What are normal homocysteine levels? How are they measured and interpreted? Explore the reference ranges, collection process, and panels related to this important biomarker.

Exploring Normal Homocysteine Levels

Homocysteine is a naturally occurring amino acid in the body that serves as an intermediate in the metabolism of methionine and cysteine. Typically, this amino acid is broken down and processed by the body, but elevated levels can indicate a deficiency in essential vitamins like B6, B9, and B12. Understanding normal homocysteine levels is crucial for diagnosing potential health issues and assessing cardiovascular disease risk.

Purpose and Uses of the Homocysteine Test

The homocysteine test is primarily used to diagnose vitamin B12 or folate deficiencies, as these deficiencies can cause an increase in homocysteine levels. This test may be ordered for individuals who are malnourished, elderly, or have a history of poor nutrition, such as those struggling with drug or alcohol addiction.

Additionally, the homocysteine test can be used as a general screening tool for people at high risk of heart attack or stroke, particularly those with a family history of coronary artery disease but no other known risk factors like smoking, high blood pressure, or obesity. However, the exact role of homocysteine in the progression of cardiovascular disease is still being studied, so routine screening for hyperhomocysteinemia is not universally recommended.

Understanding the Homocysteine Test

The homocysteine test measures the amount of this amino acid present in the blood. Elevated levels typically indicate a deficiency in the essential vitamins that help the body process homocysteine, such as vitamins B6, B9, and B12.

When should you get a homocysteine test? This test may be ordered when a healthcare practitioner suspects a vitamin B12 and/or folate deficiency, as the signs and symptoms can be subtle and nonspecific in the early stages. It may also be part of an assessment of your cardiovascular disease risk, depending on your age and other risk factors.

Obtaining a Homocysteine Test

Homocysteine testing is typically performed at a doctor’s office, hospital, or laboratory setting, as it requires a blood draw. While it is not possible to self-administer this test at home, some mobile laboratories may be able to come to your home to collect the blood sample and then deliver it to a laboratory of your choice.

The cost of a homocysteine test can vary depending on factors such as your location, healthcare provider, and insurance coverage. When ordered by a doctor, insurance usually covers the test, although you may be responsible for a copay or deductible. Your healthcare provider and insurance plan can provide more information about any out-of-pocket costs you may incur.

The Homocysteine Test Process

The homocysteine test requires a blood sample, typically taken from a vein in your arm. No special preparation is usually needed, but your doctor may instruct you to stop taking certain medications or supplements before the test.

During the test, a healthcare professional will clean the area where the needle will be inserted and then draw a small amount of blood into a tube. You may feel a slight sting when the needle enters your skin, but the process usually only takes a few minutes.

After the test, you’ll be asked to apply gentle pressure to the site with a bandage or gauze to help stop any bleeding and prevent bruising. You can then resume your normal activities.

Homocysteine Test Panels and Reference Ranges

Homocysteine levels are typically measured in micromoles per liter (μmol/L) or millimoles per liter (mmol/L). The reference range for normal homocysteine levels can vary slightly depending on factors such as age and gender, but generally, the following guidelines apply:

• Normal range: 5-15 μmol/L
• Mildly elevated: 15-30 μmol/L
• Moderately elevated: 30-100 μmol/L
• Severely elevated: >100 μmol/L

Homocysteine may also be included in certain testing panels, such as a cardiovascular risk panel or a nutritional panel, which can provide more comprehensive insight into your overall health and risk factors.

Interpreting Homocysteine Test Results

Elevated homocysteine levels are typically indicative of a deficiency in vitamins B6, B9, or B12, which are essential for the proper metabolism of homocysteine. However, other factors, such as certain medications, genetic factors, and lifestyle habits, can also contribute to high homocysteine levels.

If your homocysteine test results are outside the normal range, your healthcare provider will work with you to determine the underlying cause and develop an appropriate treatment plan, which may include dietary changes, vitamin supplementation, or other interventions.

