Homocysteine – elevated levels, a heart health risk!

Most of us know or have heard about cholesterol levels and their relationship to our cardiovascular system, but few of us have any idea about the importance of homocysteine levels.

What is homocysteine?

Homocysteine is an amino acid produced in the body, during the metabolism of methionine, homocysteine is a by product of the methylation pathway. This reaction is dependent on  nutrients such as; folate and vitmain B12, it can also be broken down via a pathway which requires vitmain B6. If these pathways receive adequate amounts of the nutrients they require then homocysteine levels do not rise, but if any one of these nutrients are not available then levels may rise – ideal homocysteine values are between 5 to 10umol/L – the level appropriate for you will depend on other risk factors you may have present, ideal is a reading below 7.5 umol/L.

What are the health risks associated with high levels of homocysteine?

Cardiovascular disease – hyperhomocysteinaemia is believed to cause problems with the cells which line the inside of our blood vessels, causing narrowing and hardening of the arteries and therefore diminishing the flow of blood.

Parkinson”s disease – L- Dopa, a drug given to treat Parkinson’s, affects the methylation pathway, resulting in increased production of homocysteine.

Alzheimer’s disease – people with elevated homocysteine levels have nearly double the risk of developing Alzheimer’s disease.

Pregnancy – high levels are known to be related to many adverse pregnancy outcomes including birth defects.

Studies have also shown how high levels relate to many other health conditions also, e.g., depression, osteoporosis, headaches, macular degeneration…….

What factors contribute to elevated homocysteine?

Deficiency or low levels of the required nutrients. These include, vitamin B12, this vitamin is only found in animal products, therefore nearly all people who follow a vegan diet (a diet which excludes animal products) or any conditions which cause malabsorption such as coeliac disease or low stomach acid (vitamin B12 requires intrinsic factor to be absorbed from the stomach into the bloodstream) can easily have inadequate levels of this vitamin.

Another nutrient commonly associated with elevated homocysteine is folate, levels of this nutrient may be low due to a genetic problem with the MTHFR and can be tested for easily and inexpensively. Also patients with existing conditions e.g., end-stage renal disease, heart transplant recipients or hypothyroidism may also have increased levels. Use of some medications can contribute, for example, lipid-lowering drugs, anti-convulsants, androgens and anti-rheumatic drugs.

Testing for hyperhomocysteinaemia!

Testing your serum homocysteine level is a simple fasting blood test through a laboratory, which is eligible for a rebate under Medicare, if your GP feels it is warranted, otherwise the out of pocket expense to you, is under $40! A high reading may warrant further testing to differentiate which vitmain is involved, this may include, one or more of the following depending on your particular health history ; “active vitmain B12”, red blood cell folate, MTHFR mutation, urinary pyroles, intrinsic factor antibodies or parietal cell antibodies. A health practitioner who understands about homocysteine, will be able to direct you, in where to start.

What factors lower homocysteine.

Dietary factors have a particularly strong influence on hyperhomocysteinaemia, understanding the relationship between homocysteine and B vitamins becomes important and effective in treatment. Most people respond to appropriate nutrient treatment despite the cause. Anti- homocysteine factors include, vitamins B6, B9, B12 and B2, serine and zinc. It is well advise to consider testing, not only if you have a family history of heart or neurological conditions but also if you are preparing for pregnancy.

The results of treatment may well prove far-reaching!

Maria Harpas
BHlthSc(ComplMed), Adv.Dip.Nut, Adv.Dip.Nat

References

• Jama Network-Homocysteine Levels in Confirmed Alzheimer Disease
• ARCH-Polymorphism in Anxiety and Depression
• Jama Network-Plasma Homocysteine