Homocysteine – What is it and Why is it Important?

Whether you can pronounce it or not, you need to know what it is and how it relates to your heart health. Homocysteine is a sulfur-containing amino acid produced in the body during the metabolism of the essential amino acid methionine, which involves a series of conversions that require enzymes. It is a natural substance made by the body, not to be feared, but to be appreciated and controlled. Homocysteine functions at a metabolic crossroad that can affect the methyl and sulfur group metabolism of key enzymes, hormones, and vital nutrients. Many important nutrients, especially B-vitamins, are needed for these enzymes.

So what is considered a normal level? I am so glad you asked. Once homocysteine came on the radar by cardiologists, research suggested that levels between 8 and 15 micromol/L were considered ideal. Research now suggests maintaining even tighter control as homocysteine levels above 6.9 micromol/L may be harmful for long-term health. A rise in serum homocysteine of 5 micromol/L may increase cardiovascular risk by 20% to 30%. Converse to hormone levels, homocysteine levels tend to rise with age. Folate and B12 absorption decline as we get older so higher doses of these nutrients are required to effectively lower homocysteine levels. Further, medications such as Advil and other NSAID’s deplete folate. Research additionally shows that supplementing 2-7 mg of folates daily helps to reverse plaque and prevent stroke.

 

Homocysteine Level

Risk Level

0-6.9 micromol/L Optimum (low risk)
7 – 9.9 micromol/L Mild risk
10.- 12.9 micromol/L Moderate Risk
13 – 20 micromol/L High risk
Over 20 micromol/L Very high risk

 

What are the risks associated with elevated homocysteine levels? Excellent question! The circulation of excess homocysteine can damage the lining of arterial walls so they become narrow and inelastic. Research suggests that a raised homocysteine level is an independent risk factor for hardening of the arteries, coronary heart disease, stroke, peripheral vascular disease and other conditions associated with abnormal blood clotting. Elevated homocysteine is also linked to a number of other serious medical conditions, including osteoporosis, Alzheimer’s disease, multiple sclerosis, rheumatoid arthritis, spontaneous abortion, placental abruption, renal failure, and type II diabetes. When homocysteine is elevated it reduces nitric oxide (NO) production via increasing levels of ADMA which can increase the risk of hypertension and erectile dysfunction. We see time and again patients with hypothyroidism having elevated levels of homocysteine. In fact, a study that was conducted on this very topic found a mean homocysteine level of 16.2 for patients with hypothyroidism. The flip side is that we can lower homocysteine levels with thyroid optimization. The bottom line – you want to keep your homocysteine DOWN!

Now that I have your attention, we need to dive a bit more into genetics. The MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. Try saying that ten times real fast. This enzyme plays a role in processing amino acids, the building blocks of proteins. Methylenetetrahydrofolate reductase is important for a chemical reaction involving forms of the vitamin folate (also called vitamin B9). Specifically, this enzyme converts a molecule called 5,10-methylenetetrahydrofolate to a molecule called 5-methyltetrahydrofolate. This reaction is required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine. The body uses methionine to make proteins and other important compounds.

If you have a genetic variant of the MTFHR gene, as many people (estimates range upward of 50%) in the U.S. unknowingly do, it simply means that the conversion of folic acid is interrupted. As a result, one of the key ingredients required for lowering homocysteine is blocked making traditional supplementation worthless.

So here comes the shameless plug. Due to the synergism of the ingredients, Genetix Homocysteine Balance offers benefits no matter where the patient’s block is in the pathway. By supplying folates and methycobalamin B12, this formula aids in the process of homocysteine being converted back into methionine. This is relevant in case the body is in need of converting methionine into SAMe (S-adenosylmethionine), which is known to improve depression, synthesize neurotransmitters and support joint comfort, function and mobility in the spine, hips and knees. It is important to the joints because of its critical role in cartilage production.

Studies show that controlling homocysteine and adequately supplementing folate and B12 will improve overall health, reduce cardiovascular risk and increase longevity. Older women are also in need of higher doses of B vitamins. After menopause, some women are less able to process homocysteine, which may explain the higher risk of coronary heart disease in this group. Hormone replacement therapy, as well as oral contraceptives, deplete B vitamins.

Why so much emphasis on converting homocysteine back to methionine? Another fine question. The most common block in the homocysteine pathway is the conversion of cystathionine to cysteine, which requires vitamin B6 to activate the cystathionine beta-synthase enzyme, making B6 an important ingredient in the process to lower homocysteine. Vitamin B6 is also required in the step that converts homocysteine into cystathionine. Serine, also included in our Homocysteine Balance formulation, is needed along with vitamin B6 to help convert homocysteine into cystathionine. This part of the pathway synthesizes cysteine needed for glutathione synthesis, and taurine, which has multiple functions including preventing catabolism due to chronic stress and aiding insulin function; both of these nutrients are important for metabolic syndrome patients.

Is methylation important? This is probably one of the more complicated questions to answer. Some of the most challenging patients will not get effective lowering of homocysteine until choline is supplemented. Choline converts to betaine with the help of riboflavin and vitamin B12, and aids methylation in this step of the pathway. TMG (trimethylglycine) provides extra methyl groups. With the help of B12, betaine can convert back to glycine and aid the synthesis of creatine for muscle health. All of these necessary nutrients have been included in our Homocysteine Balance, as well as zinc, which is a cofactor for enzymes in the pathway.

The bottom line is that awareness is key. If you don’t know your homocysteine level, you should. It is a standard protocol for us to examine. Once you know your number, lowering it does not require a prescription or a medication with nasty side effects. It simply requires the right blend of the right nutrients from a product that guarantees the purity of what you are taking. With Genetix in your corner, we can help lower your homocysteine levels and give you one more reason to celebrate optimal, long-term health.

 

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