Christopher C. Barr
Naturally Speaking
January 31, 2008

Heart of the matter

A report in the Journal of the American Medical Association (JAMA, 8/28/02) noted that a trio of B vitamins saves lives and money for those with heart disease. Dr. Guido Schnyder from the University of California, San Diego directed a team of researchers to these findings regarding folic acid, B12 and B6.

The above trio of B vitamins has been demonstrated to lower blood levels of homocysteine. Exactly one year prior JAMA featured another report on this amino acid and heart disease. That article noted those with high blood levels of this substance experience a greater number of heart attacks as well as death from heart disease. Dr. Jeffrey A. Tice from the University of California, San Francisco wrote that folic acid and cyanocobalamin (B12) reduce homocysteine levels.

So homocysteine, heart disease, and folic acid and B12 are hot, breaking stories IN THE NEWS … again!

Déjà vu

Several years ago an associate at a major metropolitan newspaper at which I was an editor asked if I had seen the ABC Television news program ‘20-20’ the previous week. I informed her that I had not and she then asked what I knew about some B vitamin related to heart disease and a doctor who lost his job over the subject.  I started to lay out the story of Kilmer McCully, homocysteine, pyridoxine (B6) and folic acid to her. She laughed and said, "I should have known that you’d already know all about it!"

Well, I don’t know about "all about it ".  However, I had written two years before the ‘20-20’ "breaking news" story about McCully when the folic acid/homocysteine stories first broke IN THE NEWS.

First of all, I wrote specifically because folic acid should be an afterthought. There is another B vitamin that is the real key.

Second of all, the "breaking news" story even at that time should have been old news.

Alas, the story I wrote was not published. It was ignored. Such has been the case for the long journey of this often told but seldom heard tale.

More déjà vu

More than 20 years before, Dr. Kilmer McCully had published the first paper about homocysteine as a factor in heart disease. Homocysteine is an amino acid. Proteins that we consume in foods consist of amino acids. However, homocysteine is a metabolite of another amino acid. That means it occurs as the result of the metabolic breakdown of an amino acid.

Homocysteine appears to injure blood vessels in such a way as to allow build-ups of matter that may subsequently lead to blockages. This may then lead to heart disease. That may then lead to a heart attack. Eventually death may result.

Dr. McCully pursued these matters, publishing numerous papers on the subject over a ten-year period.

Pressing the matter finally led to a request for the departure of McCully by his department chairman at Harvard Medical School.

Most researchers have in recent years come to a consensus that homocysteine is a risk factor for heart disease on a par with cholesterol.

The use of ample amounts of folic acid to reduce homocysteine levels had already begun to excite many in the research community several years before these current "breaking news" stories.

Closing The Barn Door Before The Horses Get Out

The papers Dr. Kilmer McCully published decades ago actually had more to do with prevention of homocysteine buildup, rather than reducing it after the fact!

The fact of the matter is that more than 20 years prior to the first published work of Dr. McCully, a deficiency of the B vitamin pyridoxine (B6) had been cited by another as a causative factor in heart disease.

McCully discovered homocysteine to be a primary factor in heart disease as a follow up to these studies! He merely isolated the chemical change that occurs because of the deficiency of B6.

Among the myriad functions of vitamin B6 is the breakdown of methionine into cysteine and cystine. These are two vital amino acids. Methionine is an amino acid categorized as essential.

McCully discovered that in the absence of sufficient quantities of vitamin B6 the above process stopped short. He found that the chemical substance homocysteine then built up instead of continuing on to the other two vital amino acids.

It was more than 20 years ago that I learned of these matters from the book ‘Vitamin B6: The Doctor’s Report’. This was not a book from some fringe element publisher. Harper and Row, a major New York publisher, released it 30 years ago. The "Doctor" of the title was the lead author, John M. Ellis, M.D.

Returning to the present time

Last year I looked up Dr. John M. Ellis and had the honor of speaking with him at his home in Texas. Dr. Ellis retired from the practice of medicine on the fiftieth anniversary of his medical degree. He currently continues his research as Medical Director of Clinical Research at a county regional medical center in virtual anonymity.

Dr. Ellis was excited to speak to someone from Arkansas.  His parents are buried in the state.  His dad was an Arkansas country doctor.  Some of the earliest breakthroughs about vitamin B6 were right here in Northeast Arkansas.  Ellis spoke excitedly about the possibility that a few more people might be reached with information about vitamin B6 through my efforts.  He sounded robust for a man well into his 80s.

Eight years ago his five-year clinical study on heart disease and vitamin B6 was published in a scientific journal.  It was virtually ignored.

In that study, those who died of heart attacks that took vitamin B6 lived on average eight years longer than those did who did not take vitamin B6. There was also a marked reduction in heart attacks among those that took vitamin B6 compared to those who did not take vitamin B6. The total incidence of heart disease events was reduced 74% in the B6 group compared to those who did not take vitamin B6.

Oh, and by the way, the co-author of that Ellis study was Dr. Kilmer S. McCully.

Last year's JAMA study trumpeted a likelihood of 8% or 13% reductions in heart disease events and deaths.

The current JAMA study went beyond predictions with a more than 30% reduction of actual adverse events such as heart attacks.

Still, Dr. Schnyder (of the more recent JAMA study) exhibited hesitation about promoting homocysteine-lowering therapy for reduction of cardiovascular problems. He suggested waiting on other ongoing studies. "In a year or two, these studies will clearly show whether there is a benefit. We would not extrapolate the results of our study to the general population."

Dr. Robert Bonow, chief of cardiology at Northwestern Memorial Hospital in Chicago and president of the American Heart Association echoed Schnyder's hesitation. "When you have a small trial like this, it's always nice to have confirmation by another group. I think it's very interesting and it needs to be followed very carefully."

Let the games continue?

The effect of treatment with vitamin B6, folic acid and vitamin B12 on heart disease was featured in JAMA the issue that followed the ginkgo story issue. A positive benefit was noted from the nutrient therapy.

The president of the American Heart Association on the basis of it being "a small trial" downplayed the results of that study. It was conducted with 553 individuals. The ginkgo study was paraded prominently for its negative results with 203 individuals while another study far exceeding twice the number of subjects was lightly regarded when positive results for a nutritional therapy were noted.

Does it sound like a leading competitor trying to beat back an up and coming competitor? Does it sound like a rigged game?

What are we waiting for?

The older Ellis/McCully study referred to above was of a much longer duration than the latest JAMA study. It demonstrated 74% reductions in heart disease events and deaths with vitamin B6 alone!

Would it not seem to be of greater value to increase vitamin B6 intake as a primary preventative, and folic acid and B12 as secondary treatments?

Will it take another 20 years for this information to get out?

Christopher C. Barr writes Naturally Speaking from Arkansas: The Natural State … naturally! You may write him c/o P. O. Box 1147, Pocahontas, Arkansas 72455 or by e-mail at servantofYHVH@hotmail.com .