Homocysteine Test | Testing.com

Test Quick Guide

The homocysteine blood test measures the amount of homocysteine in your body. Typically, this test is used to diagnose a vitamin B6, B9, B12, or folic acid deficiency. A lack of these important vitamins increases homocysteine and can put you at a higher risk of cardiovascular disease. However, this test can also be ordered for newborns to diagnose a rare inherited disorder known as homocystinuria.

About the Test

Purpose of the test

The homocysteine test may be used in the following ways:

• To diagnose a vitamin B12 or folate deficiency. The homocysteine concentration may be elevated before B12 and folate tests become abnormal. Some health care practitioners may recommend homocysteine testing in malnourished individuals, the elderly (who often absorb less vitamin B12 from their diet), and individuals with poor nutrition, such as drug or alcohol addicts.
• As a general screening for people at high risk for heart attack or stroke. It may be useful if you have a family history of coronary artery disease but no other known risk factors, such as smoking, high blood pressure, or obesity. But the exact role homocysteine plays in the progression of cardiovascular disease has not been established, so the utility of the screening test is questioned. Routine screening for hyperhomocysteinemia, such as for total cholesterol, is not recommended.

What does the test measure?

The homocysteine test measures your blood levels of this naturally occurring amino acid that serves in the body as an intermediate in the metabolism of methionine and cysteine. The amino acid is typically broken down in the blood into other substances your body needs. So elevated levels usually indicate a deficiency of vitamin B12, B6, or folic acid because these vitamins help the body process homocysteine.

When should I get this test?

This test may be ordered when a health practitioner suspects you may have a vitamin B12 and/or folate deficiency. Signs and symptoms are initially subtle and nonspecific. If you have an early deficiency, you may be diagnosed before experiencing any overt symptoms. Other affected people may experience a variety of mild to severe symptoms that can include:

• Diarrhea
• Dizziness
• Fatigue, weakness
• Loss of appetite
• Paleness
• Rapid heart rate
• Shortness of breath
• Sore tongue and mouth
• Tingling, numbness, and/or burning in the feet, hands, arms, and legs (B12 deficiency can cause neuropathy)

Homocysteine testing may be ordered as part of assessing your risk of cardiovascular disease, depending on the individual’s age and other risk factors. It may also be ordered following a heart attack or stroke to help guide treatment.

Finding a Homocysteine Test

How to get tested

Homocysteine testing is usually performed at a doctor’s office or another medical setting like a hospital or lab.

Can I take the test at home?

As a test requiring a blood draw, it is impossible to self-administer a homocysteine test at home. But there may be mobile laboratories in your area which can go to your home to perform the blood draw, then deliver the sample to a laboratory of your choice.

How much does the test cost?

The cost of a homocysteine test will vary depending on factors such as where the test is done and whether you have health insurance. When ordered by a doctor, insurance typically covers the test, although you may have to pay a copay or deductible. Your doctor’s office, lab, and health plan can provide information about any out-of-pocket costs that may be your responsibility.

Taking the Homocysteine Test

The homocysteine test requires a blood sample, usually taken from your arm in a doctor’s office, health clinic, hospital, or lab. A blood sample is typically taken from the baby’s heel for screening tests in newborns.

Before the test

Usually, no special preparation is required for a homocysteine test. Your doctor will tell you if you must stop taking any medications or supplements before the test.

During the test

A blood sample is taken from a vein in your arm. The person taking the sample may tie a band around your upper arm and will clean the area where the needle will be inserted into your skin. A small amount of blood is drawn into a tube. You may feel a slight sting when the needle enters your skin.

The process of taking a blood sample usually takes just a few minutes.

After the test

At a doctor’s office or lab, you will be asked to apply gentle pressure to the site with a bandage or a piece of gauze after the needle is withdrawn. This will help stop bleeding and may prevent bruising. Next, the site will be bandaged. You may resume your normal activities following the test.

