Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
How many vitamins should I take to lower my homocysteine level?
Daily recommended doses of folate, B vitamins, and multivitamins are
generally sufficient in regard to lowering homocysteine levels. These daily
doses are recommended by the Food and Drug Administration (FDA) and the doses in
a specific product are printed on the label of the vitamin bottle by the
manufacturer. Usually, folate supplementation is recommended at 1 milligram
daily; vitamin B6 is recommended at 10 milligram per day; and vitamin B12 at
one-half milligram per day.
Does lowering homocysteine levels prevent heart attacks and strokes?
Currently, there is no direct proof that taking folic acid and B vitamins to
lower homocysteine levels prevents heart attacks and
strokes. However, in a
large population study involving women, those who had the highest consumption of
folic acid (usually in the form of multivitamins) had fewer heart attacks than
those who consumed the least amount of folic acid. In this study, the
association between dietary intake of folate and vitamin B6 and risk of heart
disease was more noticeable than between dietary intake of vitamin B12 and heart
disease, which was minimal.
Many other observational studies have been performed to assess the effect of
folate and the other B vitamins on heart disease. Most of these studies have
concluded that oral intake of folate has been associated to lower risk of heart
disease, possibly because due to lowering of homocysteine levels. The relation
between oral intake of vitamin B12 and B6 and heart disease was not as obvious
in many of these studies. (5,6,7)
In one study, it was concluded that even in people with elevated homocysteine
levels due to genetic reasons, oral intake of folate and possibly the other B
vitamins was related to lower incidence of heart disease. (5,6,7)
Most of these data, however, are obtained from observational studies rather
than purely controlled scientific data. Therefore, it is important to mention
that despite these studies suggesting an association between the intake of these
vitamins and the lower incidence of heart disease, in general, there is no
compelling clinical evidence to treat hyperhomocysteinemia other than
homocystinuria (the severe genetic form) in regards to heart disease, stroke,
or blood clots.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
A pulmonary embolism occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate.
Deep vein thrombosis (DVT) is a blood clot in a vein located deep in the muscles of the legs, thighs, pelvis (lower torso), or arms. The most common symptoms of a deep vein thrombosis are swelling and pain in the leg that has the blood clot. A DVT is difficult to diagnose without specific tests in which the deep vein system can be examined.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Vitamins are organic substances that are essential for the proper growth and functioning of the body. Calcium is a mineral essential for healthy bones and is also important for muscle contraction, heart action, and normal blood clotting.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay inlcudes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Vitamins and exercise can lower your risk for heart attack and heart disease. Folic acid, vitamins, and homocysteine levels are interconnected and affect your risk for heart disease or heart attack. Antioxidants and exercise also play a key role in heart attack and heart disease prevention. Lower your risk factors for heart disease and heart attack by lowering cholesterol, lowering blood pressure, diabetes prevention, and smoking cesssation.
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