Homocysteine has become an important marker of cardiovascular health risk. At high levels, it has been shown to damage the vessels of the heart and promote blood clot formation, which can result in heart disease and stroke.
Many of us are unaware of our homocysteine levels, as there are no symptoms when they are too high, and testing is not routinely performed.
Many natural healthcare practitioners use this aminco acid as an important component of cardiovascular screening tests. If these amino acid levels are found to be outside the optimal range, there are several important nutrients that can lower levels and help prevent cardiovascular disease.
What is Homocysteine?
It is an amino acid that comes from the digestion of proteins. It is formed from methionine, an essential amino acid found abundantly in animal protein such as meat, seafood, dairy, and eggs. Once it is formed from methionine, it is metabolized in two ways: it is either recycled back into methionine or it is converted into another amino acid, cysteine. Both of these actions require folate (or folic acid), pyridoxine (B6), and cobalamin (B12) in order to work effectively. Inadequate levels of these nutrients prevent homocysteine breakdown and can lead to persistently high levels.
Why Are High Levels of Homocysteine Are Unhealthy?
When present in high levels, it has been linked to heart disease and stroke. High circulating homocysteine appears to cause injury to the delicate cells of the coronary arteries. Continued cellular injury leads to vascular inflammation, which ultimately causes scarring and hardening of the arteries known as atherosclerosis. This process results in thicker and less elastic artery walls and a narrowing of arterial openings, thus reducing blood flow.
Secondly, it has effects on the action of blood platelets, promoting blood clot formation. Large clots can travel through the body to the cardiac arteries of the heart, causing a heart attack, or to the vessels of the brain, causing a stroke. Further, recent evidence has also shown that even slightly elevated levels of this amino acid above normal ranges can double the risk of developing Alzheimer's disease.
Causes of High Homocysteine
Because protein-rich diets are high in methionine, they consequently produce high levels of this amino acid. For this reason, diets rich in animal protein but low in fruits and leafy vegetables tend to promote high levels of this amino acid. In addition, insufficient consumption of green vegetables results in inadequate intake of B vitamins and folic acid, which are essential for the breakdown of this amino acid. High stress levels can also contribute to high circulating homocysteine.
The body's levels of neurotransmitters epinephrine (adrenaline) and norepinephrine increase when exposed to stress. The body uses the methionine-homocysteine pathway to break these neurotransmitters down and return to a non-stressed state. Researchers have also noticed a correlation between coffee consumption and high homocysteine levels. It seems that as coffee intake goes up, so too does homocysteine.
How Do I Know If I Have High Homocysteine?
There are no physical symptoms of high homocysteine; levels can only be checked via blood tests. These tests are usually not routinely performed by physicians and are often overlooked in favour of other cardiovascular risk markers such as cholesterol levels or blood pressure measurements. Normal levels of homocysteine should range between 5-15 mmol/L, although it is suggested that levels less than 7-8 mmol/L are preferable.
Homocysteine Support Options
Conventional Treatment
Since there are no medications that directly reduce levels of this amino acid, conventional treatment usually consists of attempts to increase dietary intake of B vitamins and folic acid in order to indirectly promote breakdown of this amino acid.
Naturopathic Treatment
Naturopathic treatment emphasized foods rich in vitamins B6, B12, and folate. Beans, legumes, broccoli, asparagus, and spinach provide excellent folate sources. Meats, fortified cereals, bananas, sweet potatoes, and spinach supply vitamins B6 and B12. Avoid foods high in methionine, including red meat and dairy. Limit animal protein to 3-4ounces daily.
Breathing exercises, meditation, and yoga can help reduce homocysteine production. Regular exercise lowers stress and may reduce levels of this amino acid by up to 12%.
Vitamins B6 and B12 help break down excess levels of this amino acid. Aging can increase homocysteine levels and reduce B12 absorption. Older adults may benefit from appropriate supplementation.
- Vitamin B 12
Vitamin B12 is absorbed differently depending on delivery method. Sublingual B12 increases bioavailability by absorbing under the tongue. Injections into the muscle provide even higher absorption. Naturopathic doctors commonly administer B12 injections in clinical settings.
2. 5-Methyltetrahydrafolate (5-MTHF)
5-HTMF supports homocysteine breakdown effectively. Folic acid alone doesn't significantly raise blood folate levels. Active folate, 5-MTHF, works more efficiently at lower doses. This form improves homocysteine regulation.
3. Trimethylglycine (TMG)
TMG or glycine betaine, occurs in quinoa, spinach, lamb, and beets. It helps recycle homocysteine back into methionine. Supplementation often provides therapeutic levels.
4. SAMe
SAMe forms from methionine. It supports conversion of homocysteine into cysteine. It also enhances folate activity, improving homocysteine reduction.
5. N-acetyl-cysteine (NAC)
NAC lowers homocysteine levels. It converts homocysteine into cysteine by freeing it from protein carriers in blood.
6. Omega-3 Fatty Acids
Omega-3 fatty acids support cardiovascular health. Research shows omega-3 supplements can reduce homocysteine levels, though mechanisms remain unclear.
7. Taurine
Taurine is another nutrient well studied in cardiovascular disease. Research suggests that this amino acid might actually block the absorption of methionine, which ultimately prevents its breakdown into homocysteine.
