Z)
• Complex carbohydrates
• Copper is taken 2 to 4 mg daily if deficient, or if taking long term zinc supplementation over 15 mg daily (in Star Gold and Pycnogenol + Antioxidants)
• Curcumin (from turmeric)
• DMG (Dimethyl Glycine)
• Eggplant (you may need to avoid this nightshade vegetable if you have arthritis, though)
• Fenugreek
• Fiber (especially water-soluble fibers like guar gum, pectin, and cereal brans like oats and barley) totaling about 35 grams or more daily (water-soluble fiber is found in Star Fiber and Weight-Less)
• Folic acid (Vitamin B7) up to about 5 mg a day (in Star Gold and Stamina Plus) is essential for converting homocysteine to methionine.
• Gamma-oryzanol (from rice bran)
• Garlic and onion (in Garlic Oil and Food Tolerance)
• Ginger (Zingiber in Haena): lowers total serum cholesterol and triglycerides while increasing HDL levels; inhibits platelet aggregation, and has cardiotonic activity
• Ginkgo biloba (in Gingko Q and Energessence)
• Glycosaminoglycans are taken up to about 1200 mg three times a day (in glandular ingredients of Star Gold and Natural Resources A-Z)
• Gugulipid (from the Mukul myrrh tree)
• Hawthorn (in CoQ10): prevents and reverses atherosclerotic plaque formation, reduces serum cholesterol levels, and increases blood flow to the heart muscle.
• Iodine (in Star Gold and Kelp)
• Khella (from a medicinal plant native to the Mediterranean area)
• L-Carnitine (Vitamin B20) taken up to 1500 mg daily (in Natural Resources A-Z)
• Magnesium is taken about 500 mg daily (in Star Gold, Triple Ascorbate C, and Star Fiber)
• Niacin (Vitamin B3) building up from about 100 mg 3 times a day, increasing weekly by 100 mg 3 times a day, to a maximum of about 2 grams 3 times a day, while watching for any sign of stress in the liver (in Star Gold and Stamina Plus)
• Omega-3 essential fatty acids (EPA/DHA from cold-water fish) taken from about 3 to 10 grams daily in divided doses: EFAs lower LDL and promote HDL
• Omega-6 fatty acids (GLA), e.g., from evening primrose, flaxseed, or hemp seed oils
• Pantethine (the active form of Vitamin B5, in Star Gold and Stamina Plus) taken up to 300 mg 2 to 4 times daily with meals
• Phosphatidylcholine (e.g., from lecithin) (in Star Gold)
• Phytosterols (mainly from seeds and sprouts) taken up to about 300 mg of beta-sitosterol daily with meals (in Muti-Miracle)
• Potassium (all fruits and vegetables are a good source) (in Star Gold)
• OPCs (from pine or grape sources) (in Maxogenol)
• Pyridoxine (Vitamin B6), about 40 mg daily (in Star Gold and Stamina Plus), is essential for converting homocysteine to methionine.
• Red wine in moderation (extract in Pycnogenol + Antioxidants)
• Sardines (especially when packed in their own oil – then be sure to eat the oil, too!)
• Selenium (in Star Gold): for making glutathione, which prevents oxidative damage to artery walls.
• Silymarin (from milk thistle)
• Taurine (an amino acid) (in Star Gold and Natural Resources A-Z)
• TMG (Trimethyl Glycine from beets)
• Vegetable protein (hydrolyzed in One Step)
• Vitamin B complex (in Star Gold and Stamina Plus)
• Vitamin B12 (in Star Gold and Stamina Plus) is essential for converting homocysteine to methionine.
• Vitamin C (about 1 gram 3 times a day) (in Star Gold, Ester-C, Natural Resources A-Z, and Stamina Plus): Helps repair damaged arterial walls, preventing the formation of protective cholesterol plaques.
• Vitamin E (build up slowly to about 1600 or 1800 I.U. daily) (in Unique E, Natural Dry E, Star Gold): reduces the risk of heart disease.
• Yogurt culture (contains beneficial flora) (flora in non-dairy culture found in Friendly Flora and Colostrum)
• Zinc if deficient (in Star Gold, Pycnogenol + Antioxidants, Star Fiber, and Energessence)
• Other critical factors to avoid for successful prevention and reversal include:14,15
• Alcohol in excess (drink Microwater when exposed; small amounts of alcohol may be beneficial)
• Coffee, tea, and chocolate, including decaffeinated tea or coffee (take extra GTF Chromium when exposed)
• Fat: over 25% of the diet, cholesterol, fried foods, cooked or rancid fats, hydrogenated oils like margarine, trans-fatty acids (GTF Chromium & Weight-Less burn fat & cholesterol; improve muscle tone and blood pressure)
• Lysine (from excess animal protein)
• Sugar and refined carbohydrates (take extra GTF Chromium Picolinate when exposed)
• Vitamin D in dietary excess (usually from fortified dairy products)

The Heavy Metal Connection

One approach to detoxifying heavy metals that can trigger atherosclerosis is chelation therapy. The term chelation comes from ‘claw’ and refers to the ability of certain compounds to grab heavy metals and remove them safely from the body. Chelation can be performed intravenously using the chelating agent EDTA, or when time permits a safer and slower administration, it can be done orally with supplements.

