Homocysteine is an amino acid in the blood that's a byproduct of protein metabolism. Elevated levels of homocysteine, known as hyperhomocysteinemia, have been associated with an increased risk of cardiovascular diseases, such as heart attacks and strokes. High homocysteine levels can damage the lining of arteries and promote blood clot formation, leading to atherosclerosis, a condition characterized by narrowed and hardened arteries. Additionally, elevated homocysteine has been linked to an increased risk of venous thrombosis, where clots form in the veins.
Apart from cardiovascular risks, high levels of homocysteine have been implicated in other health issues. These include osteoporosis, where high homocysteine levels may interfere with collagen cross-linking, weakening bones and increasing the risk of fractures. There's also evidence suggesting that hyperhomocysteinemia may be associated with Alzheimer's disease, dementia, and decreased cognitive function, although the exact mechanisms are not fully understood. Elevated homocysteine levels can result from a deficiency of vitamins B6, B9 (folate), and B12, kidney disease, genetic factors, certain medications, and lifestyle factors such as smoking and excessive alcohol consumption.
On the other hand, very low homocysteine levels are rare and generally not considered a health risk. The focus in clinical practice is typically on managing high homocysteine levels, often through dietary changes and supplementation with B vitamins, particularly B6, B9, and B12, which help break down homocysteine in the body. Maintaining balanced homocysteine levels is important for cardiovascular and bone health, as well as for cognitive function.
To maintain healthy homocysteine levels:
Ensure an adequate intake of B vitamins, particularly B6, B9 (folate), and B12, through a balanced diet or supplementation if necessary. Good sources include leafy greens, fortified grains, legumes, and lean meats.
Adopt a heart-healthy lifestyle, including regular exercise, maintaining a healthy weight, and avoiding smoking and excessive alcohol consumption.
If you have a family history of hyperhomocysteinemia or are at increased risk for cardiovascular disease, work with your healthcare provider to monitor your homocysteine levels and develop a personalized management plan.
If you have a chronic condition such as kidney disease that may affect homocysteine levels, work closely with your healthcare team to manage the condition and monitor your homocysteine levels.
Homocysteine can be measured in: mg/100mL, mg/dL, mg/L, mg%, µg/mL, µmol/L
Reference ranges represent typical values for healthy individuals. Your healthcare provider must interpret your specific results.
| Age Range | Gender | Unit | Optimal | Normal | Source |
|---|---|---|---|---|---|
| 15 - 65 | All genders | µmol/L | - | 0 - 15 | Burnham, 2023 |
| 65 - ∞ | All genders | µmol/L | - | 0 - 20 | Burnham, 2023 |
Elevated levels of homocysteine have been linked to increased risk of fractures and poor bone health. Homocysteine may interfere with collagen cross-linking, impacting bone strength. It’s often measured in individuals with a history of fractures or osteoporosis.[van Meurs, 2004][McLean, 2004][McLean, 2008][Koh, 2006]
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Elevated homocysteine levels can negatively affect lipid metabolism, leading to unfavorable changes in lipid profiles. These changes can exacerbate the risk of cardiovascular disease[Daly, 2009][Momin, 2017].
Vitamin B6 is involved in the conversion of homocysteine to cysteine. Adequate levels of vitamin B6 are necessary to maintain normal homocysteine levels. A deficiency in vitamin B6 can result in elevated homocysteine, which is a risk factor for cardiovascular disease.[Selhub, 1999]
Elevated homocysteine levels can negatively affect lipid metabolism, leading to unfavorable changes in lipid profiles. These changes can exacerbate the risk of cardiovascular disease[Daly, 2009][Momin, 2017].
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