That Fatigue or Cramping in Your Legs 
Could Spell Danger

(Omega-3 EPA/DHA, Vitamins B6,A,D,E)

June 16, 2005 - There are approximately 10 to 12 million people in this country who suffer with a relatively unknown condition called peripheral artery disease (PAD). It typically affects those of us over the age of fifty, and often it manifests itself by pain and cramping in the buttocks and legs-especially when walking. Often, PAD feels just like fatigue in the legs that resolves within one or two minutes of resting. When you suffer with these leg symptoms-which quickly resolve with rest-it is known as intermittent claudication. Usually, this is a clear sign of PAD, and it could mean that you're at risk for more than just occasional leg cramps or fatigue. 
PAD is caused by a build-up of plaque and calcium in the arteries of your legs. It is similar to the dangerous build-up that occurs in the heart and blood vessels of the brain, leading to increased risk of heart attack and stroke. Our real concern lies with those of you with PAD who may also be walking around with asymptomatic coronary artery or cerebral vascular disease. These conditions can certainly be considered ticking time bombs for the development of a heart attack, stroke or even sudden death. Smokers are particularly at an increased risk of developing PAD (along with cardiac and cerebral vascular disease). Likewise, patients with diabetes and hypertension are at increased risk for developing this condition.
Unfortunately, the traditional medical treatment for PAD is somewhat lacking at this time. There are expensive drugs that can have some benefit, but they are of modest value. We are then left with the treatment of choice, which regrettably is bypass surgery in the legs. The procedure typically has variable degrees of success, but always generates a hefty medical bill.
Fortunately, for the millions of you who suffer with PAD, there are alternatives. In the current edition of the Journal of Nutrition, researchers from Spain performed a double-blinded trial in patients with PAD and intermittent claudication. Sixty male patients with PAD were randomly broken into two groups: One group was given a product which contained multiple nutrients, including EPA, DHA, oleic acid (olive oil), folic acid and vitamins A, B6, D and E. The control group was given a similar-appearing liquid (actually partially-skim milk) with only vitamins A and D added. At the end of the 12-month study, patients in the treated group had decreases in total cholesterol and lipoprotein B concentrations, along with a decrease in total homocysteine. Of more importance was the fact that there was a statistical valid decrease in the onset of claudication in the treated group compared to placebo. Likewise, peripheral artery pressure improved to a statistically significant degree in the treated group.
There have been a large number of studies in recent years discussing homocysteine as a predictor of peripheral artery disease (PAD). I have previously done a few newsletters on the subject of elevated homocysteine in regard to reducing risk of heart attack, stroke, dementia and even osteoporosis. From a logical standpoint, you would think that if decreasing homocysteine level leads to an improvement in blood flow to your heart and brain, it would also do so in regard to blood flow to your legs. You would be absolutely correct in your thinking, as this is certainly the case. It appears that elevated levels of homocysteine promote damage to the lining of your artery wall and increase platelet hyperactivity. Both lead to abnormal clotting and the development of plaque within the normal flow of arterial circulation.
Although we typically think of PAD occurring in people over the age of fifty, there are a percentage of younger adults who suffer with this condition as well. In a study published in the Journal of Vascular Surgery in 2003, 220 women between the ages of 18 to 49 years old diagnosed with PAD were compared to a control group of 629 healthy women. It was discovered that the young women with hyperhomocysteinemia had a 250% increased risk of developing PAD compared to the control group. When other factors were included, such as smoking, hypertension, diabetes and high cholesterol, the risk factor increased-although elevations in homocysteine remained an independent risk factor.
In another study out of the Journal of Vascular Surgery from last year, 392 men ages 50 years and older living in England were evaluated for PAD. Eighty six of these patients (22%) were found to have clinical criteria for PAD. They tested and calculated the folic acid, vitamins B6 and B12 intakes in those individuals who were diagnosed with PAD. They found a statistically decreased intake of both vitamin B6 and folic acid in that group. The researchers concluded that by increasing folic acid intake, the risk of PAD could be reduced by 46% and further reduced by another 29 % by increasing the intake of Vitamin B6.
