Episode Details
Back to EpisodesEXPLAINER: Medicine's Forgotten Biomarker - The Homocysteine Story Your Doctor Missed
Episode 260
Published 3 weeks ago
Description
In 1969, Harvard pathologist Kilmer McCully discovered elevated homocysteine causes arterial damage and heart disease. He was forced out of Harvard. The Framingham Heart Study confirmed him. Then the AHA buried it anyway.
CHAPTERS:
00:00 - McCully discovery and suppression
01:20 - Part 1: What homocysteine does to arteries (6 mechanisms)
03:25 - Part 2: The evidence they ignored
03:40 - Every 5 umol/L: 20-30% higher CAD risk, 60% stroke risk
04:50 - Alzheimers risk +48% (meta-analysis, 7,474 subjects)
06:10 - Part 3: Why it was abandoned (VISP, NORVIT, HOPE-2)
07:50 - Cochrane: B vitamins reduced stroke 10%
08:20 - CSPPT: folic acid reduced stroke 21% to 73%
09:10 - Part 4: Your brain on homocysteine
09:25 - VITACOG: brain atrophy 30% slower, 53% in high-Hcy group
10:05 - PNAS 2013: 7x less hippocampal atrophy
11:00 - Part 5: What to do
11:10 - Test fasting homocysteine: target under 8-10 umol
11:40 - Methylfolate, methylcobalamin, P5P
REFERENCES:
Homocysteine CVD Risk 2025: PMC12564181
VITACOG Trial (PLoS ONE, 2010): PMC2935890
VITACOG 2025 Metabolomics: PubMed 40684250
Homocysteine Alzheimers Risk: PMC12280720
Cochrane B Vitamins Stroke: Cochrane
CSPPT Folic Acid: ACC
JAMA 2010 Meta-Analysis: JAMA
HOST: Dr. Robert Lufkin MD | robertlufkinmd.com
CHAPTERS:
00:00 - McCully discovery and suppression
01:20 - Part 1: What homocysteine does to arteries (6 mechanisms)
03:25 - Part 2: The evidence they ignored
03:40 - Every 5 umol/L: 20-30% higher CAD risk, 60% stroke risk
04:50 - Alzheimers risk +48% (meta-analysis, 7,474 subjects)
06:10 - Part 3: Why it was abandoned (VISP, NORVIT, HOPE-2)
07:50 - Cochrane: B vitamins reduced stroke 10%
08:20 - CSPPT: folic acid reduced stroke 21% to 73%
09:10 - Part 4: Your brain on homocysteine
09:25 - VITACOG: brain atrophy 30% slower, 53% in high-Hcy group
10:05 - PNAS 2013: 7x less hippocampal atrophy
11:00 - Part 5: What to do
11:10 - Test fasting homocysteine: target under 8-10 umol
11:40 - Methylfolate, methylcobalamin, P5P
REFERENCES:
Homocysteine CVD Risk 2025: PMC12564181
VITACOG Trial (PLoS ONE, 2010): PMC2935890
VITACOG 2025 Metabolomics: PubMed 40684250
Homocysteine Alzheimers Risk: PMC12280720
Cochrane B Vitamins Stroke: Cochrane
CSPPT Folic Acid: ACC
JAMA 2010 Meta-Analysis: JAMA
HOST: Dr. Robert Lufkin MD | robertlufkinmd.com
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