Homocysteine is a word most people have never heard of, yet not knowing what it is and what it does could cost you your life. Homocysteine is a naturally occurring amino acid that is necessary for normal function of the body. The problem is that when it does not perform properly it can be the precipitating factor in cardiovascular diseases (heart and circulatory diseases) such as arteriosclerosis (hardening of the arteries), heart attack, high blood pressure and stroke. For many years, experts have believed the theory that measuring the level of cholesterol floating around in your blood was the best way to measure your risk of cardiovascular disease. They believed that your blood cholesterol levels would increase by eating too much cholesterol and this, simply, was the cause of circulatory and heart problems. It became accepted theory and no one really argued with it. However, there was one major problem with this thought process. When the statistics were examined, it was found that 80% of heart attacks occur in men with normal cholesterol levels. Now we have a problem. Everyone is worried about their cholesterol levels and eating too much cholesterol, yet if you have normal cholesterol, statistically speaking, you have a greater risk of heart attack than someone who has a high cholesterol level. It turns out that it is not the cholesterol floating around in your blood that is dangerous; it is the cholesterol stuck to the blood vessel walls that narrow the blood vessels preventing normal blood flow. If a piece of this plaque that has lined the blood vessel wall breaks off and begins to float free in the blood vessels, it can clog up a small blood vessel, effectively damming up the flow of blood. This can cause the organ or tissue on the other end of that blood vessel to receive improper blood flow. This can lead to deterioration. If it is the blood supply to the heart, it can cause a heart attack. If it is the blood supply to the brain, it can cause a stroke. If it is the blood supply to any other part of the body, it can cause that part of the body to malfunction and even die. The other shocking information is that avoiding cholesterol rich foods has only a limited effect on lowering your blood cholesterol levels. Cholesterol is actually a very vital component of your body. It is manufactured in your liver for use in areas such as the building blocks of steroid hormones. It also serves as an antioxidant and is used in transporting vitamin E, beta-carotene and other nutrients through the blood. Lowering cholesterol too much seems to be linked to the development of cancer and hormone imbalances. Cholesterol has been described as good cholesterol and bad cholesterol. What is known as HDL (high-density lipoproteins) are considered “good” cholesterol and LDL (low-density lipoproteins) which is considered “bad” cholesterol. HDL carries cholesterol rather quickly out of the blood, which will lower the cholesterol in the blood. LDL will carry cholesterol out of the blood more slowly and cause the blood cholesterol levels to go up, which was always thought to be bad. So it made sense to have more HDL than LDL to lower blood cholesterol levels. It gets so confusing that many doctors as well as the general public are totally confused. The reason it was so confusing is, as you probably already figured out, is there were too many rules and many of the rules did not seem to hold up. There is good news out on this, which makes sense and you can put it into practice to lower your risk of cardiovascular disease. The things you can change, that everyone agrees contributes to cardiovascular disease, are diet (more on this later), tobacco use, blood pressure levels, being overweight, stress and lack of exercise. Some factors you cannot control are age, gender, heredity and diabetes. Diabetics are at a much greater risk because high sugar levels in the blood irritate the blood vessel walls which cause the body to lay down cholesterol as a sort of patch in the irritated area which in turn narrows the blood vessel wall. Another factor is free radicals. Free radicals are molecules that attack other molecules and steal electrons from that molecule. If a molecule has an electron stolen, it can no longer do its job and it ceases to function properly. LDL’s are very susceptible to attack from free radicals. When LDL is attacked by free radicals, it is called oxidation. When LDL undergoes oxidation, it will damage the blood vessels and cause cardiovascular disease. This is where antioxidants come into play. An antioxidant will attack the free radicals and prevent them from doing damage. Antioxidant vitamins such as vitamin C, E and beta-carotene play a big role in preventing oxidation, thus helping in the prevention of cardiovascular disease from this cause. Enter