Understanding Homocysteine
The seven most commonly asked questions concerning Homocysteine are reviewed below. These topics are:
- What is Homocysteine?
- What are the Key Risk Factors?
- Which Commonly Prescribed Drugs actually increase Homocysteine?
- How do Homocysteine levels become Elevated?
- What happens when Homocysteine is Elevated?
- How do you reduce Homocysteine levels?
- What are Normal Homocysteine levels?
- Who should be Tested for elevated Homocysteine levels?
What is Homocysteine?
Homocysteine is an amino acid produced as the body digests protein. An elevation in plasma homocysteine, hyperhomocysteinemia, has been shown to be an independent risk factor of cardiovascular disease.
What are the Key Risk Factors?
Factors that can cause Homocysteine levels to increase include:
- Smoking and Tobacco use
- Chronic, high alcohol consumption
- Post-menopause
- Older age
- Post-Heart Attack or Stroke
- Kidney Failure
- Deficiency in folate, pyridoxal 5'-phosphate or methylcobalamin.
Commonly Prescribed Drugs that increase Homocysteine levels
An increasing number of drugs have been shown to interact with homocysteine metabolism.
- niacin
- fenofibrate
- metformin
- methotrexate
- levodopa
- phenytoin
How do Homocysteine levels become Elevated?
Elevated levels of homocysteine occur when your body does not have the necessary co-factors to breakdown homocysteine.
The necessary co-factors are L-methylfolate, pyridoxal 5'-phosphate and methylcobalamin.
What happens when Homocysteine is Elevated?
- Homocysteine injures arterial walls.
- Arterial cells more readily absorb LDL or "bad" cholesterol.
- Homocysteine promotes the growth of smooth muscle cells in the artery, which narrows the opening.
- Homocysteine increases the risk of blood clots, which can lead to heart attack or stroke.
How can you reduce Homocysteine Levels?
Increased intake of L-methylfolate, vitamin B12, and vitamin B6 have been shown to reduce elevated homocysteine levels by up to 72%.
What are Normal Homocysteine levels?
The American Heart Association has indicated that a reasonable therapeutic goal for homocysteine, especially for those patients at increased risk of heart disease, is less than 10 µmol per liter.
Who should be tested for elevated Homocysteine levels?
Elevated homocysteine may add to overall cardiovascular risk through it's synergistic interactions with traditional cardiovascular risk factors.
There is a growing belief that an elevated homocysteine level in high risk patients should prompt further investigation and initiation of a homocysteine therapy.
Patient groups at high risk include those with:
- Family history of Cardiovascular Disease
- Diabetes
- Smokers
- High blood pressure
- High cholesterol
- Kidney Failure