Homocysteine Levels: How They Affect Your Health

Hunter Bennett

Over the last few decades, researchers have taken a very deep dive into the various chemicals that appear within the human body. This has been done with the intent to determine how we can better manage our health.

As I am sure you can imagine, the accumulative results of this research have changed the way we look at health entirely.

And one area of particular interest relates to Hyperhomocysteinemia.

What is Hyperhomocysteinemia?

Hyperhomocysteinemia is a relatively new term used to describe a condition that occurs when your homocysteine levels become elevated beyond what would be considered ‘normal’ (Ganguly, 2015).

Homocysteine is a specific compound that has been placed under a whole lot of scrutiny since it was first discovered in 1932. To put it simply, this compound is a specific type of amino acid that is produced as a by-product during the normal synthesis of other amino acids.

In healthy cells, homocysteine is quickly converted to other products almost as soon as it is produced. Alternatively, in unhealthy cells (and in those suffering from hyperhomocysteinemia), its ability to be broken down is inhibited. Additionally, it begins to accumulate in the blood.

There are two distinct types of hyperhomocysteinemia:

A rare and severe genetic form that occurs when the enzyme involved in homocysteine metabolism is mutated. This renders it incapable of performing its role effectively. This obviously causes huge spikes in homocysteine levels.
A more common form is the result of certain pathogenic, lifestyle, and environmental factors. All of these collectively contribute to elevated homocysteine levels.

Now, I should note that hyperhomocysteinemia is of particular interest because it can have some rather serious health implications (Maron, 2009; Ansari, 2014).

You see, elevated levels of homocysteine have been shown to increase the risk for developing heart disease, peripheral vascular disease, stroke, dementia, osteoporosis. It can also contribute to a host of neurological disorders including Parkinson’s disease, multiple sclerosis, and epilepsy.

Increased levels of homocysteine have also been shown to contribute to increases in systemic inflammation, which can lower immune system function and further increase the risk of developing numerous diseases throughout the entire body (Lazzerini, 2007).

To summarise, hyperhomocysteinemia may, in fact, have a role in the development of nearly every chronic disease known to man – so yeah, its kind of a big deal.

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What are the causes of Hyperhomocysteinemia?

I have already mentioned that one form of hyperhomocysteinemia is genetic (and therefore unchangeable), while the other is driven by several different factors. As a result, when we are discussing causes, we are strictly talking about the latter of the two forms.

As I am sure you can imagine, there are a number of different lifestyle aspects that can contribute to the onset of the condition (Kim, 2018).

First and foremost, normal homocysteine metabolism is highly dependent upon three dietary vitamins, being folic acid, vitamin B12, and vitamin B6. Subsequently, a deficiency in any one of these three nutrients can contribute to the onset of hyperhomocysteinemia.

Secondly, hyperhomocysteinemia can be caused by some other key factors that limit homocysteine metabolism. These include:

Alcoholism
Kidney disease and renal failure
Thyroid dysfunction (normally low levels of thyroid hormones)
Anemia
Malignant tumors

Thirdly, certain drugs, such as cholestyramine, metformin, methotrexate, nicotinic acid (niacin), and oral contraceptive pills, have all been shown to influence the breakdown of homocysteine, thus having the potential to contribute to the disease.

What are the symptoms of Hyperhomocysteinemia?

Interestingly, hyperhomocysteinemia does not always cause any significant symptoms in adults – but fortunately, the nutritional deficiencies that underpin it do.

With this in mind, associated symptoms can include:

Pale skin
Weakness, fatigue, and lethargy
Tingling sensations in the hands, arms, legs, and feet
Dizziness
Unexplainable mood swings
Mouth sores
Cognitive decline, metal fatigue, confusion, and forgetfulness

So, if you find yourself experiencing any of these symptoms on a regular basis, then it is in your best interest to get checked out by a health professional ASAP.

How do they diagnose Hyperhomocysteinemia?

The way that Hyperhomocysteinemia is diagnosed is through a specific blood test. This test simply looks into how much homocysteine is in your blood.

With this in mind, a level of 15 μmol or more per liter of blood would indicate a diagnosable form of Hyperhomocysteinemia (Kang, 2018).

Why is this test important for your health?

Now, as I am sure you can imagine, this test has some obvious health implications.

First and foremost, it allows you to see if your homocysteine levels are higher than what we would deem to be ‘healthy’. This provides direct insight into your risk for developing the myriad of other diseases associated with elevated homocysteine.

