Why You Should Get Your Homocysteine Levels Tested

In last week's post, we explored why we recommend that all Knew Health Members have their B12 and folate levels tested through comprehensive blood work.

This week's article continues our journey through B-Vitamin testing, with a look at why everyone in our Community should have their homocysteine levels checked—for metabolic, heart, and genetic wellness.

Homocysteine is a non-essential amino acid created by your body as a by-product of a critical conversion process called methylation. This journey begins with an essential amino acid called methionine*.

*Non-essential amino acids, like homocysteine, are made by your body and don't come from food. Essential amino acids, like methionine, must come directly from food and are often converted into non-essential nutrients.

Once consumed, methionine can be isolated from our dietary proteins (with healthy digestion) and, through methylation*, can be transformed into homocysteine and then downstream into usable cysteine.

*Methylation is a metabolic process involving amino acids, B-vitamins and other nutrients which affects genetic expression, energy, nutrient conversion, metabolism, antioxidant capacity, detoxification, hormone balance and so much more.

As with many substances in our bodies, homocysteine can build up if our methylation process becomes impaired or blocked.

Excess homocysteine on its own can be toxic to your body, but a build-up also denies your body the usable cysteine it needs for other key functions.

Homocysteine levels are representative of many aspects of wellness, including:

• How your body uses B-vitamins, particularly B6, B12 and folate
• Heart wellness
• Neurological well-being
• Genetic health
• Metabolism

High homocysteine levels themselves don't produce obvious symptoms; rather, they're indicative of other health conditions. That's why it's so important to have your levels checked through regular blood work.

In conventional medicine, homocysteine testing is typically reserved as an after-the-fact investigative tool to determine causes of heart disease in patients with no other risk factors (such as smoking, high blood pressure, high cholesterol, etc.).

In functional medicine, we use homocysteine testing proactively to give us insights into the following conditions:

• Heart wellness —elevated homocysteine levels have been shown to be independently associated with increased risk of heart disease, heart attack and stroke
• Alzheimer's Disease, Parkinson's and Dementia
• B-vitamin deficiencies (which may be due to poor digestion)—particularly B6, B12 and B9 (folate)
• Pernicious anemia/B12 deficiency —homocysteine testing often helps diagnose this condition as an inability to process B12 can be rooted in methylation issues
• Gastrointestinal challenges —such as IBS and Leaky Gut Syndrome can affect your ability to absorb B-vitamins
• Genetic variations —since homocysteine plays a role in methylation of B-vitamins, elevated levels often indicate genetic variations that affect absorption such as the MTHFR, MTR or MTRR genetic mutations

Since excess homocysteine becomes toxic to your body, you want your levels to be optimally low.

At Knew Health we look for:

• "Good" homocysteine levels of less than 10 umol/L
• "Optimal/functional" levels of about 4-8 umol/L

Any higher than 10 and you'll want to work with your Health Coach to further investigate the cause.

However, rock-bottom levels of homocysteine may indicate malnutrition, insufficient protein intake or hypermethylation which can make your body vulnerable to oxidative stress.

For today's post, we'll focus on addressing the more common high levels.

First, take a deep breath. We're here to support you.

Just because you have high homocysteine doesn't mean you'll develop heart disease or a neurological condition tomorrow, next week or even next month.

That's the beauty of functional blood work; it often allows us to catch patterns of imbalance in your body before they become chronic or diagnosable.

And if you're already dealing with a chronic condition, take heart. By examining your homocysteine levels, you've taken one big step closer to uncovering the root cause and getting your wellness back on track.

The first thing you need to do is work with your Health Coach or functional medicine practitioner to identify the root cause of the imbalance.

The proper protocol for addressing high homocysteine levels is always personalized based on:

• Your current state of wellness —if a serious condition, like advanced heart disease is present or indicated by your blood work, your Knew Health Coach would refer you to a functional medicine doctor for further investigation and treatment. These Medical Needs may be eligible for sharing through your Membership after your IUA is met.
• Your B12 and RBC-folate levels —if these are low, then simple dietary changes, a digestive healing regime and/or supplementation with a methylated form of B12 and/or folate will often be recommended
  • Methylated vitamins are designed to "bypass" genetic mutations so they can be utilized and absorbed properly
• The health of your gut —optimal digestion and nutrient absorption are key to ensuring the good nutrition you consume from food actually reaches and benefits your cells
• Lifestyle choices —daily choices such as sleeping and eating habits, stress management, relationship wellness and medications all have a significant impact on your digestive tract. Our Knew Health Coaches are experts at working with Members to identify the best starting points for individual lifestyle changes.
• The presence of a genetic variation like MTHFR, MTR, or MTRR —for example, roughly 50% of Americans have the MTHFR genetic variation, which affects their ability to convert dietary folate into its usable form and thus impacts methylation pathways.

MTR and MTRR affect your body's ability to store and utilize Vitamin B12.

Your unique case may require additional investigation, and if so, your Knew Health Coach can refer you to a functional medicine provider while helping you with lifestyle choices that can help minimize the impact of those variations. Remember, many of these consultations may be eligible for sharing through your Membership.

As you can see, addressing suboptimal homocysteine can be quite straightforward, and having the support of a Knew Health Coach helps you understand and address what's at play in your unique body.

However, if genetic variations or a more serious condition is present, further investigative action may be needed.

To learn more about the diet and digestive healing changes recommended for B12 and folate imbalances, see last week's blog post: "Understanding Your Lab Work: B12 and RBC Folate Levels (folate)".

As with all blood work, how often to re-test is highly individual.

Typically, if your levels are on the high-side, your Health Coach will recommend re-testing after about 6 months. And if your levels are very high, perhaps sooner. These follow-up tests are often eligible for sharing through your Membership, and you can also use your Self-Care Credit for additional wellness support.

• Homocysteine blood work offers excellent insights into the MTHFR genetic variation, B-vitamin deficiencies, heart disease/stroke risk, neurological disease risk, pernicious anemia and gastrointestinal issues which may affect B-vitamin absorption
• You want your levels to be optimally low but not rock bottom—good levels are below 10 and optimal/functional levels are about 4-8 umol/L
• If your levels are high, it's important to investigate the specific root causes for your unique body and lifestyle
• To help optimize homocysteine, your Knew Health Coach may also recommend supplementation with methylated B-vitamins and/or additional investigation via blood work at Knew Health or with an integrative functional medicine doctor
• Re-testing is typically recommended about every 6 months, depending on how high your levels are and other causal factors

Curious about how your homocysteine levels could be affecting your wellness?

All Knew Health Members receive homocysteine testing and monitoring as part of their individual program. This comprehensive blood work, along with Health Coaching support, helps our Community take control of their wellness journey.

To learn more about the benefits of Membership visit: www.knewhealth.com/membership.

-The Knew Health Team