Two Blood Tests Your Doctor May Not Routinely Check

The next time you visit your doctor, I encourage you to ask about two blood tests that are not always included in routine blood work: homocysteine and MTHFR testing.

These two tests can give you additional information about your cardiovascular and nutritional health—and, when homocysteine is elevated, there are often straightforward nutritional strategies that can help.

1. Homocysteine: A Valuable Marker of Cardiovascular Health

Homocysteine is an amino acid that is produced naturally in the body as it processes another amino acid called methionine.

Unlike the amino acids we use to build proteins, homocysteine is not something we want accumulating in the bloodstream. Elevated homocysteine has been associated with cardiovascular and vascular disease, including stroke, coronary artery disease, and peripheral artery disease.

Research has found elevated homocysteine in a significant percentage of people with cardiovascular disease. Higher levels have also been associated with an increased risk of adverse cardiovascular outcomes.

Why might homocysteine be a problem?

Elevated homocysteine may contribute to:

• Oxidative stress

• Inflammation and dysfunction of the blood vessel lining

• Changes in lipid metabolism

• Processes involved in blood clotting

In other words, homocysteine is one more piece of the cardiovascular health puzzle that can be useful to know.

What Can You Do If Your Homocysteine Is High?

The good news is that homocysteine is closely connected to several important B vitamins.

The nutrients involved in homocysteine metabolism include:

• Folate (B9)

• Vitamin B12

• Vitamin B6

• Riboflavin (B2)

When someone has an elevated homocysteine level, it is worth looking at their intake and status of these nutrients.

For some people, supplementation with the appropriate B vitamins can help bring homocysteine into a healthier range.

But there is another piece of the puzzle that is often discussed: MTHFR.

2. MTHFR: The Gene Involved in Folate Metabolism

MTHFR stands for methylenetetrahydrofolate reductase. It is an enzyme involved in converting folate into forms that the body can use in the methylation cycle.

There are common genetic variants in the MTHFR gene. About 50% of people living in America have one of the genetic variants.  Having one of these variants does not automatically mean that you will have high homocysteine or develop cardiovascular disease. Many people with MTHFR variants have completely normal health and normal homocysteine levels.

However, MTHFR variants can affect how efficiently some people process folate. This is one reason that looking at the actual homocysteine level can be more useful than focusing on the gene alone.

What About Methylated B Vitamins?

When supplementation is appropriate, some people prefer using the more bioavailable forms of these nutrients.

For example, a B-complex may contain:

• 5-MTHF rather than folic acid

• Methylcobalamin as a form of B12

• P-5-P as the active form of B6

These forms are often referred to as methylated or activated B vitamins.

Importantly, you don't necessarily need an MTHFR variant to benefit from adequate B-vitamin intake. These nutrients are involved in numerous important biochemical processes throughout the body.

Don't Guess when you can test

Rather than assuming you have a problem, start by getting the information.

Ask your doctor whether it makes sense for you to have:

1. Homocysteine blood test
This gives you an actual measurement of your homocysteine level.

2. MTHFR genetic testing
This can identify common MTHFR gene variants if testing is appropriate for you.

If your homocysteine is elevated, your doctor or qualified healthcare practitioner can help determine why and whether nutritional support is appropriate.

It is also important to remember that elevated homocysteine can have several causes, including inadequate B-vitamin status, kidney problems, certain medications, and other factors. MTHFR is only one possible piece of the puzzle.

The Simple Takeaway

Your blood work can tell you much more than your cholesterol and blood sugar.

Know your homocysteine level. Know your nutritional status. And, when appropriate, understand your MTHFR genetics.

If your homocysteine is elevated, there are often nutritional strategies that can help—including making sure you are getting adequate amounts of the B vitamins involved in homocysteine metabolism.

Want to Support Your B-Vitamin Status?

The activated B-complex I offer my patients contains bioavailable forms of several B vitamins, including 5-MTHF, methylcobalamin, and P-5-P.

CLICK HERE to purchase the activated B-Complex I recommend. If you have not already, please create a Fullscript account to access.

Many people report experiencing better energy and improved resilience to stress when they correct an inadequate intake of B vitamins. While individual results vary, ensuring that your body has the nutrients it needs is an important foundation for good health.

Ask questions. Get the right tests. Know your numbers. Your blood work can tell you a lot about what is happening inside your body.

Clarke R, Daly L, Robinson K, et al. Hyperhomocysteinemia: an independent risk factor for vascular disease. N Engl J Med. 1991 Aprl 25; 324 (17):1149-55

MaY, Li L, Geng XB, et al. Correlation between hyperhomocysteinenemia and outcomes of patients with acute myocardial infarction.  Am J Ther. 2014 Nov 17.