Homocysteine: the Hidden Stress Marker You Need to Know

We know that caring under sustained pressure over time impacts not only our emotional health, but also our physical health. One less known and understood bio-marker of chronic stress is homocysteine.

Homocysteine is an amino acid your body makes when it breaks down protein. It is cleared with the help of B vitamins (B12, B6, folate/B9 and riboflavin/B2) through a process called methylation.

When those pathways are under strain, homocysteine can build up, and elevated levels have been linked to a higher risk of conditions including cardiovascular disease, diabetes and Alzheimer’s.

High levels can often be lowered with B-vitamin supplementation. If you’re a carer under chronic stress, it may be worth asking your doctor to check your level.

What is homocysteine?

Homocysteine is a naturally occurring amino acid produced when the body breaks down another amino acid called methionine, which we obtain from protein-containing foods.

Under healthy conditions, the body efficiently recycles homocysteine using several key nutrients including:

• Vitamin B12

• Folate (Vitamin B9)

• Vitamin B6

• Riboflavin (Vitamin B2)

• Other nutrients involved in methylation pathways

Methylation: The Body’s Everyday Repair and Regulation System

Methylation is a fundamental process upon which your life depends, and it is involved in many important functions, including:

•         Processing homocysteine

•         Making and regulating neurotransmitters involved in mood, motivation and stress responses

•         Supporting DNA repair and gene regulation

•         Producing certain hormones and other important compounds

•         Supporting liver detoxification pathways

•         Maintaining healthy immune and inflammatory responses

When methylation pathways are working effectively, homocysteine is efficiently recycled.  When these pathways are under strain, homocysteine may accumulate in the body and lead to dysfunction.

In his book The Homocysteine Solution, co-authored by Dr James Braly, Patrick Holford outlines in considerable detail the relationship between methylation and homocysteine and then explains, citing several scientific studies, why the potential risks of developing disease such as cardiovascular disease, diabetes and Alzheimer’s increase when homocysteine levels are elevated.

In a study where 750 people under the age of 60 with blockages in the coronary arteries were compared with 800 people without cardiovascular disease, they found that having a high homocysteine score was as great a risk factor for CVD as smoking or having high blood cholesterol levels.

How high is too high?

Homocysteine is usually measured in micromoles per litre (µmol/L).  Commonly used categories are:

Below approx. 9 µmol/L	Considered optimal
10-15 µmol/L	May be considered borderline or mildly elevated
15-30 µmol/L	Moderate elevation
30-100 µmol/L	High elevation
Above 100 µmol/L	Very high elevation

However, Holford believes that homocysteine levels should be below 6.3µmol/L to prevent disease and maintain optimal wellness.

Why carers should pay attention to homocysteine

Since my stroke in 2020, my health has been supervised by my Integrative Medicine General Practitioner in Melbourne and she will do full blood work at times. 

My last tests indicated a high level of homocysteine. 

Although I had heard of homocysteine, I really didn’t understand it, or its importance in preventing disease, particularly cardiovascular disease.

After reading Patrick Holford’s book and his very convincing evidence, I wondered why we don’t routinely measure homocysteine scores as we do with blood sugar and cholesterol scores, particularly given that lowering high homocysteine and therefore risk of disease, can be done quite easily with supplementation with B Vitamins.

It’s interesting to me that we know stress depletes B vitamins and so no surprise once again that there is a relationship between chronic stress, high cortisol levels and high homocysteine levels - potentially predisposing us to chronic disease.

I believe it would be prudent for all carers to supplement with a good Activated B vitamin complex, particularly with what Patrick Holford calls the Big Four B vitamins mentioned earlier (B12, B6, B9, B2).

What are ‘Activated Vitamins’?

Activated vitamins mean the vitamins are in their most active, bio-available form, ready for immediate absorption into your body.

Inactive vitamins must be converted (or “methylated”) by the liver first and this process takes time, energy and nutrients, so skipping this step is considerably less burdensome to your often already depleted system.

You may like to ask your doctor to include checking your homocysteine levels should you be required to have blood tests in the future.

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Commonly Asked Questions About Homocysteine

What is a healthy homocysteine level?

Levels are measured in micromoles per litre (µmol/L). Below about 9 is generally considered optimal, 10 to 15 borderline or mildly elevated, 15 to 30 moderate, 30 to 100 high, and above 100 very high. Patrick Holford argues levels should sit below 6.3 µmol/L to help prevent disease and maintain optimal wellness.

How do you lower homocysteine?

Holford’s work points to B-vitamin supplementation, particularly the “Big Four”: B12, B6, folate (B9) and riboflavin (B2).

Why should carers pay attention to homocysteine?

Chronic stress depletes B vitamins, and high cortisol is linked to higher homocysteine, which may raise the risk of chronic disease.

Is homocysteine tested routinely?

Not usually. It isn’t measured as a matter of course the way blood sugar and cholesterol are, but you can ask your doctor to include it in future blood tests.

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Where can I learn more about Thrive Positive Psychology?

For more information about stress, burnout, radical self-care and how to support yourself in your caregiving role, visit:

• Thrive Positive Psychology's Facbook Page: facebook.com/thrivepositivepsychologyau

• LinkedIn: Tess' LinkedIn Page

• Thrive Positive Psychology's Website: thrivepositivepsychology.com.au 

• Thrive Positive Psychology's LinkedIn page: linkedin.com/company/thrive-positive-psychology

Or sign up for Tess' Carer Fatigue & Burnout Course. You can download a FREE preview here: https://www.thrivepositivepsychology.com.au/courses