1- Psychoneuroimmunology

Increased homocysteine is an important risk factor for cardiovascular disease. This risk can be reduced by diet and supplementation with vitamins B6, B12 and folic acid. But which foods help the best? And how much should be supplemented?

Homocysteine is a toxic metabolic product of the amino acid methionine in high doses and is a potent initiator of free radical reactions, among others. The discovery of the role that this substance plays in our body is considered one of the most important clinical findings of the last 10 years.

2- A more important risk factor than cholesterol

The cholesterol hypothesis states that people with high cholesterol have a higher risk of cardiovascular disease. However, in a review of numerous studies involving a total of 68,000 people, it was discovered that “bad” LDL cholesterol is not so bad. According to the researchers, all studies have found that there is no association between high LDL cholesterol and cardiovascular disease in the elderly, or that the association is inversely proportional. Secondly, it means that LDL cholesterol can also be healthy; according to researchers, it may even protect against Parkinson’s and Alzheimer’s. This is different with homocysteine.

Higher levels of homocysteine than cholesterol appear to be an important risk factor for the development of cardiovascular disease. There is growing scientific evidence that homocysteine can damage the blood vessel wall, leading to plaque formation and less elastic blood vessels, thereby impeding blood flow. Homocysteine is also thought to promote platelet clustering. Over time, this can result in a heart attack or stroke. Other conditions such as neural tube defects, mental decline in the elderly (dementia), and rheumatoid arthritis have also been associated with high homocysteine levels.

3- Impaired homocysteine metabolism

In many people, the metabolism of homocysteine is disrupted, and homocysteine is allowed to accumulate. About 9% of the population and about 20% of patients with cardiovascular problems suffer from a genetic abnormality that prevents the adequate breakdown of homocysteine. Therefore, these people have greatly increased blood homocysteine levels. However, it is also important that relative deficiencies of vitamin B6, vitamin B12 and especially folic acid can greatly increase homocysteine levels.

Vitamin B6, B12 and folic acid are substances that are necessary to normalize a high homocysteine level. All of these three B vitamins play an important role in methylation reactions in the body, an important biochemical process in which a methyl group (-CH3) is transferred. Folic acid and vitamin B12 provide the necessary methyl groups. The reformation of methionine from harmful homocysteine is an important example of a methylation reaction. However, well-functioning methylation is also necessary for many other important reactions in the body, such as the synthesis of neurotransmitters and DNA synthesis.

4- A diet rich in B vitamins

The approach always starts with nutrition. Our old foods consisted of B vitamins, fruits, nuts, fish, shellfish, crustaceans. Our modern diet consists mainly of processed and red meat (rich in B12), margarine, dairy products, refined grains and sugars. Moreover, micronutrients have largely disappeared from these energy-rich and easily digestible foods.

In addition to the primal diet, the Mediterranean diet is also associated with increased levels of vitamins and minerals in the body. Mediterranean food mainly consists of fruits, vegetables, complex carbohydrates, olive oil, red wine, fish and white meat. Like primal nutrition, it provides more B vitamins than an average Western diet. These B vitamins contribute to a lower homocysteine content.

If homocysteine is too high, the American Heart Association’s Nutrition Committee recommends supplementing with 2.5 mg of folic acid, 0.5 mg of vitamin B-12 and 25 mg of vitamin B6 per day (in addition to a healthy diet). Thus, with nutrition and supplementation, a lot is possible, both preventive and curative.



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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


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Medically Reviewed by Professor Doctor Alper Demirbaş
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