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Homocysteine - a hidden risk factor for heart disease

Could you have raised homocysteine?

Could you have raised homocysteine? The answer could easily be “yes” without you even knowing as there are no symptoms of high homocysteine, yet it is an important independent marker of cardiovascular disease (especially stroke) and even Alzheimer's.

Unlike other risk factors for heart disease, like raised cholesterol, inflammation and high blood pressure, most of us know nothing about homocysteine. It isn’t routinely tested for, but for most people it can be managed through dietary changes and supplementing with B vitamins, in particular B6, B12 and folic acid.

So what is it and why is it dangerous?

Homocysteine is an amino acid which is one of the building blocks of proteins in our body, however to be used it must first be converted to cysteine. We don’t get homocysteine from the food we eat – our body converts it from methionine which is found in the protein in food, especially meat, fish and cheese. It is also found to a lesser extent in plant-based foods – especially those with higher protein content like nuts. Excess homocysteine in the blood is converted back to methionine.

What can go wrong?

The processes which convert homocysteine to cysteine and back to methionine rely on certain B vitamins, namely B6, B12 and folic acid. If you don’t consume enough of these vitamins, or absorb enough of them (which occurs as we age), homocysteine can become elevated in the blood. Doctors have known for years that many elderly patients hospitalised with stroke, osteoporotic fractures, heart disease and Alzheimer’s have been found to have very elevated levels of homocysteine. What had been less clear is whether the high homocysteine has caused their condition or is as a result of it. However, there is now sufficient evidence to suggest that managing raised homocysteine levels with B vitamins is worthwhile.


Who is at risk of raised homocysteine?

As raised homocysteine is a symptomless condition, anyone could have it and know nothing about it. Many of us consume diets which contain more protein and fewer vitamins than we need.

Vitamin B12is only found in animal products so if you don’t include them in your diet, or if you have problems absorbing B12, then you could have raised homocysteine. There is also a genetic condition, Homocysteinuria, which can result in elevated levels.

Why blood tests are important

The only way to discover whether you have raised homocysteine is through ablood test.

Homocysteine screening is a useful tool in predicting risk for cardiovascular disease, bone fractures and even dementia; why not get tested today?