By lowering your homocysteine level you can reduce the risk of developing many diseases including heart disease, stroke, certain cancers, diabetes, depression and Alzheimer’s. Patrick Holford BSc, Dip.ION outlines the factors that cause homocysteine levels to increase and provides a ten-step plan on how to lower it with diet and supplements
Forget your blood pressure, your cholesterol level, and even your weight. There is one indicator that can determine better than any other, whether you will live a long and healthy life, or die young. It’s the level of homocysteine in your blood.
Having a high homocysteine level isn’t just associated with a greater risk of heart disease, it actually causes heart disease. Homocysteine is a type of protein produced by the body and found in the blood that, ideally, should be present in very low quantities. However, if you are not optimally nourished, homocysteine can and does accumulate, increasing your risk of over 50 diseases, including heart disease, stroke, certain cancers, diabetes, depression and Alzheimer’s disease. One in two people in Britain have high homocysteine levels and one in two people die from preventable diseases. The good news is that this new and important risk factor can be reversed in weeks.
WHAT IS HOMOCYSTEINE?
Homocysteine is produced from the amino acid methionine, which is found in normal dietary protein. The trouble is, if you don’t have optimal amounts of B vitamins in your diet, the enzymes that turn homocysteine into either glutathione (an important antioxidant), or SAMe (s-adenosyl methionine) (an important biological agent in the human body, participating in over 40 essential biochemical reactions), don’t work efficiently, so blood homocysteine levels increase. Also, it has been discovered that one in ten people have an inherited genetic mutation that makes them more prone to high homocysteine. This is because the MTHFR enzyme that converts homocysteine into SAMe doesn’t work so well. For these individuals to stay healthy, larger daily intakes of vitamin B12 and folic acid are necessary.
While the importance of antioxidants is now well established, the new buzz word in medicine is “methylation”. The ability for the body to maintain chemical balance hinges upon its ability to add or subtract molecules called methyl groups. This is how the body turns one compound into another. To make this clearer, imagine that all this talk about homocysteine and premature death is causing you to feel stressed. Your body responds by adding a methyl group to noradrenalin to produce adrenalin – the stress hormone. On learning that homocysteine is rapidly reversible, you relax. The body responds by removing a methyl group from adrenalin, turning it back into noradrenalin. This kind of chemical reaction occurs a billion times every second, keeping everything in balance.
If there was one measure of your antioxidant “IQ” it would be the level of glutathione inside your cells. Similarly, if there was one measure of your methyl “IQ” it would be the level of SAMe inside your cells. This is because SAMe can easily donate a methyl group, or accept one back, keeping the body’s biochemistry flexible. Normally, both SAMe and glutathione are made in the body from the amino acid methionine, via homocysteine. However, if the conversion of homocysteine is blocked in any way, homocysteine levels go up and SAMe and glutathione levels go down.
This is only half of the story. The other half is the discovery that homocysteine damages the brain, arteries and DNA. That’s why your homocysteine level is theoretically the most important indicator of the health and adaptability of your body’s total biochemistry, and your risk of developing degenerative diseases. But where’s the hard proof?
HEART ATTACKS AND STROKES – REDUCE YOUR RISK BY 75 PER CENT
The largest review of 92 studies by David Wald, specialist registrar in cardiology, and colleagues from the Department of Cardiology at Southampton General Hospital, examined the association between homocysteine levels and the risk for cardiovascular disease in 20,000 people.
They found that with every 5-unit increase in homocysteine measured in the blood, the risk for heart disease went up 42 per cent in those with the MTHFR gene mutation and 32 per cent in those without. The risk for stroke went up 65 per cent in those with the genetic mutation and 59 per cent in those without. The researchers concluded that these “highly significant results indicate strong evidence that the association between homocysteine and cardiovascular disease is causal.” (1) This means that having a high homocysteine level isn’t just associated with a greater risk of heart disease, it actually causes heart disease – a conclusion that is being reached by other research groups. (2)
While the average homocysteine level – or H score - is approximately 10 units, an ideal level is 6 units or below. Those with a history of cardiovascular disease often have a homocysteine level above 15 units. By lowering a high homocysteine level from 16 to 6 units, a 10-point drop, the risk of heart disease could be cut by 75 per cent! This is not only a much more substantial risk reduction than can be achieved by lowering cholesterol, it’s also more attainable.