A blood draw is a very low-risk procedure. You may have slight bruising at the site where the blood sample was taken.

Homocysteine Test Results

Receiving test results

The doctor who ordered your homocysteine test may share the results with you, or you may be able to access them through an online patient portal. Homocysteine results are usually available within a few business days.

Interpreting test results

In cases of suspected malnutrition, vitamin B12 or folate deficiency, homocysteine levels may be elevated. If an individual does not get enough B vitamins and/or folate through diet or supplements, the body may not be able to convert homocysteine to other forms that can be used. In this case, the level of homocysteine in the blood can increase.

Studies from the mid- to late-1990s suggested that people with elevated homocysteine levels have a much greater risk of heart attack or stroke than those with average levels. Investigating the link between high homocysteine levels and heart disease remains an active area of research.

At present, however, the use of homocysteine levels for risk assessment of cardiovascular disease (CVD), peripheral vascular disease, and stroke is uncertain, given that several trials investigating folic acid and B vitamin supplementation indicate no benefit or lowering of CVD risk.

Additionally, a 2012 study of multiple datasets, including 50,000 people with coronary heart disease, called the potential for a cause-and-effect relationship between homocysteine levels and heart disease into question.

A 2015 review of studies concluded that although there is a relationship between homocysteine and CVD, there is other evidence that precludes homocysteine in being considered a biomarker for the disease. The American Heart Association (AHA) does acknowledge the relationship between homocysteine levels and heart attack/stroke survival rates but doesn’t consider elevated homocysteine an independent risk factor for CVD.

While the AHA does not recommend the widespread use of folic acid and B vitamins to reduce risk of heart attack and stroke, it does promote a balanced, healthy diet. It advises health care practitioners to consider overall risk factors and diet in managing cardiovascular disease.

You may want to ask your doctor the following questions:

• Could any medications I may be taking affect my homocysteine level?
• What are some good sources of folic acid and vitamins B6 and B12?
• Are there any follow-up tests I should do?

• Intrinsic Factor Antibody
• MTHFR Mutation
• Vitamin B Test
• Vitamin B12

Resources

• FamilyDoctor. org: High Homocysteine Level: How It Affects Your Blood Vessels
  Learn More
• FamilyDoctor.org: Vitamin B12  
  Learn More
• MedlinePlus Medical Encyclopedia: Folate deficiency  
  Learn More

Sources

A.D.A.M. Medical Encyclopedia. Homocystinuria. Updated November 1, 2021. Accessed December 21, 2022. http://www.nlm.nih.gov/medlineplus/ency/article/001199. htm.

Baloghova J, Schwartz RA, Baranova Z. Dermatologic Manifestations of Homocystinuria. In: Elston DM, ed. Updated May 17, 2022. Accessed December 21, 2022. http://emedicine.medscape.com/article/1115062-overview

Clarke R, Bennett DA, Parish S, Verhoef P, Dötsch-Klerk M, et al. (2012) Homocysteine and Coronary Heart Disease: Meta-analysis of MTHFR Case-Control Studies, Avoiding Publication Bias. PLoS Med 9(2): e1001177. doi:10.1371/journal.pmed.1001177.

Ganguly P, Alam SF. Role of Homocysteine in the Development of Cardiovascular Disease. Nutr J. 2015;14:6. Published 2015 Jan 10. doi:10.1186/1475-2891-14-6

Harvard T.H. Chan School of Public Health. B Vitamins. Date unknown. Accessed December 21, 2022. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/vitamin-b/

Mandava P, Kent TA. Homocystinuria/Homocysteinemia. In: Lutsep HL, ed. Medscape. Updated July 27, 2018. Accessed December 21, 2022. http://emedicine.medscape.com/article/1952251-overview#a30

MedlinePlus. Homocysteine Test. Updated September 28, 2022. Accessed December 21, 2022. https://medlineplus.gov/labtests/homocysteinetest.html

