Homocysteine:
Important New Risk Factor in Cardiovascular Disease*
by John J. Reynolds, PA-C, CCN
Homocysteine is a natural chemical produced by the body and is a normal
breakdown product of dietary protein. Proteins such as fish, chicken,
eggs, and meat are composed of strings of chemicals known as amino acids of
which there are approximately twenty types. One of these amino acids known
as methionine (meth-i-o-neen) is found in high amounts of red meat and breaks
down to homocysteine during normal metabolism.
In the last decade research has revealed that individuals with an elevated
homocysteine level have a higher risk of heart attack and stroke.
Unfortunately, many physicians are unaware of this correlation and do not test
for homocysteine. This can be accomplished by a simple fasting blood
test. People with homocysteine levels above ten show a marked rise in
their risk of developing an arterial blockage especially in the arteries leading
to the heart and brain. Recent data also suggests that diseases as diverse
as osteoporosis and Alzheimer's Disease may also be related to elevated
homocysteine levels. Most laboratories indicate that levels below 9 are
safe. However, one health organization suggests that 6.3 should be the
cutoff value. I generally tell patients that values between 6 and 7 are
very good.
Interestingly, an elevated homocysteine is not uncommon and appears to be
largely due to nutritional imbalance. Treatment includes reducing ones
protein intake of excessive amounts are being consumed. However, its also
known that cigarette smoking, sedentary lifestyle, and use of certain
prescription drugs can elevate homocysteine. In addition there are three
key nutrients involved in homocysteine metabolism. Vitamins B6, B12 and
folic acid. These nutrients activate enzymes in the body that break down
homocysteine. Supplementation with these three nutrients along with
appropriate dietary and lifestyle intervention will usually bring down
homocysteine to a desirable level.
Just as one is evaluated for high blood pressure, cholesterol level as
diabetes, in my opinion homocysteine level should be included in a routine
evaluation of any patient interested in preventive health care. Studies
show that detection and treatment of elevated homocysteine levels may reduce an
individual's risk of cardiovascular disease.
*Note: This article originally appeared in the Rockland Review,
June 23, 2000
