Much has been said recently about homocysteine levels becoming a new critical marker for heart disease and stroke, even more important than cholesterol levels. It now appears that high levels of this amino acid may also be linked to osteoporosis.
Homocysteine is a naturally occurring metabolite of the amino acid L-methionine used by the body for many functions including detoxification. It normally shows up in the blood at levels of about 6 millimeters(mm) to 8 mm for women and 8 mm to 12 mm for men. As long as the body keeps levels in check, there’s not much of a problem. However, excess homocysteine may be toxic and inflammatory and this can lead to serious consequences, including heart disease.
Kilmer McCully, MD, is a respected authority on homocysteine and author of The Homocysteine Revolution (Keats). Dr. McCully first became interested in homocysteine back in the 1960s when he came across a few unusual cases involving children with atherosclerosis, a heart disease that generally is associated with much older people. Dr. McCully also found atherosclerosis scattered through the arteries of a boy who had died of a stroke and he noted that all these children had high levels of homocysteine. In 1969 he wrote a paper suggesting that homocysteine was causing artherosclerotic plaque. Now, 35 years and a substantial amount of research later, it is well accepted that elevated homocysteine is a risk factor for vascular disease.
But what about the connection to osteoporosis? Talking to Carole Jackson of Bottom Line’s Daily Health News Dr McCully said "Osteoporosis is a prominent feature of children with high levels of homocysteine. About two-thirds of the children with high levels of homocysteine also have severe osteoporosis." He added "They also get scoliosis, a curvature of the spine, and have an increased risk for fractures. More recently, we’ve found that adult patients with elevated homocysteine also have an increased risk for osteoporosis."
Dr. McCully explained that the osteoporosis connection was revealed through a rather ingenious study in Japan, published in The Journal of the American Medical Association in the spring of this year. The study was done on stroke victims who, for reasons not completely understood, have a much greater risk for hip fractures.
The Japanese researchers divided a number of stroke patients into two groups and followed them for two years. One group was given a combination of 5 milligrams (mg) of folic acid and 1,500 micrograms (mcg) of vitamin B-12 while the other group received a placebo. Researchers wanted to see if the B vitamins would reduce hip fractures in this high-risk population. The results were dramatic: In the placebo group, 43 people had hip fractures, but in the vitamin group, only 10 did. Furthermore, homocysteine levels dropped in the treatment group by 38%, while they increased in the placebo group.
Could homocysteine be the connection? It sure looks like it. "Two other studies, in Germany and the Netherlands, also demonstrated that patients with higher homocysteine have a higher risk for osteoporotic fracture," Dr. McCully said. "It’s likely that homocysteine affects the matrix upon which calcium and other minerals are deposited in the bone. This matrix becomes calcified during bone formation. Homocysteine seems to affect the formation of this matrix in a negative way."
Dr. McCully also pointed out that men are less susceptible to osteoporosis than women, probably because testosterone maintains the bone matrix better. In women, it’s a double whammy since osteoporosis risk goes up after menopause, and for reasons not fully understood, so do homocysteine levels.
So how can homocysteine levels be lowered? "Easily," According to Dr. McCully. "It can be done with dietary improvement and by increasing B vitamins. Eliminate processed foods, including flour and sugar, and eat more fresh vegetables, fresh meats, fresh fruits and whole grains." The three vitamins which have been shown to markedly reduce homocysteine are B-6, folic acid and B-12. "Only about 400 mcg of folic acid and 3.5 mg of B-6 are needed," said Dr. McCully.
I would add that before going overboard with grains, check that you do not have allergies or sensitivities to them. Wheat, rye, oats and barley are particularly problematic.
Ensuring adequate vitamin B-12 is more challenging, since older people have a harder time absorbing it. Approximately 15% of people over age 65 are deficient in B-12 largely due to poor absorption. For older people supplementing B-12 (at least 1,000 mcg) with the sublingual variety is a good idea since part of it is absorbed directly through the mucous membranes. Make sure that the B-12 is in either the hydroxycobalamine or methylcobalamine form. The conventional cyanocobalamine is poorly absorbed through the mucous membranes. Read the label on the bottle as it will clearly indicate which type it is.
So this is good news and bad news. It’s good that more is understood about the importance of a good diet for controlling homocysteine. It is bad news for your orthodox doctor and the drug companies that make billions of dollars annually by selling statins for cholesterol control and equally useless drugs to combat osteoporosis. I wouldn’t worry too much about them though!
It is probably a good idea to get your homocysteine checked by a blood test, especially if you have some other risk factors for heart disease or osteoporosis. Improve your diet and talk to a health care professional about B-12, B-6 and folic acid supplements, preferably a naturopathic doctor. Assuming proper dosing, taking these supplements is one of the easiest possible things you can do to improve your health and reduce your risk for both heart disease and osteoporosis.
And the big bonus is that following a healthy diet will provide many other health benefits. Now that’s what I call good side effects!
Following the above guidelines will help you quickly deal with any serious homocysteine threat. An excellent way to procede then is to optimize your nutrition with quality nutraceuticals, which you could explore here. Do sort out any homocysteine problems as soon as you can.