NewbornScreening.info. CBS (Homocystinemia/cystathionine Beta-synthase Deficiency). Updated March 9, 2020. Accessed December 21, 2022. http://www.newbornscreening.info/Parents/aminoaciddisorders/CBS.html

Warren CJ. Emergent Cardiovascular Risk Factor: Homocysteine. Medscape. Published January 17, 2002. Accessed December 21, 2022. https://www.medscape.com/viewarticle/431273_4

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Homocysteine ​​- when testing is prescribed, homocysteine ​​norms for women and men

December 27, 2021

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Homocysteine ​​is an amino acid that is an intermediate product and is formed during the metabolism of methionine. Normally, the resulting substance, entering into connection with folic acid, vitamins B12 and B6, is quickly transformed and becomes safe for the body. But when these elements are not enough, the level of homocysteine ​​in the blood rises, causing a cytotoxic effect on the body – an increase in the oxidation of free radicals, a violation of resistance to thrombosis, the development of thrombovascular disorders.

Causes of elevated homocysteine ​​levels

Common causes of elevated homocysteine:

Blood glucose in Moscow

from 1 cal. days

from 229 ₽

Homocysteine ​​in Moscow

from 1 cal. days

from 2119 ₽

C-reactive protein (highly sensitive) in Moscow

from 1 cal. days

from 499 ₽

At risk:

• pregnant women who previously had obstetric complications;
• people with ischemic heart disease, venous or arterial thrombi;
• women over 50 who have a family history of thrombosis, stroke and heart attack;
• sedentary and overweight people;
• alcoholics, smokers.

Why is high homocysteine ​​dangerous?

Elevated levels of homocysteine ​​in the blood are dangerous for the following:

1. Damage to the inner wall of blood vessels occurs, which contributes to the formation of cholesterol plaques in these places. Atherosclerosis of the lower extremities is dangerous for the development of gangrene, muscle atrophy, thromboembolism of the vessels of vital organs in case of plaque detachment. This can lead to a heart attack, focal heart degeneration, myocardiosclerosis, intestinal gangrene, and renal hypertension, stroke, and even dementia.
   The greatest danger is an aortic aneurysm, the rupture of which, as a rule, leads to death.
2. The blood coagulation system is activated, which is fraught with atherosclerosis, venous and arterial blood clots.
3. Increased risk of developing dementia, Alzheimer’s disease.
4. During pregnancy, gross malformations of the nervous system of the fetus are possible.
5. Increased risk of miscarriage.

Who needs to get tested for homocysteine?

Indications for testing for homocysteine:

• family history of thrombosis, ischemic heart disease, stroke, heart attack;
• smoking;
• blood clotting disorders;
• preparation for IVF;
• neurological disorders in children;
• chromosomal abnormalities in the fetus;
• complicated pregnancy;
• congenital pathologies of development.

To get the most reliable results, it is necessary to properly prepare for the analysis.

Like any other, a study on the concentration of homocysteine ​​must be taken in the absence of bacterial and viral diseases (14 after complete recovery). It is important to understand that some medications can affect amino acid levels, so be sure to tell your doctor if you are taking any medications. Perhaps he will ask to cancel some of them, unless of course this will affect the quality of life and health.

Blood is taken on an empty stomach, the last meal should be 8-14 hours before the analysis. The conclusion will be ready within 1 business day.

Normal indicators:

• up to 1 year – 2.87-9.99 mmkml / l;
• up to 7 years – 2.76–7.62;
• under 12 years old – 3.43–8.45;
• under 15 years old – girls – 4.07-10.36, boys – 4.71-10.40;
• under 19 years old – girls – 4.92-11.88, boys – 5. 5-13.39;
• after 19 years – women – 4.44-13.56, men – 5.46-20.

An analysis for homocysteine ​​is prescribed by therapists, general practitioners, neurologists, endocrinologists, obstetrician-gynecologists. For a full assessment of cardiovascular risks, in addition, specialists study:

• highly sensitive C-reactive protein test;
• lipid spectrum;
• glucose;
• C-peptide;
• glycated hemoglobin;
• insulin and more.

