Must-Know Labs: Your Homocysteine Levels
Once upon a time, Homocysteine was a lab value that was used to assess your risk of heart attack and stroke. It is not standard protocol to measure this anymore. As a matter a fact, nearly every patient or client I have worked with who has tried to get their primary care physician to run this number has been denied.
However, I couldn’t disagree more. Homocysteine is an important marker! Let’s explore some of the reasons why, as well as a few clinical observations I have made in regard to this value.
What is Homocysteine?
Homocysteine is an amino acid found in every cell of our body. Although the normal lab range for homocysteine is less than 10.4 umol/L, when placed on the finer-tuned ‘functional medicine scale,’ we prefer it to be nearer to 6-7 umol/L. That level is where it is both indicating optimal function and contributing to optimal function.
Homocysteine, when everything in the body is working as it should, is a precursor for some very important processes.
High Homocysteine and Thyroid Receptor Sensitivity
A thyroid receptor’s ability to bring active thyroid into the cell for use is a commonly overlooked dysfunction in thyroid metabolism. That means that, even if you had proper signaling, production, and conversion to the active form of thyroid hormone, it could still not be readily accepted into your cells for use. Having high Homocysteine decreases your receptor’s sensitivity to the active thyroid hormone.
Heart Attack, Blood Clot, and Stroke Risk
Having high Homocysteine levels rivals smoking cigarettes regarding risk factors for developing vascular diseases. High amounts of Homocysteine appear to damage the vascular endothelial cells (inner cells of the vascular tubes), which can create atherosclerosis. This is a problem because when you have damage to the endothelial cells, cholesterol catches onto those damaged areas and begins to form clots. It also oxidizes lipoproteins and inhibits angiogenesis, your body’s ability to make new vessels to supply blood to areas that aren’t getting enough.
High homocysteine has been implicated in age-related cognitive decline. Many neurodegenerative diseases, such as Alzheimer’s and dementia, have been linked to high Homocysteine. Memory impairment is strongly associated with high Homocysteine levels. Have you ever noticed that your memory declines when you are under massive stress? I know I have!
How Do Homocysteine Levels Rise and How To Reduce Them
Homocysteine rises above optimal levels in the case of genetic variants (MTHFR, MTR, MTRR, BHMT) or when there are vitamin and mineral deficiencies, stress, or consuming large quantities of meat and little-to-no veggies.
Over the years, I have observed that most of my patients have entered my practice with high Homocysteine, either above functional medicine ranges or above lab ranges. Many have markedly improved levels at their 3-month follow up after various lifestyle changes. However, I remained troubled by Homocysteine levels that would not budge in certain people. One day it hit me like a ton of bricks. “Oh my gosh! Those are all of my CEOs!”
That wasn’t 100% true, as I had some people from different professions and walks of life with high Homocysteine that seemed resistant to lowering, but EVERY ONE of my CEOs had this problem. Myself included! These people ate lots of green, leafy vegetables. They were taking the vitamins and minerals to properly process Homocysteine. Sometimes, relatively aggressively! The ONLY factor that remained was, you guessed it, stress.
As is customary for me, I once again used myself as a guineapig to determine how stress impacted Homocysteine levels. I desperately needed to unload some of my own stress, so I was happy to participate in this experiment.
I hired new staff, doubling the size of my prior team, allowing me to focus solely on patient care. I created a ‘paperwork day’ at the office so that when I was home with my family, I wasn’t quietly thinking about all the paperwork I also needed to get done at the office while fetching juice for my son, running my daughter to activities and holding my (then) 9-month-old.
During this six-month experiment, I took a very minimal amount of B12 and Folate lozenges and no multivitamins so that I could test my stress levels independent of any other factors. As it turns out, stress is a big freakin’ deal! My Homocysteine dropped from 14, a level that I start getting concerned for stroke or heart attack risk, to 7.5, a nearly ideal functional level of 6-7! WoooHooo!
Here’s your take away. Great nutrition, a talented health management team, and all the will-power in the world aren’t enough to see you to your best self if you are stressed out. You HAVE to learn to manage your stress levels. Make the hard choices. YOU are worth it. We love you all and want to see you living your best life. Every day.