CANCER – CUT YOUR RISK BY A THIRD
Cancer is about 85 per cent preventable. Research published in the New England Journal of Medicine, describing a study involving 45,000 pairs of twins, found that cancer is more likely to be caused by diet and lifestyle choices than by genes. Identical twins, who are genetically the same, had no more than a 15 per cent chance of developing the same cancer. This suggests that the cause of most cancers is about 85 per cent environmental – that is, down to factors such as diet, lifestyle and exposure to toxic chemicals. This study found that choices regarding diet, smoking and exercise accounted for 58 to 82 per cent of cancers studied. (3)
So where does homocysteine come in to all this? Cancer is triggered by damage to DNA – and having a high homocysteine level means your DNA is more vulnerable to damage, and poorly repaired once the damage has occurred. At the other end of the scale, homocysteine levels have been found to be a very good indicator of whether cancer therapies are working. The homocysteine level rises when tumours grow, and falls when they shrink. Forms of cancer already clearly linked to high homocysteine include cancer of the breast and colon, and leukaemia, among others. Low homocysteine is likely to reduce your risk of these cancers by a third.
DIABETES – LOWER YOUR RISK
Type 2 (non-insulin dependent) diabetes is highly preventable, yet more and more young people are developing it. The obesity “epidemic” in the West has helped fuel this rise. If you are obese, the risk of developing diabetes goes up 77 times! Diabetics are at risk of having high homocysteine because it is now known that the abnormally raised insulin seen in most diabetics stops the body from lowering and maintaining a healthier homocysteine level. By following a homocysteine-lowering diet, plus taking appropriate supplements, you will be able to reduce your risk of diabetes or, if you are diabetic, you’ll be able to help keep it under better control and reduce complications.
ALZHEIMER’S DISEASE – HALVE YOUR RISK
The evidence indicates that if you can lower your homocysteine level, you will significantly lower your risk of developing Alzheimer’s disease. Homocysteine is strongly linked to damage in the brain. Dr Matsu Toshifumi and colleagues at Tohoku University, Japan, conducted brain scans on 153 elderly people and checked the results against each individual’s homocysteine level. The evidence was crystal clear – the higher the homocysteine, the greater the damage to the brain. (4) A recent study in the New England Journal of Medicine charted the health of 1,092 elderly people without dementia, measuring their homocysteine levels. Within the following eight years, 111 were diagnosed with dementia. Eighty-three of this group were diagnosed with Alzheimer’s. Those with high blood homocysteine levels (in this study, above 14 units) had nearly double the risk of Alzheimer’s. These studies strongly suggest that following a homocysteine-lowering regime should, at the very least, halve your risk of developing Alzheimer’s disease in later life. (5)
HALVE YOUR RISK OF DEATH FROM ALL CAUSES
One of the best ways to extend your lifespan is by reducing your homocysteine level. With every five-point decrease in your H score, you will gain:
A 49 per cent reduced risk of death from all causes A 50 per cent reduced risk of death from cardiovascular disease A 26 per cent reduced risk of death from cancer A 104 per cent reduced risk of death from causes other than cancer or heart disease
These are the extraordinary findings from a comprehensive research study at the University of Bergen in Norway, published in 2001 in the American Journal of Clinical Nutrition.6 Scientists measured the homocysteine levels of 4,766 men and women aged 65 to 67 back in 1992, and then recorded any deaths over the following five years, during which 162 men and 97 women died. They then looked at the risk of death in relation to their homocysteine levels. Remarkably, they not only reconfirmed the relationship between heart attacks, stroke and high homocysteine, but also observed that “a strong relation was found between homocysteine and all causes of mortality.” In other words, homocysteine is an accurate predictor of how long you are going to live, whatever the eventual cause of death may be!
If you are already in your fifties or sixties, you might be tempted to view all this news with gloom. But with a tried and tested solution the news is all good, because you can begin to do something about it right now.
It was formerly believed that a “high” homocysteine level was above 15 units. But now, levels as low as 7 units are being linked to increased disease risk
MEASURING YOUR HOMOCYSTEINE LEVEL
Your homocysteine level is easy to measure at home. York test Laboratories (call 0800 074 6185 or visit www.yorktest.com) offers a home test kit that requires just a pin prick of blood. You put a drop of blood onto a card which separates and stabilises the plasma portion of the blood. You then send in your card and you’ll know your H score within days.
Homocysteine is measured in mmol/l. It was formerly believed that a “high” homocysteine level was above 15 units. This is what increases your risk of a heart attack and doubles your Alzheimer’s risk. But now, levels as low as 7 units are being linked to increased disease risk. Basically, there’s no safe level and no guarantee that the diet and supplements you are currently taking are keeping your homocysteine level at bay. Up to 30 per cent of people with a history of heart disease have a homocysteine level above 14 units. The average level in Britain is 10.5. What you want is a level below 6 units. If you have any of the associated risk factors below, it’s especially important to get your homocysteine level tested.
HIGH HOMOCYSTEINE RISK FACTORS
Inherited genetic mutation (abnormal functioning of the MTHFR enzyme) Family history of heart disease, stroke, cancer,Alzheimer’s disease, schizophrenia, diabetes Folic acid deficiency Increasing age Male sex Oestrogen deficiency Excessive alcohol, coffee or tea intake Smoking Lack of exercise Hostility and repressed anger Inflammatory bowel diseases (coeliac disease, Crohn’s disease, ulcerative colitis) H.pylori-generated ulcers Pregnancy Strict vegetarian or vegan diet (due to a possible lack of vitamin B12) High fat diet, excessive red meat and/or dairy intake High salt intake
LOWERING YOUR HOMOCYSTEINE LEVEL
Whatever your homocysteine level is, you can lower it with the right combination of nutrients and diet, together with lifestyle changes designed to reduce your risk. Follow the H Factor Diet below.