In yet another related study published in the journal Atherosclerosis from February of this year, researchers out of Germany assessed the one-year risk of death and cardiovascular morbidity associated with PAD. It was found that patients with PAD exhibited high levels of plasma homocysteine and had a markedly increased risk of premature death. More evidence that none of us can take PAD or its symptoms lightly.
Another risk factor to be wary that may be linked to PAD: A recent study indicated that low magnesium levels are linked to increased C-reactive protein (CRP). Elevations of CRP clearly indicate increased inflammation is occurring in the body and may damage your heart, arteries and circulatory system. Numerous studies prove magnesium is essential for healthy cardiovascular function and blood pressure.
As most of you know, I am a practicing neurologist. Unlike the vast majority of other nutrition experts, I have the daily experience and privilege of taking care of patients. I love my work, but I'm often frustrated by much of the "traditional" medicine that I see practiced, which usually consists of heavy drug use to mask the symptoms, sometimes followed by surgery when the condition progresses and the drugs fail.
I know firsthand what allopathic medicine can and cannot do. Most allopathic physicians are great at lowering blood pressure and cholesterol levels, but at what price? It is not uncommon for me to see a patient coming into the office complaining of generalized fatigue, dizziness and "just not feeling right". When I look at their list of medications (and many times they're amazingly long!), I immediately realize why. Unfortunately, we continue to ignore the underlying condition and merely "treat" the symptom. Outside of infectious disease, we cure very little in modern allopathic medicine.
Thankfully, there are natural alternatives. I've dedicated my medical career to help you and others like you, to find the right balance between proper nutritional supplementation and traditional medicine. Much to my delight, this hybrid approach is finally starting to show some growth in the medical community
As was illustrated in the first study I pointed out, patients with symptomatic PAD responded quite favorably to a series of nutrients. It is the synergistic use of multiple nutrients where the greatest benefit is shown. Unfortunately, on the rare occasions when mainstream medicine does study nutrients, they have a tendency to look at only one or two items at a time. Modern medicine cannot see its way to study the synergistic effects of multiple nutrients in a single study because scientifically they would not be able to sort out which nutrient or nutrients is/are the key component(s). It is also quite expensive, and the big pharmaceutical companies that often fund sophisticated, multi-variant studies just haven't figured how they can profit from natural remedies.
Practitioners of holistic medicine, on the other hand, already know that combinations of high-quality nutrients provide the best benefit, as long as the benefit is safely provided. It has been the goal of the Nutraceutical Sciences Institute (NSI) to understand the unique benefits of nutritional supplements, how they work individually and in combination to better our health. We will continue to fund and explore the synergy of multiple nutraceuticals naturally working in concert with our bodies. It is the reason that we proudly call our popular multi-vitamins - Synergy.
(NSI) remains the flagship brand of Vitacost. Our doctor-formulated products have been around for over 10 years, providing you with the highest degree of potency, efficacy and exceptional value. Our Synergy multi-vitamin formulations have been revised multiple times in the last several years based on the medical literature. I know you have many choices for multi-vitamins from other companies, but I strongly urge all of you to start using one of the Synergy multi-vitamin options. Compare them ingredient for ingredient: You will find that Synergy is the clear winner every time. I also urge you to take an Omega-3 essential fatty acid product containing EPA and DHA, as well. I've written about the amazing health benefits for your heart, mind and body on many occasions. We have several formulations from the NSI line that again are of the highest quality and best value available. Finally, consider adding components of a Mediterranean diet to your regimen. With lots of brightly-colored vegetables, fruits, whole grains, lentils and olive oil, you'll please your heart and your palate equally.
Have a pleasant summer, and remember: There's a lot riding on your health…don't shortchange yourself!
To review all of your Synergy multi-vitamin options, click here.