Homocysteine

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In the last two articles in this series,we discussed the significance of HDLcholesterol, triglycerides and C-reactiveprotein (CRP) in evaluating—and lowering—your risk of cardiovascular disease. Now we’lldiscuss another lesser known but extremelyimportant blood marker: homocysteine.

Dangers of High Homocysteine
You don’t often hear people talking abouthomocysteine, yet a high level of this aminoacid in the blood is an independent risk factorfor heart and vascular disease. This means thateven when your cholesterol and other healthmarkers are within normal ranges, elevatedhomocysteine levels raise your risk.

Evidence suggests that excess homocysteinepromotes plaque buildup in blood vessels andcauses damage to the inner linings of arteries,increasing the likelihood of blood clots.

What’s Your Risk?
If you have type 2 diabetes, elevatedhomocysteine levels significantly increaseyour mortality risk, whether or not you haveany other cardiovascular risk factors andregardless of your overall health. In fact, onestudy showed that for each five-point increasein homocysteine, risk of dying within five yearsrose by 17 percent in nondiabetic subjectsand by 60 percent in diabetic subjects. Even amoderate elevation in homocysteine appearsto be an independent risk factor for fatal heartattacks in people with type 2 diabetes.

How to Lower Homocysteine Levels
Although the normal range for homocysteineis 5.2 mmol/l to 12.9 mmol/l, Robert C. Atkins,MD, had a goal for patients of 8 mmol/l or less.Most of his patients were able to achieve thiswith a controlled-carbohydrate meal plan.Atkins prescribed his controlled-carbohydrateplan along with supplemental nutrients thattarget homocysteine: vitamins B6 and B12 andfolic acid.

Why the Supplements?
Blood levels of homocysteine increasewhen you have an inadequate supply ofthese nutrients. As processed and refinedfoods have crowded out whole foods in ourdiets, our intake of these vital nutrients hasdropped. Refining destroys folate (folic acid)and vitamins B6 and B12. Dark leafy greens,whole grains and legumes are some of thebest sources of folic acid and vitamin B6; meatand dairy provide B12, although many peopleover 60 years of age may not have adequatestomach acid to absorb B12. If you eat proteins,natural fats, whole grains, legumes and greenvegetables, your homocysteine levels probablyreflect that healthful diet. If not, it’s time tochange your eating habits and consider takingsupplements to reduce this deadly risk factor.You may also want to discuss homocysteinewith your physician.

A Note From R. Keith Campbell, RPh, CDE
I would like to point out that homocysteine levelsare never ordered as part of a lab evaluationof patients, and many patients would have topay for the test to get the results. I have all ofthe patients I work with take the folic acid plus Bvitamins. They do not do any harm, and they cando good.


Research has implicated homocysteine in a host of diseases and conditions, including:

  • Cardiovascular disease, stroke, depression and cancer
  • Blood clots
  • Narrowing of blood vessels
  • Diabetic neuropathy
  • Dementia and Alzheimer’s
  • Cirrhosis of the liver
  • Kidney disease
  • Bone fractures

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