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Homocysteine
Caution: Consult with your diabetes care team before starting a lower-carbohydrate meal plan. Diabetes medications such as insulin or oral drugs that stimulate insulin production (sulfonylureas or meglitinides) will need adjustment to prevent hypoglycemia (low blood glucose) when carbohydrate intake is decreased. In addition, blood glucose levels need to be checked more often.
What You Need to Know About This Silent Threat
In the last two articles in this series, we discussed the significance of HDL cholesterol, triglycerides and C-reactive protein (CRP) in evaluating—and lowering— your risk of cardiovascular disease. Now we’ll discuss another lesser known but extremely important blood marker: homocysteine.
Dangers of High Homocysteine
You don’t often hear people talking about
homocysteine, yet a high level of this amino
acid in the blood is an independent risk factor
for heart and vascular disease. This means that
even when your cholesterol and other health
markers are within normal ranges, elevated
homocysteine levels raise your risk.
Evidence suggests that excess homocysteine promotes plaque buildup in blood vessels and causes damage to the inner linings of arteries, increasing the likelihood of blood clots.
What’s Your Risk?
If you have type 2 diabetes, elevated
homocysteine levels significantly increase
your mortality risk, whether or not you have
any other cardiovascular risk factors and
regardless of your overall health. In fact, one
study showed that for each five-point increase
in homocysteine, risk of dying within five years
rose by 17 percent in nondiabetic subjects
and by 60 percent in diabetic subjects. Even a
moderate elevation in homocysteine appears
to be an independent risk factor for fatal heart
attacks in people with type 2 diabetes.
How to Lower Homocysteine Levels
Although the normal range for homocysteine
is 5.2 mmol/l to 12.9 mmol/l, Robert C. Atkins,
MD, had a goal for patients of 8 mmol/l or less.
Most of his patients were able to achieve this
with a controlled-carbohydrate meal plan.
Atkins prescribed his controlled-carbohydrate
plan along with supplemental nutrients that
target homocysteine: vitamins B6 and B12 and
folic acid.
Why the Supplements?
Blood levels of homocysteine increase
when you have an inadequate supply of
these nutrients. As processed and refined
foods have crowded out whole foods in our
diets, our intake of these vital nutrients has
dropped. Refining destroys folate (folic acid)
and vitamins B6 and B12. Dark leafy greens,
whole grains and legumes are some of the
best sources of folic acid and vitamin B6; meat
and dairy provide B12, although many people
over 60 years of age may not have adequate
stomach acid to absorb B12. If you eat proteins,
natural fats, whole grains, legumes and green
vegetables, your homocysteine levels probably
reflect that healthful diet. If not, it’s time to
change your eating habits and consider taking
supplements to reduce this deadly risk factor.
You may also want to discuss homocysteine
with your physician.
A Note From R. Keith Campbell, RPh, CDE
I would like to point out that homocysteine levels
are never ordered as part of a lab evaluation
of patients, and many patients would have to
pay for the test to get the results. I have all of
the patients I work with take the folic acid plus B
vitamins. They do not do any harm, and they can
do good.
Research has implicated homocysteine in a host of diseases and conditions, including:
- Cardiovascular disease, stroke, depression and cancer
- Blood clots
- Narrowing of blood vessels
- Diabetic neuropathy
- Dementia and Alzheimer’s
- Cirrhosis of the liver
- Kidney disease
- Bone fractures
Categories: Diabetes, Diabetes, Food, Low Carb, Type 2 Issues
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Diabetes Health
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.
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Topics
- Diabetic / Diabetes Health
- Type 1 / 1.5 Diabetes
- Type 2 Diabetes
- Blood Glucose / Sugar
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- Insulin- Pumps, Pens & Syringes
- Continuous Glucose Monitors, CGM, Infusion Sets
- Type 2 Medications
- Hyperglycemia
- Hypoglycemia
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