Wisdom Wednesday: Homocysteine

A homocysteine test measures the amount of homocysteine in your blood. Homocysteine is a type of amino acid, a chemical your body uses to make proteins. Normally, vitamin B12, vitamin B6 and folic acid break down homocysteine and change it into other substances your body needs. There should be very little homocysteine left in the bloodstream. If you have high levels of homocysteine in your blood, it may be a sign of a vitamin deficiency, heart disease, or a rare inherited disorder.

If your health care provider thinks a vitamin deficiency is the reason for your high homocysteine levels, he of she may recommend dietary changes to address the problem. Eating a balanced diet should ensure you get the right amount of vitamins.

If your health care provider thinks your homocysteine levels put you at risk for heart disease, he or she will monitor your condition and may order more tests.

My Take:
Another “dummied down” press release from NIH. Again, the information is fairly accurate, although misleading. I write about homocysteine frequently. Please review my blog “Cardiovascular Disease: Risk Assessment with Nontraditional Risk Factors” posted on July 13, 2018. This will familiarize you with the cardiac risks associated with homocysteine.

Homocysteine is an intermediate metabolite in the sulfur amino acid pathway. We consume sulfur attached to amino acids, most commonly in cruciferous vegetables like broccoli, cauliflower, arugula, and kale. Methionine (a sulfur bearing amino acid) is converted to SAM-e, a popular nutritional supplement used to calm the brain. SAM-e is then converted to homocysteine.



As noted above, vitamin B12 and folic acid can then convert homocysteine back to methionine and the cycle starts over again. However, both B vitamins need to be in their methylated or “active form” to catalyze this reaction. The “rare inherited disorder” that inhibits or prevents this methylation occurs in a third of the population. Not quite so rare. Please review my blog Wisdom Wednesday: 23ANDME posted November 18, 2015. Just type 23ANDME into the search window in the upper left-hand corner of my blog site.

The alternative pathway uses vitamin B6 to convert homocysteine to cysteine. From there cysteine cascades down a couple of pathways. One pathway creates ammonia. There can be a genetic defect in this pathway as well again revealed by 23ANDME testing. The preferred pathway uses molybdenum to free the sulfur.

Sulfur is needed for five of the ten pathways in Phase II liver detoxification. Phase II detoxes alcohol, hormones, drugs and virtually all man-made chemicals that enter our body.

Sulfur is also needed for GAGS synthesis to produce glucosamine and chondroitin sulfate – popular supplements used for joint and connective tissue repair.

Finally, the sulfur is used to control candida in the bowel.

Bottom Line:
Homocysteine is an important blood test. I order it as part of my routine lab work and recommend you have it performed yearly. It can be used to assess cardiac risk, vitamin B12, vitamin B6, and folic acid status but more importantly assess sulfur amino acid metabolism. Genetic defects in this pathway are common and often multiple. When suspected, 23ANDME genetic testing is warranted.

Source: July 27, 2018 National Institutes of Health