Homocysteine is a sulfur amino acid produced in our bodies and a part of the body’s methylation process. It which play a major role in cellular metabolism and protein synthesis. However, elevated levels of homocysteine in the blood can pose serious health risks, including heart disease, stroke, and even cognitive decline. Fortunately, there are natural and effective ways to lower high homocysteine levels.
WHAT IS HOMOCYSTEINE?
Before diving into the natural approaches to reduce homocysteine levels, let's grasp why this amino acid is so significant. Homocysteine is produced when the body metabolizes methionine, an essential amino acid found in various foods, including meat, fish, and dairy products (Venes and Clarence, 2005). The metabolism of homocysteine requires the B-vitamins: folate (B9), B12, B6, and B2. Ideally, the body should convert homocysteine into other beneficial substances, but sometimes this process is disrupted leading to elevated homocysteine levels in the blood (hyperhomocysteinemia). Hyperhomocysteinemia is a risk factor for vascular disease, neurodegenerative disease, and other clinical conditions.
HOMOCYSTEINE AND CARDIOVASCULAR DISEASES
Cardiovascular diseases (CVD) comprise of diseases of the heart and blood vessels. CVDs are believed to account for one third of all deaths worldwide, and the prevalence is still on the rise (Mangge et al., 2014). Several risk factors are involved in the development of CVD, which makes it difficult to pinpoint a particular factor alone. However, elevated homocysteine level was shown to be a risk factor or correlate with:
atherosclerosis (Boushey et al., 1995; Graham et al., 1997; Pang et al., 2014)
myocardial infarction (Stampfer et al., 1992¸ Bots et al., 1999)
ischaemic heart disease (Wald et al., 1998)
stroke (Bots et al., 1999; Yuan et al., 2021)
coronary and extra‐coronary vascular calcification (Karger et al., 2020)
venous thrombosis (Faeh et al., 2006).
“NORMAL” REFERENCE RANGES
Homocysteine concentration is measured in fasting blood, but there is no consensus about the upper reference limits for plasma homocysteine concentrations. “Normal” concentration of homocysteine in the plasma of healthy individuals was set to be 5.0-15.0 μmol/L. Higher levels of homocysteine are split into three main categories: moderate (15-30 μmol/L), intermediate (30-100 μmol/L) and severe (>100 μmol/L).
However, it has been shown that the upper limit of 15 µmol/L is far too high in even in individuals without obvious vitamin deficiency. Already at the concentration above 9 μmol/L homocysteine exerts detrimental effects on the vascular endothelium and increases the risk of coronary artery disease (Nygard et al., 1997).
Each increase of 5µmol/L in homocysteine level increases the risk of coronary heart disease events by approximately 20-50%, independently of other risk factors (Humphrey et al., 2008).
Some scientist report that a homocysteine measurement over 6.3 µmol/L represents an increased risk of CVD. Thus, the homocysteine level below 6 µmol/L for woman and 7 μmol/l for men is now considered as the healthy range.
CAUSES OF ELEVATED HOMOCYSTEINE LEVEL
Elevated homocysteine levels (hyperhomocysteinemia) are seen in both children and adults due to (Hankey and Eikelboom, 1999; Domagała, 2002; Bednarek-Tupikowska et al., 2004; Moczulski and Grzeszczak, 2005; Faeh et al., 2006):
genetic MTHFR mutation
deficiency in vitamin B6, B12 or folate
diseases, such as kidney failure, diabetes, hypothyroidism, liver failure, psoriasis, lymphoblastic leukaemia, or Cushing’s syndrome
various drugs e.g., methotrexate, oestrogen-containing contraceptive pills, thiol drugs, niacin, metformin
alcohol and coffee intake
NATURAL APPROACHES TO LOWER HIGH HOMOCYSTEINE LEVEL
Now, let's explore the natural approaches that can help you maintain optimal homocysteine levels:
Cut off processed and ready-made food, artificial food additives, conventional dairy, refined vegetable oils, trans fats, and sugar as they increase inflammation.
Consume organic and unprocessed food. Homocysteine is produced in our body from the amino acid methionine presented in the animal sources like meat, fish. Be sure to eat grass-fed meat and wild caught fish.
Consume anti-inflammatory foods rich in omega-3 fatty acids, such as wild caught fatty fish, flaxseed, chia seeds, and walnuts.
Use healthy fat like olive oil, coconut oil, walnuts, flaxseed.
Increase intake of folate-rich foods: dark green leafy vegetables, broccoli, Brussels sprouts, beans, and lentils.
Consume vitamin B12-rich foods: fish, lean meats, organ meats, nuts, beans, and fermented dairy products. These same sources also supply zinc and other amino acids, which further help with methylation.
Supplement when necessary:
Folate (vitamin B9) – to support homocysteine metabolism.
Vitamin B12 – to support homocysteine metabolism.
Pyridoxine (vitamin B6) – to convert homocysteine to cysteine.
Betaine – to help lower homocysteine levels.
Choline – to assist in homocysteine metabolism.
