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).

  • Register For This Twitter Chat Series

    When you register, we will send you timely reminders about upcoming Twitter chats via email.

    Simply enter your email address below and click on the "Register Me" button.

  • This field is for validation purposes and should be left unchanged.

Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.