PART II, Homocysteine – The Silent Killer that Framed Cholesterol and That Very Few Doctors Look At

By: Dr.Jin Sung
Functional Chiropractic
May, 2014


Where does homocysteine come from?

Homocysteine comes from a faulty breakdown of methionine which is an essential amino acid, which we find in most of our protein rich foods, such as animal meats. This breakdown occurs from a methylation pathway in the liver. All this means is that a methyl group is passed from molecule to molecule until eventually methionine is recycled. Think of the methylation pathway is if it were like a 4x400m relay between sprinters. In a 4×400 relay race each runner must pass the baton to the next runner and eventually the baton will end up back where it started and make a complete circle around the track. Well the baton in this analogy is like the methyl group that needs to be passed to the next runner in order to finish the race. If there is an inefficiency in this pathway and the baton (methyl group) is not passed to the next person (or molecule) then homocysteine is created. Now sometimes our body needs an extra methyl group for another process so the homocysteine pathway loses a methyl group. When this happens we can call on some methyl donors to keep the “4×400 race going to the finish” and avoid stopping halfway, which creates homocysteine.

What are some of the methyl donors that we can call on to prevent homocysteine from being made?

B-vitamins are some of our primary methyl donors – well most B-vitamins. Vitamins B-2, B-6, Folate and B-12 have all been shown help aid in donating a methyl to prevent homocysteine from being made. It is important to know that vitamin B-3 (niacin) has actually been shown to raise homocysteine levels, which is why a proper supplement with the right ratios of B-Vitamins would work better at lowering homocysteine levels when compared to a standard B-complex (with all the B-vitamins). Here in the clinic we use a product called “Homocysteine Supreme” by designs for health because it not only has the right B-vitamins in the correct ratio, but it also has products in it like: Trimethylglycine, Choline, Serine, and N-Acetyl-Cysteine which all help the methylation pathway and ultimately bring down homocysteine levels.

When everything is flowing smoothly in any direction, and our body has plenty of methyl donors our liver can facilitate the efficient breakdown homocysteine. This is important not only to avoid homocysteine, but to be able to break it down properly to make important end products. Some of these end products are the sulfur-containing amino acids taurine and cysteine as well as necessary neurotransmitters like: epinephrine, dopamine and serotonin which are all necessary for proper brain and nervous system function. By the way the methylation pathway is the same pathway used to eliminate our estrogens from the body.

What causes homocysteine to be elevated?

One of the most common conditions affecting our homocysteine levels is hypochlorhydria, or low stomach acid. With hypochlorhydria you get a decrease absorption in almost all nutrients, including the B-vitamin methyl donors we talked about earlier. One of the other factors effecting absorption of nutrients is inflammatory foods including food sensitivities. Inflammatory foods interfere with absorption in the small intestine, where 90% of our absorption takes place. Having a chronic infection, eating inflammatory foods all the time, or having heavy metals in our body is very taxing on our immune system which will create a greater need and ultimately deplete our glutathione (our bodies own natural anti-oxidant) stores. This in turn will cause us to deplete our vitamin B6 which is an important methyl donor in homocysteine metabolism. One of the other more common conditions we see at our clinic is hypothyroidism. Hypothyroidism decreases out liver enzymes involved in the remethylation pathway of homocysteine. Some other things that effect either the methylation pathway or the absorption of important B-vitamins are:

• Metformin

• Oral Contraceptives

• Antacids and Proton pump inhibitors

• Anti-depressants

• Genetic defect in the MTHFR gene

• Being sympathetically dominant

How can I find out about lowering my homocysteine levels?

The best way to go about addressing homocysteine levels is to address “The Cause.” To find out what is causing your homocysteine to be elevated requires proper testing. Without proper testing and addressing the underlying mechanism as to why homocysteine is elevated in the first place, it will keep coming back. Here in our clinic we run very comprehensive tests to get at the underlying cause whether it be a problem in the absorption of our nutrients, inflammation, or underlying pathologies like hypothyroidism. We also stress the importance of functional lab ranges. This is especially true when it comes to homocysteine! Normal lab ranges are from 0-15 micromol/L. This is too wide. We like to see levels below 7 micromol/L especially when research suggests that anything above 7 is harmful for long-term health. In fact newer research is saying that when levels approach 15 or greater, that these levels are high enough in homocysteine to actually cause micro hemorrhages through the entire blood vessel! We cannot stress the importance of functional lab ranges, especially when 15 is still considered normal on regular lab ranges!

Homocysteine is a real problem and can hinder any improvements in our health if it is elevated. If you suffer from any of the above diseases and symptoms, please do not hesitate to ask about your homocysteine levels.

I would like to thank my friend and mentor Dr. Ed Beyer for the content of this article.

Dr. Jin Sung is a chiropractor and the owner of Functional Chiropractic, Inc. He manages chronic patients both neurologically and metabolically to achieve the best outcome. He can be reached at 978 688-6999. Or visit his website at