The H Factor Solution: Homocysteine, the Best Single Indicator of Whether You Are Likely to Live Long or Die Young

By James Braly, Patrick Holford and Jonathan Wright

Elevated homocysteine is a powerful, independent risk factor in more than 100 major medical conditions, including heart disease, strokes, and Alzheimer's disease. The authors discuss factors that contribute to high homocysteine, tell how to detect it if it's too high, and explain how to dramatically lower it.

• Language: English
• Publisher: Turner Publishing Company
• Release date: Jun 15, 2013
• ISBN: 9781591206156

James Braly

James Braly, M.D., is an internationally recognized expert on food allergy. He is senior medical editor of "Food Allergy and Nutrition Update" and "The Herbal Pharm", and is involved in teaching, lecturing, consulting, and product research and development.

Book preview

Introduction

Staying healthy, happy, clearheaded, and full of energy into old age—this is what we all want. But insuring that we do depends on how well we can read the state of our health. What if there was a single test that could do that, as well as point the way to a superhealthy future?

This book is about an extraordinary discovery that has taken the world of medicine by storm. Open almost any medical journal today and you’ll find something about homocysteine, a substance with a remarkable trait. Like a chemical crystal ball, it reveals exactly what we should be doing to guarantee our future health.

This amazing predictive chemical is an amino acid (a building block of protein) found naturally in the blood. Our levels of it, or our H score are more accurate than a cholesterol reading for predicting our risk of a heart attack or stroke, and a better measure than genes of our risk of Alzheimer’s disease. In fact, your H score predicts your risk of more than 100 diseases and medical conditions—including increased risk of premature death from all common causes. It can even tell you how quickly you will age. And, by revealing your B-vitamin nutritional status, immune-system function, and the state of your brain, it shows how well your body’s chemistry can roll with the punches.

If this was the whole story, many of us would rather not know our levels of homocysteine. But a high H score is anything but cause for gloom. The reason? It’s remarkably easy to fix. In a mere two months, you can insure your future health, potentially cutting your risk of most life-threatening diseases in half, and even slow down the aging process. We know how, and we want you to know, too.

You might already be taking steps in the right direction. Maybe you’ve quit smoking, lost some weight, lowered your cholesterol, or are taking a high-quality daily multivitamin and mineral supplement. But how do you really know where you stand on the scale of health and disease? If you don’t know your H score, you won’t ever really know.

What you will discover in this book is that most people’s H scores, which can now be tested at home using a simple kit, are around 11 points. Probably two in ten people reading this book will have a superhealthy H score below 6, and two in ten will have an extremely unhealthy H score above 15. But what does this mean?

Researchers from the University of Bergen in Norway, one of the world’s leading homocysteine research centers, measured the homocysteine levels of 4,766 people in their sixties a decade ago, and then recorded who died and who didn’t. They discovered that a mere 5-point decrease in H score predicted the following:

• A 49 percent reduced risk of death from all causes.

• A 50 percent reduced risk of death from cardiovascular disease.

• A 26 percent reduced risk of death from cancer.

• A 104 percent reduced risk of death from any disease or medical condition other than cancer or heart disease.

These are pretty staggering statistics, and you’ll find them confirmed again and again by researchers all over the world. But let us look at what this means in real terms.

Let’s say that you’re average—with an H score of 11 units (micromoles/liter of plasma). By following the H-Factor Solution, which you’ll find detailed in Parts Four and Five of this book, your H score should drop by up to 5 units in two months. And your risk of getting more than 100 diseases will also substantially decrease. If your H score is 16 units and you follow the H-Factor Solution for four months, you’ll decrease your score by up to 10 points and end up with a fraction of the risk you started with.

And we’re not just talking about adding years to your life. We’re also talking about how to add life to your years.

Whether you are young or old, sick or healthy, the best time to measure your H score is now. Then, if necessary, you can do what you need to do to bring it into the healthy range. If you’re young, remember that homocysteine does much more than predict risk for diseases—it also shows how well one will cope with life’s long roller-coaster ride.

Alan is a case in point. His father died of heart disease at age fifty-six. Not surprisingly, when Alan turned fifty-six, he was concerned about his family’s history of heart disease. He was equally concerned that he wasn’t as active as he used to be—and then, there was that glass or two of wine he drank every night. Alan decided to get his heart-disease risk factors checked out. His cholesterol was normal, as was his blood pressure. His homocysteine, however, was 14.6, putting him in the high-risk category. He started supplementing with therapeutic doses of vitamins B6, B12, and folic acid. Within three months, his homocysteine dropped dramatically to 9.6, reducing his risk of a heart attack by more than a third.

