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November 2003

Startling New Findings About Homocysteine
William Faloon

Several years ago, we made an alarming discovery! People who had previously been in safe ranges were calling us to report that their new blood tests revealed markedly higher homocysteine levels.

We expected to see some elevation, as homocysteine levels are known to rise during normal aging. What startled us was the magnitude of increase that occurred in as little as one year. In some cases, this sharp rise in homocysteine was accompanied by the onset of a degenerative disorder (angina, stroke, renal impairment, aortic stenosis, memory loss, depression, etc.).

In response to our findings, we alerted members about the importance of testing their blood annually to guard against unexpected surges in cardiovascular risk factors such as homocysteine, C-reactive protein, and low-density lipoprotein (LDL).

Newly published studies are confirming the observations we first made in the late 1990s. In the latest study, a startling 100% of French elderly hospitalized patients showed higher than desired homocysteine levels, with 45% suffering from severe hyperhomocysteinemia (blood homocysteine greater than 18 µmol/L).1

Some physicians still define excess homocysteine as blood levels greater than 15-18 µmol/L. Published studies, on the other hand, indicate that keeping homocysteine below 7-8 µmol/L is ideal for reducing the risk of lethal diseases.2

In a three-year study of 600 Italian elderly hospitalized patients, the mean fasting homocysteine level was a frighteningly high 16.8 µmol/L. Patients with hyperhomocysteinemia in this study showed a greater prevalence of serious disease states, such as vascular and cognitive disorders.3

In a German paper titled Hyperhomo-cysteinemia In Advanced Age, the following conclusions where made as it relates to homocysteine and age-related disease:4

  • Hyperhomocysteinemia often occurs with advanced age
  • Impairment of physical condition or social situation seems to increase the risk of hyperhomocysteinemia
  • Administration of vitamins B6 and B12, and folate, causes a significant decrease of elevated serum homocysteine concentrations in older persons
  • Homocysteine-lowering treatment should improve the prevention of chronic diseases.

No Safe Range
The clear message from scientific findings is that there is no safe “normal range” for homocysteine. While commercial laboratories state that normal homocysteine can range from 5 to 15 micromoles per liter (µmol/L) of blood, epidemiological data reveal that homocysteine levels above 6.3 cause a steep progressive risk of heart attack (see the American Heart Association’s journal Circulation).2 One study found that each 3-µmol/L increase in homocysteine caused a 35% increase in heart attack risk.10

One reason Life Extension recommends homocysteine levels be kept below 7-8 mmolL is that this is about the best an aging person can realistically accomplish, even when taking high doses of vitamin B6, TMG, and other homocysteine-lowering nutrients.

The chart above illustrates the results of the American Heart Association study: incremental increases in homocysteine levels correlate with increased risk for coronary artery disease. Levels of risk: 15.0=high risk; 9.0=moderate risk; 7.0=low risk.

The Homocysteine “Hypothesis” of Degenerative Disease
Life Extension members were warned about the dangers of high homocysteine way back in 1981 and were advised to take folic acid, along with vitamins B12 and B6, to reduce it.

Throughout the 1980s, many doctors debunked the “hypothesis” that homocysteine was a risk factor for heart attack.5-7 Beginning in the mid-1990s, however, the findings from large human trials concluded that high homocysteine levels were associated with a significantly greater risk of heart attack and stroke.

More recent studies not only confirm the cardiovascular dangers of homocysteine, but also its toxic effect on the brain. It turns out that high blood levels of homocysteine increase the incidence of depression, memory impairment, and even Alzheimer’s disease.

The latest findings reveal that elderly people with common degenerative diseases frequently present with very high levels of homocysteine.

The medical establishment woke up to the dangers of homocysteine when The New England Journal of Medicine and The Journal of the American Medical Association (JAMA) published articles suggesting that vitamin supplements be used to lower homocysteine levels.8-9

The evidence that homocysteine increased heart attack risk was substantial in 1981. It is regrettable that 22 years later, most doctors still do not recognize homocysteine as a toxic amino acid that should be reduced in the bloodstreams of all their aging patients.

What Doctors Are Overlooking
Optimal blood homocysteine levels are under 7 mmol per liter of blood, yet newly published research findings confirm that as humans grow older, homocysteine levels increase substantially. High homocysteine has been linked to many common age-related diseases including vascular occlusion, kidney failure, and dementia. A consistent finding in these studies is that hyperhomocysteinemia is associated with poor nutritional status.

Some doctors now recognize the lethal role that homocysteine plays in the development and progression of common degenerative diseases. These doctors, however, seldom treat their patients in a scientific manner. For instance, patients with high homocysteine levels are sometimes told to take a folic acid supplement or moderate doses of vitamin B12, vitamin B6, and folic acid. Homocysteine blood levels are rarely checked again. These vitamin-prescribing doctors assume that homocysteine will be adequately lowered as long as the patient takes the recommended dose of vitamins, which is often the same dose recommended for all their patients.