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Homocysteine: What Your Level Means

Updated: Jan 2, 2023

One of the most important markers on the blood panel is homocysteine. Homocysteine is an amino acid and part of the methylation cycle, which is one of the most important detox pathways in the human body. If homocysteine is high, then methylation is impaired by a lack of methylfolate, methyl B12, and other cofactors. If homocysteine stays high for many years it becomes a big risk factor for atherosclerosis and heart disease. High homocysteine is usually caused by mutations in the MTHFR c667t and other genes involved in the methylation cycle, or by simply a lack of methyl folate and methylB12 in the diet.


If homocysteine is low it’s also not great. It indicates there is an active CBS gene mutation that is causing homocysteine to be shunted down the transsulfuration pathway instead of being recycled back into methionine, and methylation is impaired. The problem is, when it goes down the other pathway, ammonia is produced, which is a neurotoxin, and methylation is not proceeding smoothly.


I have a CBS mutation, but we didn’t know if it was active or not until we tested it by adding some methyl B12. Sure enough, my homocysteine level dropped from 7.2 to 5.9. So we stopped the methyl’s and went back to hydroxy b12 until I got my CBS mutation to turn off.

In contrast, my husband has high homocysteine (15.0), so he needs lots of methyl folate and methyl B12. When homocysteine is high, it's very unlikely that CBS is active.


That’s why it’s difficult to recommend supplements before any testing is done. If I had randomly decided to take an active B complex , I’d have continued to produce ammonia and would have made myself more ill. Yet, I needed B vitamins. Just in the right form.



Optimal homocysteine levels fall between 6.0 and 7.2 for adults. For children, optimal is a bit lower.


B vitamins are vital to so many functions in your body. They are cofactors to practically everything, so get tested and get the right form for you.


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