Homocysteine: The Missing Piece Of the Health Puzzle


Homocysteine is one of the most important blood tests to have. Elevated homocysteine is a vastly more important finding on blood test than elevated cholesterol.

Homocysteine predicts increased risk for heart attack, stroke, depression, arthritis, infertility, osteoporosis, and Alzheimer's disease. Some authors estimate that elevated homocysteine predicts 90% of cases of cardiovascular disease.

Two recent items of health news illustrate just how important homocysteine is:

1) B-vitamins halt the progression of dementia

"These vitamins are doing something to the brain structure - they're protecting it, and that's very important because we need to protect the brain to prevent Alzheimer's."
- Professor David Smith, Oxford University (1)

In a study conducted by Oxford scientists, a high dose B-vitamin supplement was found to dramatically slow brain shrinkage and prevent dementia. (2) The vitamins work by reducing the level of homocysteine, a biochemical marker that has been linked with Alzheimer's disease, heart disease, depression, osteoporosis and other conditions.

2) SAMe effective for depression

The natural supplement S-Adenosyl Methionine (SAMe) fared well in a double-blind trial at Harvard Medical School. When combined with standard antidepressant medication, SAM-e provided significant improvement and caused no side effects compared to placebo. (3) Previous studies have shown that SAM-e works well as a primary treatment for depression. It may also be effective for liver disease, arthritis, and prevention of Alzheimer's disease.

SAM-e works by assisting in the production of brain neurotransmitters, and by lowering homocysteine. (Speak to your doctor before changing your depression treatment.)

One of the most important blood tests that you should have: Homocysteine

When I talk to patients about their elevated homocysteine, I am always greeted with a blank stare. Those patients who do absorb the information will often forget all about it by the next appointment. How can I communicate the importance of this blood marker?

Homocysteine is a vastly more important blood test than cholesterol. Homocysteine is a proven risk factor for heart attack, stroke, depression, arthritis, infertility, osteoporosis, and Alzheimer's disease. Some authors estimate that elevated homocysteine predicts 90% of cases of cardiovascular disease. (4)

Cholesterol tests seem easy to understand because cholesterol is in food, in blood, and built up in arteries. Nice and easy, like medicine for kindergarten kids. (This simple scenario is flawed because cholesterol is actually a relatively innocent bystander in heart disease.)

Homocysteine, on the other hand, is not simple. It is a bewildering foray into university-level organic chemistry, but that is no reason to ignore it.

What is homocysteine exactly? Why is it so bad?

Elevated homocysteine is a sign that the body is not methylating properly. ("What?!" you say.)

Methylation is the nuts and bolts of your body chemistry. It is the transfer of small molecule fragments (methyl groups) from one molecule to another. It is essential for the healthy function of DNA, neurotransmitters, cell machinery, and well, basically everything. I'm sorry, that's as simple as I can make it!

We generally methylate well when we're young, but as we age, the process slows down, and this occurs more dramatically in some people. Under-methylators age more rapidly, and they are more prone to degenerative disease. That's the bad news.

The good news is that under-methylation (elevated homocysteine) is very easy to treat nutritionally. Methylating nutrients such as B-vitamins and SAM-e are highly effective treatments, as we see in the Oxford and Harvard studies above.

A "methylation diet" includes plenty of leafy green vegetables, legumes, and animal products.

Homocysteine rises after menopause

Effective methylation depends on many factors. For example, oestrogen assists with methylation, and homocysteine levels may rise after menopause. (5)

Get Tested

Homocysteine testing is available from Sensible- Alternative Clinic or from your GP. (Recommended homocysteine value for optimal health is equal to or less than 7umol/L)

Article by Lara Briden BSc, ND.

  1. Vitamin B 'puts off Alzheimer's'. BBC News Health. 8 Sept 2010. http://www.bbc.co.uk/news/health-11232356
  2. News release, Alzheimer's Research Trust. Smith, D. PLoS ONE; vol 5 Issue 9: p e12244.
  3. Papakostas, George I. S-Adenosyl Methionine (SAMe) Augmentation of Serotonin Reuptake Inhibitors for Antidepressant Nonresponders With Major Depressive Disorder: A Double-Blind, Randomized Clinical Trial. Am J Psychiatry 2010; 167:942-948
  4. Cooney, Craig. A review of methyl magic: Maximum Health through methylation. Kansas City : Andrews McNeel Pub., ©1999.
  5. Morris MS at al. Total homocysteine and estrogen status indicators in the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2000. 152(2):140-148.


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