Homocysteine is referred to as “the new cholesterol”. Isn’t that playing it down, because the consequences of high homocysteine levels are more diverse and also more dramatic?
dr Paul Hudson: I think that as a doctor and as a patient, you should understand the importance of both substances to health. According to the current state of knowledge, it is correct that permanently high homocysteine levels can cause significantly more health problems than high cholesterol levels. Because cholesterol mainly damages the blood vessels and primarily causes heart attacks and strokes. Homocysteine is responsible for significantly more diseases .
So why has the importance of high homocysteine levels been so neglected up until now?
This is certainly not due to medical research. In many studies, she has adequately documented the health hazard emanating from homocysteine. There is a problem with doctors and health insurance companies. They do not put the new and sometimes alarming findings into practice in a timely manner. One reason for this is that health insurance companies do not pay for the measurement of homocysteine values, although it is now undisputed among scientists that too high a value is one of the causes of many common diseases. “Especially from the age of 40, the risk of critical homocysteine levels increases with each year of life”
And which ones are they?
A study recently showed that homocysteine that has not been broken down can accelerate cell death in the brain and contribute to dementia and Alzheimer’s becoming widespread diseases. With homocysteine levels that are permanently too high, the risk of cardiac insufficiency, infarction, stroke, osteoporosis and eye diseases such as glaucoma increases significantly. This is why early diagnosis is so important.
How many Germans have high homocysteine levels?
As far as I know, there are no concrete figures, since doctors and health insurers do not keep statistics. But I hear from German colleagues who carry out regular homocysteine measurements in their private patients that around 40 percent of patients over the age of 50 and around 60 percent over the age of 60 have a critical value. This is because the aging cell metabolism works more slowly and is less and less able to obtain the necessary B vitamins from food, which reliably prevent too much homocysteine.
Can the values in young people also rise under certain circumstances?
Yes. Because the processing of the B vitamins in the metabolism is very complex, inflammation of the gastric mucosa, for example, can disrupt the absorption mechanism in the body’s cells. Even in teenagers. That’s why I advise all people with chronic stomach or intestinal problems – including young people – to have their homocysteine levels checked. Incidentally, I also give this advice to anyone who has chronic liver problems, since the liver plays a major role in the utilization of homocysteine.
Do risk groups such as vegetarians, vegans or overweight children have to have their homocysteine levels checked particularly carefully?
Yes, because vegetarians and vegans very often have a lack of vitamin B12 and therefore a possible homocysteine problem. That’s easy to understand because meat, fish and eggs have the highest concentration of vitamin B12. Incidentally, for a long time it was believed that the soy product tofu, for example, was also rich in vitamin B12. That was a fallacy, because tofu unfortunately only contains a substance that is chemically similar to the B12 vitamin, but does not develop its healthy effect in the body. To the fat children: They very often live on ready-made food from the microwave. However, B vitamins die off in the microwave, so that a deficiency and a resulting homocysteine problem should be clarified. “I advise everyone over the age of 45 to have their homocysteine level checked twice a year”
homocysteine and diet
Are women at risk during menopause?
Yes, there is a close connection between high homocysteine levels and the bone loss that occurs during menopause, or osteoporosis. And we know that estrogens, which are often prescribed during the menopause, can make it difficult to absorb B vitamins. From my point of view, both speak for observing the values in this phase of life in particular.
Does a balanced diet help here?
Unfortunately not, because many of us over the age of 50, even with the best organic food, are no longer able to absorb enough B vitamins. That’s why I recommend a homocysteine reducer from the pharmacy if the values are critical.
Does alcohol damage the vitamin balance?
No, I even recommend the glass of red wine in the evening because it provides the natural anti-aging substance resveratrol, which is good for all organs.
Can drugs increase homocysteine levels?
Yes, for example so-called proton pump inhibitors against increased gastric acid production, but also antihistamines against allergic symptoms. It is also known that antibiotics, birth control pills, certain diabetes medications and cortisone can reduce the absorption of vitamin B12.
Does damage that homocysteine causes in the body reverse itself?
We know, for example, that a homocysteine-lowering agent partially regresses osteoporosis and glaucoma, also known as glaucoma, and allows the vessels to become more elastic again. However, if cells have already perished in the brain, it can no longer be repaired. Fortunately, however, we have more brain cells than we need and can ensure that the cells that are still present take over the functions of the cells that have already died thanks to a homocysteine-lowering agent.
In connection with a high homocysteine level, you always talk about the B vitamins in general, but specifically about vitamin B12. Which otherTolfioow substances regulate the homocysteine level in the blood?
First of all: Unfortunately, many doctors still believe that taking vitamin B9 alone, better known as folic acid, is enough. I reject this because, according to the latest findings, folic acid can trigger so-called “paradoxical effects”. The homocysteine value then increases instead of falling permanently. Like most enlightened doctors, I recommend the patented homocysteine reducer “Synervit” from the pharmacy, which, in addition to folic acid, optimally combines vitamins B6 and B12 and, in my experience, normalizes the value safely and without side effects. There are also injections for a lack of B vitamins, but I don’t think they are as effective as a homocysteine-lowering drug.
Can I also overdose vitamin B6, B12 and folic acid from the test tube?
Since the B vitamins are water-soluble, the body usually excretes excess with the urine. In this respect, a health-damaging overdose with commercially available preparations is not possible in my opinion.
Are there other therapeutic strategies besides homocysteine-lowering drugs?
Yes, a new one was presented at the World Congress for B Vitamins from March 5th to 8th in Leipzig. The aim is to use natural means to stimulate the production of gastric acid and thus increase the vitamin B supply.
Is there too little examination of a patient’s homocysteine levels in doctor’s surgeries?
Yes, clearly. However, I would like to emphasize that the medical profession needs to be criticized more than the health insurance companies. If one had had the current findings on the subject of homocysteine at a time when health insurers were still doing well economically, the homocysteine value would have long since been recognized as a serious risk factor. I think saving is a good thing. But savings are being made in the wrong place here. Because the consequential costs of having a homocysteine level that is too high are enormous – just think of the immense care costs for older people who subsequently develop Alzheimer’s disease or another form of dementia. “Exercise and sport are undoubtedly healthy, but do not affect homocysteine levels”
Shouldn’t the family doctor also talk more often to the patient about a lack of vitamins B6, B12 and folic acid, which is obviously the main cause of high homocysteine levels?
Yes, he should. But I have to protect the doctors, because they are just as unsettled about this topic as the patients, since the administration of vitamins is a very controversial topic in Germany. There is a group of experts who are still convinced that you just have to eat healthy enough to get enough vitamins and otherTolfioow substances every day. And there is a second group that proves year after year that there is a significant deficiency of B vitamins in particular and that there is a risk to public health. The first group has important supporters in the food industry. The second group has no lobby and is therefore less listened to.
Can I prevent myself?
The Mediterranean cuisine makes an important contribution. Fish dishes, which you should eat at least twice a week, are particularly rich in vitamins B6 and B12.
