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Homocysteine:  Important New Risk Factor in Cardiovascular Disease*

by John J. Reynolds, PA-C, CCN

Homocysteine is a natural chemical produced by the body and is a normal breakdown product of dietary protein.  Proteins such as fish, chicken, eggs, and meat are composed of strings of chemicals known as amino acids of which there are approximately twenty types.  One of these amino acids known as methionine (meth-i-o-neen) is found in high amounts of red meat and breaks down to homocysteine during normal metabolism.

In the last decade research has revealed that individuals with an elevated homocysteine level have a higher risk of heart attack and stroke.  Unfortunately, many physicians are unaware of this correlation and do not test for homocysteine.  This can be accomplished by a simple fasting blood test.  People with homocysteine levels above ten show a marked rise in their risk of developing an arterial blockage especially in the arteries leading to the heart and brain.  Recent data also suggests that diseases as diverse as osteoporosis and Alzheimer's Disease may also be related to elevated homocysteine levels.  Most laboratories indicate that levels below 9 are safe.  However, one health organization suggests that 6.3 should be the cutoff value.  I generally tell patients that values between 6 and 7 are very good.

Interestingly, an elevated homocysteine is not uncommon and appears to be largely due to nutritional imbalance.  Treatment includes reducing ones protein intake of excessive amounts are being consumed.  However, its also known that cigarette smoking, sedentary lifestyle, and use of certain prescription drugs can elevate homocysteine.  In addition there are three key nutrients involved in homocysteine metabolism.  Vitamins B6, B12 and folic acid.  These nutrients activate enzymes in the body that break down homocysteine.  Supplementation with these three nutrients along with appropriate dietary and lifestyle intervention will usually bring down homocysteine to a desirable level.

Just as one is evaluated for high blood pressure, cholesterol level as diabetes, in my opinion homocysteine level should be included in a routine evaluation of any patient interested in preventive health care.  Studies show that detection and treatment of elevated homocysteine levels may reduce an individual's risk of cardiovascular disease.

*Note:  This article originally appeared in the Rockland Review, June 23, 2000



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