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- Patient Comments: Homocysteine - Elevated Levels
- Patient Comments: Homocysteine - Lowering Levels
- Patient Comments: Homocysteine - Testing
- What is homocysteine (definition), and when was it discovered?
- What are hyperhomycysteinemia and homocystinuria, and how are the inherited (genetic)?
- How many people have elevated homocysteine levels, and who gets the condition?
- Does a lowering homocysteine level prevent heart attacks and strokes?
- How can homocysteine levels be lowered?
- Who should get tested for elevated homocysteine levels, and how is it treated?
How can homocysteine levels be lowered?
Eating cereals that are fortified with folic acid, and to a lesser extent vitamins B6 and B12, can lower blood homocysteine levels. These supplements may even be beneficial in people with mild genetic hyperhomocysteinemia to lower their homocysteine levels. However, it is noteworthy that so far there is no compelling data to support the treatment of hyperhomocysteinemia for prevention of heart disease or treatment of known heart disease or blood clots. Homocysteine levels are not routinely measured in people with heart disease (atherosclerosis) or other diseases.
Who should get tested for elevated homocysteine levels, and how is it treated?
Currently, there are no official recommendations as to who should undergo testing for homocysteine blood levels. Before more scientific data become available from the currently ongoing studies, many experts do not recommend a screening test for blood homocysteine levels, even in patients with unexplained blood clot formation. In addition, the consensus recommendation is against treating elevated homocysteine levels with vitamins to prevent heart disease. Rarely, a few specialists may test for elevated homocysteine levels in patients with early onset of blood clot formation, heart attacks, strokes, or other symptoms related to atherosclerosis, especially if these patients do not have typical risk factors, such as smoking cigarettes, diabetes, high blood pressure, or high LDL cholesterol levels and they suspect genetic causes
There is also no consensus as to the optimal dose of folic acid and other B vitamins for the treatment of elevated blood homocysteine levels. (For example, treatment of patients with high homocysteine levels may require higher doses of folic acid and other B vitamins than the amounts contained in a multivitamin.) Therefore, a decision regarding testing should be individualized after consulting with your doctor and/or a specialist in genetic diseases.
American Heart Association. Homocysteine, Folic Acid and Cardiovascular Disease.
Abrahaham, MD, J.M. et al. The homocysteine hypothesis: Still relevant to the prevention and treatment of cardiovascular disease? Cleveland Clinic Journal of Medicine December 2010 vol. 77 12 911-918.
UpToDate. Overview of homocysteine.