HOMOCYSTEINE MEASURES YOUR BODY’S AGE AND INTELLIGENCE

It’s an incredible fact that not only are we made from the food we eat, but also 70 percent of our bodies are renewed every year. The you that stares back from the bathroom mirror isn’t the same you that stared back a year ago! It is, quite literally, a miracle. So, what is theintelligence in our makeup that keeps making us new, or nearly new, every year?

It’s all down to two extraordinary chemical balancing acts in the body. One is called methylation. The other is oxidation-reduction. If you can get these two chemical processes working at peak levels, you are going to feel great and stay vibrant and young—mentally, emotionally, and physically. Both processes are measured and predicted by your blood levels of homocysteine and both can be improved by the right nutrients gleaned from diet and supplements.

And this is vital: Methylation and oxidation-reduction largely control how rapidly you age and how early chronic disease sets in. If your diet lacks antioxidants, such as vitamins A, C, E, and selenium, you age more quickly and get sick sooner. The same happens if your diet lacks methylating agents, such as vitamin B12 and folic acid (also called folate). These two chemical processes have a greater impact on your life span and pattern of diseases than your genes have.

In fact, even gene mutations that increase the risk of disease can be controlled by methylation. According to Dr. Adrian Bird of Edinburgh University, One in three mutations that cause human disease can be attributed to methyl groups on our genes.

Homocysteine reflects the health of your genes, how well you are holding back the clock, and your risk of premature death from all common causes. That’s how all-encompassing the homocysteine story is. Your H score is more important than your weight, your blood pressure, or your cholesterol level. Quite simply, it is your most vital, preventable, and reversible health statistic.

LOWERING HOMOCYSTEINE IS EASY WITH THE H-FACTOR SOLUTION

So, let’s say your H score is higher than you’d like. What can you do over the next two months? All the H-Factor Solution involves are some simple changes to your diet and daily homocysteine-busting supplements. For a few cents extra a day, you can progress from having a potential health risk to maximizing your health potential.

Using homocysteine as our yardstick, we’ve been researching exactly what kind of diet, supplement, and lifestyle will put you in the super-health category. We’ve looked at meat versus vegetables, wine versus beer, and the effects of coffee, smoking, salt, being overweight, and many other potentially harmful or protective foods, drinks, and habits. And there are some surprises in store.

As you might expect, drinking excess alcohol and smoking are extremely bad news. But do you have to quit completely? Yes, for smoking. No, for alcohol. In fact, small amounts of alcohol may even have some benefits. Smokers, on the other hand, have high H scores that plummet upon stopping but barely change upon cutting back. Strict vegetarians are more likely to have a high H score than meat eaters. We’ll explain why later in the book. Surprisingly, going on a weight-loss diet of any kind increases, rather than decreases, H scores. This doesn’t mean you shouldn’t diet, but it does mean you definitely shouldn’t go on a diet without taking homocysteine-lowering supplements.

Speaking of supplements, the evidence is clear: certain vitamin and mineral supplements lower your H score much more effectively than dietary changes alone. There are at least two vitamins that increase your H score! We advocate both supplements and dietary changes and will tell you exactly what to take depending on your H score.

As you will see, the right combination of four B vitamins, magnesium, zinc, and a nutrient you might never have heard of—trimethylglycine (TMG)—can lower homocysteine in a matter of weeks. There are other beneficial supplements, too. Much of the medical profession has honed in on folic acid as the answer and, in the United States and Britain, folic acid supplements are starting to be more widely recommended both by doctors and by government health advisers. However, on its own, folic acid often can’t lower a high H level to within a safe range. On the other hand, the right combination of nutrients works almost every time.

Interestingly, no drug that lowers your H level has yet been discovered, which is probably why the medical profession has been slow to embrace this vital breakthrough. With no drug, there are no patentpending, government-protected profits to be made. In fact, exactly the opposite is the case. If you do what we recommend in this book, you could bankrupt a few of the pharmaceutical companies that sell drugs that treat only symptoms of disease, while promoting and profiting companies and therapies that treat underlying causes of diseases with the right diet, lifestyle, and supplements.

We’ve put all this together in an easy, economical plan. All you do is measure your H score to know exactly where you are right now, then follow the recommendations in Parts Four and Five, retest, and see your H score fall. Once you hit the superhealthy goal—an H score below 6—you’ll have programmed yourself for superhealth.

ABOUT THIS BOOK

One last note before we plunge into the particulars. We have made some bold claims here, and in the rest of the book, we’ll show you how everything we say is backed up with good science—lots of it!

• Part One explains what homocysteine is, why it’s so bad when elevated, how lowering it decreases your risk of having the top-five killer diseases, and how widespread the homocysteine problem is the world over.

• Part Two explains the risk factors for high homocysteine, and how you can test your own H level to see where you are on the scale from health to disease.

• Part Three gives you detailed information on some of the 100 medical conditions now linked to high homocysteine. If you suffer from any of these diseases, we want you to know the whole story.

