Do You Know Your Homocysteine? One More Reason Why Your Should

The standard lab panel, if one is done at all, in a cardiology office, even a university clinic visit, harks back to the 1980s, as nothing has changed. One of the lab tests that should be routinely done, at least in the experience of the Kahn Center for Cardiac Longevity, is the homocysteine (HC) level. This is a marker of diet, B vitamin adequacy, genetic input (MTHFR and methylation),  and directly causes endothelial dysfunction, hypertension, and other poor outcomes. 

 

Homocysteine is an amino acid. Vitamins B12, B6 and folate break down homocysteine to create other chemicals your body needs. High HC levels may mean there is a vitamin deficiency. Without treatment, elevated HC increases the risks for blood clots, heart disease and stroke.

 

A new study now indicates that the higher the HC level, the greater the risk of congestive heart failure (CHF). In our opinion, everyone needs to have their HC level measured and managed. 

 

The new study examined the relationship between HC, CHF overall, and CHF subtype (CHF with preserved ejection fraction [HFpEF] and CHF with reduced ejection fraction) in the Multi‐Ethnic Study of Atherosclerosis cohort.

 

Multi‐Ethnic Study of Atherosclerosis participants with baseline HC and CHF data were included (N=6765). The data were stratified by impaired fasting glucose/type 2 diabetes status, and the combined impact of elevated HC and impaired fasting glucose/type 2 diabetes on CHF incidence was examined.

Elevated HC (>12 μmol/L) was statistically significantly associated with CHF overall and HFpEF, and conferred a higher risk for CHF overall among individuals with dysglycemia impaired fasting glucose/type 2 diabetes compared with those with normoglycemia.

Additionally, there was a statistically significant increased risk of CHF overall and CHF with reduced ejection fraction and a trend towards increased risk of HFpEF in individuals with both elevated HC and dysglycemia.

HC appears to be a more significant contributor to HFpEF risk than dysglycemia, whereas dysglycemia seems to be more important in driving CHF with reduced ejection fraction risk.

This study confirms an association between hyperhomocysteinemia (HC) and CHF risk in a large, multi‐ethnic cohort.

This is the first study to demonstrate that the impact of HC differs by CHF subtype and appears to contribute more to HFpEF risk (preserved ejection fraction) than CHF with reduced ejection fraction risk (cardiomyopathy).

 

What is unknown is whether if the HC level is reduced with higher doses of methylated B-vitamins, like those used at the Kahn Center, is the risk for CHF reduced. This is an important outcome to determine. Fortunately, B complex vitamins are safe and inexpensive so it would make sense to measure and treat elevated HC levels. 

At the Kahn Center, the B complex we prefer is Homocysteine Supreme by Designs for Health, 2 capsules a day. https://shop.drjoelkahn.com/homocysteine-supremetm-120-vegetarian-capsules.html