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1 Homocysteine Homocysteine is an amino acid made from a common dietary amino acid, methionine, that inflicts damage to the inner arterial lining (endothelium) and contributes to many diseases:

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3 Functionally this should be between 5-8

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6 Homocysteine, Silent Brain Infarcts, and White Matter Lesions: The Rotterdam Scan Study Vermeer, S., et al., Ann Neurol 51: ; March, 2002 Highest quintile of homocysteine (> 13.8) risk of: silent brain infarction 2.5 X severe white matter lesions 2.3 X

7 Homocysteine, Silent Brain Infarcts, and White Matter Lesions: The Rotterdam Scan Study Vermeer, S., et al., Ann Neurol 51: ; March, ,077 people aged yrs -The overall risk of having either a silent infarct or severe white matter lesions was strongly associated with total homocysteine levels.

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10 Homocysteine in cerebral macroangiopathy and microangiopathy Faßbender K., et al., Lancet 353:1586-7; May 6, Vascular dementia is the second most frequent cause of dementia in the elderly after Alzheimers disease This study on a large cohort of patients with subcortical vascular encephalopathy (disease of the brain) and controls demonstrates that homocysteine concentrations are markedly increased in cerebral microangiopathy.. Definition Microangiopathy (or microvascular disease, or small vessel disease) is an angiopathy (i.e.disease of blood vessels) affecting small blood vessels in the body.

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12 Homocysteine in cerebral Damage Faßbender K., et al., Lancet 353:1586-7; May 6, 1999 We speculate, therefore, that progression of vascular dementia in patients with identified hyperhomocysteinaemia could be prevented by vitamin supplementation..

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14 Methylation Cycle Methyl Naked-B12 Folate B9 Methyl-B12 Homocysteine 5-8

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16 The only difference was the brown mouse was fed food that contained METHYL DONORS.

17 Homocysteine

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19 12 Tips to Optimize Your Methylation Process Just as there are many causes of poor methylation, there are lots of things that support its proper functioning. Here s how to maximize methylation and prevent conditions like heart disease, cancer, dementia, depression, and more. 1) Eat more dark, leafy greens You want to eat l cup a day of vegetables like bok choy, escarole, Swiss chard, kale, watercress, spinach, or dandelion, mustard, collard, or beet greens. These are among the most abundant sources of the nutrients needed for optimal methylation 2) Get more B s in your diet Good food sources include sunflower seeds and wheat germ (vitamin B6); fish and eggs (vitamin B6 and B12); cheese (B12); beans and walnuts (vitamin B6 and folate); leafy dark green vegetables; asparagus, almonds, and whole grains (folate); and liver (all three) 3) Minimize conventional animal protein, sugar, and saturated fat Animal protein directly increases homocysteine. Sugar and saturated fat deplete your body s vitamin stores

20 4) Avoid processed foods and canned foods These are depleted in vitamins 5) Avoid caffeine Excess amounts can deplete your B vitamin levels 4) Avoid processed foods and canned foods These are depleted in vitamins 5) Avoid caffeine Excess amounts can deplete your B vitamin levels 6) Limit alcohol to 3 drinks a week More than this can deplete your B vitamin levels 7) Don t smoke As noted above, smoking inactivates vitamin B6 8) Avoid medications that interfere with methylation See notes on this above

21 9) Keep the bacteria in your gut healthy Take probiotic supplements and use other measures to make sure the bacteria in your gut are healthy so you can properly absorb the vitamins you do get 10) Improve stomach acid Use herbal digestives (bitters) or taking supplemental HCl 11) Take supplements that prevent damage from homocysteine Antioxidants protect you from homocysteine damage. Also make sure you support methylation with supplements like magnesium and zinc Functional less than ) Supplement to help support proper homocysteine metabolism Talk to your doctor to determine the best doses and forms for you. Here are a few suggestions: Folate (folic acid): Amounts can vary based on individual needs from 200 mcg to 1 mg. Some people may also need to take preformed folate (folinic acid or 5 formylthf) to bypass some of the steps in activating folic acid

22 13) Vitamin B6: Take 2 to 5 mg a day. Some people may need up to 250 mg or even special active B6 (pyridoxyl-5-phosphate) to achieve the greatest effect. Doses higher than 500 mg may cause nerve injury 14) Vitamin B12: Doses of 500 mcg may be needed to protect against heart disease. Oral vitamin B12 isn t well absorbed; you may need up to 1 or 2 mg daily. 15) Betaine: This amino acid derivative is needed in doses from 500 to 3,000 mg a day, depending on the person

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