Elation! is an excellent oral chelation program available through Remission Foundation. This program is a perfect health restoration and prevention program for reducing the risk of cardiovascular disease, including heart attack and stroke, the #1 and #3 killers of our time.

To improve fat and cholesterol metabolism, one component of the program contains soluble dietary fibers, lecithin, and other nutrients involved in the physiology of lipoproteins, cholesterol, and bile acids, plus EDTA, which is also used to preserve freshness.

Another component of the program combines the nutritional benefits of allicin-rich garlic with alfalfa, parsley, citrus extract, chlorophyll, aloe, and spearmint. Garlic is an excellent source of organic sulfur, important in the detoxification of heavy metals. Garlic also has powerful benefits for cardiovascular health. Additional EDTA is incorporated in this supplement as well.

The program also includes Chlorella, which has been found to remove mercury better than any other supplement tested, plus a special non-flush form of niacin, and lysine to pull cholesterol off the artery walls and into a solution so it can be removed.

Another oral chelation agent available to pull out lead and mercury is DMSA. For more details on oral chelation, see the Chelation report.

Stopping statins, like taking or stopping any drug, is ultimately under a patient’s volitional control, but going cold turkey off any drug can potentially trigger a cleansing reaction or other health crisis due to adaptation or detoxification, so unless you know more, it is generally advisable to wean off gradually when getting off drugs. Legally, only the prescribing physician can advise a patient in that process without threat of violence by earthly governments. Still, anyone can legally educate and advocate for the patient’s intelligent use of health care products and services. Ethically, morally, and even legally, we are all compelled to stop and correct errors when we see them…

Some doctors will prescribe a different statin when serious or dangerous side effects are encountered, such as memory loss, fatigue, depression, or muscle pain. Still, all statins work by the same mechanism, inhibiting HMG Co-A reductase, thus blocking the mevalonate pathway of cholesterol biosynthesis that is essential for cellular protection, maintenance, repair and regeneration, synthesis of Vitamin D and most hormones, and the production of bile used in the final phase of digestion of fats and oils, as well as achieving adequate alkalinity in the small intestine for completing digestion of both proteins and carbohydrates.

Some people may consider alternative ways of reducing cholesterol and should be aware that Red Rice Yeast extract works by the same mechanism as statins. In contrast, other supplements work by alternate mechanisms.

Chitosan works by binding and eliminating bile salts, which are otherwise absorbed and recycled back into cholesterol. Chitosan also binds and eliminates most offending foreign substances that can trigger the liver to make more protective cholesterol.

Other remedies frequently used to help lower cholesterol include aged garlic, guggulipid, and policosanol.

Statins’ possible reduction of cardiovascular disease risk is not even due to blockage of cholesterol synthesis, but rather to anti-inflammatory activity by inhibiting nuclear factor kappa B (NF-kB), a substance vital to inflammatory immune function that is essential for periodic tissue detoxification, and thus prevention of other diseases such as cancer.

An alternative to blocking the immune system’s ability to mount vital inflammatory responses is to restore the body’s counterbalancing anti-inflammatory control mechanism centered in the adrenals.

7-Keto is an OTC active metabolite of DHEA (which is also safe enough to be available OTC) that supports the restoration of adrenal function and down-regulation of inflammatory processes without directly affecting other hormone levels, including the sex hormones. The adrenals depend on the liver to make the precursor: cholesterol for anti-inflammatory hormones.

Phytosterols, the plant fats with a homologous structure to cholesterol, are crucial dietary immune modulators that reduce damaging hyperimmune responses such as chronic inflammation and allergy while actually increasing effective immunity against pathogens associated with triggers chronic inflammation in cardiovascular disease. These most beneficial plant fats are filtered out of commercial oils for attractive visual clarity in the marketplace. Flax oil is now available unfiltered. The best dietary source of phytosterols is sprouting, and I recommend any but alfalfa, which quickly becomes toxic as it wilts.

Uncovering and repairing past damage and removing its causes is essential to cure the disease process, restoring healthy function.

