Saturday, August 8, 2009

Heart Disease- Homocysteine

If you are at risk of heart disease, ask your doctor to measure your homocysteine levels. What was once a relatively obscure laboratory measurement (from a blood draw); homocysteine assessments have become somewhat common place. Even so, many physicians stubbornly continue to look solely at cholesterol to determine cardiovascular risk despite evidence that up to 50% of patients with heart disease have normal levels of cholesterol.

Homocysteine is an amino acid that when produced in excess, can damage the inner lining of blood vessels. Elevated homocysteine has been shown to increase risk of stroke, coronary artery disease and death. Homocysteine can also accelerate atherosclerosis. While certain genetic mutations can cause high levels of homocysteine, it can also be a result of low B vitamin status including B6, folate and B12.

While vitamin supplements are helpful in lowering homocysteine, a heart healthy diet alone also has this cardioprotective effect. This study showed that you can naturally lower homocysteine by increasing intake of vegetables, fruits and berries (and subsequently folate levels) for a few months.

The point is, cholesterol has long been a marker for heart disease. We now understand that homocysteine is also a very important marker and can easily be lowered by increasing B vitamin intake through diet or supplementation. Nonetheless, it is important that we don't mistake homocysteine as "the new cholesterol" and misinterpret it to be the sole determinant of heart disease risk. All diseases, including heart disease, involve multiple variables. Now that we've identified this particular contributor, be sure you know where your homocysteine levels are.

"Homocysteine, however, remains an important field of study as an unconventional risk factor, one facet of a complex metabolic puzzle- a veritable Rubik's cube- that promotes atherosclerosis." Mayo Clinic Proceedings 2008 Nov; 83 (11) :1200-2.

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