Homocysteine and Your Health

Contributed by: Holly J. Ruder, Pharm.D. Candidate

KU School of Pharmacy

Text Box: What is homocysteine?
Homocysteine is an amino acid that is produced by the body, usually as a byproduct of consuming meat. It is used by the body to make protein and build and maintain tissue. The only source of homocysteine for use in our bodies is that which is formed by the liver after the ingestion of another amino acid, methionine. Methionine is found in protein foods. Animal protein contains two to three times the amount of methionine as does plant protein. What causes elevated homocysteine levels?
Homocysteine is chemically transformed into other amino acids called methionine and cysteine with the help of folic acid, vitamin B12, and vitamin B6. Therefore, insufficient amounts of these vitamins in the body can hinder the natural breakdown of homocysteine. This can cause homocysteine to accumulate in the blood. How can homocysteine levels be lowered?
The consumption of folic acid supplements or cereals that are fortified with folic acid, and to a lesser extent vitamins B6 and B12, can lower blood homocysteine levels. Homocysteine levels should be medically tested to ensure that the proper combination and dosages of supplements are taken. Dosages should be adjusted based on individual needs. How do elevated levels of homocysteine increase the risk of heart attacks and strokes?
Homocysteine is a potent toxin to the cells that line the blood vessels and can contrib

Text Box: ute to vascular disease in several manners. Elevated levels of homocysteine in the blood are believed to cause narrowing and hardening of the arteries. This narrowing leads to diminished blood flow through the affected arteries. Elevated levels of homocysteine in the blood also cause the blood to clot easier. Blood clots inside the arteries further diminish the flow of blood. The resultant lack of blood supply to the heart muscle causes heart attacks, and the lack of blood supply to the brain causes strokes. What are some good sources of folic acid and vitamins B6 and B12? Cereal grains are the main source of folic acid. Fruits and vegetables have significant amounts of vitamin B6, and vitamin B12 can be found in red meats, poultry, fish, and other seafoods. People with high homocysteine levels also may benefit from taking multivitamins to supplement this amount. Does lowering homocysteine levels prevent heart attacks and strokes?
Currently, there is no direct proof that taking folic acid and B vitamins to lower homocysteine levels prevents heart attacks and strokes. However, in a large population study involving women, those who had the highest consumption of folic acid (usually in the form of multivitamins) had fewer heart attacks than those who consumed the least amount of folic acid. What should I do to prevent heart attacks and strokes?
Losing excess weight, exercising regularly, controlling diabetes and high blood pressure, lowering the bad LDL

Text Box: cholesterol, and stopping cigarette smoking are important steps in preventing heart attacks and strokes. Who should undergo testing for homocysteine blood levels?
Currently, there are no official recommendations as to who should undergo testing for homocysteine blood levels. Until results of controlled clinical trials become available, population-wide screening is not recommended. A decision regarding testing should be individualized after consulting with your physician. However, you should try to consume plenty of folate and vitamins B6 and B12 in your diet by eating vegetables, fruits, beans, meats, fish, and fortified grains and cereals. Could any medications I may be taking have an effect on my homocysteine level? Yes. There are numerous drugs that may either increase or decrease the amount of homocysteine in your body. You should always keep your physician and pharmacist aware of any medications, traditional or herbal, you are taking, since they may interfere with the test results. For more information talk to your pharmacist or physician or visit the American Heart Association website

Relief is in Sight (continued)

Contributed by: Tammy Stack, Pharm.D.

Community Pharmacy Resident

Text Box: Vitamin A is found in dark green and yellow vegetables and yellow fruits, such as broccoli, spinach, turnip greens, carrots, squash, sweet potatoes, pumpkin, cantaloupe, and apricots, and in animal sources such as liver, milk, butter, cheese, and whole eggs. Vitamin C is found in many fresh vegetables and fruits, such as broccoli, raw green and red peppers, collard

Text Box: greens, Brussels sprouts, cauliflower, lemon, cabbage, pineapples, strawberries, citrus fruits. Vitamin E is found in margarine and vegetable oil (soybean, corn, safflower, and cottonseed), wheat germ, green leafy vegetables. For more information, ask your pharmacist or your eye care practitioner for the best

Text Box: products for your use. For more information see the websites www.stlukeseye.com/Conditions/DryEyeSyndrome.asp or www.allaboutvision.com/conditions/dryeye.htm.