Homocysteine and Your Heart: Is There A Connection?

Reviewed by Robert Ehrman, MD 

High blood pressure, diabetes, smoking, and high LDL (bad) cholesterol raise your risk for heart disease. But have you heard that high levels of  something called “homocysteine” in the body may be one more risk factor for heart disease? This article describes the link between homocysteine and heart disease. It also offers you tips for simple ways to lower your risk of heart disease.

What is homocysteine?

Homocysteine is an amino acid made in the body when your body digests proteins. Proteins are long chains of amino acids. As the body digests foods that contain protein—especially meats, homocysteine enters the blood.

The connection between homocysteine and heart disease

A number of studies done over the past decade show that a high level of homocysteine in the blood may harm the heart and blood vessels. There are four ways by which this damage can happen:

1. Promoting the laying-down of fatty deposits (plaque) on the artery walls.
2. Promoting blood clots.
3. Damaging the inner lining of arteries.
4. Narrowing the insides of blood vessels

Because of these effects, a high level of homocysteine has been linked to a higher risk of heart disease, stroke, and blood vessel disease in the legs and feet (peripheral vascular disease).

What is a high level of homocysteine?

The American Heart Association (AHA) has said that a reasonable level for homocysteine is less than 10 micromoles per liter. At this time, the test to measure homocysteine is not generally ordered by most healthcare providers The main reason is that there are several other tests, such as measuring blood fats and doing a stress test, that help your health care provider find out if you are at risk for, or have, heart disease.

What can you do to lower your high homocysteine level?

Three B vitamins—folate, B6 and B12—have been found to help break down homocysteine and lower the levels of it in the blood. Folate and B12 lower homocysteine levels by turning them into a different amino acid called methionine. B6 helps break homocysteine down into cysteine and other waste products that do not have the same harmful effects as homocysteine.

Research shows that people who don’t get enough folate, B6, and B12 from the foods they eat have higher homocysteine levels. Other studies have shown that people who eat more fruits , vegetables and dairy foods have lower homocysteine levels.

Is it time to take action?

The answer is yes! Today, the American Heart Association suggests that people who are at high risk for—or who already have—heart disease should be sure to eat enough folate, B6 and B12. “Enough” means at least five servings of fruits and vegetables each day. The AHA doesn’t believe there is enough evidence at this time to call a high homocysteine level a major risk factor for heart disease. The AHA also doesn’t currently recommend widespread use of Folic Acid, B6 and B12 as dietary supplements.

If it’s hard for you to eat this many servings of fruits, vegetables and dairy foods, you might want to take a daily multivitamin and mineral supplement. When you buy a daily multivitamin and mineral supplement, look for one that provides 100 percent of the Recommended Daily Allowance for folic acid, B6, and B12. This way you can be sure that you get the amounts you need for good health. Speak to your health care provider or Walgreens pharmacist about the best product for your needs.

The Bottom line

Keep in mind that the link between a high homocysteine level and heart disease is still being debated by experts. But, you can’t go wrong eating more fruits and vegetables! There are many well-known benefits of these foods beyond keeping your homocysteine level in check. Also, keep in mind that there are many other known risk factors for heart disease. While researchers learn more about homocysteine, there are steps to take today to lower your risk for heart disease. These include stopping smoking, limiting the amount of saturated and trans-fats you eat, being physically active, taking your heart and blood pressure medicines as directed and taking daily aspirin (if it is recommended for you by your health care provider).