THE TEN-STEP H FACTOR DIET
Eat Less Fatty Meat, More Fish and Vegetable Protein
Eat no more than four servings of lean meat a week; eat unfried fish at least three times a week; and if you’re not allergic or intolerant, have a serving of a soya-based food (such as tofu, tempeh or soya sausages) or beans, such a kidney beans, chickpea hummus or baked beans, at least five times a week.
Eat Your Greens
Have at least five servings of fruit or vegetables a day. This means two pieces of fruit every day, and three servings of vegetables. Vary your selection from day to day. Make sure half of what’s on your plate for each main meal is vegetables.
Have a Clove of Garlic a Day
Either eat a clove of garlic a day, or take a garlic supplement. You can take garlic oil capsules or a powdered garlic product.
Don’t Add Salt to Your Food
Don’t add salt while you’re cooking or to the food on your plate. The only salt that is considered reasonably healthy is a product called Solo, which has half the sodium of table salt, together with potassium and magnesium. If desired, this can be used in moderation instead.
Cut Back on Tea and Coffee
Don’t drink more than one cup of caffeinated or non-caffeinated coffee, or two cups of tea a day. Instead choose from the wide variety of herbal teas and grain coffees available.
Limit Your Alcohol
Limit your alcohol intake to no more than half a pint of beer, or one glass of red wine a day. Ideally, limit your intake to two pints of beer or four glasses of wine a week.
Reduce Your Stress
If you are under a lot of stress, or find yourself reacting stressfully much of the time, make a decision to reduce your stress load, both by changing the circumstances that are causing you stress and by changing your attitude. Simple additions to your life, such as yoga, meditation and/or exercise, or seeing a counsellor if you’ve got some issues to resolve, can make all the difference.
Stop Smoking
If you smoke, make a decision to stop, and seek help to do it. There is simply no safe level of smoking as far as homocysteine and your health is concerned. Smoking is nothing less than slow suicide. The sooner you stop the longer you’ll live.
Correct Oestrogen Deficiency
If you are postmenopausal, or have menopausal symptoms or other menstrual irregularities, check your oestrogen and progesterone levels with a hormone saliva test (available from Higher Nature on 01435 882880). If you are oestrogen or progesterone deficient, you can correct this with “natural progesterone”, in the form of a transdermal skin cream. Natural progesterone has none of the associated risks of HRT and your body can make its own oestrogen from progesterone.
Supplement a High-Strength Multivitamin and Mineral Every Day
Take a high-strength multivitamin and mineral supplement, providing at least 25 mg of the main B vitamins, 200 µg of folic acid and 10 µg of B12, plus vitamins A, D, E and the minerals magnesium, selenium, chromium and zinc. Also supplement 1 gm of vitamin C daily for general health.
HOMOCYSTEINE-LOWERING SUPPLEMENTS
The most powerful and quickest way to restore a normal H score, below 6 units, is to supplement specific homocysteine-lowering nutrients. These include vitamins B2, B6, B12, folic acid, tri-methyl glycine (TMG) and zinc. Here are the guidelines.
The current vogue to lower homocysteine is by recommending folic acid, however this alone is far less effective than the right nutrients in combination. The amount you need also depends on your current homocysteine level. One study found that H scores were reduced by 17 per cent with high dose folic acid alone, 19 per cent with B12 alone; 57 per cent with folic acid plus B12; and 60 per cent with folic acid, B12 and B6 in combination.(7) All this was achieved in three weeks!
The combination of supplements recommended, plus correct diet, has the potential to halve your homocysteine score in weeks However, even better results would have been achieved by including TMG. TMG is the best “methyl donor” to take as a supplement; even better than SAMe. This is because it can immediately donate a methyl group to homocysteine, thus detoxifying it. (See Figure 2 opposite)
In a study in New Zealand, patients with chronic kidney failure and very high homocysteine levels, homocysteine was reduced by a further 18 per cent when 4 gm of TMG was given, along with 50 mg of B6 and 5,000 µg of folic acid, compared to patients taking just B6 and folic acid.(8) Some supplement companies produce combinations of these nutrients such as Solgar’s Homocysteine Modulators or Higher Nature’s H Factors. These are the most cost-effective supplements for restoring a healthy homocysteine level.
The combination of supplements recommended, plus the diet, has the potential to halve your homocysteine score in weeks. The goal is to achieve an H score of 6 or below. Mine is 4.5. Your H score is probably the best objective measure of whether you are achieving optimum nutrition.