• Part Four gives you the raison d’être of the H-Factor Solution. And it shows you why too much meat or extreme vegetarian diets can be bad news, why a little (but not too much) alcohol may help, and why coffee, tea, smoking, and stress all raise homocysteine—and what you can do about it.

• Part Five explains why certain supplements can lower high homocysteine levels and which combinations and doses work best, depending on your H score.

• A Review: Twelve Solutions for Superhealth puts it all together in a simple twelve-step action plan to bring your homocysteine level into the superhealthy zone.

In each part of the book, you’ll find numbered references. These refer to research papers listed in the Notes section in the back of the book. They are there for readers who want to study this subject in depth.

Wishing you the best of health … and low homocysteine scores.

A GUIDE TO ABBREVIATIONS AND MEASUREMENTS

Homocysteine is measured in micromoles per liter (mmol/l). These are referred to as units throughout this book. Most vitamins, minerals, and amino acids are measured in milligrams (mg) or micrograms (mcg).

1 gram (g) = 1,000 mg = 1,000,000 mcg

Part One

The Homocysteine Story

Chapter 1

The Health Secret of Homocysteine

We owe a lot, and very possibly our lives, to one smart, courageous man—Dr. Kilmer McCully. His discovery that homocysteine is probably our single most vital health statistic, and his tenacity in proving it despite immense resistance, has led to a revolutionary breakthrough in medicine. As this book unfolds, you will see how the discovery of homocysteine has revealed the cause of heart disease, strokes, cancer, diabetes, Alzheimer’s disease, and potentially more than 100 other diseases. And, most important, you will see how this knowledge can help you to prevent yourself from getting them. But let’s begin at the beginning.

Back in 1968, Dr. McCully, who trained at Harvard Medical School, was studying children with a rare genetic disorder called homocystinuria. Children born with this condition lack certain enzymes required to turn a naturally occurring yet potentially toxic substance, homocysteine, into a harmless substance called cystathionine. As a consequence, they have extraordinarily high levels of homocysteine in their urine and blood, well above 100 units. To give you some idea of how serious this is, even a score above 9 is now considered high risk. Unless they are diagnosed and treated, these children often die at a very young age of heart attacks and strokes, once thought to be caused in large part by high cholesterol despite completely normal cholesterol levels in the children. One two-month-old infant died of old age from advanced arteriosclerosis. Sufferers also often experience a variety of other ailments.

When he was reviewing these cases, Dr. McCully came to realize that homocysteine, rather than cholesterol, might be a fundamental independent risk factor of hardening or stiffening of the arteries (arteriosclerosis) and clogging or blockage of the arteries (atherosclerosis), and, therefore, of heart attacks and strokes—and he went on to prove that it is. But the medical profession wasn’t ready to listen. Dr. McCully was dismissed from Harvard and shuffled from job to job, insistent on continuing this unpopular line of research, which was then sidelined in cardiovascular medicine until the 1990s. Over the past decade, thanks to Dr. McCully’s hard work and tenacity, evidence for the homocysteine theory has piled up. Now, finally, mainstream medicine is sitting up and taking note.¹

The initial research focused on the relationship of homocysteine to cardiovascular and cerebrovascular disease—heart attacks, strokes, and artery disease. In 1992, a study of 14,000 male doctors found that those with homocysteine levels in the top 5 percent had three times the risk of having a heart attack, compared with those in the bottom 5 percent. This increased risk was confirmed in 1995 by the internationally acclaimed Massachusetts-based Framingham Heart Study, which found that having more than 11.4 micromoles of homocysteine per liter of blood (a measurement we will now begin to call units) increased the risk significantly.² Another study at the University of Washington found that having a high H score doubled the risk of heart attack even in young women.

The real clincher was a study carried out by the European Concerted Action Group, a consortium of doctors and researchers from nineteen medical centers in nine European countries.³ They studied 750 people under the age of sixty with blockages in their coronary arteries, and compared them to 800 people without cardiovascular disease. They found that having a high H score was as great a risk factor for cardiovascular disease as smoking or having a high blood cholesterol level. Those whose homocysteine levels were in the top fifth had double the risk of cardiovascular disease. Most significantly, the group also found that those taking B-vitamin-containing supplements had a risk factor two-thirds less than those not taking them. That’s because certain supplements lower your H score and your risk.

Today, totally vindicated, Dr. McCully is a best-selling author and pathologist at the Veterans Affairs Medical Center in Providence, Rhode Island. And in conventional cardiology, the branch of medicine that deals with heart disease, homocysteine is rapidly becoming recognized as a significant independent cause of risk, on a par with cholesterol. (Later on, we will show you why high homocysteine is, in fact, a far greater risk factor for heart disease than high cholesterol.) However, this link to heart disease is just the tip of the iceberg; the discovery of homocysteine has identified a fundamental cause and biological indicator or marker of premature aging, in every single one of us.

