Homocysteinemia accelerates the aging process and causes cellular structural and functional impairments. Impaired homocysteine metabolism contributes to the development and severity of neurodegeneration. Hyperhomocysteinemia is a risk factor of cardiovascular complications and kidney dysfunction. Impairment of homocysteine metabolism contributes to development of osteoporosis, rheumatoid arthritis etc.

Hyperhomocysteinemia occurs in chronic- and end-stage kidney disease at the time when dialysis or transplant becomes indispensable for survival. Excessive accumulation of homocysteine (Hcy) aggravates conditions associated with imbalanced homeostasis and cellular redox thereby resulting in severe oxidative stress leading to oxidation of reduced free and protein-bound thiols (Thiol modifications such as N-homocysteinylation, sulfonation, cysteinylation, glutathionylation, and sulfhydration control cellular responses that direct complex metabolic pathways).

The vascular disease in homocystinuria due to cystathionine β-synthase (CBS) deficiency, methylenetetrahydrofolate reductase (MTHFR) deficiency, or inborn errors in cobalamin metabolism bears little resemblance to the atherosclerotic and atherothrombotic vascular disease seen in the adult general population.

Homocystinuria seems to be associated with a factor or factors that primarily cause venous and arterial thrombosis. Whether the same factor (that in homocystinuria does not seem to cause the characteristic changes of primary atherosclerosis) would be atherogenic in much lower concentrations in the general population remains uncertain.

We found increased levels of atherosclerosis-inducing homocysteine in parkinsonian patients with long-term application of levodopa compared with previously untreated parkinsonian patients and controls. We conclude that antiparkinsonian treatment with levodopa promotes occurrence of vascular disease in Parkinson’s disease.

How Are Elevated Homocysteine and chronic diseases Levels Determined?

Homocysteine levels are commonly checked through blood tests, though doctors may also order urine samples for infants with a family history of the condition.

Normal levels of homocysteine are between five and nine micromoles per liter (μmol/L). Individuals are diagnosed with elevated homocysteine, or hyperhomocysteinemia, when their levels reach between 10 and 100 μmol/L. Borderline hyperhomocysteinemia is between 10 and 12 μmol/L, moderate is 13 to 30 μmol/L, intermediate is 31 to 100 μmol/L, and severe hyperhomocysteinemia is diagnosed when someone has more than 100 μmol/L. Usually, individuals that have elevated homocysteine levels don’t show any symptoms.

High concentrations of homocysteine have a connection with an increased risk of heart attack and stroke. These increased levels can contribute to plaque formation by damaging arterial walls and affect blood platelets by increasing the risk of clot formation.

While high homocysteine has negative effects on your heart, more research is required to confirm if it can actually cause cardiovascular disease. However, there is evidence to support the claim that individuals with elevated levels of homocysteine have double the risk of developing Alzheimer’s disease at some point in their lifetime.

What Causes Elevated Homocysteine Levels?

Increased levels of homocysteine can have a negative impact on our health, but what causes elevated homocysteine levels?

Most commonly, an inadequate intake of B vitamins in combination with genetic factors can affect the body’s absorption and use of folic acid, which causes homocysteine levels to spike.

Chronic nutritional deficiencies in folate, choline, methionine, vitamin B-6 and/or vitamin B-12 can perturb the complex regulatory network that maintains normal one-carbon metabolism and homocysteine homeostasis. Genetic polymorphisms in these pathways can act synergistically with nutritional deficiencies to accelerate metabolic pathology associated with occlusive heart disease, birth defects and dementia.

Some other causes of elevated homocysteine levels include both stress and coffee consumption. So, the more coffee you consume daily, the higher your risk will be of having a high level of homocysteine.

Certain allopathic medications, low levels of the thyroid hormone, kidney disease, and psoriasis are also contributing factors to increased levels of homocysteine.

In addition to not eating foods with the right nutrients, the chances for developing a homocysteine deficiency increase as you age. Men tend to have a higher risk, especially those who smoke and drink alcohol.

Others who are likely to run low on these essential nutrients include pregnant women and breastfeeding mothers; alcoholics or drug users; anyone with kidney disease or on kidney dialysis; and those with diabetes, thyroid disorders, or hormone imbalances.

The Effects of Elevated Homocysteine Levels

Those that experience elevated homocysteine may be at a higher risk of deep vein thrombosis and pulmonary embolism as well as Alzheimer’s disease and other forms of dementia.

Infants who have inherited abnormalities that affect their levels of homocysteine can experience dislocation of the lens in their eye, a sunken chest, Marfan-like appearance (long, thin body type), mental retardation, seizures, and neonatal strokes.

For these reasons, it’s important for infants to get tested early on for the disease, especially if they have a family history of elevated homocysteine.

While high levels of homocysteine can affect everyone, there are certain implications for women. Increased homocysteine has been more prevalent among women that have experienced pregnancy complications, such as preeclampsia, placental abruption, recurrent pregnancy loss, and giving birth to a small, low birth weight baby.

While elevated homocysteine is common with women that fit into this group, it’s even more common for those who have a child with a neural tube defect. Medical research suggests that higher homocysteine levels may be a consequence of these pregnancy and birth complications, rather than the cause.

Elevated levels of homocysteine can take its toll and cause lasting damage, even though there often aren’t many apparent symptoms.

This condition can be treated with vitamin supplementation and controlled by routine blood tests. So, if you have a patient with any disease and you think he/she is ill due to homocysteine levels, along with other symptomatic medicine always prescribe Moringa and Ashwagandha; be attentive to keep a check on digestive system especially hepatic function.