Secondly, this same test can be used to see if you have a deficiency in folic acid, vitamin B12, or vitamin B6. As a result, it can be used to determine whether your high homocysteine levels are the result of a nutrient deficiency or a genetic factor.

Finally, through this diagnosis, this test allows you to determine an appropriate method of treatment.

Why do athletes perform this test?

Interestingly, over the last few years this particular test has been taken up by a number of athletic populations as a way to help track stress and recovery (Borrione, 2007).

It is well known that during times of high physical and psychological stress, homocysteine levels can increase, which can also drive up inflammation. This increase indicates that the body requires a period to adequately recover, in which training can then be adjusted accordingly.

As with the above scenario, this same test can also provide insight into the nutritional status of the athlete, which can similarly guide their dietary needs.

In this manner, it offers a simple test that athletes can use to help guide training, recovery, and diet.

Does Hyperhomocysteinemia effect liver health?

Moving away from athletic populations, there has been a growing body of research indicating that homocysteine levels may also have some interesting implications for the health and function of your liver (de Carvalho, 2013).

You see, your body can extract fatty acids from your blood and store them. They are stored within your cells, and less often, within your liver.

When homocysteine levels remain chronically elevated, it can lead to a reduction in insulin sensitivity (note: insulin is responsible for shuttling fatty acids from your blood and into your cells). Additionally, there is a direct increase in the amount of fatty acids found in your blood.

This pretty much means when you have elevated homocysteine levels, that you have more fat in your blood, but your body is less effective at taking that fat from the blood and putting it in your cells.

So, what happens?

Well, they are instead shuttled to the liver, where they can then be broken down and stored – again, in the liver.

First, this increase in load places a heap of stress on the liver. This can make it less effective at performing its many other functions. Secondly, this increase in liver fat storage this can lead to the physical accumulation of fat on your liver. This is an indicator of early non-alcoholic fatty liver disease.

In short, hyperhomocysteinemia has the potential to decrease liver health and contribute to liver disease. This is not good, given declines in liver health can lead to huge disruptions in nearly every aspect of human health.

Does exercise impact on homocysteine levels?

Now, I have already mentioned that in times of extreme training stress, athletes appear to see an increase in homocysteine levels.

Interestingly, this same phenomenon appears to occur in individuals from the general population (AKA you and me). An acute bout of exercise will cause a subsequent increase in homocysteine levels (Deminice, 2016).

However, it is important to note that this is strictly in response to a single bout of exercise.

On the other hand, chronic exercise (and the adaptations that come with it) in individuals with already high homocysteine levels instead offers some rather serious benefits – which are mainly typified by a reduction in homocysteine.

Endurance training and homocysteine levels

There is an abundance of research clearly demonstrating that individuals who have lower levels of cardiorespiratory fitness tend to have higher levels of homocysteine in their blood (Maroto-Sánchez, 2016).

This provides a clear indication that improved cardiovascular health and function may contribute to the improved metabolism of homocysteine throughout the body. This can, in turn, cause a subsequent improvement in health.

This is indeed a developing area of research. There is evidence to suggest that performing as little as 45 minutes of low-intensity aerobic activity, three times per week for a total of eight weeks, can cause significant reductions in blood homocysteine levels (Mahmoudi, 2018).

HIIT training and homocysteine levels

So we have touched on endurance training and its impact on homocysteine, but what about high-intensity interval training (HIIT)?

Well, the first thing to note is that there currently is no research clearly demonstrating the effect of long term HIIT on homocysteine levels. However, there is a study that looks into the acute effects of HIIT (Herrmann, 2003).

In this study, swimmers were separated into two groups. One did a three week intensive period of long-distance moderate intensity exercise. The other did three weeks of HIIT.

As you would expect, at the end of the three week training period, both groups saw a significant increase in their homocysteine levels. Interestingly, these increases were comparable between the two groups.

This research didn’t look into the long term of effects of this training after recovery had occurred. However, it would be reasonable to suggest that the improvement in fitness caused by HIIT would have corresponded with a subsequent reduction in resting homocysteine levels.

Resistance training and homocysteine levels

Improving cardiorespiratory fitness is often considered to be the gold standard when it comes to stave off declines in health and function. Research has shown time and time again that resistance training often offers comparable benefits.