REDUCE YOUR RISK OF THE TOP-FIVE KILLER DISEASES

Currently, at least one in two people dies prematurely from preventable diseases, and more than one in two have high homocysteine levels. Huge numbers of us tend to adopt the ostrich technique, burying our heads in the sand and letting all that sensible health advice wash over us—until it’s too late. Our clinics are full of people who have had a heart attack or stroke, or whose mental gears are slipping into a state of senility, or who have been diagnosed with cancer or diabetes. It’s only then that, out of desperation, they become willing to listen to medical advice.

It doesn’t have to be this way. There is a way to age slowly and gracefully and stay physically vital and mentally sharp to the very end of a long and healthy life. It’s prevention—always much simpler and more pleasant than cure. Remember, the top-five killer diseases—heart attacks, strokes, cancer, and the complications of diabetes and Alzheimer’s disease (some provocateurs might include death from prescription medications here)—are mostly preventable.

The trick is to start your disease prevention strategy before you have the disease. How? One of the best places to begin is to find out your H score. If your homocysteine levels are too high, you can bring them down to safe levels with our simple H-Factor Solution. Once you’ve done that, you’ve effectively insured yourself for a healthy future. You’ll find out all about this in Parts Four and Five.

But knowing your H score doesn’t only give you an indication of what measures you need to take to protect yourself from many diseases. It’s also a clear indicator of your ability to fight infections, your mental and physical energy, and how quickly you are aging.

EXTENDING YOUR HEALTHY LIFE SPAN

Once you hit age sixty-five, statistics say you’ll live another sixteen years if you’re a man and eighteen years if you’re a woman. Amazingly, this hasn’t changed much over the decades. Back in the 1930s, once you reached age sixty-five, you’d have had a life expectancy of only three years less than the contemporary figure.⁴ So, technically, modern medicine has only added three more years to your life! According to the American Academy of Anti-Aging Medicine, this is still a long way short of our true potential as human beings, which they believe is living to the maximum life span of 120, free of degenerative disease.

As Figure 1.1 below shows, the ideal health objective is to flatten the life-span curve, so you live fully, with all your senses intact, free of pain, depression, and disabling fatigue, until you die. For most of us, realistically, that point should be around 100 years old, at least. This is what is conservatively being predicted for those who have followed the practice of optimum nutrition and a healthy lifestyle all their lives. If you’ve only started behaving yourself in your forties or fifties, your maximum life span may be in the

Reviews for The H Factor Solution

[lynleys-1 · Rating: 4 out of 5 stars]

This book could have been a thick pamphlet rather than a book -- there seemed to be a lot of repetition, particularly near the beginning. But once I got past all the ways in which an elevated homocysteine level can kill you, the chapters on exactly *how much* supplementation is necessary was very useful, and in our family's experience, has been lacking from advice from the doctor, who simply advised to 'take some vitamin B' after my nearest and dearest came back with a dangerously high level.

Despite its likely importance, the writing style is a bit melodramatic. I was hoping to read something with fewer exclamation marks. Those little bastards never help to hammer home the importance of anything, sounding instead like one of those emails your great auntie forwards weekly via the webbernets.

I'm not one of those readers who needed to be convinced about the importance of homocysteine, which is probably the only reason I felt the first half of the book to be a bit of a drag. I only wanted to know what to do about it.

I'm also doubtful about some of the conventional dietary wisdom espoused in this book. I'm not convinced by the recommendation to eat less saturated fat. Unlike the other advice, there was no real reason given. How does a diet high in saturated fat elevate homocysteine levels? According to Mark Sisson, (in his post 'Common Nutritional Deficiencies and What To Do About Them; Mark's Daily Apple), Sisson points out that eating more fat increases the need for choline. So this probably explains it. He also points out that you don't need to reduce your fat; you just need to increase your choline intake. Fortunately for us (and no accident, really), choline comes packaged in nature with fats. Eggs are a good example. So is liver.

But rather than recommend people eat liver, the authors of this book assume most of us are not up to that challenge, and instead recommend expensive supplementation. While I admit that most people would find it easier to supplement rather than make large dietary modifications, I'd have liked this book to go a bit further, and to encourage readers to incorporate a bit of beef liver into our diets. There may well be micronutrients in whole foods which haven't even been found yet, therefore rendering pills less effective than actual food.

This book was a good reminder to ask the GP for a homocysteine test, and I've never had mine done. After reading this book I'm definitely interested to know what my level is. Whether or not my Australian GP will order it for me is another matter. (I may have to present with something wrong with me first.)

In sum, reading this book only made me more sure that eating primally is the way to go. Now, I'd better go and transfer that kilo and a half of beef liver pate into the fridge...