Homocysteine can be very risky

There are new evidence that beside cholesterol, there is another culprit called homocysteine independently responsible for heart attack or stroke. High levels of homocysteine are related to the early development of heart and blood vessel disease. It is capable of causing atherosclerosis (fatty deposits in blood vessels) by damaging the inner lining of arteries and promoting blood clots. By promoting the oxidation of the bad cholesterol (LDL), it facilitates the cholesterol depositing as plaques in the blood vessels.

Homocysteine is a common amino acid converted from methionine, an essential amino acid found abundantly in animal-derived foods like meats, seafood, dairy products and eggs. Most vegetables such as beans, peas and lentils, are low in methionine. Few exceptions are like sesame seeds and Brazil nuts.

History

The unexpected discovery dated back to 1969 when Dr. Kilmer S. McCully, as a member of the Harvard human genetics group then, was present when pediatricians presented the story of the death of an eight-year old boy. Suffering from a rare hereditary disease called homocysteinuria, he had died of a stroke at that tender age. This rare condition had been discovered only six years earlier by medical investigators in Belfast.

In the ensuing years several more cases were identified. In this condition, a genetic error occurs in a liver enzyme known as cystathionine synthase. When this conversion enzyme is lacking or is present in inadequate amounts, toxins built up leading to abnormal arteries, with hardening and loss of elasticity that greatly increase the tendency for heart attacks and strokes.

Not only did McCully focus on this observation, but he also knew of the work of George Spaeth, an ophthalmologist friend, who informed him of the dramatically beneficial effect of vitamin B6 supplementation on some of the homocysteinuria patients he had treated with dislocated lens. He informed that the excretion of homocysteine in the urine of such patients frequently could be increased dramatically by this vitamin.

His further findings showed the child's walls of the carotid arteries leading to the brain were severely thickened and damaged by arteriosclerosis. He also found fibrous plaques forming in virtually all the small arteries of the body as a result of blood platelets clustering more readily. Soon he had identified ten more cases of homocysteinuria in children, mostly died of blood clots to the brain, heart and kidneys.

How much is dangerous level?

+ Blood levels of total homocysteine increase throughout life in men and women.

+ Prior to puberty, both sexes enjoy optimally healthy levels (about 6 µmol/L).

+ During puberty, levels rise and more in males than females to almost 10 µmol/L and more than 8 µmol/L respectively. (because most guys are meat eaters)

+ As we age, levels continue to rise with males exceeding the females.

+ Even at 12 micromoles per liter of blood plasma the risk of heart attack and stroke doubles, with increasing blood clots in the veins.

+ At 15 micromoles or above, a heart attack rate is three times as high as normal.

Pertinent health issues

+ The higher homocysteine levels seen in the elderly may be caused by many factors including mal-absorption of B12 or a suboptimal intake of B-vitamins (especially vitamin B12), reduced kidney function and medications that reduce the absorption of vitamins.

+ In a remarkable study published in The New England Journal of Medicine in 2002, a large contingent of elderly people free of dementia were studied in advance. The results showed those with an elevated blood plasma level of homocysteine were more inclined to develop Alzheimer’s later. At a high level (over 14 micromoles per liter of blood), the risk of Alzheimer’s disease doubled.

+ Elevated levels of homocysteine have been linked to increased fractures in elderly persons. Homocysteine does not affect bone density but has corrosive effect on collagen by interfering with the cross-linking between the collagen fibers and the tissues they reinforce.

Vitamin B effects

+ High homocysteine is associated with low intake of vitamin B2, B6, B12 and folate. They are involved in homocysteine metabolism - to keep it at bay and to convert from methionine into the beneficial amino acid - cysteine, a precursor to glutathione, a substance that detoxifies the liver by binding with harmful substances there. Cysteine can be used for treating most illnesses, promotes collagen formation and retards aging.

 

+ Though some medical research has shown that reducing homocysteine levels with vitamins does not reduce the risk of heart disease, the contention is that inadequate doses of B vitamins were applied to reduce study participants’ homocysteine levels to the optimal target range of <7-8 µmol/L.


Stress-related?


As B-vitamin levels decline, the methylation cycle becomes impaired-leading to a concurrent increase in homocysteine levels as it is no longer being recycled efficiently. This may cause a disruption in neurotransmitter synthesis affecting the change of mood especially during times of stress, depression and anxiety.


Lowering homocysteine levels through supplementation with B-vitamins might reduce symptoms of mood disorders by freeing up metabolic resources involved in neurotransmission. Other studies have clearly tied genetic abnormalities such as a mutation in the folic acid-activating enzyme, MTHFR, to high homocysteine levels. As such, it becomes a prime target in psychiatric imbalances.

Other comments

+ Higher homocysteine levels related to lifestyle factors such as smoking, coffee consumption, excessive alcohol intake, lack of exercise, obesity and stress can be avoided.

+ High-risk patients with high homocysteine levels should increase their intake of B-vitamins so as to recycle homocysteine into methionine or convert into cysteine. Include in the diets a wide variety of fruits, green, leafy vegetables and grain products fortified with folic acid. The high content of Vitamin C present in these foods acts a powerful antioxidant that has been shown to prevent the plaque that builds up in the arteries.

+ Combining heart disease and stroke account for 70% of all deaths. Even children as young as 14 are beginning to face the deadly consequences plaguing the adults in recent times. Now you understand why having low cholesterol does not render you free of heart disease.


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