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Elevated Homocysteine Levels
  Homocysteine Elevated
 Signs, symptoms, indicators
 Conditions that suggest it
 Contributing risk factors
 Conditions suggested by it
 Treatment recommendations
 


A study at the National Institute on Aging found that homocysteine does more than just damage the arterial wall. As a major consequence of folic acid deficiency -- a particular problem with the elderly -- elevated homocysteine impairs DNA repair. Diagnosis & Tests


S-Aadenosylhomocysteine, which is the precursor of homocysteme, appears to be a more sensitive marker for differentiating cardiovascular patients from control subjects than homocysteine. [Am J Clin Nutr, 2001;74: pp.723-9]





Signs, symptoms & indicators of Elevated Homocysteine Levels:
Lab Values - Chemistries  High homocysteine levels (confirmed)

Conditions that suggest Elevated Homocysteine Levels:
Aging  Premature/Signs of Aging
 A recent large-scale prospective study of 4700 Norwegian men and women between the ages of 65 and 67 revealed that higher levels of homocysteine in plasma were associated with a significantly increased risk of mortality. For each 5 mmol/L increase in plasma homocysteine levels, the number of deaths from all causes in this "youthful" senior population jumped by 49%. This included:
  • a 50% rise in deaths from cardiovascular disease
  • a 26% rise in deaths from cancer
  • a 104% rise in deaths from other causes.
These dramatic results may indicate a need for more routine screening in the elderly population. [Am J Clin Nutr 2001;74: pp.130-6]

  Alzheimer's Disease
 People with elevated levels of homocysteine have nearly double the risk of developing Alzheimer's disease, according to a report from researchers at Boston University. The findings, which come from the long-running Framingham Study, are the first to tie homocysteine levels measured several years before with later diagnosis of Alzheimer's and other dementias. The report, which appeared in the New England Journal of Medicine, provides some of the most compelling evidence yet of an association between high plasma homocysteine and eventual significant memory loss.

Autoimmune

  Ulcerative Colitis
 Because people with inflammatory bowel disease (IBD), like ulcerative colitis and Crohn's disease, have a much higher risk of both thromboses and osteoporosis, a team of researchers from McGill University in Montreal explored the idea that homocysteine excess may play an important role in this chronic gastrointestinal disease.

To test this hypothesis, they measured homocysteine levels in the plasma of 65 patients with IBD and in 127 healthy controls. Their results revealed a striking difference: The patients with IBD had nearly a six-fold increased incidence of hyperhomocysteinemia - having homocysteine levels above the normal range - compared to controls.

About one in every seven patients in the IBD group had hyperhomocysteinemia. As expected, those with vitamin B12 deficiency tended to have higher homocysteine levels. Yet researchers were also surprised to find that 80% of the IBD patients with hyperhomocysteinemia had normal blood levels of vitamins.

This suggests that homocysteine imbalances could be an early warning sign of B-vitamin deficiency inside cells - one that occurs well before vitamin levels actually decline in serum. It is still too early to tell if treating high homocysteine could actually reduce IBD symptoms in patients.

Importantly, as homocysteine levels rose in the patients with IBD, so did the clinical ratings of IBD disease severity, including its length of duration and the use of steroid medications to treat it. [Am J Gastroenterol. 2001 96(7): pp.2143-9]

Circulation

  Atherosclerosis
 Multiple studies indicate that 15-30% percent of patients with premature occlusive vascular disease have moderately elevated total plasma homocysteine concentrations. [ JAMA 1992; 268: pp.877-81]

  Coronary Disease / Heart Attack
 Elevated homocysteine levels are believed to exacerbate oxidative injury to blood vessels and increase pro-clotting mechanisms linked to stroke and heart attack.

Mental

  Depression
 Nutrients which lower elevated homocysteine levels, including the B-vitamins, are related to depression in several ways [Am J Psy 1997;154: pp.426-428]. The methyl group provided by normal homocysteine metabolism is necessary for the production of depression-relieving neurotransmitters such as serotonin and dopamine. The B-vitamins are also crucial in the direct synthesis of the brain neurotransmitters. [J Affect Disord. 1986;10: pp.9-13; Psychosomatics. 1980;21: pp.926-929]

Musculo-Skeletal

  Osteoporosis - Osteopenia
 Elevated homocysteine levels disrupt collagen-forming processes in the body and raise the likelihood of developing osteoporosis.

