Normal range of homocysteine levels. Understanding Homocysteine: Levels, Tests, and Health Implications

24.10.198011.12.2021 by alexxlab

What is homocysteine and why is it important for your health. How do homocysteine levels affect your body. What causes high homocysteine levels and how can they be managed. When should you consider getting a homocysteine test. What are the risks associated with elevated homocysteine levels.

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What is Homocysteine and Its Role in the Body?

Homocysteine is an amino acid present in the bloodstream that plays a crucial role in various bodily functions. It’s primarily involved in the production of proteins and is metabolized by vitamins B12, B6, and B9 (folate) to create other essential chemicals.

The primary functions of homocysteine include:

Converting to methionine, an essential amino acid and antioxidant that synthesizes proteins
Transforming into cysteine, a non-essential amino acid that reduces inflammation, enhances immune cell communication, and promotes liver health

In a healthy individual, homocysteine levels typically range from 5 to 15 micromoles per liter (mcmol/L). Most of this homocysteine is converted into other proteins, maintaining a balance within the body.

The Impact of High Homocysteine Levels on Health

Elevated homocysteine levels, particularly those exceeding 50 mcmol/L, can have detrimental effects on your health. What happens when homocysteine levels are too high?

Damage to the lining of arteries, potentially leading to cardiovascular issues
Increased risk of blood clots and blood vessel blockages
Higher susceptibility to heart attacks and strokes

These health risks underscore the importance of maintaining optimal homocysteine levels through proper diet, supplementation, and lifestyle choices.

Conditions and Disorders Affecting Homocysteine Levels

Several factors can interfere with the normal breakdown of homocysteine, leading to elevated levels in the blood. What conditions are associated with high homocysteine levels?

Deficiencies in vitamins B12, B6, or folate
Heart disease
Rare inherited disorders such as homocystinuria
Kidney disease
Hypothyroidism
Certain medications

Understanding these underlying conditions is crucial for proper diagnosis and management of elevated homocysteine levels.

Health Risks Associated with High Homocysteine

Untreated high homocysteine levels can lead to severe health complications. What are the potential risks of elevated homocysteine?

Increased risk of cardiovascular diseases
Higher likelihood of blood clots
Greater susceptibility to stroke
Potential cognitive decline and dementia
Complications during pregnancy

Given these risks, it’s essential to monitor and manage homocysteine levels, especially for individuals with a predisposition to these conditions.

Homocysteine Testing: When and Why?

Homocysteine testing can be a valuable tool in assessing cardiovascular health and vitamin B deficiencies. When should you consider getting a homocysteine test?

If you have a high risk of heart disease
When experiencing symptoms of vitamin B deficiency
If you have a family history of cardiovascular disorders
As part of a comprehensive health check-up

Common symptoms that might warrant a homocysteine test include:

Persistent dizziness
Unexplained fatigue
Muscle weakness
Pale complexion
Tingling sensations in extremities
Tongue or mouth soreness

It’s important to note that unusual homocysteine levels don’t necessarily indicate a medical condition. Various factors can influence your homocysteine blood levels, including age, gender, diet, and certain medications.

Managing and Maintaining Healthy Homocysteine Levels

If you’ve been diagnosed with high homocysteine levels, there are several steps you can take to manage and maintain healthy levels. What are the primary methods for keeping homocysteine levels in check?

Supplementation with vitamins B6, B12, and folic acid
Dietary changes to increase intake of B vitamins
Lifestyle modifications to reduce overall cardiovascular risk

While increasing vitamin intake is crucial, it’s important to understand that this alone may not be sufficient to reduce your risk of heart disease. To lower your overall cardiovascular risk, consider the following lifestyle changes:

Quit smoking or avoid exposure to secondhand smoke
Limit sodium intake to less than 2,300 milligrams daily
Engage in regular physical activity, aiming for at least 3-5 sessions per week
Monitor and manage your blood pressure
Maintain a healthy weight through proper diet and exercise
Limit alcohol consumption
Manage stress through relaxation techniques or mindfulness practices

These lifestyle modifications, combined with proper supplementation and medical guidance, can significantly improve your homocysteine levels and overall cardiovascular health.