Homocysteine, what is now believed to be the major cause of cardiovascular disease. Unlike cholesterol, Homocysteine is supposed to exist only a short period of time, then it is converted into a molecule that is either useful or harmless. When it is not converted quickly and builds up in the blood system, problems occur. Protein, specifically the amino acid methionine, is the indirect source of Homocysteine. When the body breaks down certain proteins into methionine, the methionine is then converted into Homocysteine. The Homocysteine is then either converted into cystathionine with the help of vitamin B6, or it is converted back into methionine and the process starts all over again. If there is not enough B6, or if there is too much methionine, abnormally high levels of Homocysteine buildup and this will cause damage to the blood vessels. The damage is done because the Homocysteine attacks and strips away areas of the blood vessels. These injured, bare patches need to be filled in, sort of like plaster filling in the hole in the wall. The “plaster” the body uses is called arteriosclerosis, or hardening of the arteries. As blood cells pass by these hardened areas, they get injured. This injury causes the cell to clot abnormally and these clots can clog up blood vessels, preventing normal blood flow to whatever part of the body is on the other end of the clogged vessel. If it is the heart vessels, it can cause a heart attack. When it is the brain, it can cause a stroke. Researchers find that Homocysteine is up to 40 times more predictive than cholesterol in assessing cardiovascular disease risk. This is a simplified version of how this occurs and there are other steps involved in this process . A genetic factor can also play a role. About 12 percent of people have a defective gene that causes enzymes not to work properly and this can cause a Homocysteine buildup. The good news is that eating a good diet high in folic acid, which is found in a diet high in fruits, vegetables, seeds and nuts can help the enzymes work better and often solves the problem. Normal Homocysteine levels should be between 4.9 and 11.7 micromoles per liter of blood. There is normally a very small amount of Homocysteine in the blood, and even a tiny increase can dramatically increase your risk of cardiovascular disease. One thing that will increase your Homocysteine levels is consuming a lot of methionine, which is found in large amounts in animal proteins such as milk and meat. The more methionine, the more of it converts to Homocysteine which may not be processed fast enough and it will then build up in the blood. Another food that will increase Homocysteine levels is coffee. If is not the caffeine, however that causes the problem. In studies, participants were given coffee and an equal amount of caffeine from other sources such as soda or chocolate. The non-coffee participants did not have an increase in Homocysteine, the coffee group did have an increase. Diet can play a very important role in lowering Homocysteine. Vitamin B6 will help convert Homocysteine to a form that is not dangerous. B6 consumption for women should be about 2mg. and for men is should be 1.6mg per day. B6 is found in beans, nuts, bananas, cabbage, cauliflower, potatoes and whole grains. Eating a diet high in fruits, vegetables, grains and nuts should give you plenty of B6. Oral contraceptives will increase your B6 requirements. Folic acid will help the enzymes process the Homocysteine out of the blood. Folic acid is found in brewer’s yeast (which is high in many nutrients and should be part of everyone’s diet), spinach, broccoli, oranges and other fruits and vegetables. A daily intake of 400 mcg of folic acid is recommended. Oral contraceptives, certain cancer treatments, alcohol and smoking will increase folic acid requirements. Vitamin B12 will help lower Homocysteine and is found in high amounts in brewer yeast (especially Red Star brand) and seaweed and ripe fruits. Add about 2 tablespoons of brewer’s yeast to your diet every day to be assured you get plenty of B12 and other B vitamins as well as quality protein and essential fatty acids. Sprinkle seaweed on salads when you can or eat vegetarian sushi with seaweed as a source of B12, iodine and other important nutrients. The simplest, easiest and most cost effective way to fight high Homocysteine levels is to eat a diet high in fruits, vegetables, seeds and nuts. Avoid all animal products, alcohol, coffee, tobacco products and any unnecessary drugs. Be sure 40-60% of your diet is raw to assure cooking has not destroyed the foods natural nutrients. And as always, try to limit stress, because stress will complicate any health problems. To set up an appointment please call my office at 770-427-7387 or you can send us a message in the live chat.