Inflammation is the buzzword when it comes down to what causes heart disease. It’s the scourge on the body that creates all the issues. However, the bigger question that many practitioners are not asking is: “What’s causing the inflammation around the heart in the first place?”. Three molecules, homocysteine, insulin, and sugar, are the top contenders for “free radical production”. Read on and let’s take a look at these root cause inflammatory markers of cardiovascular disease.

4 causes of inflammation around the heart and cardiovascular system

Generally, a house doesn’t spontaneously combust into flames. There’s something that causes the fire to start in the first place. Let’s assume your inflamed blood vessels and heart are like a house on fire. You can come in with ladder trucks and water, but the fire doesn’t stay out. Why? The reason for the house fire is a burst gas line that continues to feed the fire. Inflammation in your body is the same. Whether it’s hives, joint pain, irritable bowel syndrome (IBS), hormonal disruption, or cardiovascular disease, you might try supplements that may help, however, in the long run, it’s more important to learn the root cause of the inflammation.

1. Homocysteine

Many of you may have never even heard of homocysteine, however high homocysteine levels is a major cause of cardiovascular disease, (11) free radicals (more on these guys later), (27) stroke, (29) and mental illness. (11) It may be the best early indicator for deficiencies of B6, B12, and folate. (8)(17) Also, there is a genetic component to homocysteine levels. In families where there is a history of sudden cardiac deaths in the men of a family, high homocysteine may be the silent cause. (6)

What makes homocysteine so bad? Its shape. If you can imagine a medieval, spiky ball, that is homocysteine. Now imagine that ball cruising along with blood in your soft blood vessels. As it moves along in your vessels, it scratches up the interior causing damage. Think “road rash”, after you have taken a tumble and your knees are all skinned up due to the gravel. That’s what’s happening to the inside of your vessels. (23)

Sounds terrible? Well, it is! This is the beginning of inflammation and plaque formation. Your immune system sees the damage and starts to repair the damage by making a “scab”, white blood cells, and cholesterol rush to the scene, to “pave” over the damage. (30)

practitioner talking to their patient

Your Functional Medicine Health Practitioner can help determine whether homocysteine is a risk factor for you.

What are normal homocysteine levels? The research says that anything less than 6 to 7 umol/L is optimal. Ask your healthcare practitioner for your number to ensure your homocysteine levels fall within the optimal range. (22)

The good news is that appropriate doses of B-complex vitamins, including B6, B12, and folate, can reduce homocysteine levels very effectively and inexpensively. (11) Using an “activated” or “methylated” form of these B vitamins may be more effective. (20)(26)(32)

2. Insulin

Insulin in normal amounts is necessary to move glucose, the body’s form of sugar, into each cell to make energy. However, with the advent of the processed, high carbohydrate, Standard American diet (SAD), insulin levels soar. (16) High amounts of insulin become ineffective because only so much sugar can be shoved into a cell before it’s overloaded. This is called insulin resistance. (34)

The excess insulin signals other molecules to change. For example, in men, testosterone can shift to estrogen, and conversely in women, estrogen shifts to testosterone. These hormonal changes create a number of issues and inflammation results. Obviously, reducing sugar will reduce insulin output. (34)

There are some supplements that will improve insulin sensitivity, and remember, you cannot supplement over a poor diet. In other words, taking supplements is not the answer for insulin resistance in the long run. A lifestyle shift is necessary. However, in the interim, as you are making necessary changes alpha-lipoic acid, (24) resistant starch, (3) and berberine (13) have been shown to improve insulin resistance.

variety of carbohydrates including bread

Diets including high amounts of carbohydrates can increase inflammation in the heart.

3. Sugar and high carbohydrate diets

Sugar and high carbohydrate foods are everywhere. However, many of the foods in the SAD that are deemed “healthy” are really full of empty calories, carbohydrates, and sugar. (9)(19) Take the typical granola bar or yogurt. Each could have up to 30 to 40 g of sugar and carbohydrates. (1)(18)

The Institute of Medicine recommends that adults consume 130 grams of carbohydrates per day in a healthy diet. (28) The two snacks, mentioned above, comprise up to over half of the carbohydrate count for the day. Add in oatmeal or a sandwich and 150 grams of carbs are easy to exceed. Pizza, pasta, breaded anything, croutons, or a roll or bun for your burger also adds needless carbohydrates, devoid of nutrition. Even “whole grains” are loaded with carbohydrates, and in some people, they are not a good choice. (5)

This high carbohydrate/high sugar diet, aka the SAD, is responsible for the rise of diabetes, heart disease, and obesity in the country. (15)(31)

