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A very simplistic and unhelpful explanation from WebMD:
In fact, a high level of homocysteine is a risk factor for heart disease. It’s associated with low levels of vitamins B6, B12, and folate, as well as renal disease. Research has shown, however, that getting your homocysteine levels down with vitamins doesn’t reduce your chance of having heart disease.
Why is Homocysteine Associated with a Higher Risk of Heart Disease?https://www.webmd.com/heart-disease/guide/homocysteine-risk
Doctors aren’t sure how. They’re also not certain if your chance of having heart and blood vessel disease goes up if your homocysteine level is high. There does appear to be a relationship between high levels of homocysteine and artery damage. That can lead to atherosclerosis (hardening of the arteries) and blood clots.
Do I Need to Have My Homocysteine Level Checked?
There’s no universal recommendation for checking homocysteine levels. The test is still relatively expensive, it isn’t widely available, and insurance rarely covers it.
Brain, Heart, Nerves, and Hormones
If WebMd is the only article you read on homocysteine you will never know just how important homocysteine is to your health. This article briefly mentions a connection to heart disease, but fails to mention the many other problems that are related to high homocysteine levels. It also doesn’t discuss the known benefits of B vitamin supplementation for other conditions besides heart disease. It states that doctors aren’t sure about all the details, but this is not 100% true. Some doctors are sure that high homocysteine is associated with cardiovascular disease, but no one seems to know what to do about it. And it’s also true that doctors do not normally even test for homocysteine, despite the known association with many other conditions in all ages and both sexes, not just older men. In other words, don’t expect your family doctor or PCP to order a homocysteine test if you come in with anxiety.
Have you ever heard of Kilmer McCully? Me, either, until today when I was listening to a podcast called the Keto Naturopath. He mentioned that Dr. McCully had come up with a theory about heart disease and homocysteine that got him not only fired in 1979, but also blackballed and cancelled by Harvard because his theory went against prevailing wisdom. But later in1997 he was vindicated when others began to research the connection. He also published a book called the Homocysteine Revolution. Now, get this, he works for the US government as Chief of Pathology and Laboratory Medicine Services for the United States Department of Veterans Affairs Medical Center in West Roxbury, Massachusetts. He is 88 years old and Wikipedia is still claiming he holds this position. He may actually be retired. McCully is not totally debunking the cholesterol theory of heart disease. He advocates for a healthy diet free from processed foods.
As we can see by McCully’s story, new theories that upset the profits of current drugs and systems are not very welcome. That’s why it is so important to take charge of your own health, do your own research to find out what studies are being done, what alternative treatments have been found to be helpful, and ways you can experiment with your own body to feel better.
Research has shown that high levels of homocysteine are associated with many conditions that are related to vascular health including, neuropathy, cognitive impairment, infertility and miscarriage, stroke and mental health symptoms such as depression, attention deficit, panic attacks, and anxiety.
What research has been done?
Despite the known connections between homocysteine, B vitamin deficiency and poor health outcomes, there is still a lot scientists don’t know. Correlation or association between things doesn’t always mean causation. And some studies have not shown improvement in supplementing with B vitamins and folate.
Even though there are many articles on Google about homocysteine, I doubt your doctor will mention it, but you could still ask then to test you. https://familydoctor.org/high-homocysteine-level-how-it-affects-your-blood-vessels/
High homocysteine levels are usually correlated with low levels of B6, B12 and folate, which is also called B9. You can get a test for this at https://empowerdxlab.com/products Here is a list of symptoms related to high homocysteine.
Mutations in the MTHFR gene are also known to cause elevated homocysteine levels and I will be writing more about that when I have time. Learn more about MTHFR gene mutations here. Aging is also a known risk factor, and simply being male increases your likelihood of higher levels.
In a world with skyrocketing anxiety, depression, and numbers of people spending billions on psychoactive medications, the lack of research on homocysteine and mental health is criminal. People need help now! And before you blame it all on sin, just don’t. Plenty of devout believers suffer from these symptoms that are actually caused by metabolic disorders.
Psychoactive prescription drugs often do not work well, have bad side effects that may even be worse than the original diagnosis, and sometimes if they work at first , their effectiveness wanes over time. The truth has even been recently published about anti-depressants not actually boosting serotonin. When a doctor gives you prescription drugs for depression and anxiety they are experimenting on you. That is why you have to try several drugs until you find one that helps a little, or it might help a lot, but scientists don’t understand why it works.
As for heart disease, the problem is that because of the lack of conclusive studies proving the benefits of vitamin supplements, or even the necessity for testing, at this time doctors do not routinely test your homocysteine level unless you are known to be at risk for heart attack or stroke. This is because insurance doesn’t usually cover tests that are not considered ‘necessary’ by insurance companies. However, you can get your own tests from certain labs such as https://www.ultalabtests.com/test/Homocysteine.
