Diabetes 167from the blood into the cells. Betty had trouble believing that carpal
tunnel and diabetes were related, since the conditions that trigger them
are entirely different. The infl amed tissues in carpal tunnel, a narrow
passageway in the wrist, are associated with repetitive wrist motions
such as those involved in typing, while diabetes is caused by eating too
much sugar or refi ned fl our and sugar products. Betty spent her entire
workday transcribing tapes onto a computer. She also consumed plenty
of sugar. The company she worked for kept its underpaid employees
happy by having the best bakery in New York deliver a cake, consisting
mostly of icing, to the offi ce every afternoon. Betty had been eating
two hefty slices of this cake every day for the past twenty years, the
period of time she had been working for the fi rm.
The condition that diabetes and carpal tunnel syndrome have in
common is a defi ciency of vitamin B 6. Dr. Kilmer McCully’s research
into homocysteine as a possible cause of atherosclerosis laid the ground-
work for Dr. Ellis’s discovery of the role it plays in diabetes and carpal
tunnel.^3 (For more on atherosclerosis, see Chapter 6.) McCully proved
that excess homocysteine (an amino acid used in the repair and genera-
tion of new cells), caused by a defi ciency of vitamin B 6 and the enzyme
that activates it, triggers hardening of the arteries. (Some studies, show-
ing no relationship between elevated homocysteine levels and heart
disease, have not confi rmed McCully’s fi ndings.) The supplements
McCully gave his research subjects, namely, vitamins B 6 , B 12 , and folic
acid, made their arteries more fl exible and acted as heart attack preven-
tatives. Ellis, a medical doctor and researcher, noting that his patients
with diabetes and carpal tunnel syndrome, like McCully’s heart
patients, suffered from a vitamin B 6 defi ciency, concluded that they also
had elevated homocysteine levels. He prescribed 100 to 200 mg/day of
B 6 for these patients. The treatment alleviated both the carpal tunnel
syndrome and the diabetes, indicating that excess homocysteine not
only injures the arteries but is also a contributing factor in both dis-
eases. On the basis of this research I recommended that Betty take 150
mg/day of B 6. Before long her blood sugar normalized and the pain and
tingling in her wrists lessened.
It’s most likely that in carpal tunnel syndrome, excess homocysteine
accumulates in the ligaments in the carpal tunnel area of the wrist and
causes them to become infl amed. Homocysteine’s role in diabetes isn’t
quite so obvious. But given the high blood glucose levels in diabetics