Dr. Sherman’s Integrative Approach to this Critical Heart Disease Risk Factor

Elevations in homocysteine are strongly associated with increased cardiovascular risk in all age and ethnic groups. In 1968, Dr. Kilmer McCully, a Harvard researcher, reported that a genetic defect that caused sharp elevations in homocysteine led to early, aggressive atherosclerosis and coronary heart disease.

Elevated homocysteine irritates the lining of the blood vessels, causing them to become scarred, hardened, and narrowed due to lack of repair caused by essential nutrient cofactor deficits. This loss of homeostatic repair increases resistance to blood flow, thus increasing the work the heart must do. Increased propensity for blood clotting- especially in people consuming too much Omega-6 and not enough Omega-3 fatty acids- further decreases or blocks the flow of blood through blood vessels, resulting in greater risk of strokes, heart attacks, dementia and a host of other problems.

Epigenetic risk and resilience in connection with homocysteine levels is related to methylation capacity-the body’s ability to move methyl groups around to make molecules more or less soluble as needed for cell functions and repair. Lower homocysteine levels are associated with improved tissue repair competence and reduced inflammation.

What is methylation and how does it affect homocysteine levels?

Methylation is a chemical reaction that occurs in every cell and tissue in our body. Our genes and our nutritional state control whether methylation runs slowly or quickly. The methylation process helps convert the potentially toxic amino acid (homocysteine) into a useful and necessary amino acid (methionine) with the help of mainly folate and vitamin B12. Every important function in our bodies is regulated by or depends on this process. If your body cannot methylate properly, toxins build up in your bloodstream and may eventually cause disease.

What is MTHFR genotyping and why is it important to get tested?

MTHFR is an enzyme that is involved in the metabolism of folate and homocysteine. Certain mutations in the gene coding for MTHFR produce an enzyme that is impaired and has reduced activity leading to high homocysteine blood levels, especially when folate levels are low. Having your MTHFR gene tested is important in determining your methylation status and providing information about potential causes of elevated homocysteine and approaches for addressing it.

Next Steps

Low homocysteine levels correlate with longer and healthier life; elevated levels are indicators of high risk of debilitating chronic illness. There are robust data to support homocysteine as a predictive biomarker for all-cause 10-year morbidity and mortality across all ethnic groups and geographies. Plasma homocysteine levels under 6 µmol/L predict a 10-year survival rate of around 99%. On the other hand, 10-year survival in people with homocysteine levels greater than 18 µmol/L is around 40%.

The methylation process can be almost completely fixed through diet, detoxification, and nutritional supplements, even if you have impaired methylation status. Elevated homocysteine levels will drop fairly quickly after a few weeks of supplementation with a special vitamin B complex and mineral cofactors. Further improvement occurs when phase 1, 2, and 3 detoxification supplements are added.
The first step in getting a handle on homocysteine and the inflammation it reflects is to have your plasma homocysteine levels measured and MTHFR genetic variant tested. Based on your results, Integrative Medicine of New Jersey will develop dietary, nutritional, and medical recommendations.

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