The real question is why isn’t more being done to find out what is causing high homocysteine levels and how to treat it? I think the answer always comes down to money and whether big pharma can make a profit off it or not. Researchers need grant money. The CDC actually downplays the role of MTHFR on their website and doesn’t mention homocysteine’s connection to heart disease. Remember that these are the same people who told us that many dangerous drugs were safe. But nothing is stopping you from doing your own research.
Take Charge of your health!
The reality is that many symptoms and diseases are caused by nutritional, vitamin, and protein deficiencies caused by eating the SAD diet of processed foods, too much sugar, alcohol, few vegetables, processed grains and flour-based products, hydrogenated soybean oil and other bad oils, as well as the side effects of many prescription drugs given to us by doctors who don’t really know the risks of these drugs.
But people want a quick fix, a magic pill, someone else to tell them what to do, rather than doing what they know they need to do, eat health foods, exercise, and get off those RX drugs. For example, antacids are widely prescribed and they can cause elevated homocysteine levels and B vitamin deficiencies leading to a myriad of symptoms including mental health problems. Here is a good list of which drugs can be hurting you.
B vitamins are very involved in mental health. Anyone with depression or Bipolar or OCD or schizophrenia should be tested for B vitamin deficiency but this rarely happens. Therefore the easiest thing to do is simply start supplementing and see how you feel. However it is important to buy quality supplements and, even better, change your diet. But for some people diet will not be enough to see improvement because they have genetic mutations which impair B vitamin metabolism. These people may need very specific supplements ( I am not an affiliate for this company, but I did buy some of their products and this website is very informative).
What else can you do? Some conventional wisdom is still helpful, such as eating leafy green vegetables such as spinach; eating more protein, including eggs and meat; and eating more fruits and vegetables every day.
But you can also get tested for B vitamin deficiencies and genetic mutations and then treat them accordingly. You will have to be your own experiment of one. It will be worth it.
Don’t expect taking a cheap multivitamin to make you healthy if you are destroying your health with smoking, alcohol, poor food choices, and not enough sleep.
In many cases, a low carb, moderate protein, high fat diet and some quality supplements, along with stress management, exercise, and other lifestyle changes can fairly quickly change your health. But in people with genetic conditions such as MTHFR, or food allergies like wheat and soy, it may take more time to get health. You will need to discover what you can eat, what you need to supplement, and if there are any prescriptions that would be appropriate. If you have had chronic digestive symptoms, it can take months to heal your gut. Drinking bone broth can be helpful for this. There is a lot to learn, but your health is important!
So if you have been counting on modern medicine to help you, and going to doctors for years, but are only getting worse, I urge you to become your own health detective. If you can get a friend to refer you to a tried and true naturopath or osteopath or even a chiropractor, that can save you a little time, but insurance may not cover their services because they tend to go against the status quo. But be careful because even they are going to be treating you according to protocols and you need to find what works for YOU.
A few supplements you can try
I am an affiliate for Amazon. I am no longer an affiliate with Life Extension, but they have good products. I highly recommend taking magnesium and D3 as well, unless you are sure you are getting enough in your diet. Also check this page if you have the MTHFR mutation or symptoms of it. https://methyl-life.com/pages/what-should-i-order
Here’s a link to all the available products on Amazon. https://amzn.to/3DjyU1k plus a few that I picked out . But please do your research and remember that supplements can take a while to work.
Want to read some science articles? Here ya go.
ABSTRACT Homocysteine (Hcy) is a sulfur-containing amino acid that is generated during methionine metabolism. It has a physiologic role in DNA metabolism via methylation, a process governed by the presentation of folate, and vitamins B6 and B12. Physiologic Hcy levels are determined primarily by dietary intake and vitamin status. Elevated plasma levels of Hcy (eHcy) can be caused by deficiency of either vitamin B12 or folate, or a combination thereof. Certain genetic factors also cause eHcy, such as C667T substitution of the gene encoding methylenetetrahydrofolate reductase. eHcy has been observed in several medical conditions, such as cardiovascular disorders, atherosclerosis, myocardial infarction, stroke, minimal cognitive impairment, dementia, Parkinson’s disease, multiple sclerosis, epilepsy, and eclampsia. There is evidence from laboratory and clinical studies that Hcy, and especially eHcy, exerts direct toxic effects on both the vascular and nervous systems. This article provides a review of the current literature on the possible roles of eHcy relevant to various neurologic disorders.
CONCLUSION Elevated level of Hcy has been observed in many medical conditions including various neurologic disorders. The pathogenesis of eHcy is currently attracting considerable research interest, simply because early intervention to normalize the Hcy level may be beneficial to these patients and prevent them from suffering eHcy-induced additional cell damage and dysfunction. However, current clinical observations have produced inconsistent conclusions. Although controversy exists, this review on the relationship between eHcy (namely hyperhomocysteinemia) and neurologic disorders may help toward a better understanding of the current knowledge and rationales for further clinical and basic research. A simple blood test that can easily detect eHcy may be useful during the initial workup of common neurologic disorders. The strategy of attempting to normalize eHcy using a simple and relatively harmless multivitamin regimen can be tried in addition to the usual standard of care for that particular disorder. The usefulness of this potential strategy should be addressed in future studies.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198708/ published 2014
A 2020 Chinese study found persistent differences between males and females in homocysteine levels with males having higher levels..