Lysine works by solubilizing cholesterol, which binds to arterial walls by reversibly attaching to lysine in cell membrane proteins.

Vitamin C works by healing the original wounds in the blood vessel walls patched with protective cholesterol bandages.

MicroChitosan and other chelators work by binding and removing toxins and irritants that caused the initial damage.

Monocyte adhesion, macrophage recruitment, smooth muscle migration, and platelet activation are essential functions of our immune system’s defensive inflammatory response. When the underlying triggers of inflammation are not addressed so that this defense mechanism becomes chronically activated in our blood vessel walls, this becomes part of the process of atherosclerosis.

The single best predictor of this process is directly linked to our culture’s most common vitamin deficiency. Homocysteine, the metabolite of SAMe, responsible for mood elevation, liver and cartilage repair, is a good predictor of atherosclerosis.

Homocysteine is recycled back into SAMe by methylation. Folate, from dark green leafy vegetables, our most deficient vitamin, is a methyl donor, like vitamins B6 and B12.

Please be aware that Methylcobalamin, an active form of B12, also methylates mercury, making it one thousand times more toxic. An alternative active coenzyme form of B12 is dibencozide. The most efficient methyl donor for recycling blood vessel irritating homocysteine into joint and liver repairing and mood-elevating SAMe is TMG (trimethylglycine) from beets. For a therapeutic dosage, don’t try to get it all from whole beets or beet juice since this would provide excess Iron, and even normal Iron levels decrease longevity compared to slightly low levels.

Platelet activation is essential for clotting, which seals off damaged vessels, but can also cause collateral damage. Statins inhibit NF-kB, reducing the clotting response to vascular inflammation and any other kind of insult or injury. That is how statins can reduce the risks of atherosclerosis and cardiovascular disease. Still, statins do not remove the cause of the inflammation, nor do they repair the damage to the blood vessels. They merely stop the body’s process of trying to bandage the injury temporarily. Deeper healing would mean removing any foreign substances or toxins that block functions or irritate tissues and supplying essential and accessory nutrients needed to repair accumulated damage.

Recent studies show that some people have an overshoot of restored platelet stickiness, peaking in the second week after stopping the statin. The result is a small but statistically significant increase in strokes and heart attacks right after abruptly stopping statins without support. As with most medications, tapering off statins is advisable. Additional support could include fish oil (assayed to ensure the absence of heavy metals), aged garlic, and clot-busting enzymes like nattokinase or lumbrokinase. When needed, lumbrokinase is the strongest clot-dissolving enzyme. At the same time, nattokinase has the added benefit of coming with PQQ, a quinone (structurally related to Coenzyme Q10), the only supplement that promotes regeneration of mitochondria.

The real beauty of the human body and our living biosphere on earth is that it contains a tremendous depth and breadth of the accumulated wisdom of genetically encoded memories. Realize that our bodies are actually smarter than all of our minds put together. Find a way to listen in to that wisdom, and support it, and your body can heal just about anything. Remove the specific stress-related causes of disease in your environment, your diet, your behavior, and your thinking while supporting your innate capacity for self-regulation, cleansing, regeneration, rejuvenation, and energy production with fresh, ripe, raw organic produce and judiciously selected natural therapies that support, restore and stimulate functions rather than masking the symptoms of the body’s best-unsupported attempts at health maintenance through toxic and damaging interventions.

For more education, read former NASA Astronaut Duane Graveline, M.D., M.P.H.’s book Statin Drugs Side Effects, download free portions of my e-books at smashwords.com or read my blog at wordpress.com. You can access all my links directly at about.me/DrGlen.

For a healthier world,

Rev. Dr. Glen Swartwout, A.B., B.D., O.D., N.D., F.C.S.O., F.I.C.A.N., retired from commerce

Founder, Remission Foundation

P.S. Only middle-aged men with coronary heart disease may benefit from statins, but even then, statins may only work short-term and should be stopped before adverse effects begin.

High cholesterol levels are protective in elderly and heart failure patients. In fact, cholesterol is crucial for energy, immunity, fat metabolism, leptin, thyroid hormone activity, liver related synthesis, protection from stress, adrenal function, sex hormone syntheses, and brain function.

P.P.S. A Canadian government report found overestimation of benefit and underestimation of harm. Statins triple the risk of coronary artery and aortic calcification. Vascular surgeons are concluding that statins may cause more harm than good. (S. Sultan and N. Hynes, “The Ugly Side of Statins. Systemic Appraisal of the Contemporary Un-Known Unknowns,” Open Journal of Endocrine and Metabolic Diseases, Vol. 3 No. 3, 2013, pp. 179-185. DOI: 10.4236/ojemd.2013.33025.)