Heart Health : Dil Dhadak Ne Do!

Dr. Sneha Shah - Functional Nutritionist

Health on Your Plate Nutrition Program

Heart Health : is dependent on 2 Major Risk Factors -

HOMOCYSTEINE & HS-CRP

What is homocysteine?

Homocysteine is a type of substance in your blood that your body makes when body breaks down a protein called methionine. In simple terms from methionine, homocysteine is made. Homocysteine in normal levels does not cause any problems. Problem arises when this homocysteine is accumulated too much in the body. Reason being homocysteine is either not used again to form methionine or other useful proteins in the body.

When there’s too much homocysteine, it can cause heart problems, like heart disease and stroke, also dementia, Alzheimer's, bone fractures, pre eclampsia etc.

High homocysteine is also the commonest reason for sudden deaths in young individuals.

Why homocysteine is important for heart health:

1. Increased Risk of Cardiovascular Disease

High levels of homocysteine can damage the inner lining of blood vessels, leading to inflammation and the buildup of fatty deposits, or atherosclerosis. This condition can narrow and harden arteries, increasing the risk of heart attack, stroke, and other heart problems.

2. Blood Clot Formation

High homocysteine levels are linked to an increased tendency for blood clot formation, which can lead to thrombosis (the formation of a blood clot inside a blood vessel). If a clot obstructs the flow of blood to the heart or brain, it can cause a heart attack or stroke.

3. Interference with B9 (folate) and Vitamin B6/B12 process

Homocysteine metabolism is closely linked to B vitamins like folate, vitamin B6, and vitamin B12. These vitamins help convert homocysteine into harmless substances like cysteine or methionine. If there’s a deficiency in these vitamins, homocysteine levels can rise. That’s why people with low levels of folate or B vitamins might have higher homocysteine levels and an increased risk of heart disease.

4. Genetic and Lifestyle Factors

Genetic mutations: Certain genetic mutations (like the MTHFR gene mutation) can affect body’s ability to break homocysteine to useful proteins, leading to higher levels in the blood.
Lifestyle factors such as poor diet, smoking, excessive alcohol intake, and lack of exercise can also contribute to elevated homocysteine levels.
Another reason for high homocysteine that we have observed in our practice is, due to Long COVID side effects (Long COVID refers to a range of symptoms that some people continue to experience after they have recovered from the initial infection of COVID-19. Even if someone doesn't have the virus anymore, they can still feel sick for weeks, months or years. Taking 'B vitamins' in such cases can help upto a certain limit. But including certain supplements to improve methylation along with B vitamins can help to reduce these high levels of homocysteine, which are due to long COVID effects. (Read more about this in our blog- Did You Know That?)

How to Manage High Homocysteine Levels

Diet: Adequate intake of folate, vitamin B6, and vitamin B12 through diet or supplements can help lower homocysteine levels.
Lifestyle Changes: A healthy lifestyle with regular physical activity, a balanced diet, and avoiding smoking or no alcohol consumption.
Medical Treatment: In some cases, doctors may recommend supplementation to help lower homocysteine levels (as per your body's requirement)

What is HS-CRP?

HS-CRP is a test that checks for signs of inflammation (swelling) in your body. When there is too much inflammation, it can be a warning that your blood vessels or heart could be at risk. By testing HS-CRP doctors can identify early signs of inflammation, even before symptoms appear. While CRP is produced by the liver in response to inflammation but it CANNOT detect small levels of inflammation, while HS-CRP is a more sensitive test that can detect very small levels of inflammation which is a signal to detect heart diseases / diabetes, etc.

HS-CRP is important:

1. To detect inflammation in the Arteries

Chronic inflammation in the blood vessels is a major cause of atherosclerosis (plaque buildup in the arteries), which is a key factor in heart disease, heart attacks, and stroke. High levels of HS-CRP can indicate the presence of this inflammation, even before other symptoms appear. This can help identify people at higher risk for cardiovascular problems.

2. To detect heart disease risk in people with Metabolic Syndrome

People with metabolic syndrome (high blood pressure + high blood sugar + excess body fat around the waist + high cholesterol levels), are at higher risk for heart disease due to high levels of HS-CRP/INFLAMMATION.

3. To know the effect of Inflammation-reducing therapies

For individuals who are undergoing treatment to reduce inflammation, with anti-inflammatory medications or dietary changes (like increasing omega-3 fatty acids), regular HS-CRP tests can help us to know how well the body is responding to these treatments.