Homocysteine

What To Think About

• It is unclear whether elevated homocysteine levels alone increase your risk of heart disease. Your overall risk factors for heart disease must be evaluated along with your homocysteine levels. The relationship between homocysteine and cardiovascular disease is being studied in clinical trials.
• If your homocysteine blood level is high, you may use diet and medicine to lower your homocysteine levels. It is not clear whether treatment will reduce your risk for coronary artery disease.
• A urine test may be done to help detect and monitor homocystinuria. However, a blood test is more accurate.
• Homocysteine testing may be most valuable in evaluating the overall risk of heart disease for people who have a strong personal or family history of heart disease but who do not have other risk factors that can be controlled, such as smoking or high blood pressure.
• Studies are currently being done to determine the effect of B vitamin supplements on homocysteine levels. But recent studies have shown that folic acid and B vitamin supplements may not lower the risk of heart disease or stroke.^{1, 2} The American Heart Association recommends a healthy, balanced diet to provide the recommended dietary amounts of folic acid and B vitamins.
• Research does not clearly show that treating people who have high homocysteine levels and had certain types of stroke will lower their chance of having another stroke. Many doctors recommend that these people take a multivitamin to be sure they get enough folic acid (400 micrograms or µg), vitamin B6, and vitamin B12. Talk to your doctor to see if you may benefit.
• For more information on folic acid and vitamin B12, see the medical tests Folic Acid and Vitamin B12.

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Author:	Jan Nissl, RN, BS	Last Updated: March 5, 2007
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Brian Leber, MDCM, FRCPC - Hematology
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