The Role of Diet in Homocysteine Management

Diet plays a crucial role in managing homocysteine levels. What foods can help lower homocysteine levels?

Leafy green vegetables (spinach, kale, collard greens)
Legumes (lentils, chickpeas, beans)
Fruits (oranges, bananas, melons)
Whole grains
Fish (salmon, tuna, sardines)
Lean meats
Eggs
Nuts and seeds

These foods are rich in B vitamins and folate, which are essential for homocysteine metabolism. Incorporating them into your daily diet can help maintain healthy homocysteine levels naturally.

The Impact of Cooking Methods on Nutrient Retention

How you prepare your food can affect its nutrient content. What cooking methods best preserve B vitamins?

Steaming
Microwaving
Stir-frying
Grilling

These methods minimize nutrient loss, ensuring you get the maximum benefit from your B vitamin-rich foods. Avoid boiling vegetables for extended periods, as this can lead to significant nutrient loss.

Homocysteine and Cardiovascular Health: The Connection

The link between homocysteine and cardiovascular health has been a subject of extensive research. How does homocysteine affect your blood vessels?

High levels of homocysteine can damage the lining of arteries, a condition known as endothelial dysfunction. This damage can lead to:

Increased inflammation in blood vessels
Reduced elasticity of arteries
Enhanced platelet aggregation, increasing the risk of blood clots
Oxidative stress, which can further damage blood vessels

These effects collectively contribute to an increased risk of atherosclerosis, the buildup of plaque in arteries, which is a major risk factor for heart disease and stroke.

Homocysteine as a Biomarker for Cardiovascular Risk

While traditional risk factors like cholesterol levels and blood pressure are well-established indicators of cardiovascular health, homocysteine is increasingly recognized as an important biomarker. How does homocysteine compare to other cardiovascular risk factors?

It provides additional insight into vascular health
It can indicate increased risk even when traditional markers are normal
It’s particularly useful in assessing risk in younger individuals
It can help identify those who might benefit from more aggressive preventive measures

However, it’s important to note that homocysteine levels should be considered in conjunction with other risk factors for a comprehensive cardiovascular risk assessment.

Genetic Factors Influencing Homocysteine Levels

Genetic variations can significantly impact an individual’s homocysteine levels. What genetic factors are associated with elevated homocysteine?

Mutations in the MTHFR gene, which is involved in folate metabolism
Variations in genes encoding enzymes involved in the methionine cycle
Inherited disorders of methionine metabolism, such as homocystinuria

These genetic factors can affect how efficiently your body processes homocysteine, potentially leading to elevated levels even with adequate vitamin intake.

Genetic Testing for Homocysteine-Related Disorders

In some cases, genetic testing may be recommended to identify underlying genetic factors contributing to high homocysteine levels. When might genetic testing be considered?

When there’s a family history of early-onset cardiovascular disease
In cases of persistently high homocysteine levels despite treatment
When there’s suspicion of inherited disorders of methionine metabolism
As part of a comprehensive evaluation of cardiovascular risk

Genetic testing can provide valuable insights into an individual’s predisposition to high homocysteine levels and guide personalized treatment strategies.

Homocysteine and Cognitive Health: Emerging Research

Recent studies have suggested a potential link between elevated homocysteine levels and cognitive decline. How might homocysteine affect brain health?

It may contribute to the formation of beta-amyloid plaques associated with Alzheimer’s disease
High levels can potentially damage brain blood vessels, affecting cognitive function
It might interfere with neurotransmitter function, impacting memory and learning
Elevated homocysteine may increase oxidative stress in the brain

While research in this area is ongoing, maintaining healthy homocysteine levels through proper nutrition and supplementation may have potential benefits for cognitive health.

Homocysteine-Lowering Strategies for Cognitive Health

What strategies can potentially support cognitive health by managing homocysteine levels?

