by Glen Swartwout

Are Heart Attacks and Strokes A Sign of Chronic Nutritional Deficiency?

Ball and stick model of the homocysteine molec...

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, within the medically normal range, can double and triple cardiovascular disease including heart attack and stroke. A number of recent studies published between 1992 and 1995 show that increasing homocysteine levels are related to increasing levels of risk for both carotid artery disease, and heart disease.

How does homocysteine contribute to cardiovascular disease? Animal studies show that increased levels of homocysteine 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 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, dihydr...

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, and shows how the B vitamins play a key role, when present in the diet, or dietary supplementation at adequate levels, in preventing increased levels of homocysteine that are 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 (Trimethyl Glycine) 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)


Berberine (found in goldenseal as well as in Berberis species like Oregon Grape root)


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 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 taken up to about 30 mg daily in divided doses (in Natural Resources A-Z)

Complex carbohydrates

Copper 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)


Fiber (especially water soluble fibers like guar gum, pectin, and cereal brans like oats and barley) totalling 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): essential for the conversion of 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 taken up to about 1200 mg three times a day (in glandulars 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 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, flax seed 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

Phosphatidyl choline (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): essential for the conversion of homocysteine to methionine.

Red wine in moderation (extract in Pycnogenol + Antioxidants)

Sardines (especially 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 (hydrolized in One Step)

Vitamin B complex (in Star Gold and Stamina Plus)

Vitamin B12 (in Star Gold and Stamina Plus): essential for the conversion of 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 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 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 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.