What does the risk of stroke depend on?

Everyone knows that age, high blood pressure, smoking, obesity, diabetes and high cholesterol levels increase the likelihood of stroke, an important cause of disability and the third leading cause of death in Italy. There is, however, another risk factor, well known to specialists but little known to the general public: high blood levels of an amino acid called homocysteine, which also poses a risk for neurodegenerative diseases and bone fragility.

What are homocysteine and hyperhomocysteinemia?

Homocysteine is derived from methionine, another amino acid that is taken in through food, and particularly through meat, eggs, milk, and legumes. Normally, in healthy people homocysteine is converted back to methionine or converted to cysteine (a precursor to glutathione) byfolic acid and vitamins B6 and B12. However, in cases of particular diseases, mutation of the MTHFR gene, or unbalanced diets, blood levels of homocysteine can rise above normal values, resulting inhyperhomocysteinemia. This condition can be dangerous because it leads to the thickening of the inner lining of the walls of the arteries, which damages them.

People with high levels of homocysteine, cholesterol, and triglycerides are 40% more likely to experience a stroke than those with normal values

What do the studies show?

As early as 2013, a study published in Neural Regeneration Research showed that those with high levels of homocysteine, cholesterol, and triglycerides were 40 percent more likely to experience a stroke than those with values in the normal range, all other risk factors being equal. Again, a meta-analysis published in Stroke in 2020 showed that correcting hyperhomocysteinemia results in a 34 to 70 percent reduction in risk.

What does the amount of homocysteine in the blood depend on?

The amount of homocysteine normally present in the blood depends on several factors:

• Physiological: age and sex. Women on average have lower levels than men; however, there is an increase after menopause due to the decrease in estrogen.
• Environmental: smoking, alcohol, excessive coffee consumption, low physical activity
• heredity
• Diseases: e.g., renal failure and hypothyroidism
• Medications: e.g., oral contraceptives or antiepileptic drugs

Women have lower homocysteine levels on average than men, but there is an increase after menopause due to the decrease in estrogen

How is homocysteine measured?

The test for homocysteine assay is a simple venous blood draw after 10-12 hours of fasting. Keeping a periodic check on this blood value is essential. Here are the reference values:

• normal values: 5-9 μmol/L
• Borderline hyperhomocysteinemia: 10-12 μmol/L
• Moderate hyperhomocysteinemia: 13-30 μmol/L
• intermediate hyperhomocysteinemia 31-100 μmol/L
• Severe hyperhomocysteinemia >100 μmol/L

How can you lower high homocysteine levels?

You can lower blood homocysteine by increasing your intake of folic acid and vitamins B6 and B12. How? Either through a vitamin-rich diet and/or taking dietary supplements. A clinical study published in Nutrients in 2020 showed how the use of the supplement CardioAge, developed by SoLongevity Research, can effectively reduce homocysteine by converting it into endogenous glutathione, a powerful antioxidant. CardioAge also provides folate, either directly or by stimulating its production. SoLongevity’s scientific team has long been involved in studying the effects of homocysteine on cerebrovascular health and pursuing clinical trials of new nutraceuticalNutraceutical is a syncratic neologism from "nutrition" and "pharmaceutical" coined by Stephen de Felice in 1989. Nutraceuticals are those nutrients contained in foods that have beneficial effects on health, their effectiveness has been proven by clinical trials. formulas that can counteract this risk factor.

Regarding diet, foods rich in vitamin B6 are found in: fish, meat, eggs, fruits, vegetables, dairy products and nuts; foods rich in vitamin B12 in: herring, tuna, mackerel, sole, some cheeses. It should be kept in mind, however, that cooking foods disperses these nutrients to some extent. For example, about half of the vitamin B6, vitamin B12 and folic acid found in milk is lost by boiling. In addition, it is important to pay attention to fat intake.