However, in certain scenarios, it may even be better – as in the case of hyperhomocysteinemia.

Research has consistently shown that like aerobic exercise, a single bout of weight training will cause an immediate rise in blood homocysteine. However, when implemented over a longer duration, it will cause substantially greater reductions in chronic homocysteine levels (Tsai, 2015; Deminice, 2016).

Now, while this may look to suggest that you should choose resistance training over aerobic exercise, I would suggest that a combination of the two is best.

Are there any natural remedies to help treat Hyperhomocysteinemia?

In conjunction with exercise, there is also a number of natural remedies you can implement to help treat Hyperhomocysteinemia.

As an added bonus, each of these remedies has also been shown to help fight the inflammation associated with the disease. This has lead to marked improvements in health across the board.

These remedies include:

Diet: increase your intake of key vitamin-rich foods, including green leafy vegetables, beets, and berries. Decrease your intake of dairy and red meat.
Supplements: supplementing with folic acid, Vitamin B6, Vitamin B12, and Taurine have all been shown to reduce blood homocysteine levels.
Relaxation: both mindfulness and meditation have been shown to cause a significant reduction in stress and inflammation. Both are well known to contribute to the onset of hyperhomocysteinemia.

So, if you want to know how to lower your homocysteine levels (and the inflammation associated) using these remedies in conjunction with regular exercise is a great place to start.

Take Home Message

In conclusion, taking note of your homocysteine level is pretty darn important. They appear to have a link with nearly every disease known to man. Moreover, they can act as a sign of overtraining. They also offer an excellent way for athletes to monitor fatigue.

In this article we outline some great ways that you can keep on top of your homocysteine levels, so let us know what you think.

References

Ganguly, Paul, and Sreyoshi Fatima Alam. “Role of homocysteine in the development of cardiovascular disease.” Nutrition journal 14.1 (2015): 6.

Maron, Bradley A., and Joseph Loscalzo. “The treatment of hyperhomocysteinemia.” Annual review of medicine 60 (2009): 39-54.

Ansari, Ramin, et al. “Hyperhomocysteinemia and neurologic disorders: a review.” Journal of clinical neurology 10.4 (2014): 281-288.

Lazzerini, Pietro Enea, et al. “Hyperhomocysteinemia, inflammation and autoimmunity.” Autoimmunity reviews 6.7 (2007): 503-509.

Kim, Jihyun, et al. “Causes of hyperhomocysteinemia and its pathological significance.” Archives of pharmacal research (2018): 1-12.

Kang, Soo-Sang, and Robert S. Rosenson. “Analytic Approaches for the Treatment of Hyperhomocysteinemia and Its Impact on Vascular Disease.” Cardiovascular drugs and therapy (2018): 1-8.

Borrione, P., et al. “Hyperhomocysteinemia in winter elite athletes: a longitudinal study.” Journal of endocrinological investigation 30.5 (2007): 367-375.

de Carvalho, Sylene Coutinho Rampche, et al. “Plasmatic higher levels of homocysteine in non-alcoholic fatty liver disease (NAFLD).” Nutrition journal 12.1 (2013): 37.

Additional References

Deminice, Rafael, Diogo Farias Ribeiro, and Fernando Tadeu Trevisan Frajacomo. “The effects of acute exercise and exercise training on plasma homocysteine: A meta-analysis.” PloS one 11.3 (2016): e0151653.

Maroto-Sánchez, Beatriz, et al. “What do we know about homocysteine and exercise? A review from the literature.” Clinical Chemistry and Laboratory Medicine (CCLM) 54.10 (2016): 1561-1577.

Mahmoudi, Asghar, and Abbasali Gaeini. “Interaction of Endurance Training and Low-Calorie Diet on Homocysteine Levels. And Lipid Profile of Plasma in Males with Non-Alcoholic Fatty Liver Disease.”. Journal of Rehabilitation Sciences and Research 5.2 (2018): 46-52.

Herrmann, Markus, et al. “Comparison of the influence of volume-oriented training and high-intensity interval training on serum homocysteine. And its cofactors in young, healthy swimmers.” Clinical chemistry and laboratory medicine 41.11 (2003): 1525-1531.

Tsai, Chia-Liang, et al. “The effects of long-term resistance exercise on the relationship between neurocognitive performance. And GH, IGF-1, and homocysteine levels in the elderly.” Frontiers in behavioral neuroscience 9 (2015): 23.

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