The charity The Food for the Brain Foundation (foodforthebrain.org) is launching a home test today to measure ‘homocysteine’, an indicator of a person’s B vitamin status. Knowing this can help reduce the risk of mental illness and can help a person take steps to reduce their risk of mental illness.
Why do some have a greater risk of depression, dementia and schizophrenia than others? Which factors are driving the significant increase in problems in children?
“Homocysteine is a biomarker for over 100 diseases, but especially those of the central nervous system,” says pharmacology professor David Smith FMedSci, formerly Deputy Head of the Faculty of Medical Sciences at the University of Oxford.
“It is a biomarker of impaired cognitive abilities in children, and in adults is a risk marker for stroke and dementia and Alzheimer’s, but also possibly for depression, anxiety, bipolar, schizophrenia, obsessive-compulsive disorder, Parkinson’s and multiple sclerosis.
“It is very much the forgotten factor, despite the research evidence being strongly positive[1]. And the good news is, it is so easily corrected.”
Patrick Holford (right), a psychologist and nutritionist who heads the foodforthebrain.org charity, says, “A raised homocysteine level means something is going wrong with a vital process that controls how we think, feel and perceive.
“It’s called methylation and is totally dependent on B vitamins. Some people absorb B12 less well. Some just need more of the B vitamin than others, and that biochemical individuality, especially if their diet is already deficient, can tip them into a mental or neurological illness.”
Those suffering from depression are also more likely to have higher homocysteine levels. [2][3] Amanda-Jane is a case in point. She was suffering from chronic fatigue and low mood, so she decided to check her homocysteine level. She was shocked when she found her score was 26 mcmol/l.
After changing her diet and supplementing the B vitamins, her sleep improved almost immediately, and within four weeks, she had much more energy. Two months later, she re-tested her homocysteine level and found it had dropped to 9. “I feel much better. My mood is very positive – no panic or depression. I feel buoyant, energetic and enthusiastic. I’m sleeping much better, and my PMS has disappeared,” she said.
Every 5-point increase in Homocysteine increases the risk of being diagnosed with schizophrenia by a staggering 70%![4] Yet very few sufferers are ever checked for raised Homocysteine.
Professor Joseph Levine from the Stanley Research Centre and Beersheva Mental Health Centre at Ben Gurion University in Israel devised a study to see what effect lowering Homocysteine with B vitamins would have.[5]
He gave half of a group of 42 schizophrenic patients B vitamins (B6, B12 and folic acid) and the other half a placebo.
Those taking the B vitamin supplements had both a dramatic reduction in their homocysteine levels and a significant improvement in their symptoms, except for one patient, who didn’t comply with the B vitamin treatment, didn’t improve and didn’t have a reduction in their homocysteine level. They were the exception that proved the rule.
Professor David Smith, writing in the Journal of Internal Medicine, together with a world-leading expert on Homocysteine, Professor Helga Refsum from the University of Oslo, Norway, stated, “There are five diseases that can, at least in part, be prevented by lowering total Homocysteine: neural tube defects, impaired childhood cognition, macular degeneration, primary stroke, and cognitive impairment in the elderly.
“We conclude from our review that total homocysteine values in adults of 10 mcmol/L or below are probably safe, but that values of 11 above may justify intervention. Homocysteine is more than a disease biomarker: it is a guide for the prevention of disease.”
Not only does it predict an increased risk for a stroke, but having a lower homocysteine level, achieved by eating B12-rich foods such as fish and eggs, and folate and B6-rich foods such as whole foods, vegetables, nuts, seeds and beans, and supplementing B vitamins, helps those who’ve had a stroke recover faster.[6]
The charity foodforthebrain.org recommends anyone with a homocysteine level over ten mcmol/L to supplement extra B vitamins, especially B6 (20mg), folate (400mcg) and B12 (500mcg). Homocysteine is a toxic amino acid that accumulates when there is a lack of B vitamins and literally damages your brain as well as your arteries.
Professor Smith’s research group at Oxford University has shown that giving people with pre-dementia these vitamins reduced the rate of brain shrinkage to less than half of that in those given placebos.
