The most important thing:
- The role of homocysteine and folate in our body
- Symptoms of folate deficiency
- Why dietary sources are not enough
- A practical solution to the problem of deficiency
When we talk about cardiovascular health, most people think of cholesterol, blood pressure and physical activity. But there are two little-known molecules that play an extremely important role: folate (vitamin B9) and homocysteine. These molecules are closely linked and affect not only the heart and blood vessels, but also the functioning of the nervous system. Understanding this connection could change our approach to preventing stroke, heart attack and cognitive decline.
What is homocysteine and why is it important?
Homocysteine is an amino acid that is formed in the body during the metabolism of another amino acid, methionine. Think of it as an intermediate in a complex chain of biochemical reactions necessary for many cellular processes. Under normal circumstances, homocysteine is converted back into methionine or is otherwise broken down, thereby maintaining a balance in its blood levels.
The problem arises when this process does not work correctly and homocysteine begins to accumulate. The condition of elevated levels of homocysteine in the blood is called hyperhomocysteinaemia and is associated with a number of serious health risks.
High levels of homocysteine are associated with:
- Increased risk of cardiovascular disease – Research shows that elevated levels of homocysteine increase the risk of stroke, heart attack, and damage to blood vessels.
- Neurological disorders – Homocysteine has a neurotoxic effect on the brain. Numerous studies show that elevated homocysteine is associated with cognitive decline, changes in white matter, and an increased risk of depression and Alzheimer's disease. These effects are linked to damage to the small blood vessels in the brain, oxidative stress, and the direct neurotoxicity of homocysteine.
- Blood vessel damage – Homocysteine can damage the inner lining of blood vessels through oxidative stress and inflammation, which facilitates the formation of atherosclerotic plaques.
What is the role of folate (vitamin B9)?
Folate plays a central role in managing homocysteine. This vitamin is essential for the methylation process – a biochemical reaction in which homocysteine is converted back into methionine. Without sufficient folate, this process is disrupted and homocysteine begins to accumulate in the blood.
Studies confirm that an adequate intake of folic acid can reduce the risk of stroke by around 10% and cardiovascular disease by approximately 4%. This may sound modest, but at a population level, these percentages mean thousands of lives saved. (1)
In addition to its role in vascular health, folate is also extremely important for the nervous system. It is involved in the synthesis of key neurotransmitters such as serotonin, dopamine, and noradrenaline, which regulate mood, motivation, and cognitive function.
Folate is also essential for the production of DNA and RNA, making it crucial for normal cell division, growth, and tissue repair. Additionally, it plays a role in maintaining the myelin sheath of the nerves – the protective 'insulating layer' that enables the rapid and proper transmission of nerve impulses.
One study in patients with severe depression and elevated homocysteine showed significantly reduced folate levels in the serum, red blood cells, and cerebrospinal fluid. A reduction in the concentrations of metabolites of the three main neurotransmitters – serotonin, dopamine and noradrenaline – was also determined.
Symptoms and risk groups for folate deficiency
Folic acid deficiency can go unnoticed for a long time, but with serious consequences. Certain groups of people are at greater risk:
- People with an unbalanced diet – An insufficient intake of green leafy vegetables, legumes, and fortified foods can lead to a deficiency.
- Pregnant women – During pregnancy, folate requirements increase dramatically due to the rapid cell division in foetal development. A deficiency can lead to neural tube defects.
- Older adults – With age, the body's ability to absorb and utilise folate decreases.
- People with MTHFR polymorphism – Genetic variants in the MTHFR gene are quite common – in many population groups, around 40% of people carry at least one C677T variant. This gene is responsible for an enzyme that converts folate into its active form. In people with the C677T polymorphism, the enzyme works less efficiently, which can disrupt the normal metabolism of folate and homocysteine.
Folate deficiency symptoms often develop slowly and can easily be mistaken for 'ordinary fatigue' or stress. The most common symptoms are:
- Persistent fatigue and weakness – you feel exhausted and have no energy for daily tasks, even after getting enough sleep. Shortness of breath on exertion and a rapid heartbeat can sometimes occur because the blood is carrying less oxygen.
- Megaloblastic anaemia – this is a type of anaemia in which the red blood cells are large and immature and cannot function properly. It manifests with pale skin, fatigue, dizziness, ringing in the ears and headaches.
- Problems with concentration and memory – difficulty focusing, "cloudy" thinking, forgetting everyday things. Some people describe it as feeling like their "brain isn't working at full capacity".
- Numbness and tingling in the extremities – tingling, pins and needles or a burning sensation in the hands and feet, a feeling of 'stiff' extremities. This is a sign that the nervous system is suffering from a folate deficiency.
