Homocysteine is an amino acid formed in the body from another amino acid called methionine. Certain B vitamins are needed to breakdown these amino acids. The vitamins include
vitamin B12, and
folate. A deficiency of any one of these vitamins, most particularly folate, can lead to an elevation in blood levels of homocysteine.
Levels of homocysteine increase with age, and elevation is more common in men and postmenopausal women. Although some studies have found an association with high homocysteine levels and heart disease, whether or not homocysteine is a risk factor for heart disease remains controversial.
During the last several years, a connection between mild to moderate elevations of homocysteine and heart disease has shown up in some, but not all studies. Organizations like the American Heart Association (AHA) do not currently identify high homocysteine levels as a major risk factor for cardiovascular disease.
Do not be surprised if your doctor is somewhat reluctant to measure your homocysteine level. If other risk factors for heart disease are already present, knowing that your homocysteine level is elevated most likely not change your treatment. However, according to the AHA, getting screened for homocysteine levels may be useful if you have a personal or family history of cardiovascular disease and do not have the common risk factors, like smoking, high blood pressure, high cholesterol.
Homocysteine levels are reduced when intake of folate, vitamin B6, and vitamin B12 is increased. However, studies have not shown that taking these vitamins can prevent or treat cardiovascular disease.
The AHA suggests that people at high risk should make sure they are getting enough folate, vitamin B6, and B12 in their diet. Your doctor can give you specific recommendations about the appropriate dosages for you. Here are the general recommendations for daily intake of folate, vitamin B6, and B12: Folate Males and females aged 14 and older—400 micrograms (mcg)Vitamin B6 Males aged 19-50 years—1.3 milligrams (mg)Males aged 51 years and older—1.7 mgFemales aged 19-50 years—1.3 mgFemales aged 51 years and older—1.5 mgVitamin B12 Males and females aged 14 years and older—2.4 micrograms
Here are a few examples of foods that are high in these vitamins: Folate—citrus fruits, fortified breakfast cereal, vegetablesVitamin B6—fortified breakfast cereal, bananas, baked potatoes with skinVitamin B12—fortified breakfast cereal, fish, meat, poultry, and dairy products
If you are concerned about your risk factors for heart disease or if you would like to take supplements, talk to your doctor to decide what the best approach would be based on your health and diet.
Folate. Office of Dietary Supplements—National Institutes of Health website. Available at: https://ods.od.nih.gov/factsheets/Folate-HealthProfessional. Updated April 20, 2016. Accessed December 9, 2016.
High homocysteine level: How it affects your blood vessels. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/high-homocysteine-level-how-it-affects-your-blood-vessels. Updated May 2014. Accessed December 9, 2016.
Liem A, Reynierse-Buitenwerf GH, Zwinderman AH, Jukema JW, van Veldhuisen DJ. Secondary prevention with folic acid: effects on clinical outcomes. J Am Coll Cardiol. 2003;41(12):2105–2113.
Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA. 2002;288(8):973–979.
Vitamin B6. Office of Dietary Supplements—National Institutes of Health website. Available at: https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional. Updated February 11, 2016. Accessed December 9, 2016.
Vitamin B12. Office of Dietary Supplements—National Institutes of Health website. Available at: https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. Updated February 11, 2016. Accessed December 9, 2016.
Last reviewed December 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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