By Patrick Holford
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Your blood homocysteine level predicts your risk for over 100 diseases.
No other blood biomarker does this.
Not glucose, not cholesterol, not even a gene test.
“The commonest associations are with cardiovascular diseases and diseases of the central nervous system (eg. your brain and nerves), but a large number of developmental and age-related conditions are also associated.” Says Professor Helga Refsum who, more than any other, put homocysteine on the map.
Those conditions that affect the brain include age-related cognitive decline to Alzheimer’s; depression to anxiety; bipolar to schizophrenia; and migraines to macular degeneration. Macular degeneration affects the eyes, not the brain but the eyes are the outwards extension of the brain – literally the visual interface between the world and your brain. Hearing loss is another disease predicted by raised blood (plasma) homocysteine. Then there are strokes affecting the blood’s circulation in your brain. Children with autism have higher levels. It also predicts problems in pregnancy. (Read more about this here)
“Five diseases can at least in part be prevented by lowering total homocysteine: neural tube defects, impaired childhood cognition, macular degeneration, primary stroke, and cognitive impairment (which means dementia and Alzheimer’s) in the elderly,” conservatively conclude Professors Refsum and David Smith, our ‘homocysteine and B vitamin’ expert on our Scientific Advisory Board.
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Two studies illustrate the predictive power of homocysteine; one showed that 2/3rd of heart attacks and strokes in older people could be predicted, not by cholesterol, but by homocysteine (1). The other is that you can predict a child’s school grades by knowing their homocysteine level, according to a study in a Swedish school, averaging a child’s school grades and comparing them to both homocysteine and B vitamin status (2).
But there are two other reasons why knowing your homocysteine level is a brain health imperative.
The first is that you can’t ‘see’ it or predict it just by knowing a person’s diet or lifestyle.
The second is that it is easily lowered with B vitamins.
A lot of people want to know if they have the ApoE4 gene. Statistically, it increases your risk of developing Alzheimer’s by about 5 per cent. While you can mitigate its effects by improving your diet and lifestyle you can’t change the fact that you’ve got it.
The extent to which a raised homocysteine level (above 11mcmol/l) increases your risk of cognitive decline is illustrated by two studies. One shows that having a high level raises risk by 10 times (3). Another shows double the rate of brain shrinkage between those in the top quarter of homocysteine versus the bottom quarter (4). Different studies show different ‘predictive power’ but it is certainly more important than your ApoE4 status.
The other reason it is important to know your level is illustrated by the story of a mother and daughter who attended one of my lectures. Hearing about the strong link to strokes, which the mother had had, the daughter said “Mum, I really think you should have the test.” In fact they both did. The mother’s result was a healthy 6 mcmol/l while the daughter’s was extremely raised, above 20 mcmol/l. She had chronic fatigue. A month later, having taken a homocysteine-lowering supplement, her level was normal – and her chronic fatigue had gone.
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So, you can’t just assume your level is OK.
In fact, about half of those over 65 (my age) have a raised homocysteine level. Why? This is not an easy answer because there are many ‘lifestyle’ associations – from smoking to stress. Vegans who don’t supplement vitamin B12 would also be at risk. Since vitamin B6, folate and B12 are key to lowering homocysteine one’s intake of these nutrients, eg. from foods such as greens, beans and fish, is also very relevant but…it isn’t just a dietary marker.
The big unknown is that some people, especially as they age, absorb vitamin B12 poorly. This requires stomach secretions. Some people inherit this deficit and are diagnosed with pernicious anaemia, others acquire it with age. Either way, the net result is only ‘clinically’ shown by measuring homocysteine.
Homocysteine is called a ‘functional’ test because it indicates whether or not a person can do ‘methylation’. Methylation is a vital second-by-second chemical balancing act that the body and brain use to micro-adjust everything from making insulin, serotonin, and adrenalin or turning gene expression up or down, to repairing DNA and detoxifying all sorts of things in the liver, from histamine to mercury. Knowing your B12, folate or B6 status isn’t as good as knowing if you are or aren’t a healthy ‘methylator’. Homocysteine is the gold standard test for this.
An analogy here is a single-pin prick glucose test will only show you if, in that moment, your blood sugar level is too high. However, HbA1c (glycosylated haemoglobin) shows you both whether your blood sugar levels are damaging cells and gives you an ‘average’ of 3 month’s worth of glucose levels. Thus, we also call HbA1c a ‘functional’ test.
Knowing your levels of these is so important which is why we have created DRIfT (Dementia Risk Index functional Test) so that you know exactly where you are at and how to reduce your risk of not just dementia but over 100 other diseases.
This is one of the most important brain health tests you can do (and thankfully due to new technology you can do it accurately and easily with a simple pinprick at-home test)
Remember every test kit you order will not only help you upgrade your brain it will also help us in our vital research – you will become a part of our ‘Citizen Science’ team and be donating to our wider charitable work and research.
Thank you!
Thank you for reading!
Food for the Brain is a non-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.
By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.
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REFERENCES
To read more on the science behind ‘Homocysteine – from disease biomarker to disease prevention’ read this review by Professors Helga Refsum and David Smith.
1 W. de Ruijter, et al., ‘Use of Framingham risk score and new biomarkers to predict cardiovascular mortality in older people: Population based observational cohort study’, British Medical Journal, 2009 Jan;338:a3083
2 https://pubmed.ncbi.nlm.nih.gov/21746721/
3 10.3389/fnagi.2022.868777
4 Smith AD, Smith SM, de Jager CA, Whitbread P, Johnston C, Agacinski G, Oulhaj A, Bradley KM, Jacoby R, Refsum H. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010 Sep 8;5(9):e12244. doi: 10.1371/journal.pone.0012244. PMID: 20838622; PMCID: PMC2935890.
