Ladd McNamara, M.D discusses the future of medicine both as it relates to health, supplementation, and how health professionals are finding new ways to increase income in an ever evolving world!

Understanding Your Homocysteine Lab Test

If you asked to have your homocysteine level checked with the rest of your lab work, you were probably told it is “fine.” Don’t be so sure. You could be at risk for heart disease and not know it.  Let’s talk about what could possibly save your life.

Most lab results will indicate that a “normal” homocysteine level is anything less than 10.4; others indicate the “normal” range to be from 4.0 to 20!  Yikes!   The studies show that high levels of homocysteine is associated with atherosclerosis, heart disease, and stroke, as well as kidney disease.   Lower levels are associated with less risk of chronic disease.  What you’re told is “normal,” may be true.  However, since men and women “normally” die of heart disease, let’s work on having a HEALTHY HOMOCYSTEINE LEVEL.

A healthy homocysteine level is less than 7.0, and ideally less than 6.5.   And, for every 3 points above 6.5 there is a 33 to 35% increase risk of heart disease!  So, if you’re told that your 9.5 homocysteine level is “fine,” think again!

However, homocysteine should not considered the end all, be all blood test to assess your risk of heart disease.  It is just one indicator of several to take into consideration.  The homocysteine should be viewed in light of the C Reactive Protein, HDL, LDL, VLDL, and in particularly the Oxidized LDL-to-HDL ratio!

For example, if your homocysteine is 7.5 to 8.0, and your Oxidized LDL-to-HDL ratio is Low Risk, and your C Reactive Protein is 1.5 or less, than you’re at low risk of heart disease compared to the normal population.   However, with the same homocysteine level, and you have a Borderline Elevated (or even Elevated) Oxidized LDL-to-HDL Ratio, and a C-Reactive Protein of 2.5 or greater, it’s time to make changes to lower your risk of heart disease.

Homocysteine is an amino acid complex (a protein of sorts) that is created in the liver, and is a intermediary “by product” of normal amino acids methionine and cysteine.  The problem is that homocysteine causes problems.   Homocysteine causes damage to the lining of arteries, called the endothelium.  The endothelium is a thin layer of cells that line the arteries, which carry out very important functions, including releasing nitric oxide (NO) that allows for the arteries to relax, dilate, and allow for increased blood flow to organs and muscles (let alone the penis …there is a reason that male diabetics and those with atherosclerosis have difficulty with erections).

Homocysteine oxidizes, or causes micro-gashes in the lining of the endothelium.  It damages the cells, and exposes the inner wall of the artery just below the endothelium.  Now, “bad” things can get under the endothelium and cause inflammation and further damage.  What bad things get under the endothelium?  Oxidized LDL Cholesterol!

Only the oxidized form of LDL Cholesterol gets stuck under the damaged endothelium, and through a cascade of inflammation, macrophage clean up process, more inflammation, foam cell spillage of “cholesterol goo,” and more inflammation, the infiltration of smooth muscle and calcification, ….why you now have arterial plaque!  And, to think, it all started with homocysteine and oxidized LDL cholesterol!

Certainly, you MUST keep your oxidized LDL cholesterol low, and your HDL cholesterol as high as possible (see other blog posts for pointers on how to do this), but you must also keep your homocysteine levels as low as possible.

Think of homocysteine as burrs, or spiked molecules that travel throughout your blood stream, nicking and gouging your endothelium, creating areas where oxidized LDL cholesterol can get a foot hold and start the process of atherosclerosis.   Obviously, you want to keep these damaging molecules as low as possible.  But, how do you do that?

Well, what causes elevated homocysteine?

1.  Age; as you age, your homocysteine elevates.

2.  Diabetes will increase your homocysteine.

3.  Smoking will do all sorts of bad things inside your body, including raising your homocysteine.

4.  Lack of vitamins (Folic Acid, B12, B6, Betaine), lack of healthy eating, lack of supplementation.

5.  Lack of activity (exercise).

6.  Almost any chronic disease, particularly inflammatory diseases, cancer, kidney failure, liver disease, etc. will all increase your homocsyteine.

7.  Certainly genetics has something to do with it, as it does with all aspects of your health.

8.  Alcohol consumption.  The more you drink the more you create more homocysteine.

9.  Coffee!  Yes, I said coffee..   The more you drink, the more homocysteine you create!   (And, it is NOT mostly due to the caffeine content.)

Well, if you can see what causes homocysteine to elevate, you can figure out what you need to do to lower homocysteine if it is elevated.  There may be areas that you’re doing fine, but there are areas that you can improve.

So, Here’s how to Lower Your Homocysteine:

1.  Eat a healthy diet.  (Avoid Trans Fats, get plenty of vegetables.)

2.  Supplement with vitamins and minerals.

3.  Increase your Vitamin B12, Vitamin B6, Folic Acid.

4.  Supplement with Betaine (a.k.a., TMG, or Tri-Methyl-Glycine).

5.  Supplement with Choline, a precursor to the neurotransmitter, acetylcholine, converts into Betaine within your body, and helps lower homocysteine.

6.  Don’t Smoke!

7.  Limit coffee drinking to one cup per day, or avoid it all together.

8.  Moderate exercise, 30 continuous minutes per day.  Even a 30 minute brisk walk makes a difference.

9.  Minimize your alcohol consumption, or eliminate it.

10.  Reduce excessive inflammation throughout your body with Grape Seed Extract, Olive Extract, and Tumeric Extract (Curcurmin), in addition to your essential vitamins, minerals, fish oil, and calcium and magnesium supplementation.

As you do all of the above, you will also lower the inflammation in the body, which will lower your C Reactive Protein (CRP), as well as your oxidized LDL Cholesterol.  The beauty of all this, is making healthy changes changes everything!

Take these steps and recheck your homocysteine in 8 to 12 weeks.  You should see a decrease in this toxic molecule.  Again, shoot to get your level to around 7.0 or below.   However, if you have a low oxLDL-to-HDL ratio, and your homocysteine level persists in the mid-range (of 7.5 to 8.0), don’t worry about trying to lower it further if you are already taking a full-spectrum, quality nutritional supplement.  However, if you wish to lower your homocysteine further, then consider betaine, a.k.a. Tri-Methyl-Glycine (TMG).

Finally, remember, doctors are supposed to treat the patient, not their lab tests.   Take care of yourself!

Reference:  Semin Thromb Hemost. 2000;26(3):243-54.

Medical Disclaimer- Everything on this website, and in this article, is not to be interpreted as, or substituted for, medical advice.  It is for informational purposes only, to be used to faciliate a conversation with your health care provider.  Please consult with your own personal health care provider before embarking on a supplement program.   The information on this website is not meant to take place of the information and recommendations you receive from your personal physician or other licensed health care provider, as the information and considerations offered on this website may not apply to your health condition and needs.   Do not use any information on this website for the use of diagnosing, treating, or managing your care without a thorough discussion with your health care provider.   Do not stop, start, or change any medication without consulting with your physician.   If you have, or suspect that you have, a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this website.  Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

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Medical Disclaimer

Information on this web site is provided for informational purposes only. The information is a result of years of practice experience and study by the author. This information is not intended as a substitute for the advice provided by your physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this website for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read on this web site. Information provided on this web site and the use of any products or services purchased from this website (or as a result of information provided this website) by you DOES NOT create a doctor-patient relationship between you and any of the physicians or authors affiliated with this website. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.