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Homocysteine (cont.)

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Can nutritional problems cause elevated homocysteine levels?

The other more common (5%-7% of the population) and less severe type of elevated homocysteine level may be caused by nutritional deficiencies in folate, vitamin B6 and vitamin B12, chronic (long-term) kidney disease, and cigarette smoking.

As mentioned above, these vitamins are essential in the breakdown of homocysteine. In some studies, lower levels of these vitamins, especially folate, have been demonstrated in people with elevated homocysteine levels. On the other hand, other studies have suggested that adequate intake of folate, Vitamin B6, and Vitamin B12 have resulted in lowering of the homocysteine level. (3)

How common is hyperhomocysteinemia?

Mild hyperhomocysteinemia levels are seen in about 5%-12% of the general population. In specific populations such as, alcoholics (due to poor vitamin intake) or patients with chronic kidney disease, this may be more common. The severe genetic form, homocystinuria, is rare.

How can homocysteine levels be lowered?

The consumption of folic acid supplements or 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. There are many studies underway to determine whether there may be any benefit to treat high levels of homocysteine in patients with known heart disease or blood clots. Further recommendations may be available when these studies are completed. (4)

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