Independent use of Cardio SAP twice daily is expected to significantly lower blood homocysteine and to provide support to the body's B vitamin-dependent pathways.
Each non-GMO vegetable capsule contains:
Folic Acid (folate)... 400 mcg
Vitamin B12 (methylcobalamin) ... 500 mcg
Vitamin B6 (pyridoxal-5-phosphate) ... 20 mg
Betaine (trimethylglycine) ... 668 mg
Note: 1000 mcg = 1 mg
Contains no: preservatives, artificial flavor or color, sugar, milk, starch, corn, wheat, yeast, citrus
A high level of homocysteine in circulation is an independent risk factor for the development of disability and death from cardiovascular disease (CVD) including stroke. CVD risk increases proportionately by 6 to 7% with every 1 μ mol/L increase in blood homocysteine. Elevated blood homocysteine is also thought to relate to onset of diseases of the brain and kidneys and to diabetic complications. Elevated homocysteine levels are often observed in the elderly and in individuals with compromised nutrition, gastrointestinal disorders or a genetic tendency for hyperhomocysteinemia. Cardio SAP provides a combination of scientifically supported doses of B vitamins (folate, vitamin B6, vitamin B12) and betaine to optimize breakdown of homocysteine, thus preventing its build-up in the blood.
FORM and DOSE to GUARANTEE EFFICACY and SAFETY • The folate, methylcobalamin, pyridoxal-5-phosphate and trimethylglycine forms used in this blend are better absorbed and more bioavailable than other forms of the same compounds. • By following Canadian and US Daily Recommended Intake (DRI), Recommended Daily Allowances (RDA) and Upper Limits (UL) as well as cutting edge scientific evidence, the doses of folate, vitamin B12, vitamin B6, and betaine in Cardio SAP have been carefully selected to ensure efficacy and safety.
PURITY and CLEANLINESS Third party testing of finished product is done to ensure Cardio SAP is free of heavy metals, pesticides, volatile organics and other impurities.
WHAT IS HOMOCYSTEINE? Total homocysteine is a non-protein forming, highly reactive sulfur amino acid. It is an intermediary product of methionine metabolism and can be remethylated to methionine (a methyl donor in nucleic acid metabolism) or metabolized to cysteine (a precursor of glutathione) through biochemical pathways dependent on the presence of folic acid (folate), vitamin B12, vitamin B6 and betaine (see Fig. 1)(1). Blood homocysteine can be measured in a fasted or post-methionine load state. In a fasted state, blood homocysteine above approximately 10 μ mol/L is considered elevated and a potential risk factor for certain diseases, most notably cardiovascular disease (CVD)(2). Figure 1. Homocysteine Metabolism: Biochemical Pathways(3) Ser = serine; Gly = glycine; MTHF = methylenetetrahydrofolate; MTHFR = N5,N10 methylenetetrahydrofolate reductase; THF = tetrahydrofolate; SAM = S adenosylmethionine; SAH = S-adenosylhomocysteine; DMG = dimethylglycine; C β S = cystathionine β -synthase.
WHO HAS HOMOCYSTEINE IMBALANCE? Elevation of intracellular and subsequently plasma homocysteine levels occurs when the remethylation route or saturation of the transsulfuration pathway (see Fig. 1) is inhibited as a result of an inadequate presence of substrate, cofactor or enzyme(2). Such increases are observed with advancing age, in vascular disease patients, in individuals homozygous for a genetic mutation in the gene encoding MTHFR or C β S enzymes (see Fig. 1), in younger men over younger women(4) and levels can be influenced by the use of some medications, by lifestyle and by clinical factors(1). Epidemiological research demonstrates B vitamin intake inversely relates to total plasma homocysteine levels and B vitamin deficiency is the cause of over 60% of hyperhomocysteinemia cases(2, 4). Those at greater risk for clinically significant B vitamin deficiency are vegetarians, the elderly, pregnant women, renal disease patients, and individuals with absorption disorders (i.e. irritable bowel syndrome) or malignant disease(4).
NUTRITION THERAPY IN HOMOCYSTEINE CONTROL Folate, B12, B6 and betaine have been researched in clinical trials individually and in combinations to result in significantly lower blood homocysteine levels. The greatest response to treatment with B vitamins and folate is expected to occur in individuals with high baseline homocysteine and/or low baseline folate status(4). Folate – Dietary folic acid, similar to B6 and B12, is a water-soluble B-vitamin. It is obtained from green leafy vegetables and grains and is fortified in some grain products in North America. As a coenzyme in methionine metabolism (see Fig. 1), folic acid has a profound effect on homocysteine levels in humans. The results of over 14 controlled human trials support supplementing 0.2 to 5 mg/day folate to lower blood homocysteine by 16 to 39%(5, 6). In a recent trial, a dosage of 0.8 mg/d folate demonstrated maximal homocysteine lowering in CVD patients(5). B12 – B12 is a coenzyme in the formation of methionine (see Fig. 1). In the diet, B12 is obtained from fortified cereals, meat, fish and poultry. With respect to optimizing homocysteine levels, based on human trials, an additional 7% lowering in blood homocysteine can be expected when 0.5 mg/d B12 is supplemented along with folate(4, 5, 6). B6 – B6, a coenzyme in the metabolism of methionine, can be found in the diet in fortified cereals, organ meats and fortified soy-based meat substitutes. Supplementing B6 (50–250 mg/d) has not been shown to consistently influence homocysteine levels in clinical trials(6, 8); however, this may be due to its effects being masked by those of folate and B12 (5). Further, because it is an important cofactor in transsulfuration (see Fig. 1), B6 is recommended for supplementation along with folate and B12 for the optimization of homocysteine levels(4, 5). Betaine – Betaine is formed from the oxidation of choline, is found naturally in most living organisms, including humans, and is available in the diet from spinach, beets and broccoli. An alternative methyl donor in the remethylation of methionine (see Fig. 1), betaine, alone or combined with folic acid, at doses 1.5 to 6 g has been demonstrated in clinical research to significantly lower blood homocysteine levels up to 20% both in subjects with severe hyperhomocysteinemia attributable to inborn errors in homocysteine metabolism, a group most commonly selected for betaine supplementation, but also in healthy men and women with blood homocysteine of about 12.5 to 25 μ mol/L(7).
Canadian and US federal standards have set recommended dietary allowances (RDA)
and tolerable upper limits (UL) for effective and safe lifelong consumption of these
vitamins (see Fig. 2). As for betaine, animal and human betaine supplementation
research has observed significant increase in serum LDL-cholesterol by 10% with
higher intakes of betaine (6 g/d).
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4. Stanger O, Herrman W, Pietrzik, et al. Z Cardiol. 2004;93:439-453.
5. Strain JJ, Dowey L, Ward M et al. Proc Nutr Soc.2004;63:597-603.
6. Homocysteine Lowering Trialists' Collaboration. BMJ 1998;316:894-898.
7. Olthof MR, Verhoef P. Curr Drug Metab. 2005;6:15-22.
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9. Mangoni AA, Jackson SHD. Am J Med. 2002;112:556-565.
10. Toole JF, Malinow MR, Chambless LE, et al. JAMA. 2004;291:565-575.
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12. Ellinson M, Thomas J, Patterson A. J Hum Nutr Diet 2004;17:371-83.
13. Elias AN, Eng S. Diabetes, Obesity and Metabolism 2005;7:117-1221.
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