Probiotics, Homocysteine and Your Heart

Homocysteine is an independent risk factor for heart disease. B vitamins have been shown to lower homocysteine, but unfortunately this does not protect from heart disease. So, what to do about high homocysteine? A study has recently shown that probiotics can help to lower homocysteine. Perhaps this is the approach we have been searching for?

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Probiotics, Homocysteine, and Your Heart

Dr. Michael Ruscio: Hi, this is Dr. Ruscio. And homocysteine is essentially a protein that can damage your arteries and is an independent risk factor for heart disease. Now, the question then is what can you do about homocysteine that may help protect your heart?

Well, recently in our podcast, we went through a very intensive review of all the medical literature showing that, by lowering—which would be improving because high homocysteine is bad, and lower homocysteine is good. So by lowering homocysteine with B vitamins, consistently, it’s been shown to have no impact on heart disease.

However, what this may tell us is that homocysteine may not be something that we can simply lower with a vitamin, per se, to have a beneficial effect. It may be that homocysteine is telling us that there’s something wrong in the body.

And that is what needs to be treated in order to lower the homocysteine in order to improve someone’s health because again, right now, if you use a B vitamin, yes, we can lower homocysteine. But no, that does not correlate with any decrease in cardiovascular disease or death.

So then what else might we be able to do? Or how else can we address this high homocysteine that’s an independent risk factor for heart disease. Again, independent, meaning irrespective of your weight, your blood pressure, your cholesterol levels. Homocysteine, if increased, does correlate with an increased risk for cardiovascular disease.

A recent study Trusted SourcePubMedGo to source published offers some very interesting information that I think makes a lot of sense. In this study, subjects that had high homocysteine were given a probiotic. And this was a very traditional probiotic, a combination of lactobacillus and bifidobacterium. And what this did was it helped to increase the amount of these bacteria in the gut. That then increased B12 and folate production naturally. And then that correlated to a decrease in homocysteine. So we’re achieving the same endpoint here of lowering homocysteine, but we’re doing it through giving a probiotic.

So potentially, what this may mean is that homocysteine may be ultimately a sign of dysbiosis or imbalance in the gut. And by giving or restoring the correct bacterial balance in the gut, we can then allow those bacteria to produce the natural B vitamins that they produce, amongst many other things. And this all creates an environment that lowers homocysteine.

Now, what we don’t know is how this specific trial correlates with heart disease because it wasn’t long enough, and it didn’t really track that. But there have been some initial trials showing that probiotics do have favorable impacts on things like cholesterol levels and inflammation.

So there is still much that we have to learn here about the long-term effects of probiotics on hopefully improving cardiovascular disease. But I think this is a very interesting study that shows a different approach for lowering homocysteine through the gut that will hopefully be shown to have a long-term benefit on cardiovascular disease.

One final point here I should mention that I think is very important. There is increasing discussion about a subset of cardiovascular disease that is autoimmune in nature. And if you think about the pathophysiology of much of heart disease, it has to do with immune activation against cholesterol. And we know that the largest density of immune cells in the body is in the small intestines.

So, again, another tie-back—again, theoretical, so we have to be cautious—but another tie-in to how modulating the gut may help with the immune system, may help with heart disease. And also modulating the gut may help with B vitamin production, homocysteine metabolism, homocysteine levels, and hopefully heart disease.

So in short, a better approach may be—again, we don’t know this for sure—to use probiotics in attempts to lower homocysteine. And hopefully, this will have a positive impact on cardiovascular disease. Certainly, there have been many benefits to probiotics outside of cardiovascular disease that have been well documented. So we don’t need a really strong support rationale to suggest to try a probiotic, track your homocysteine, see if it has a positive impact.

So this is Dr. Ruscio. I hope this information helps you get healthy and get back to your life. Thanks!

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