- Depressed mood and irritability – a bad mood, lack of motivation, increased sensitivity and nervousness.
How can we maintain normal levels?
Dietary sources of folate
Folate is naturally found in a variety of foods. The richest sources are green leafy vegetables (spinach, kale, rocket), citrus fruits (oranges, grapefruits), legumes (lentils, chickpeas, beans), asparagus and avocado.
Although these foods are rich in folate, one important fact must be taken into account: the nutritional value of fruit and vegetables has significantly decreased in recent decades. Analyses of historical data from the last 50–70 years show that the mineral and vitamin content in many fruits and vegetables has decreased by an average of 40%, including calcium, iron, and B vitamins. (2)
The main reasons for this are soil depletion due to intensive farming and increased levels of carbon dioxide in the atmosphere. This means that even if we eat a healthy diet, we may not be getting the expected nutritional benefits from our food.
A combination with vitamins B6 and B12
To maintain normal homocysteine levels, not only is folate important, but other B vitamins as well. Vitamin B6 helps the body to 'dispose' of homocysteine via one of its main pathways, and vitamin B12 works together with folate to convert it back into methionine. Therefore, the best approach is to ensure an adequate amount of all three vitamins – folate, B6 and B12.
The importance of the methyl form of folate
This is where a key point comes in: for folate to perform its functions, it must be converted into its active form – 5-methyltetrahydrofolate (5-MTHF). In people with MTHFR polymorphism, this process is partially impaired, which can reduce the efficiency of converting standard folic acid into its active form. In such cases, the direct intake of the methylated form (5-MTHF) bypasses this stage and provides active folate that is ready to participate in homocysteine metabolism.
A practical solution: adequate intake and the role of Folacide Meta
For people who find it difficult to obtain the required amounts of folate from food alone, whether due to an inadequate diet or genetic factors, there are specialised products that contain the active form of folate.
Folacide Meta contains L-methylfolate – a form of folate that is absorbed directly and does not require additional metabolic conversion. This makes it particularly suitable for individuals with genetic variants of MTHFR, in whom standard folic acid cannot be efficiently metabolised. By directly providing L-methylfolate, the product supports the remethylation of homocysteine back to methionine, thereby helping to maintain healthy blood homocysteine levels.
The Folacide Meta formula supports:
- Maintaining the balance between folate and homocysteine
- Circulatory system health by reducing the risk of vascular damage
- Normal functioning of the nervous system
- Proper cell division and DNA synthesis
The product provides guaranteed nutritional value at a time when the quality of food continues to decline, and provides an active form that any organism can absorb, regardless of its genetic characteristics.
Final words
Folate and homocysteine are two molecules of immense importance for our health – they are crucial for both protecting the heart and blood vessels and for the normal functioning of the nervous system. Maintaining appropriate levels of folate and homocysteine is an important preventative measure against cardiovascular disease, stroke, and cognitive decline.
Given the declining nutritional quality of food and the presence of genetic characteristics such as the MTHFR polymorphism, it is more difficult to obtain enough active folate from diet alone. In such cases, products like Folacid Meta offer a reliable solution for providing the necessary active form of folate. Prevention starts with awareness and regular use – protect your heart and brain by giving your body everything it needs.
Frequently Asked Questions
How can I check my homocysteine levels and when should I do it?
Homocysteine levels are measured with a simple blood test, usually in the morning on an empty stomach. In most laboratories, normal values are approximately between 5 and 15 µmol/L, but the exact reference ranges may vary slightly. The homocysteine test is most often discussed with a doctor when there is a suspicion of a B-vitamin deficiency, premature or familial cardiovascular disease, after a stroke or heart attack, and in certain cases when planning a pregnancy.
Are there any medications that affect folate and homocysteine levels?
Yes, some commonly used medications can lower folate or vitamin B12 levels and thereby indirectly increase homocysteine levels. These include methotrexate (used for rheumatoid arthritis and certain types of cancer), antiepileptic drugs such as phenytoin and carbamazepine, and metformin with long-term use (by reducing vitamin B12). The prolonged use of proton pump inhibitors (omeprazole, pantoprazole) can also reduce the absorption of vitamin B12, and some diuretics affect B-vitamin levels. If you take such medicines long-term, it is wise to consult your doctor about the need to monitor your vitamin B12 and folate levels and, if necessary, to have a homocysteine test.
Sources:
- https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Folate-Consumer/
- https://doi.org/10.1186/1475-2891-14-6
- https://doi.org/10.1146/annurev-nutr-071715-050947
- https://doi.org/10.3109/00498254.2013.845705
- https://doi.org/10.1080/07315724.2004.10719409
