Homocysteine - A precursor to Disease?
Donald Aulds, M.D.
Homocysteine is an amino acid produced by the body from the conversion of methionine found in foods. Small amounts of homocysteine in the body are normal and can be converted to positive chemicals that act as antioxidants and anti-aging factors for the body. Abnormal elevations in the level of homocysteine, however, can lead to many different types of disease.
What diseases can be associated with an elevated homocysteine?
The following diseases have been shown to be more frequent in the presence of elevated levels of homocysteine:
- Coronary artery disease - homocysteine has been shown to be one of several factors along with elevated cholesterol, elevated triglycerides, and a protein called C-reactive protein. A decrease in homocysteine levels of only 3 micromoles has been shown in studies to decrease heart disease by as much as 16%.
- Strokes - a decrease in homocysteine in the blood stream has been suggested in studies to decrease risk of strokes by as much as 24%.
- Deep vein thrombosis - a decrease of 25% of the frequency of blood clots in the legs has been seen in studies with a small decrease in homocysteine.
- Alzheimer's disease - studies have strongly suggested that elevated levels of homocysteine may increase frequency of the disease by up to 25%.
- Fractures - increase in the frequency of fractures in older people who have been diagnosed with osteoporosis has been reported to increase by 15-20%.
What causes homocysteine levels to be elevated?
Homocysteine produced by the body is usually converted to other compounds and the conversion process requires B vitamins to take effect. Vitamin B6, B12 and folic acid help to convert the homocysteine and vitamin deficiencies may be present in individuals with elevated homocysteine levels. Other conditions also have been shown to increase homocysteine levels including low thyroid hormone levels, kidney diseases, psoriasis, post gastric bypass surgery, and some types of medications. By increasing folic acid, and vitamin B6 and B12 intake in the diet, studies have shown homocysteine levels to decrease in most cases.
What do the results of homocysteine tests mean?
Homocysteine can easily be measured in a simple blood test. In most labs, a level less than 12 micromoles per liter is considered normal. A level of 12 to 15 is a moderate elevation and a level over 15 is usually considered to be high. An elevated level in many studies is usually felt to be placing an individual at risk.
What can be done to lower the level of homocysteine?
Adjustment in diet may help to lower homocysteine levels. Folic acid is found in fruits, green leafy vegetables such as spinach, lentils, asparagus, cereals, and most beans. Vitamin B6 and B12 can be consumed by eating fortified cereals, bananas, potatoes, chicken, dairy products, liver, beef, and chickpeas. If the diet does not allow these foods then a supplement of B vitamins and folic acid may be helpful.
Who should be concerned about homocysteine levels in the blood?
There are studies that suggest that every adult should have the level done. If it is elevated on initial levels, then measures to lower the level should be considered. There are differences in opinion as to the frequency of retesting, but experts seem to suggest that the level should be rechecked if measures are taken to try to lower the levels at eight to sixteen weeks after starting these measures. If the levels do not decrease, then studies for other health conditions may be necessary. The American Academy of Family Medicine recommends testing may be needed 2-3 times a year if an individual has risk factors for heart disease or strokes. Discuss with your physician if testing is appropriate for you and if done, then take measures with diet adjustments and possible supplements for reduction of homocysteine.
More about Dr. Aulds
Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.
Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.
Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.