In summary, this population-based, cross-sectional study showed that Hcy concentrations first decreased and then increased, being minimum at 30–50 years of age and significantly increasing after 50 years of age. Hcy levels in males were significantly higher than in females in each age range. The trend did not abate with age; instead, the levels for males remained above normal. This may be a contributing factor to gender differences in atherosclerosis and coronary artery disease.
A 2020 study found that children diagnosed with depression had low B12 and high homocysteine levels.
Depression of children and adolescents is associated with the interaction of environmental and genetic factors. Homocysteine, vitamin B12, and folate related to one-carbon metabolism are associated with psychiatric disorders such as depression in adulthood. Vitamin D also contributes to psychiatric disorders pathogenesis. There are not enough studies in the literature about these parameters in children with depression. Low vitamin B12 and vitamin D levels and increased homocysteine levels may play a role in the pathogenesis of depression in children and adolescents. Investigation of vitamin B12, folate, homocysteine, and vitamin D levels are recommended in children and adolescents with depression. https://pubmed.ncbi.nlm.nih.gov/32304285/
A 2021 study found a definite connection between elevated homocysteine during pregnancy and miscarriage. They conclude that supplementing with high doses of folic acid during pregnancy might help.
Homocysteine (Hct) is a substance produced in the metabolism of methionine. It is an essential type of amino acid gained from the daily diet. Methylenetetrahydrofolate reductase (MTHFR) gene mutation is related to elevated total homocysteine (tHct) expressions, in particular, among women with low folate intake. Hyperhomocysteinemia (HHct) is caused by numerous factors, such as genetic defects, lack of folic acid, vitamin B6 and B12 deficiency, hypothyroidism, drugs, aging, and renal dysfunction. Increased Hct in peripheral blood may lead to vascular illnesses, coronary artery dysfunction, atherosclerotic changes, and embolic diseases. Compared to nonpregnant women, the Hct level is lower in normal pregnancies. Recent studies have reported that HHct was associated with numerous pregnancy complications, including recurrent pregnancy loss (RPL), preeclampsia (PE), preterm delivery, placental abruption, fetal growth restriction (FGR), and gestational diabetes mellitus (GDM). Besides, it was discovered that neonatal birth weight and maternal Hct levels were negatively correlated. However, a number of these findings lack consistency. In this review, we summarized the metabolic process of Hct in the human body, the levels of Hct in different stages of normal pregnancy reported in previous studies, and the relationship between Hct and pregnancy complications. The work done is helpful for obstetricians to improve the likelihood of a positive outcome during pregnancy complications. Reducing the Hct level with a high dosage of folic acid supplements during the next pregnancy could be helpful for females who have suffered pregnancy complications due to HHct. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121575/
A good JAMA article.
This JAMA article about homocysteine mentions Dr. McCully and is quite informative about the various research findings. https://jamanetwork.com/journals/jamaneurology/fullarticle/777652
There is strong epidemiologic evidence indicating that elevated plasma homocysteine levels constitute an important risk factor for vascular disease, including ischemic stroke. Hyperhomocysteinemia appears to be independent of other factors, such as smoking, hypertension, diabetes mellitus, and hyperlipidemia, and since homocysteine levels can usually be lowered by polyvitamin therapy, which is inexpensive, well tolerated, and perceived to be “natural,” this association has attracted much attention in the medical as well as the lay community. Neurologists must also consider the relationship of homocysteine levels to dementing illnesses and to anticonvulsant use as well as to the documented usefulness of homocysteine measurements as a sensitive indicator of functional vitamin B12 deficiency in neuropsychiatric diseases. The efficacy of polyvitamin therapy in these settings is less well established, and there is a need for clinical research in this area.
Given the intense public interest in medicine and nutrition, many patients will not wait for definitive studies, and practicing neurologists will be faced with the need to give advice based on limited information. The first practical question relates to when homocysteine levels should be measured in neurologic practice. It seems reasonable to measure homocysteine levels in patients presenting with cerebral infarction, especially microvascular infarction, at a young age or when other cerebrovascular risk factors are not prominent. This information may refine risk assessment and raises the question of whether vitamin therapy should be prescribed for patients with high homocysteine levels. Answers to the latter question must await the results of randomized clinical trials that are currently under way. While some have argued in favor of prescribing multivitamin supplements without measuring homocysteine levels, the effectiveness of that practice is unknown, and some patients may require higher than normal vitamin doses to normalize homocysteine concentrations. These issues and others will be the focus of intense clinical investigations over the next decade.
Accepted for publication December 21, 1999.