“Further cognitive decline virtually stopped in those taking the B vitamins,” says Smith. As many as two in five people over 60 have a raised homocysteine level. The reason why the B vitamin folic acid is recommended in pregnancy is because it lowers Homocysteine. In ‘normal’ pregnancies with no complications in either mother or child, Homocysteine remains below 7mcmol/L.
“In five out of seven studies, women who have spontaneous abortions or miscarriages have a level above 15. The risk of having a pre-term baby is four times higher in women with a homocysteine level above 12.[7]
“A study of 81 healthy women who then became pregnant found that the children of the women whose Homocysteine before conceiving was above 9 were significantly more withdrawn, anxious and depressed and had more social problems, including increased aggressive behaviour.[8]
“It is vital that a woman intending to become pregnant first checks her homocysteine level. Raised Homocysteine, plus a lack of omega-3 fats found in fish, for example, is a major promoter of developmental problems and mental illness in children later in life,” says Holford.
A child’s homocysteine level even predicts their school grades. A study compared the sum of school grades for ten core subjects with homocysteine levels in a group of 692 Swedish school children aged 9 to 15. Increasing homocysteine levels were strongly associated with reducing grades, as was inadequate folate intake.[9]
The home pinprick blood test is available from www.foodforthebrain.org/tests. The charity also encourages those having the test to complete a free Cognitive Function Test to help research the impact of Homocysteine on mental health.
References:
[1] Smith AD, Refsum H. Homocysteine – from disease biomarker to disease prevention. J Intern Med. 2021 Oct;290(4):826-854. doi: 10.1111/joim.13279. Epub 2021 Apr 6. PMID: 33660358.
[2] Moradi F, Lotfi K, Armin M, Clark CCT, Askari G, Rouhani MH. The association between serum homocysteine and depression: a systematic review and meta-analysis of observational studies. Eur J Clin Invest 2021: e13486.
[3] Nabi H, Bochud M, Glaus J, Lasserre AM, Waeber G, Vollenweider P, Preisig M. Association of serum homocysteine with major depressive disorder: results from a large population-based study. Psychoneuroendocrinology 2013; 38: 2309-18.
[4] JW Muntjewerff,Molecular Psychiatry (2006) 11, 143–149. doi:10.1038/sj.mp.4001746
[5] Levine J, Stahl Z, Sela BA, Ruderman V, Shumaico O, Babushkin I, Osher Y, Bersudsky Y, Belmaker RH. Homocysteine-reducing strategies improve symptoms in chronic schizophrenic patients with hyperhomocysteinemia. Biol Psychiatry. 2006 Aug 1;60(3):265-9. doi 10.1016/j.biopsych.2005.10.009. Epub 2006 Jan 17. PMID: 16412989.
[6] Yahn GB, Leoncio J, Jadavji NM. The role of dietary supplements that modulate one-carbon metabolism on stroke outcome. Curr Opin Clin Nutr Metab Care. 2021 Jul 1;24(4):303-307. doi: 10.1097/MCO.0000000000000743. PMID: 33631772; see also
[7] Dai C, Fei Y, Li J, Shi Y, Yang X. A Novel Review of Homocysteine and Pregnancy Complications. Biomed Res Int. 2021 May 6;2021:6652231. Doi: 10.1155/2021/6652231. PMID: 34036101; PMCID: PMC8121575.
[8] Roigé-Castellví J, Murphy M, Fernández-Ballart J, Canals J. Moderately elevated preconception fasting plasma total Homocysteine is a risk factor for psychological problems in childhood. Public Health Nutr. 2019 Jun;22(9):1615-1623. doi: 10.1017/S1368980018003610. Epub 2019 Jan 14. PMID: 30636652; PMCID: PMC10261079.
[9] Torbjörn K. Nilsson, Agneta Yngve, Anna K. Böttiger, Anita Hurtig-Wennlöf, Michael Sjöström; High Folate Intake Is Related to Better Academic Achievement in Swedish Adolescents. Pediatrics August 2011; 128 (2): e358–e365. 10.1542/peds.2010-1481.
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