Homocysteine is a normal breakdown product of the essential amino acid methionine. High levels in the blood may irritate blood vessels leading to atherosclerosis (blockages in the arteries); cause cholesterol to change into oxidised low-density lipoprotein, which is also damaging to the arteries; cause the blood to clot more easily than it should increasing the risk of blood vessel blockages.

Increased homocysteine levels may also be a risk factor for the development of many other conditions, including stroke, thromboembolism (blood clots that can dislodge and cause stroke, heart attack, and other complications), osteoporosis, Crohn’s disease, ulcerative colitis, Alzheimer’s disease, death from diabetes, miscarriage, other complications of pregnancy, and hypothyroidism. Some experts believe that high homocysteine is linked to over 100 different disorders and by keeping levels normal or even low, many of these can be prevented.

Scientists have yet to prove that elevated homocysteine levels cause any of these diseases, even though up to 20% of people with heart disease have high homocysteine. However, most doctors believe that high homocysteine increases the risk of at least heart disease.

Homocysteine is normally broken down into the antioxidant protein glutathione or turned back into methionine for use by the body. These processes require adequate amounts of B vitamins, magnesium, zinc and folic acid in the diet. When these nutrients are not available, homocysteine builds up and reaches the levels which are toxic and damaging to health. Many nutritionists believe that our modern diet which relies heavily on processed foods is the main cause of high homocysteine levels.

Homocysteine levels in the blood can be checked using a simple blood test. Your doctor may be willing to do this for you, otherwise York Laboratories, do a test where you take a pin prick of blood at home and send it off for analysis.

Homocysteine levels (H Score) should ideally be 6 or under, 9 to 15 is considered high and above 15 very high risk. However, the good news is that levels can be reduced dramatically by dietary changes and appropriate supplementation. Studies at the University of Bergen in Norway have shown that reducing the H Score by 5 points reduced the risk of death from all causes by 49% and reduced risk of death from heart disease by 50%.

Nutritional Supplements that could help. (Refer to the individual supplement for cautions in use.)

Above 15 9 – 15 6 – 9 below 6
Very high risk high risk low risk no risk
Folic Acid 2000mcg* 1200mcg* 400mcg 200mcg
Vitamin B2 50mg 20mg 15mg 10mg
Vitamin B6 100mg 75mg 50mg 25mg
Vitamin B12 1500mcg 1000mcg 500mcg 250mcg
Magnesium 400mg 300mg 200mg 100mg
Zinc 20mg 15mg 10mg 5mg

* At these levels it is important that Vitamin B12 is also taken.

If the homocysteine score is below 9, most of the above nutrients can be obtained from a good high potency multivitamin such as Solgar or a high strength B complex.  Solgar and Higher Nature also make products specifically for reducing the H Score.

Consider the following if your H Score is very high and the above regime is not effective:

Supplement/Herb What it does Dosage
TMG Also known as betaine, TMG donates methyl groups to the vascular-damaging compound homocysteine, which converts it back to harmless methionine. 10-2000mg 3 times daily
Garlic To raise glutathione which lowers homocysteine. aged garlic supplement 3 times daily or a whole clove


Diet and Lifestyle Factors

  • Eat plenty of fresh fruit and vegetables, at least 5 portions a day. Wholegrains and pulses will also help provide the key nutrients which are needed.
  • Eat garlic and oily fish.
  • Cut out refined carbohydrates, processed, refined and junk foods from the diet.
  • Cut out coffee and keep tea intake to no more than 3 cups a day.
  • Drink no more than 4 units of alcohol a week. (2 pints of beer or 4 glasses of wine.)
  • Avoid foods which are high in methionine until homocysteine levels have normalised:- meat, dairy products, eggs. Use fish and vegetable proteins such as tofu, tempeh, soya milk, beans and hummus as a replacement.
  • Reduce stress levels by learning relaxation techniques.
  • Stop smoking.
  • Be aware that certain medications can raise levels of homocysteine. These include: methotrexate, corticosteroids, cyclosporin, metformin, L-dopa, cholestyramine, phenytoin, primidone, phenobarbital, sulphasalazine, protease inhibitors and theophylline. If you take these drugs you may wish to discuss alternatives with your doctor.

Suggested further reading:

  • Homocysteine explained
  • The effects of high levels

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