Magnesium, omega-3 fatty acids, Coenzyme Q10, selenium, and vitamins C, D and E – to protect the heart, help improve blood flow, cholesterol, and blood pressure.
Quit smoking: Smoking can elevate homocysteine levels, so quitting is essential for overall health.
Limit or quit alcohol intake.
Exercise regularly: Engaging in physical activity helps lower homocysteine levels and promotes cardiovascular health.
Manage stress: Chronic stress can impact homocysteine metabolism. Practicing stress-reduction techniques like meditation or yoga can be beneficial.
Certain herbs like garlic and ginkgo biloba have shown potential in reducing homocysteine levels and improving vascular health. Consult an herbalist before using herbal supplements.
Periodic blood tests to monitor homocysteine levels are crucial. This enables you to track your progress and adjust your natural approaches as needed.
High homocysteine levels are a significant health concern, but with natural approaches, one can take control of your health and reduce your risk of cardiovascular disease, stroke, and cognitive decline. A holistic approach, including dietary changes, supplements, lifestyle modifications, and herbal remedies, can effectively lower high homocysteine levels and improve the overall well-being. Remember, it's always best to consult a healthcare professional before making significant dietary or supplement changes to ensure they are tailored to your specific needs and health status. By taking proactive steps to lower homocysteine levels naturally, you're investing in a healthier and happier future.
Bots, M. L, Launer, L. J., Lindemans, J., et al. (1999). Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam study. Arch Intern Med. 159: 38–44.
Boushey, C. J., Beresford, S. A., Omenn, G. S., et al. (1995). A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. J Am Med Assoc. 274: 1049–1057.
Domagała, T. B. (2002). Rodzinna hiperhomocysteinemia a miażdżyca tętnic. Kraków: Medycyna Praktyczna. 9-29.
Faeh, D., Chiolero, A., Paccaud, F. (2006). Homocysteine as a risk factor for cardiovascular disease: should we (still) worry about it? Swiss Med Wkly. 136:745–56.
Graham, I. M., Daly, L. E., Refsum, H. M. et al. (1997). Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project. J Am Med Assoc. 277: 1775–1781.
Hankey, G. J., Eikelboom, J. W. (1999). Homocysteine and vascular disease. Lancet. 354:407–413.
Harvey, R. A., Ferrier, D. R. (2011). Amino acid degradation and synthesis. In: Rhyner S, ed. Lippincott’s Illustrated Reviews, Biochemistry. 5. Philadelphia: Wolters Kluwer Health. pp. 264–265.
Humphrey, L.L., Fu, R., Rogers, K., Freeman, M. and Helfand, M. (2008). Homocysteine level and coronary heart disease incidence: a systematic review and meta-analysis. Mayo Clin Proc. 83(11):1203-1212.
Karger, A. B., Steffen, B. T., Nomura, S. O., Guan, W., Garg, P. K., Szklo , M., Budoff, M. J., Tsai, M. Y. (2020). Association Between Homocysteine and Vascular Calcification Incidence, Prevalence, and Progression in the MESA Cohort. J Am Heart Assoc. 9(3):e013934.
Mangge, H., Becker, K., Fuchs, D., Gostner, J. M. (2014). Antioxidants, inflammation and cardiovascular disease. World J Cardiol. 6(6):462–477.
Moczulski, D., Grzeszczak, W. (2005). Hiperhomocysteinemia w cukrzycy. Czyn Ryzyka 2. supl. 11: 16-17.
Nygard, O., Nordrehaug, J.E., Refsum, H., Ueland, P.M., Farstad, M. and Vollset, S.E. (1997). Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med. 337:230–236.
Okura, T., Miyoshi, K., Irita, J., Enomoto, D., Nagao, T., Kukida, M., et al. (2014). Hyperhomocysteinemia is one of the risk factors associated with cerebrovascular stiffness in hypertensive patients, especially elderly males. Nature.com Sci Rep. 4:5663.
Pang, X., Liu, J., Zhao, J., Mao, J., Zhang, X., Feng, L., et al. (2014). Homocysteine induces the expression of C - reactive protein via NMDAr-ROS-MAPK-NF-κB signal pathway in rat vascular smooth muscle cells. Atherosclerosis. 236:73–81.
Shenov, V., Mehendale, V., Prabhu, K., Shetty, R., Rao, P. (2014). Correlation of serum homocysteine levels with the severity of coronary artery disease. Ind J Clin Biochem. 29(3):339–344.
Stampfer, M. J., Malinow, M. R., Willett, W. C. et al. (1992). A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. JAMA. 268: 877–881.
Venes, D., Clarence, W. T., (2005). Taber’s Cyclopedic Medical Dictionary. 21. Philadelphia: F.A. Davis, p. 1089.
Wald, N. J., Watt, H. C., Law, M. R., et al. (1998). Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention. Arch Intern Med.158: 862–867.
Yuan, S., Mason, A. M., Carter, P. et al. (2021). Homocysteine, B vitamins, and cardiovascular disease: a Mendelian randomization study. BMC Med. 19:97.