Homocysteine and hip fracture

Homocysteine and hip fracture are closely correlated. For men the risk is four times, and nearly double for women.

I first came into contact with this dilemma some 30 years ago when attending a lecture by a prominent researcher who was invited to investigate why sheep brought in from the Karoo to a feedlot in the Western Cape were fracturing their forelimbs and walking about on their elbows, so to speak.

On examining the bones of the feedlot sheep he was astonished to discover the calcium content was high, but they were extremely brittle. He went on to research the diet of the sheep, finding that a Karoo lamb would have about 9 percent protein in the diet, but in the feedlot it was raised to over 35%.

Obviously they got a lot less exercise too; couch potatoes, so to speak.

This page was last updated by Bernard Preston on 13th November, 2019.


Homocysteine is a toxic breakdown product during the metabolism of the amino acid methionine. Under normal circumstances, in the presence of certain vital minerals and vitamins, it is immediately deactivated into Glutathione and SAMe.

However, if the levels of zinc and vitamins B2, B6 and B9 are low, the enzymes are unable to do their work with a consequent rise of this amino acid intermediate.

Methionine is an essential amino acid; we cannot survive without it in the diet. Those eating meat have no worries, but vegetarians often get it from sesame seeds ground into a paste called tahini.

Researchers reporting in J Clin Endocrinol Metab say that poor renal function is another cause of raised homocysteine and the associated risk of hip fracture[1].

Homocysteine and hip fracture

Homocysteine and hip fracture can be easily modified by simple dietary intervention according to researchers reporting in the New England Journal of Medicine.[2]

The alternative is not only cardiovascular disease but also osteoporosis with an increased risk of hip fracture, substantial disability, high medical costs and even death.

It is their opinion that raised homocysteine interferes with cross linking in the collagen that forms the substrate of bony tissue, thus weakening the structure and greatly increasing the risk of a break.


Zinc is a vitally important mineral for optimal well-being and prevention of a hip fracture. It is known to be a cofactor in over 300 enzyme reactions, one of which is breaking down homocysteine; a deficiency thus has far reaching consequences in widely diverse parts of the body.

The ten best sources of zinc are grass-fed beef, spinach, asparagus, mushrooms, lamb, sesame and pumpkin seeds, chickpeas, lentils and green peas, and oats.

We need to aim for at least 11mg per day.

A typical helping of beef, from cattle raised on pastures, the size of the palm of your hand, three ounces, contains about 3mg, or a quarter of your daily needs.

However corn-fed beef has only a quarter of the zinc, compared to those raised on pastures. Many other foods such as tomatoes, squash and broccoli also have plentiful zinc but remember it may be lost in the cooking.

In short, if you are eating from a wide range of foods you will probably be getting enough zinc, but the population at large is often deficient.

Vitamin B2, or riboflavin

Vitamin B2 is also required for the breakdown of homocysteine to prevent hip fractures, but is involved in many other pathways in the body too. For example, it is very necessary for energy production, absorption of iron and the production of antioxidants like glutathione, mentioned above.

Good sources are your greens like spinach and kale, legumes, dairy products, chicken and eggs. In short, provided we are eating from a wide range of foods, we need have no fear of a deficiency.

Eggs Hilton for breakfast, this divine green salad for lunch and butter chicken curry for dinner would see you home. But a meat and potatoes man would certainly be deficient with risk of homocysteine cardiovascular disease and hip fracture.

Poached eggs Hilton.
Divine green salad.
Butter chicken curry and salad.

By Bernard Preston

Vitamin b6, or pyridoxine

Pyridoxine is another of the vitamins absolutely essential for the breakdown of homocysteine and the prevention of hip fracture, cardiovascular disease and neurodegenerative condions like Alzheimer's.

This is a subject on which the last word is yet to be written. Many folk who are eating the required daily amount of 1.7 milligrams still have very low plasma levels, and are thus susceptible to raised homocysteine and hip fracture. A deficiency will also make you anaemic as vitamin B6 is central to the manufacture of haemoglobin.

Fish, poultry, pork and beef are all good sources as are sweet potatoes and whole, unrefined grains such as brown rice and our low GI bread. Avocados and our dark green leafy vegetables like spinach again are other good ways to increase your pyridoxine without having to take a supplement.

Because so many people have low plasma levels of vitamin B6 we recommend you overemphasize these foods. Those on the black and white diet are certainly going to be deficient.

Again a wide range of foods will keep you covered. Meat and potatoes will not.

Vitamin B9, or folate

Folate is the last of the vitamins we will be discussing in relation to homocysteine and hip fracture. However, it has far reaching benefits into many other areas of the body, notably prevention of neural tube defects like cleft palate and spina bifida, and formation of healthy red blood cells.

The richest sources are your legumes like lentils and chickpeas, and the dark green leafy vegetables like broccoli, spinach and kale.

There are many different forms of folate so to be getting adequate amounts we need again to be enjoying a wide range of foods.

Our authentic hummus recipe enjoyed liberally on a green salad will take you a long way home.

The elderly are vulnerable

Often when a loved one has passed on, the surviving spouse could not be bothered to cook for themselves and this is when they are particularly likely to be deficient in one or more of these vitamins and zinc that are so vital in the prevention of a devastating hip fracture.

Simple balance exercises done daily also help to prevent a fall. See newsletter #53 at the bottom of any page at chiropractic-help.com for more specifics.

  1. Bernard Preston
  2. Easy Lunch Recipes
  3. Homocysteine and hip fracture
  1. Homocysteine levels and risk of hip fracture in postmenopausal women.
  2. Homocysteine as a Predictive Factor for Hip Fracture in Older Persons.

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Hilton, KZN

South Africa