Risk factors for Elevated Homocysteine Levels:
Nutrients  Vitamin B-Complex Requirement
 Homocysteine imbalances could be an early sign of B-vitamin deficiency inside cells, one that occurs well before vitamin levels actually decline in serum. "Homocysteine may, in fact, be a more sensitive marker of vitamin B12, B6 or folate deficiency and… may precede deficiency of circulating vitamins." [Am J Gastroenterol. 2001 96(7): pp.2143-9]

Organ Health

  Chronic Renal Insufficiency
 Homocysteine levels in patients suffering from chronic renal failure are significantly elevated at an early stage. The kidney plays a very significant role in homocysteine metabolism but this does not occur during chronic renal failure. In addition, there is a decreased extra-renal catabolism, which contributes to the hyperhomocysteinemia state. [Hyperhomocysteinemia: A Role in The Accelerated Atherogenesis of Chronic Renal Failure?, Netherlands Journal of Medicine, 1995;46: pp.244-251]

Symptoms - Food - Preferences

  Vegan/raw food diet

Elevated Homocysteine Levels suggests the following may be present:
Organ Health  Chronic Renal Insufficiency
 Homocysteine levels in patients suffering from chronic renal failure are significantly elevated at an early stage. The kidney plays a very significant role in homocysteine metabolism but this does not occur during chronic renal failure. In addition, there is a decreased extra-renal catabolism, which contributes to the hyperhomocysteinemia state. [Hyperhomocysteinemia: A Role in The Accelerated Atherogenesis of Chronic Renal Failure?, Netherlands Journal of Medicine, 1995;46: pp.244-251]

Recommendations and treatments for Elevated Homocysteine Levels:
Psychological  Stress Management
 It was recently found that periods of stress increase serum homocysteine, an amino acid known to be a significant risk factor for coronary artery disease.

Vitamins

  Folic Acid
 A deficiency of vitamin B12 is associated with elevated homocysteine levels and folic acid is essential for its proper metabolism.

  Vitamin B6 (Pyridoxine)
  Vitamin B12 (Cobalamine)
 Since most people with a high homocysteine level don't get enough folic acid, vitamin B6 or B12 in their diet, supplementing with these vitamins helps return homocysteine to normal levels.


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
May do some good
Highly recommended


GLOSSARY

Alzheimer's Disease (Alzheimer's)
A progressive disease of the middle-aged and elderly, characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Alzheimer's disease is the most common cause of dementia.

Amino Acid (Amino Acids)
An organic acid containing nitrogen chemical building blocks that aid in the production of protein in the body. Eight of the twenty-two known amino acids are considered "essential," and must be obtained from dietary sources because the body can not synthesize them.

Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.

Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Cardiovascular
Pertaining to the heart and blood vessels.

Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.

Chronic Renal Failure (Chronic Renal Insufficiency, Kidney Failure, Renal Insufficiency)
(CRF) Irreversible, progressive impaired kidney function. The early stage, when the kidneys no longer function properly but do not yet require dialysis, is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to diagnose, as symptoms are not usually apparent until kidney disease has progressed significantly. Common symptoms include a frequent need to urinate and swelling, as well as possible anemia, fatigue, weakness, headaches and loss of appetite. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxic metabolites, normally filtered out of the blood by the kidneys, build up to harmful levels. Over time (up to 10 or 20 years), CRF generally progresses from CRI to End-Stage Renal Disease (ESRD, also known as Kidney Failure). Patients with ESRD no longer have kidney function adequate to sustain life and require dialysis or kidney transplantation. Without proper treatment, ESRD is fatal.

Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).

Crohn's Disease (Crohn's)
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.

DNA
Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.

Dopamine
A neurohormone; precursor to norepinephrine which acts as a stimulant to the nervous system. Carries signals between neurons and controls feelings of satisfaction, arousal, reward and mood.

Folic Acid
A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.

Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.

Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.

Metabolism (Metabolic, Metabolize, Metabolizes, Metabolizing)
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds. Also defined as the sum total of changes in an organism in order to achieve a balance (homeostasis): Catabolic burns up, anabolic stores and builds up; the sum of their work is metabolism.

mol (mmol, nmol, pmol, umol)
Mole. The amount of a substance that contains as many atoms, molecules, ions, or other elementary units as the number of atoms in 0.012 kilograms of carbon 12. The number is 6.0225 × 10^23, or Avogadro's number. Also called gram molecule.
mmol: millimole: 0.001 or one thousandth of a mole.
umol: micromole: 0.000001 or one millionth of a mole.
nmol: nanomole: 0.000000001 or one billionth of a mole.
pmol: picomole: 0.000000000001 or one trillionth of a mole.

Neurotransmitters (Neurotransmitter)
Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.

Osteoporosis
A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.

Precursor (Precursors)
A biochemical substance, such as an intermediate compound in a chain of enzymatic reactions, from which a more stable or definitive product is formed.

Serotonin
A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.

Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Steroid (Steroids)
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.

Stroke (Stroke-Type Event)
A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.

Ulcerative Colitis (Colitis Ulcerosa)
Ulceration of the colon and rectum, usually long-term and characterized by rectal bleeding or blood in the stool, frequent urgent diarrhea/bowel movements each day, abdominal pain.

Vascular
Relating to the blood vessels of the body. The blood vessels of the body, as a group, are referred to as the vascular system. They are composed of arteries, veins and capillaries - arteries that pass oxygen-rich blood to the tissues of the body; veins which return oxygen-depleted blood from the tissues to the lungs for oxygen; and the capillaries that are the tiniest vessels and are between the arteries and veins.

Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.




Last updated: Apr 13, 2008


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