When Homocysteine Levels Won’t Come DownOctober 2006
By William Faloon
A Different Kind of Folic Acid
When you consume folic acid, it goes through several metabolic steps before being converted to Metafolin®, which is the active form of folate in the body that actually reduces homocysteine. Some people fail to convert folic acid to L-methylfolate, which results in them accumulating higher-than-desired levels of homocysteine.
A patented form of folic acid called Metafolin® provides enormous benefits for those who do not naturally produce enough L-methylfolate. L-methylfolate is available both as a dietary supplement and as a prescription drug called Cerefolin®. The manufacturer of Cerefolin® claims that L-methylfolate reduces homocysteine almost three times more than folic acid.154
Because Cerefolin® is a prescription drug, it is very expensive. The manufacturer’s claims, however, appear to be somewhat embellished. The study citied by the manufacturer (showing almost three times greater homocysteine reduction) compared one-time dosing of 5200 mcg of L-methylfolate to 5000 mcg of regular folic acid. Since Cerefolin® is absorbed much quicker than folic acid, it would be expected that one-time dosing of Cerefolin® would produce faster results.
What the manufacturer fails to mention is that dietary supplement users seeking to lower homocysteine usually take vitamin B12, vitamin B6, and sometimes TMG with their folic acid. If a group of dietary supplement users were compared to a group that took only L-methylfolate, there might be not be a significant average difference in homocysteine levels over the long term.
The key factor here is individual need. For people who are unable to efficiently convert folic acid to L-methylfolate in their bodies, the more expensive L-methylfolate product will benefit them tremendously. Most people, however, can achieve desired homocysteine reduction merely by taking enough conventional homocysteine-lowering supplements.
All of this points to the critical importance of having your blood tested to assess your homocysteine level. If you are taking high doses of homocysteine-lowering nutrients and your homocysteine level remains persistently high, then you should first make sure that you do not suffer from kidney impairment. Whether or not you suffer from kidney impairment, if your homocysteine remains persistently high, consider taking 800-5600 mcg of L-methylfolate two times a day to achieve at least some improvement.
Where to Obtain L-methylfolate
The drug company Merck holds the patent on L-methylfolate and has set up a number of barriers that prevent it from being more widely available as a dietary supplement. Fortunately, a few supplement companies (such as Source Naturals) were able to overcome these hurdles and make L-methylfolate available without a prescription.
Remember, this form of folic acid is not required if the supplements you take are keeping your homocysteine below 7-8 µmol/L of blood. For those who take proper doses of folic acid, B12, B6, and TMG, but still suffer higher-than-optimal homocysteine, L-methylfolate may be the solution.
Some people need only 800 mcg twice a day of L-methylfolate to optimize homocysteine. Others will need much higher potencies of L-methylfolate and may want to consider asking their doctor to prescribe Cerefolin® at a dose of one to two tablets daily. Each tablet of Cerefolin® provides:
Cerefolin® can be obtained in pharmacies and some insurance companies may cover it. The downside is that you have to get your doctor to prescribe it.
The Life Extension Buyers club offers Source Naturals’ L-methylfolate supplement to members at a discount off the retail price. The trade name of this supplement is Metafolin® and it comes in bottles containing 120 800-mcg tablets. The retail price is $17.98 per bottle, but members of the Life Extension Foundation can obtain it for only $12.50. Please remember that L-methylfolate is for those who are unable to lower their homocysteine with lower-cost conventional supplements. Most people do not need it.
Blood Testing Probably Saved My Life
Had I not had regular blood tests performed, I would have assumed that the nutrients I took every day were adequately suppressing my homocysteine levels. I was fortunate to learn a long time ago that I needed a lot of vitamin B6 to reduce my homocysteine to safe ranges.
The blood tests I took in November 2005 alerted me to an underlying kidney disorder that I was able to reverse simply by discontinuing a drug (ibuprofen). Many other drugs can adversely affect the liver, kidneys, and bone marrow. A CBC/chemistry blood test reveals drug-induced pathologies before they cause irreversible damage. If I had not taken this blood test, I may have continued taking ibuprofen for its sleep-inducing and cancer-preventive effects. Since early-stage renal failure does not usually present symptoms, I could have suffered irreversible kidney damage, along with the life-threatening complications—such as sharply increased risk for heart attack and stroke—caused by that kidney disease.
Kidney disease is a leading cause of death in the United States, yet most cases of renal dysfunction are preventable if annual blood tests are taken to rule out factors such as diabetes, drug-induced toxicities, early-stage atherosclerosis, and chronic inflammation.
Discount Blood Testing Available to Foundation Members
Since the early 1980s, Life Extension has advised its members to have annual blood tests to identify disease risk factors that can be reversed before serious illness develops.
Some members are able to obtain blood tests from their doctors. A problem that I frequently encounter is that even when doctors order all the blood tests requested, the phlebotomist often fails to check off the appropriate codes on the laboratory requisition form or does not properly draw the blood. When the results come back incomplete, another blood draw becomes necessary, thus inconveniencing the patient.
Even today, many doctors still refuse to prescribe blood tests for important cardiovascular risk factors such as homocysteine and C-reactive protein. Life Extension resolved this problem 10 years ago by offering blood tests directly to its members.
Members can obtain blood tests for a fraction of the price charged by commercial laboratories. For example, the comprehensive Male or Female Panels cost around $1,100 at a commercial laboratory, yet Foundation members can obtain these identical tests for only $299.
Based on what I have discovered as a result of having my own blood tested regularly, I am convinced that I have corrected a number of genetic risk factors that would have predisposed me to a premature death. Whether using your own doctor, a commercial laboratory, or our blood-testing service, I encourage every member to have his or her blood tested at least once a year.
For longer life,
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