What to do to normalize the level of homocysteine?

If an increase in homocysteine ​​is detected in a timely manner and measures are taken, the correction is successful. According to available research data, in patients who took folate for three years, the level of homocysteine ​​decreased by 26%.

Each case is individual, only a doctor can foresee all the nuances and develop an adequate treatment for the situation. The most commonly prescribed are L-methylfolate and other B vitamins.

The general recommendations are:

1. Elimination of vitamin deficiency.
2. Quitting smoking, alcohol abuse, and reducing the amount of coffee and caffeinated drinks consumed per day – no more than 5 cups per day.

Recommended daily intake of B vitamins:

• B ₆ – 1.5 mg;
• B ₁₂ – 2.5-3 mcg;
• folic acid – 400 mcg.

You can get these vitamins naturally from:

• cereals – bran, greek, sesame, oatmeal, sunflower seeds;
• dairy products;
• meat and offal – heart, liver;
• vegetables – pumpkin, beans, cabbage, leafy greens, beets, onions, carrots, cucumbers, tomatoes;
• fish;
• egg yolk.

In addition to elevated homocysteine ​​levels, there are other risk factors for developing heart and vascular disease. However, the level of homocysteine ​​is one of the main ones. A sufficient amount of B vitamins is a prerequisite for the correct transformation of this amino acid into safe compounds.

Dear patients! A new important study has been added to our price list – a blood test for HOMOCYSTEIN

Homocysteine ​​is
amino acid that is synthesized from methionine, which is part of the group
essential amino acids in the human body. Methionine enters the body with
protein food of animal origin and is involved in the conversion process
protein into energy. Homocysteine ​​is a byproduct of the digestion of methionine.

In normal quantities
homocysteine ​​does not pose any danger to the body, but when it
increase, it becomes a very toxic substance, accumulating not only in
cells, but also in blood plasma and intracellular space.

More recently received
one conclusion – if homocysteine ​​is elevated, then most likely the patient has
atherosclerosis. That’s why you need
be sure to monitor the level of this indicator in the blood.

Standards
homocysteine.

• Prior to puberty, homocysteine ​​levels in
  boys and girls are approximately the same (about 5 µmol/l).
• During puberty (adolescents) – level
  homocysteine ​​rises to 6-7 µmol / l, in boys this increase is more than
  more pronounced than in girls.

Adult homocysteine:

• Men – 6.26 to 15.01 µmol/l.
• Women
  – from 4.6 to 12.44 µmol/l

Level with age
homocysteine ​​gradually increases, and in women, the rate of this increase
higher than in men. Gradual rise in homocysteine ​​levels with age
attributed to decreased kidney function, and higher levels of homocysteine ​​in men
– more muscle mass.

During pregnancy in
Normally, homocysteine ​​levels tend to decrease. This decline takes place
usually at the border of the first and second trimesters of pregnancy, and then remains
relatively stable. Normal homocysteine ​​levels are restored after
2-4 days after delivery. It is believed that a decrease in homocysteine ​​levels with
pregnancy favors placental circulation.

But if homocysteine ​​is
pregnancy is increased, this leads to violations of the fetoplacental
circulation, which can cause miscarriage and infertility
as a result of implantation defects of the embryo. In the later stages
pregnancy, hyperhomocysteinemia is the cause of chronic
placental insufficiency and chronic intrauterine fetal hypoxia.
It is the increase in homocysteine ​​levels during pregnancy that leads to the development
preeclampsia.

Folic acid deficiency
one of the main causes of hyperhomocysteinemia.

High concentration
homocysteine ​​can be reduced by replenishing the body with an appropriate dose
folic acid, vitamin B6 and B12.

Therefore, it is recommended
these indicators are also checked periodically so that their level remains normal.