What is homocysteine?

Homocysteine isan amino acid produced by the body. Elevated levels of homocysteine in the blood may be associated with increased risk of heart attacks, strokes, blood clots, and hardening of the arteries.

Why is it important to monitor homocysteine levels?

It is one of independent and quite a major risk factor for coronary heart disease and almost all other chronic degenerative disease as well due to its pro-inflammatory in effect. Elevated levels of homocysteine (>10 micromoles/liter) in the blood may be associated with atherosclerosis (hardening and narrowing of the arteries) as well as an increased risk of heart attack,  strokes, blood clot formation, and possibly ALzheimer’s disease.

Observational study showed that subjects with higher homocysteine level above 20 micromoles/liter significantly shorter life-span than those below 9 micromoles/liter. The higher the level proportionate to the higher risk of heart disease and stroke. Since it is treatable with basic supplements and trimethylglycine, homocysteine level should be tested.

Insufficient amounts of folate, vitamins B6 and B12 are associated with increased levels of homosysteine in the blood. Magnesium and zinc are two minerals that also have a role in reducing and maintaining lower homocysteine level.

In 1969, Dr. Kilmer S. McCully reported that children born with a genetic disorder called homocystinuria, which causes the homocysteine levels to be very high, sometimes died at a very young age with advanced atherosclerosis in their arteries. However, it was not until the 1990’s that the importance of homocysteine in heart disease and stroke was appreciated.

Theoretically, an elevated level of homocysteine in the blood (hyperhomocysteinemia) is believed to cause narrowing and hardening of the arteries (atherosclerosis). This narrowing and hardening of the vessels is thought to occur through a variety of ways such is inflammatory pathway. Elevated levels of homocysteine in the blood may also increase blood clotting tendency. To keep homocysteine-induced endothelial damage to a minimum, levels of homocysteine should be kept below 7-8 µmol/L.

Mild hyperhomocysteinemia levels are seen in about 5%-12% of the general population.

Most of these data, however, are obtained from observational studies rather than purely controlled scientific data.

What should you do to prevent heart attacks and strokes?

Not only lowering homocysteine matters but it is part of the holistic approach to treat as well as prevent heart disease and stroke. Losing excess weight, exercise regularly, controlling diabetes, (even glucose spike in non-diabetic is also deadly) and high blood pressure, increase HDL-cholesterol, lowering the bad LDL-cholesterol, and stopping cigarette smoking are crucial steps in preventing heart attacks and strokes.


1. Ray, JG. Meta-analysis of hyperhomocysteinemia as a risk factor for venous thromboembolic disease. Arch Intern Med 1998; 158:2101.

2. den Heijer, M, Rosendaal, FR, Blom, HJ, et al. Hyperhomocysteinemia and venous thrombosis: a meta-analysis. Thromb Haemost 1998; 80:874.

3. Vermeulen, EG, Stehouwer, CD, Twisk, JW, et al. Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo- controlled trial. Lancet 2000; 355:517.

4. Eikelboom, JW, Lonn, E, Genest, J Jr, et al. Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence. Ann Intern Med 1999; 131:363

5. Robinson, K, Arheart, K, Refsum, H, et al. for the European COMCAC Group. Low circulating folate and vitamin B6 concentrations. Risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation 1998; 97:437.

6. He, K, Merchant, A, Rimm, EB, et al. Folate, vitamin B6, and B12 intakes in relation to risk of stroke among men. Stroke 2004; 35:169.


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