Homocysteine levels as related to Portal Hypertension

Hyperhomocysteinemia is the terminology used to describe high levels of homocysteine in the blood. Homocysteine is an amino acid in the blood. Studies have shown that too much homocysteine in the blood (plasma) is related to a higher risk of stroke, peripheral vascular disease (fatty deposits in peripheral arteries), not to mention coronary heart disease.

Blood in veins and especially arteries are more likely to clot as a result of higher levels of homocysteine, although researchers do not yet know why. What they do know is that a poor diet, low in B vitamins, causes a build-up of homocysteine in the bloodstream, which is not good for our bodies. In a article posted Nov. 24, 2008 on the Canadian Heart and Stroke Foundation web site, Dr. Angela Devlin of the University of British Columbia, thinks that homocysteine may affect the ability of our genes to send information to the liver about how to process fat so it doesn’t end up staying in our bloodstream. Increased amounts of fat can circulate in blood vessels which may heighten the risk of clotting.

Dr. Devlin became excited about the advances in understanding of the interactive effects of dietary components with our genes. She feels this relatively new knowledge will support the development of preventative measures, at least as it applies to heart and stroke prevention, and quite possibly can be carried over in addressing portal hypertension.

If Dr. Devlin’s research is correct, this study will uncover a key mechanism by which our diet interacts with our genes. This could lead to better recommendations for diets that can help prevent heart disease and stroke, as well as potentially leading to genetic therapies to help those at the highest risk.

Not wanting to pour water on Dr. Devlin’s research, I did manage to find a research article posted on The Journal of the American Society of Hematology which contained medical terminology that mostly was hard for me to understand, but ended with an interesting statement.   As was written, “The results of our study do not show that homocysteine lowering by B vitamin supplementation prevents recurrent venous thrombosis”. The research article was titled, “Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: a randomized, placebo-controlled, double-blind trial”. Click the link above to read the article in detail.

When first diagnosed with portal hypertension, my hematologist recommended I take Vitamin B50 to combat higher homocysteine levels. Despite what I have recently learned for and against,  I will err on the side of caution and continue the vitamin protocol in hopes it is working to combat high homocysteine levels thus keep me ticking much longer!   Countless studies have also shown that diet is an important component in one’s overall health, and on that note I try to stay on track by eating healthy foods along with taking my vitamins.

In summation, many will also agree that genetics play a huge role in an individual’s health condition, and how that person responds to treatment.   On that note it be interesting to see what new developments may arise  for treating hyperhomocysteinemia, and how it will affect portal hypertension.

At some point in the near future I hope to address this information with my hematologist and post his thoughts on this blog?  In the meantime, your story or comments concerning this subject are always welcome.

5 thoughts on “Homocysteine levels as related to Portal Hypertension

  1. Patti

    Just had my second banding in eight weeks. I am thankful i am in the states and have the advantage of immediate medical tests and procedures. I have done a lot of research in the past few weeks but feel I have gotten the best info. From you, someone who has experienced much of what I have been through. I have had autoimmune hepatitis for many years. It recently changed to cirrhosis and I have never drank alcohol…go figure. Thanks for your posts hope you are feeling well. Patti

    1. Clint Post author

      Hi Patty,

      Thanks for your comments. Happy to know that you have had the advantage of the tests and procedures where you are located. I hope and pray that you do not have any further complications. As for me I am currently stable and I am thankful for that as things can always be worse! If you have any questions or additional comments please feel free to come back here often. Best regards, Clint

  2. Mark

    Hi Clint,
    Just wanted to thank you for maintaining this blog for awhile now it seems. I am actively researching PVT as I was diagnosed in a 9-day hospital stay in early July with “extensive” PVT. I am on Lovenox currently until my next CT in October. Anyway, the doctors haven’t been able to pin point any root causes so I am searching for what other blood tests should be done to get some ideas. Again, thanks.

    1. Clint Post author

      Hi Mark,

      First of all, please accept my apologies for the delayed response.

      Thank you for your kind words of encouragement regarding this blog. I never pretend to know everything there is to know about this condition, but am always learning and passing on my findings on this blog so others may possibly benefit from what I have gleaned. It is good to actively research the condition, and I think most people do that when they find out the rarity of this condition and other blood clotting issues.

      Like yourself, doctors have never been able to pinpoint the cause of my portal hypertension, and it was not for lack of trying. At the time of my diagnosis for portal vein thrombosis, I was tested for 7 known causes for blood clotting, but tests came back negative on all fronts. Subsequently I was tested again a number of years ago, and still no known cause. That being said, I have talked to many others with the same who have tested positive for at least one cause and you can view that here: https://ghr.nlm.nih.gov/condition/protein-s-deficiency You may want to ask your doctors about this one, or other protein deficiencies to see if that is your cause. The fact is though, you have the same clot as I and a small number of people in th world and likely are by now on the standard protocol for the treatment (not cure) of the said clot. That protocol usually consists of a beta blocker to slow your heart rate down, a blood thinner (Lovenox) in your case, and other meds to counter acid in the stomach which can affect the varices that likely developed in your esophagus due to the clot itself. You can read all that on this blog, but there are also other good resources to explain why they are there, and the (sorry) impending danger they may impose. It all sounds pretty scary I know, but if its any consolation, I know many people including myself who have this and are still doing quite well. I have lived 18 years past my actual diagnosis now, and along the way 3 major events that could have taken me out.

      The latest news on the front of this condition is a non-evasive treatment developed and tested on 61 patients by a team of 14 doctors, and headed up by Dr. Raid Salem at Northwestern University in Chicago. Dr. Salem reached out to be personally back in February to tell me about this procedure, and so far I am hearing good reports. A friend and fellow sufferer from Minneapolis is in Chicago now being evaluated or has already had the procedure so I am anxious to hear what he has to say. Dr.Salem has offered to preview my work-ups so I am in the process of updating everything for his evaluation on my condition. I start this week with an Ultrasound, then I go for a CT Scan with contrast 2 weeks after, with a colonoscopy in October. I posted the procedure on my blog here if you want to read about it: https://www.portal-hypertension.com/2020/03/non-surgical-procedure-portal-vein-thrombosis/
      Also can send you the research papers if you wish – just let me know. I have full permission to send them along to anyone.

      Well I certainly hope this is helpful. I always say don’t despair to people, so I hope you don’t do the same. It can be overwhelming to take it all in, but there are many people who may have to contend with the unknown such as I, but I try to remain optimistic despite the odds. I don’t know where you live, but maybe we could talk in person if you find that would help?

      Keep pressing on – hope to hear back from you soon.



      1. Mark

        Hi Clint,
        Thanks for the thoughtful response. Haha – I hardly consider a day response a delay. No worries!! Yes I am only about 2 months into this so far. I am getting homocysteine levels checked through some of my research (and noted it was brought up here) which wasn’t checked in a hospital stay or followup with hemotology – only upon my prompting. Even though treatment through B-vitamins may not reduce some overall risks, it would be nice to know as so many other tests have given no clues at what is going on or causes. Turns out my homocysteine is indeed highly elevated, so I need to look a bit more into that.

        I did read about the procedure from Dr. Salem you shared. At this point I am not sure if I am going to explore that route or not but sure if you want to send the research. Depends on how or if this resolves or how helpful it may be for my situation as not only the portal vein was blocked but several branching connections. I am not able to exert myself much since being hospitalized as I get to a point where I start having abdominal pain and have to stop, and I have been having some discomfort on and off that my primary care doctor indicated is expected.


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