You are working a busy cardiac unit and the physician has ordered a homocysteine level for your angina patient. The level comes back at 8 units, but you have no idea what this means in terms of the patient and his health. “Homocysteine is a type of protein, produced by the body and found in the blood” (Holford, 137) and is measured in mmol/l. The healthiest score is below 6 units and the greatest health risks occur at levels higher than 15 units. How do you teach your patient the importance of this level and how to change it for better health?

Homocysteine is a product of protein metabolism. The body takes methionine from dietary protein and converts it using B vitamins and zinc into either glutathione or SAMe. These are both desired substances in the body as they are essential to the chemical reactions that fight stress and aid all of those antioxidants that we all consume now. They do this intracellularly by adding or subtracting methyl groups. The more of those you have, the better able your body can fight oxidation, aging, and stress on a cellular level. The problem occurs if the homocysteine does not convert, but remains intact in the bloodstream. This can occur as a result of genetics or vitamin deficiency. The genetic mutation that prevents homocysteine conversion is called the MTHFR gene mutation. (Holford, 139)

According to a study in the British Medical Journal, with every 5 unit increase in homocysteine levels, the risk of heart disease increased by 42% with the genetic mutation and 32% in those without, and stroke risk increases 65% and 59% , respectively.(Holford, 139) The reason for this is because homocysteine directly damages body tissue. This is added to the harm caused by having less glutathione and SAMe in the cells. Homocysteine levels have been found to rise with tumor growth, and in a study from the New England Journal of Medicine a level higher than 14 was found to double the risk of Alzheimer’s disease. (Holford, 141)

There are behaviors that can decrease homocysteine levels, thereby decreasing risk of heart disease, stroke, diabetes, cancer, and Alzheimer’s disease…all states of disease that are measurably tied to the homocysteine level.

1. Eat more plants. This decreases the amount of homocysteine being produced and increases the consumption of the vitamins and minerals that add to the conversion process.

2. Eat less salt. This can be achieved by decreasing the amount of processed foods and using other seasonings when cooking such as cumin, pepper, and garlic. An easy way to eat less processed foods is to choose more plants.

3. Avoid smoking, alcohol, and excessive coffee or tea consumption. Excessive means more than two cups a day!

4. Reduce your stress. Take time out of your day to focus on your breath, clearing your mind, and allowing your muscles to relax. Doing this at each meal is highly recommended.

5. Supplement the vitamins needed to convert homocysteine. These are the Bs, zinc, and trimethyl glycine.

Armed with this data and knowledge, the nurse can positively impact the health risks of her patients. Being able to explain what this lab measures and the values that are safe and those that are dangerous can empower the patient to make effective changes that impact the outcome of allopathic medicine.

Holford, P. The New Optimum Nutrition Bible. Crossing Press, 2004.

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