Just like spilling a soda on the counter and leaving it for a couple of days, sugar gets sticky in your body. It sticks to cells, and they can’t communicate properly – like putting a mask on. It sticks to your red blood cells making them less effective at delivering oxygen to the cells of your heart and other organs. (33) In addition, over time, sugar damages the small vessels in your eyes, kidneys, heart, hands, and feet, as in diabetes. (25) A healthy vascular system isn’t only necessary for good heart function, all organs depend on oxygen to make energy. (10)

Since the stickiness of the sugar is the inflammatory root. The way out of high insulin and high sugar is to consume more lean protein and vegetables and less sugar and processed foods. (16)

With all of the confusing dietary recommendations, the one diet that stands as the least controversial is the Mediterranean diet. (15) The focus is on lean proteins and half of your plate filled with vegetables (other than potatoes), and a small serving of whole grains or potato. This diet is associated with an overall lower risk of cardiovascular disease. (12)

4. Reactive radicals

Each of the three molecules, homocysteine, sugar, and insulin, create these “free radicals”. Free radicals do the actual damage inside and outside your cells of every vessel and heart cells, as mentioned above about plaque creation. (7) There’s also an effect on nitric oxide production which allows the vessels to stay flexible. Without this flexibility, hypertension results. (21)

That damage, or oxidation, needs to be repaired, so your immune system gets involved by creating inflammatory and repair molecules. However, when the free radicals continue to be created, by continued poor lifestyle choices, inflammation takes over and repair doesn’t occur. It becomes a vicious cycle. Inflammatory molecules create free radicals which in turn create more inflammatory molecules. These inflammatory molecules, or cytokines, like TNF-alpha, NF-kB, and many interleukins, act to damage the vessels and set you up for more cardiovascular plaque production, heart failure, and other cardiac myopathies. (2)

The answer to all these free radicals causing oxidation is traditional anti-oxidants. Anything from as simple as vitamin A and vitamin C to resveratrol from red wine and anthocyanins, flavonoids, or polyphenols found in dark purple fruits like blueberries and blackberries can help the body fight the damage. (14) Supplements containing these antioxidants may also be used.

The bottom line

Your cardiovascular system depends on having clean vessels to move oxygen and nutrients around your body. Ultimately, the way to tame these molecules and radicals begins with a dietary shift that includes lean protein and lots of vegetables. 80% of our health outcomes have to do with our lifestyle choices. (4) As your diet shifts, less of the inflammatory molecules are made and you become healthier. The homocysteine, insulin, and sugar are present in smaller and more “normal” amounts. Once there are fewer of these molecules, fewer inflammatory molecules are made and fewer free radicals will be created. The cycle is broken!

