What is homocysteine?
Homocysteine is an amino acid produced by the body, usually as a byproduct of consuming meat. Amino acids are the building blocks of all the proteins in the body. Homocysteine levels are measured in the blood by taking a blood sample. Normal levels are in the range between 5 to 15 micromoles (measurement unit of small amount of a molecule) per liter.
Elevated levels are classified as follows:
- 15-30 micromoles/liter - moderate
- 30-100 micromoles/ liter - intermediate
- Greater than 100 micromoles/ liter - severe
Should all people have their homocysteine levels screened?
Based on the available evidence, screening is recommended only for specific populations, which includes people with:
- Family members who developed heart problems at a young age
- Family members whose tests have revealed high homocysteine.
- Known cardiovascular disease, a history of cardiovascular problems, or prior heart attacks
- A high risk of cardiovascular disease
- A diagnosis of homocystinuria
- Demonstrated folate deficiency or symptoms of this deficiency
If you dont fall into any of the above groups, screening is not recommended. Considering the conflicting research on people with low risk of cardiovascular disease, screening results may only open the door to unanswerable questions.
Q: What are the factors can affect your homocysteine levels?
- Deficiency of Vitamin B complex( mainly vit B6, B9-Folic acid and B12)
- Genetics/family history
- Lifestyle (e.g., alcohol, tobacco, and coffee use)
- Disease/health conditions
- Chronic kidney disease
- Medications/treatments
- Living inactive life
Normally, most of the homocysteine is recycled as other amino acids. However, the body needs sufficient amounts of dietary vitamin B12 and folate to do this. Therefore, insufficient amounts of these vitamins in the body can hamper the natural breakdown of homocysteine. Without enough B12 and folate in the diet, the recycling process becomes faulty, causing homocysteine levels in the blood to rise.
Now studies have shown that homocysteine damages the smooth vascular wall tissue, creating a scratch inside of the vessel where plaque( deposition of cholesterol inside the blood vessels) can build up. Plaque is the waxy and sticky material made up of LDL cholesterol, (along with platelets and white blood cells that arrive to fix the damage). Plaque deposits where the wall of an artery has been damaged blocking the passage of blood flow. Homocysteine can also turns LDLs,(the bad cholesterol) to be even more sticky and also attracts more white blood cells and promotes more blood clotting. Such clots along with plaque may totally or partially block the blood flow. Thus Homocysteine along with cholesterol adds more volume to the cardiovascular diseases. Homocysteine also plays a part in such diverse health concerns as osteoporosis, depression, Alzheimer’s disease.
How to reduce homocysteine levels?
Consumption of folic acid supplements or cereals that are fortified with folic acid, and to a lesser extent vitamins B6 and B12, can lower blood homocysteine levels. Usually, folate supplementation is recommended at 1 milligram daily; vitamin B6 is recommended at 10 milligram per day; and vitamin B12 at one-half milligram per day. Apart from that regular exercises, quitting smoking, alcohol and consumption of meat in moderation will also help to reduce homocysteine levels with the supplements.
Does lowering homocysteine levels prevent heart attacks and strokes?
In a large population study involving women, those who had the highest consumption of folic acid (usually in the form of multivitamins) had fewer heart attacks than those who consumed the least amount of folic acid. In this study, the association between dietary intake of folate and vitamin B6 and risk of heart disease was more noticeable than between dietary intake of vitamin B12 and heart disease, which was minimal.
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