Reversing High Homocysteine and Heart Disease

Naturally Savvy
Naturally Savvy

In my last blog, I explained how high homocysteine levels can cause heart disease. This week I will discuss how to lower high homocysteine levels, helping to prevent or reverse heart disease.

Normalizing elevated homocysteine

One of the answers to high homocysteine levels is to increase one’s intake of vitamin B6, B12, and folic acid. While most conventional medical practitioners and dietitians do not recommend supplementing the diet with any of these B vitamins in capsule or tablet form, they do advise the public to at least increase their intake of high folic acid-containing foods. The American Heart Association, for example, advises a “healthy, balanced diet that’s rich in fruits and vegetables, whole grains, and fat-free or low-fat dairy products.”

The current RDA for folic acid is 400 mcg, the minimum dose thought to prevent neural tube defects in the fetus of a pregnant woman. Dark leafy greens, kidney beans, lentils, oranges, and orange juice are especially good sources of folic acid.

Folate content of foods:

Fresh spinach (1 cup)-262 mcg

Kidney beans (1 cup)-229 mcg

Lentils, cooked (½ cup)-179 mcg

Chickpeas, cooked (½ cup)-145 mcg

Asparagus, cooked (½ cup)-131 mcg

Orange juice (1 cup)-109 mcg

Broccoli (1 cup)-107 mcg

Split peas, cooked (½ cup)-64 mcg

Good sources of vitamin B6 are meat, poultry, fish, fruits, vegetables, and whole grain products. A daily intake of 50 mg is optimal.

Vitamin B12 can be obtained in highest amounts from meat, poultry, fish, milk, and dairy products. B12 is not found in fruits, vegetables, beans, grains, nuts, or seeds but may be found in cultured soy products, algae, and seaweeds. A daily intake of 500 mcg is considered to be optimal.

Regular aerobic exercise (more than 3 times weekly) also lowers the harmful levels of homocysteine.

Adequate amounts of trace minerals in the diet can also help lower homocysteine. Minerals such as zinc, copper, and magnesium are required as cofactors for enzymes that lower homocysteine to function properly and maintain proper DNA methylation.

Betaine (1000 mg) a.k.a. trimethylglycine (TMG) is yet another important nutrient. Derived from sugar beets, betaine functions as a methyl donor (much like folic acid) and also helps lower homocysteine levels.

Poor absorption

One unsuspected problem for some people is the inability to assimilate or absorb certain nutrients from their foods. For example, older individuals (age 65 or older) may not produce enough stomach acid to help absorb vitamin B12, folic acid, zinc, copper, manganese, iron, and dozens of other nutrients. Others may be deficient in the gut levels of intrinsic factor and pancreatic digestive juices. Still others have had damage to their intestinal absorption capacity due to illnesses like celiac disease, food allergies or chronic gut infections. In some people vitamin B6 is not converted efficiently enough to its active form (pyridoxyl-5’-phosphate). Supplementing these people with pyridoxyl-5’-phosphate (50 mg) directly is necessary.

Sometimes the only way that these individuals can be helped is by intramuscular or intravenous injections or high dose oral vitamin and mineral supplementation combined with digestive enzymes like glutamic acid and pepsin, pancreatin or others. If one suspects an absorption or nutrient assimilation problem, this can be verified by tests done through a health care practitioner.

Dissenting voices of ultra orthodoxy

Despite considerable evidence to the contrary, the conservative forces of orthodoxy within the medical profession and dietetics establishments continue to downplay the importance of keeping homocysteine levels under control. The main bulk of literature from similar bastions of ultra orthodoxy continue to claim that the only known risk factors for heart disease are age (being 45 or older for men; 55 or older for women), a family history of early heart disease, high blood pressure, high blood cholesterol, smoking, obesity, physical inactivity, and diabetes. There are even several recent studies funded by the manufacturers of cholesterol-lowering drugs concluding that there is no relationship between homocysteine and heart disease.

While it is always wise to make health decisions on sound scientific principles, there is no harm in taking a daily B complex and multi-mineral supplement while we wait for the scientific, economic, and political conflicts to play themselves out.

The bottom line

While it may cost you some money ($50-$100), get at least one blood test for homocysteine done. If the test shows a high level, change your diet to include foods high in folic acid, vitamin B6, and vitamin B12. Also, take at least one high potency B complex vitamin and multi-mineral supplement daily. Keep rechecking your homocysteine blood test until it normalizes.

If there is no improvement, discuss vitamin injections or other options with your natural health care provider. Chances are you will prevent a great deal more unpleasant future medical attention.

Dr. Zoltan Rona


American Heart Association website:

Challem, Jack. Homocysteine: The New “Cholesterol”, Keats Publishing, New Canaan, CT, 1996.

Malinow MR, Bostom AG, Krauss RM. Homocyst(e)ine, diet, and cardiovascular diseases: a statement for health care professionals from the nutrition committee, American Heart Association. Circulation 1999; 99:178-182.

Malinow MR, Duell PB, Hess DL, Anderson PH, Kruger WD, Phillipson BE, Gluckman RA, Block PC, Upson BM. Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. N Engl J Med 1998; 338:1009-1015.

McCully K. The Homocysteine Revolution. Keats Publishing, New Canaan, CT,1997.

McCully KS. Editorial: Homocysteine, folate, vitamin B6, and cardiovascular disease. JAMA 1998; 279:392-393.

Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M, Vollset SE. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med 1997; 337:230-6.

Rimm EB, Willett WC, Hu FB, Sampson L, Colditz GA, Manson JE, Hennekens C, Stampfer MJ. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA 1998; 279:359-364

Welch GN, Loscalzo J. Review: Homocysteine and atherothrombosis. N Engl J Med 1998; 1042-1050.

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Dr. Zoltan P. Rona is a graduate of McGill University Medical School (1977) and has a Master’s Degree in Biochemistry and Clinical Nutrition from the University of Bridgeport in Connecticut (1984). He is past president of The Canadian Holistic Medical Association (1987-88) and is the author of three Canadian bestsellers: The Joy of Health (1991), Return to the Joy of Health (1995) and Childhood Illness and The Allergy Connection (1997). He is co-author with Jeanne Marie Martin of The Complete Candida Yeast Guidebook (1996) and is the medical editor of the Benjamin Franklin Award winning Encyclopedia of Natural Healing (1998). He has had a private medical practice in Toronto for the past 35 years, has appeared on radio and TV as well as lectured extensively in Canada and the U.S. Dr. Rona currently writes regular articles for Reader’s Digest, Alive, Vitality magazine and for several web sites. His latest book “Vitamin D, the Sunshine Vitamin” was published in 2010. In 2011, Dr. Rona was named Chief Medical Advisor for NAKA Herbs and Vitamins and has developed a line of nutritional supplements (TriStar Naturals) which are sold in health food stores across Canada. He can be found at