Whenever the topic of kidney disease arises in my practice, the first thought that crosses my mind is diabetes, since almost 40 percent will eventually have kidney problems.1 There is evidence of a correlation between homocysteine levels in diabetic patients and diseases of the kidneys, heart and eyes.2 To lower homocysteine, we have a powerful, proven way to do it with three members of the B vitamin family.3 Many health care professionals have reasonably concluded that lowering homocysteine lowers the risk, degree or progression of secondary problems often seen in patients with diabetes.
Homocysteine: What Is Normal?
Normal plasma homocysteine values vary widely between labs and can range from as low as 2.2 to as high as 17 micromoles per liter (abbreviated as mcmol/L or umol/L). Homocysteine increases with age and runs ~1.5 umol/L higher in males than females. There is a debate on what is optimal, and this too is affected by gender and age. In general, "optimal homocysteine" ranges run from less than 10 to under 6 umol/L.
The DIVINe Study
The Diabetic Intervention with Vitamins to Improve Nephropathy (DIVINe) study followed a screened group of diabetic patients with kidney disease for three years. Those who met the criteria had diabetic nephropathy, but their condition was not considered advanced.4 The 238 subjects who qualified were divided into two groups. One took 2,500 mcg of folic acid, 1,000 mcg of vitamin B12, and 25 mg of vitamin B6 a day. The second group took a look-alike placebo. Eighty-three percent of the patients were white male, 81 percent had type 2 (as opposed to type 1) diabetes, and their mean age was 60. Plasma homocysteine levels at baseline were 16.4 umol/L and 14.7 umol/L in the placebo and B-vitamin groups, respectively.
Results
In approximately three years of follow-up, the B-vitamin group had mean homocysteine levels decline from 14.7 umol/L to 12.5 umol/L, while those assigned to placebo had their averages increase from 16.4 umol/L to 19 umol/L. However, the B-vitamin group also had an accelerated rate of GFR decrease, more strokes and more heart attacks. [See table]
| A health economic analysis of screening and optimal treatment of nephropathy in patients with type 2 diabetes and hypertension in the USA. Nephrol Dial Transplant, 2008;23(4):1216-23. July 2010 
Trending
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic." Carpal Tunnel / Extremities / Neuropathy
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Charles Annunziata, DC, CFMP
Your Practice / Business
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Jamy Antoine, BS, DC, BCN
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