Fullscript simplifies supplement dispensing

Create your dispensary today I'm a patient
  1. Aleksejeva, S., Siksna, I., & Rinkule, S. (2017). Composition of Cereal Bars. Journal of Health Science, 5(3), 139–145.
  2. Bartekova, M., Radosinska, J., Jelemensky, M., & Dhalla, N. S. (2018). Role of cytokines and inflammation in heart function during health and disease. Heart Failure Reviews, 23(5), 733–758.
  3. Bindels, L. B., Segura Munoz, R. R., Gomes-Neto, J. C., Mutemberezi, V., Martínez, I., Salazar, N., … Ramer-Tait, A. E. (2017). Resistant starch can improve insulin sensitivity independently of the gut microbiota. Microbiome, 5(1), 12.
  4. Bland, J. S. (2017). Cardiology meets personalized lifestyle medicine. Integrative Medicine, 16(6), 12–16.
  5. Brisbois, T., Marsden, S., Anderson, G., & Sievenpiper, J. (2014). Estimated intakes and sources of total and added sugars in the Canadian diet. Nutrients, 6(5), 1899–1912.
  6. Burke, A. P., Fonseca, V., Kolodgie, F., Zieske, A., Fink, L., & Virmani, R. (2002). Increased serum homocysteine and sudden death resulting from coronary atherosclerosis with fibrous plaques. Arteriosclerosis, Thrombosis, and Vascular Biology, 22(11), 1936–1941.
  7. Dizdaroglu, M., & Jaruga, P. (2012). Mechanisms of free radical-induced damage to DNA. Free Radical Research, 46(4), 382–419.
  8. Ganguly, P., & Alam, S. F. (2015). Role of homocysteine in the development of cardiovascular disease. Nutrition Journal, 14(1), 6.
  9. Howard, B. V., & Wylie-Rosett, J. (2002). Sugar and cardiovascular disease. Circulation, 106(4), 523–527.
  10. Institute for Quality and Efficiency in Health Care (IQWiG). (2010). How does the blood circulatory system work? In Retrieved from
  11. Kumar, A., Palfrey, H. A., Pathak, R., Kadowitz, P. J., Gettys, T. W., & Murthy, S. N. (2017). The metabolism and significance of homocysteine in nutrition and health. Nutrition & Metabolism, 14(1), 78.
  12. Kuritzky, L., & Lang, S. (2018). The Mediterranean diet: Lost in translation. Current Hypertension Reports, 20(12), 104.
  13. Li, C., He, J.-Z., Zhou, X.-D., & Xu, X. (2017). [Berberine regulates type 2 diabetes mellitus related with insulin resistance]. Zhongguo Zhong Yao Za Zhi, 42(12), 2254–2260.
  14. Lobo, V., Patil, A., Phatak, A., & Chandra, N. (2010). Free radicals, antioxidants and functional foods: Impact on human health. Pharmacognosy Reviews, 4(8), 118–126.
  15. Locke, A., Schneiderhan, J., & Zick, S. M. (2018). Diets for health: Goals and guidelines. American Family Physician, 97(11), 721–728.
  16. Ludwig, D. S., & Ebbeling, C. B. (2018). The carbohydrate-insulin model of obesity. JAMA Internal Medicine, 178(8), 1098–1103.
  17. Markišić, M., Pavlović, A. M., & Pavlović, D. M. (2017). The Impact of homocysteine, vitamin B12, and vitamin D levels on functional outcome after first-ever ischaemic stroke. BioMed Research International, 2017, 5489057.
  18. Moore, J. B., Horti, A., & Fielding, B. A. (2018). Evaluation of the nutrient content of yogurts: a comprehensive survey of yogurt products in the major UK supermarkets. BMJ Open, 8(8), e021387.
  19. Nguyen, P. K., Lin, S., & Heidenreich, P. (2016). A systematic comparison of sugar content in low-fat vs regular versions of food. Nutrition & Diabetes, 6(1), e193.
  20. Paul, C., & Brady, D. M. (2017). Comparative bioavailability and utilization of particular forms of B 12 supplements with potential to mitigate B 12-related genetic polymorphisms. Integrative Medicine, 16(1), 42–49.
  21. Pinheiro, L. C., Tanus-Santos, J. E., & Castro, M. M. (2017). The potential of stimulating nitric oxide formation in the treatment of hypertension. Expert Opinion on Therapeutic Targets, 21(5), 543–556.
  22. Pizzorno, J. (2014). Homocysteine: Friend or foe? Integrative Medicine, 13(4), 8–14.
  23. Pushpakumar, S., Kundu, S., & Sen, U. (2014). Endothelial dysfunction: The link between homocysteine and hydrogen sulfide. Current Medicinal Chemistry, 21(32), 3662–3672.
  24. Rahimlou, M., Asadi, M., Banaei Jahromi, N., & Mansoori, A. (2019). Alpha-lipoic acid (ALA) supplementation effect on glycemic and inflammatory biomarkers: A systematic review and meta- analysis. Clinical Nutrition ESPEN, 32, 16–28.
  25. Rask-Madsen, C., & King, G. L. (2013). Vascular complications of diabetes: Mechanisms of injury and protective factors. Cell Metabolism, 17(1), 20–33.
  26. Seremak-Mrozikiewicz, A. (2013). Metafolin – alternative for folate deficiency supplementation in pregnant women. Polish Gynaecology, 84(7), 641–646.
  27. Sibrian-Vazquez, M., Escobedo, J. O., Lim, S., Samoei, G. K., & Strongin, R. M. (2009). Homocystamides promote free-radical and oxidative damage to proteins. Proceedings of the National Academy of Sciences, 107(2), 551–554.
  28. Slavin, J., & Carlson, J. (2014). Carbohydrates. Advances in Nutrition, 5(6), 760–761.
  29. Stehouwer, C. D. A., Weijenberg, M. P., van den Berg, M., Jakobs, C., Feskens, E. J. M., & Kromhout, D. (1998). Serum homocysteine and risk of coronary heart disease and cerebrovascular disease in elderly men. Arteriosclerosis, Thrombosis, and Vascular Biology, 18(12), 1895–1901.
  30. Tehlivets, O. (2011). Homocysteine as a risk factor for atherosclerosis: Is its conversion to S-adenosyl-L-homocysteine the key to deregulated lipid metabolism? Journal of Lipids, 2011, 1–11.
  31. Temple, N. (2018). Fat, sugar, whole grains and heart disease: 50 years of confusion. Nutrients, 10(1), 39.
  32. Vrolijk, M. F., Opperhuizen, A., Jansen, E. H. J. M., Hageman, G. J., Bast, A., & Haenen, G. R. M. M. (2017). The vitamin B6 paradox: Supplementation with high concentrations of pyridoxine leads to decreased vitamin B6 function. Toxicology in Vitro, 44, 206–212.
  33. Watała, C. (1988). In vitro glycation of red blood cell proteins: high levels of glucose lower lipid fluidity of erythrocyte membranes. Experimental Pathology, 33(4), 233–238.
  34. Wilcox, G. (2005). Insulin and insulin resistance. The Clinical Biochemist Reviews, 26(2), 19–39.