Hyperhomocysteinemia: the vitamin deficiency concern in pregnancy

A natural protein by-product, homocysteine is a sulphur-containing amino acid generated from methionine. The levels of homocysteine in the body are usually the result of a person’s dietary habits and their genetic factors, with high homocysteine levels (hyperhomocysteinemia) indicating a vitamin B12 or folate deficiency. Elevated levels may negatively influence many bodily functions including the heart, brain and bones—and can put developing babies at risk in the womb. If you’re trying to get pregnant or at risk of heart disease, and notice any of the symptoms of vitamin deficiency listed below, your doctor may send you to have your homocysteine levels tested.

Elevated levels of homocysteine have been associated with various diseases including cardiovascular disease as homocysteine degrades and inhibits the formation of collagen, elastin and proteoglucans, the three main structural components of arteries. Hyperhomocysteinemia combined with low levels of B6 and B12 are also risk factors for dementia and have also been linked with increased fractures in elderly people. If you’re trying to get pregnant, you’ll likely be well aware of the need to increase your folate intake, as deficiency is associated with foetal neural tube defects—unfortunately, hyperhomocysteinemia’s impact on the blood vessels can result in hypercoagulability, where blood clots more easily than it should. In pregnancy, it is thought this causes the blood vessels in the placenta to become blocked, leading to miscarriage—while not yet proven, if you’re suffering repeat miscarriages, your doctor may recommend checking your homocysteine levels. If you do have your levels checked, remember that normal homocysteine levels fluctuate during pregnancy anyway thanks to all those hormones, and your daily nutrition may affect your levels on a day-to-day basis.

Symptoms of vitamin B12 deficiency may include pale skin, weakness, fatigue, dizziness, mouth sores and mood changes, while symptoms of a folate deficiency are often similar and include fatigue, mouth sores, swelling of the tongue and growth problems in children. Your doctor can perform a simple blood test to measure homocysteine levels and can also detect a vitamin deficiency. If diagnosed with hyperhomocysteinemia, you may have to change your diet to increase your vitamin B and folic acid intake. Foods rich in vitamin B12 include animal products such as fish, meat, eggs and milk; while vitamin B12 is not generally found in plant foods, vegetarians will be able to find many fortified breakfast cereals and other staple foods. Vegetarians will easily find sources of folate with dark leafy greens, asparagus, broccoli, beans, peas and lentils particularly rich.

While studies continue, there are no formal recommendations surrounding homocysteine levels in people at risk of heart disease or expectant mothers, but speak to your doctor if you have any concerns.