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Homocysteine (cont.)

What are high homocysteine levels?

Most laboratories report normal homocysteine levels in the blood between 4 and 15 micromoles/liter (µmol/L). Any measurement above 15 is considered high. Optimal homocysteine levels are below 10 to 12.

Hyperhomocysteinemia has been classified into moderate, intermediate, and severe types based on the level of homocysteine as follows:

  • Moderate (15 to 30 µmol/L)
  • Intermediate (30 to 100 µmol/L)
  • Severe (greater than 100 µmol/L)

What causes elevated homocysteine levels?

Homocysteine levels increase in the body when the metabolism to cysteine of methionine to cysteine is impaired. This may be due to dietary deficiencies in vitamin B6, vitamin B12, and folic acid.

While alcoholics tend to be malnourished and lacking in B vitamins, alcohol itself may independently cause homocysteine levels in the blood to rise.

Can elevated homocysteine levels be hereditary?

Genetic abnormalities may affect the body's ability to metabolize homocysteine in to cytsteine, causing elevation of homocysteine levels in the blood and urine. Screening is often suggested in infants if there is a family history of this disease.

How can homocysteine levels be lowered?

The treatment for homocysteinuria is vitamin supplementation with pyridoxine (vitamin B6), vitamin B12, and folic acid. The effects of vitamin treatment may be monitored by routine, scheduled blood tests. However, evidence to support the value of treating elevated blood levels of homocysteine (except in cases of severely high levels) in the general population is lacking. Therefore, it is not recommended that people be treated with vitamins to lower homocysteine levels as a way to prevent vascular disease.

Some patients do not respond to the vitamin supplementation and are considered pyridoxine-resistant. A diet low in methionine is recommended in addition to the B vitamins.

Medically Reviewed by a Doctor on 2/22/2016

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