Why We Test Your Homocysteine and MMA Levels - The Apeiron Life Perspective
- Elizabeth Bradley, MS
- Nov 25, 2024
- 5 min read
What it is:
A blood test can determine your Homocysteine (Hcy) and methylmalonic acid (MMA) levels. Tracking these specific items can inform you and your healthcare provider about the state of your methylation cycle. This is crucial as methylation regulates every inch of our body, including but not limited to:
Energy, physical health, and athletic performance
Genes, aging, and longevity
Detoxification of heavy metals, chemicals, and other harmful substances
Cognitive and mental health via neurotransmitters like serotonin and dopamine
Immune function
A well-functioning cycle is indicated by your homocysteine and methylmalonic acid (MMA) levels.
Homocysteine is an amino acid that occurs naturally in the body and is converted to the essential amino acid methionine. This allows the full process of the methylation cycle to occur. If there is a disruption, homocysteine levels can build up and cause damage to our cells, such as our cognitive or cardiovascular health.
Methylmalonic Acid (MMA) is broken down within a healthy methylation cycle and utilized in our metabolism.
Purported claims:
Methylation depends upon B Vitamins
Homocysteine (Hcy) and methylmalonic acid (MMA) levels reflect possible B-vitamin deficiencies
What the science says:
Homocysteine is a vital component of the methylation cycle. It is produced naturally by the body and interacts with B vitamins to produce other amino acids, such as Methionine. Methionine is an essential amino acid, which means we do not produce it in significant amounts in the body. Therefore, it must be accessed through other means.
The homocysteine and B-vitamin process is, therefore, crucial to an optimally functioning methylation cycle. Homocysteine interacts with Vitamin B-12, from foods such as animal proteins or supplements, allowing it to break down into other vital chemicals.
When tested, if homocysteine levels are high, it may indicate it is not being converted efficiently due to a vitamin B deficiency. Prolonged elevated homocysteine may increase your risk for dementia, heart disease, and stroke. The latest research is also showing strong links between B vitamin deficiencies and risk for cardiovascular disease and cognitive decline.
Methylmalonic Acid (MMA) is converted in the methylation cycle by Vitamin B12. If there is a build-up and high levels of MMA are seen in a blood test, this could indicate insufficient levels of B12.
There are many components of the methylation cycle, but certain items have a greater impact. Apart from B12, other molecules, such as folate and choline, are utilized to process homocysteine into methionine. Low choline can lead to heart issues, mental health imbalance, fertility problems, and birth defects.
What is MTHFR gene?
The MTHFR (methylenetetrahydrofolate reductase) gene is an enzyme essential for processing folate and, consequently, for the entire methylation cycle. Variants of this gene can reduce the enzyme's efficiency, making it harder for the body to process folate into its active form, methylfolate. Individuals with certain MTHFR gene variants may have higher levels of homocysteine due to decreased folate metabolism. This genetic predisposition can increase the risk of health issues, including cardiovascular disease, neurological disorders, and pregnancy complications.
Genetic testing can determine whether a person has unbalanced methylation levels due to genes such as the MTHFR gene. MTHFR affects folate metabolism and may require supplementation, such as methylated folate or methylated B12, to rebalance levels.
Food & Supplements
Most people can increase their B vitamin levels naturally through food. Optimizing your food intake is the first step, as the foods themselves also contain a multitude of other vitamins, minerals, and antioxidants that are needed in different areas of the methylation cycle.
For B-vitamin rich foods, think of this rhyme: “lean meats, beans & greens”
Lean meats & seafood: chicken, turkey, lamb, beef, salmon, sardines, shrimp, scallops
Beans/legumes: navy, black, kidney, pinto, lima, garbanzo, soybeans/tempeh, lentils, green peas
Greens: asparagus, brussel sprouts, beet greens, spinach, cabbage, broccoli, collard greens, swiss chard, mustard greens, bok choy, turnip greens, kale
Others of note: sunflower & flax seeds, eggs, cow’s milk/yogurt, avocado, sweet potatoes
Especially focus on intake of B6, B9, and B12 vitamins.
Vitamin B12 rich foods (aim for 2.4 mcg):
20 small clams (7000% DV) - would meet your week’s requirement
1 oz sardines (100% DV)
3 oz salmon (100% DV)
Folate, Vitamin B9-rich foods (aim for 400 mcg per day)
1 cup cooked lentils 358 mcg
1 cup cooked kidney beans 131 mcg
1 cup cooked asparagus 268 mcg
1 cup beets 149 mcg
Probiotic Lactobacillus plantarum 299v (Increases circulating folate levels)
Vitamin B6 rich foods (1.5 mg per day)
1 cup chickpeas 1.1 mg
3 oz salmon 0.6 mg
3 oz chicken 0.5 mg
1 cup potato 0.4 mg
The types of supplements you may come across on the market include methylated folate or methylated B12. By consuming the active form of folate or B12 it allows the body to bypass the conversion process. Methylating the items means it already has the required methyl group attached and is therefore helpful to those with genetic variations or other restrictions that may need assistance in processing B vitamins.
There are multiple processes that rely on the Methylation cycle, including detoxification. Glutathione supports natural methylation via detoxification, especially in neutralizing free radicals. Excess oxidative stress can impair methylation by damaging DNA and depleting the availability of SAM (S-adenosylmethionine), the main methyl donor in methylation reactions. By managing oxidative stress, glutathione helps maintain cellular conditions that favor methylation reactions.
SAM is essential for methylation, and its regeneration depends on the availability of sufficient glutathione and other cofactors. Glutathione helps in recycling homocysteine back to methionine, a precursor for SAM.
During high oxidative stress or low glutathione levels, homocysteine may be diverted away from the methylation cycle toward the production of cysteine and subsequently glutathione, to counteract oxidative damage. This diversion may reduce SAM availability and thus decrease methylation activity.
Both elevated homocysteine and heavy metals increase oxidative stress, which can damage cells, proteins, and DNA. Therefore, maintaining balanced levels of anti-oxidants allows you to detox and de-stress efficiently.
Our take:
A well-functioning methylation cycle depends upon many factors, but the first step is to ensure your blood tests are balanced. We measure both your MMA and Hcy in your blood work. High homocysteine levels may indicate a vitamin B deficiency, specifically folate, B12, or B6. And MMA reflects vitamin B12 status.
By understanding your MMA and Hcy levels, we can implement nutritional and supplemental protocols to optimize your health. But also lifestyle changes such as exercise, smoking, alcohol, and stress management can affect methylation pathways.
Will this benefit you?
Yes, knowing your methylation cycle is performing at optimal levels is vital. However, if you already consume adequate amounts of B-vitamins, you will not likely notice an appreciable change in these symptoms with a further increase in B-vitamins intake.
For the general population, there is limited evidence that methylation supplements offer significant benefits as most people are able to source their needs via a balanced eating pattern and lifestyle choices.
Still curious to try it? If you do, here’s what to keep an eye on:
Excessive intake of methylation-related supplements, especially without a deficiency, can disrupt normal metabolic processes and potentially lead to side effects.
Other factors such as kidney disease, low levels of thyroid hormones, psoriasis, certain medications, or genetic anomalies may also be a factor of high homocysteine levels.
References and additional reading:
Krause's Food & the Nutrition Care Process. Elsevier Inc, 2017.
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