Ensuring adequate intake of B vitamins, particularly B12 and folate
Regular physical exercise, which can help regulate homocysteine levels
Cognitive stimulation through mental exercises and social engagement
Managing cardiovascular risk factors, which can indirectly benefit brain health
Considering omega-3 fatty acid supplementation, which may have synergistic effects with B vitamins

While more research is needed to fully understand the relationship between homocysteine and cognitive health, these strategies align with general recommendations for maintaining brain health as we age.

Homocysteine During Pregnancy: Special Considerations

Homocysteine levels during pregnancy require special attention due to their potential impact on both maternal and fetal health. Why is monitoring homocysteine important during pregnancy?

Elevated levels may increase the risk of pregnancy complications
It can affect fetal development, particularly neural tube formation
High levels might be associated with an increased risk of preeclampsia
It may influence birth weight and gestational age at delivery

Given these potential risks, healthcare providers often recommend folate supplementation before and during pregnancy to help manage homocysteine levels.

Nutritional Strategies for Managing Homocysteine During Pregnancy

What nutritional approaches can help manage homocysteine levels during pregnancy?

Taking prenatal vitamins that include folic acid, B12, and B6
Consuming a diet rich in folate-containing foods
Ensuring adequate protein intake from diverse sources
Considering choline-rich foods, which may support methionine metabolism
Staying hydrated to support overall metabolic function

It’s crucial for pregnant women to consult with their healthcare provider before making significant dietary changes or starting new supplements to ensure safety and appropriateness for their individual needs.

Future Directions in Homocysteine Research

The field of homocysteine research continues to evolve, with new areas of investigation emerging. What are some promising directions for future homocysteine research?

Exploring the potential of personalized medicine approaches based on genetic profiles
Investigating the role of homocysteine in neurodegenerative disorders
Examining the interplay between homocysteine and gut microbiota
Studying the long-term effects of homocysteine-lowering interventions on cardiovascular outcomes
Investigating novel biomarkers related to homocysteine metabolism

These research directions hold promise for enhancing our understanding of homocysteine’s role in health and disease, potentially leading to more targeted and effective interventions.

Technological Advancements in Homocysteine Testing

How might technological advancements improve homocysteine testing and monitoring?

Development of rapid, point-of-care testing devices for more accessible screening
Integration of artificial intelligence for interpreting complex patterns in homocysteine data
Advancements in genetic testing to identify individuals at risk for homocysteine-related disorders
Creation of wearable devices that can monitor homocysteine levels in real-time
Improvements in metabolomics techniques for a more comprehensive understanding of homocysteine metabolism

These technological advancements could potentially revolutionize how we approach homocysteine testing and management, leading to more personalized and effective interventions.

As research in the field of homocysteine continues to advance, it’s crucial for individuals to stay informed about their homocysteine levels and work closely with healthcare providers to maintain optimal health. Regular check-ups, a balanced diet rich in B vitamins, and appropriate supplementation when necessary can all contribute to managing homocysteine levels effectively. By understanding the role of homocysteine in our bodies and taking proactive steps to maintain healthy levels, we can potentially reduce our risk of various health complications and improve our overall well-being.

Levels, Tests, High Homocysteine Levels

What is homocysteine?

Homocysteine is an amino acid. Amino acids are chemicals in your blood that help create proteins. Vitamin B12, vitamin B6 and vitamin B9 (folate) break down homocysteine to generate other chemicals your body needs.

What does homocysteine do?

When it interacts with the B vitamins, homocysteine converts to two substances:

Methionine, an essential amino acid and antioxidant that synthesizes (creates) proteins.
Cysteine, a nonessential amino acid synthesized from methionine that reduces inflammation, increases communication between immune cells and increases liver health.

What happens if I have too much homocysteine?

In a healthy person, homocysteine levels are around five to 15 micromoles per liter (mcmol/L). Nearly all that homocysteine converts to other proteins.

If you have more than 50 mcmol/L, the excess homocysteine may damage the lining of your arteries (blood vessels that carry oxygen-rich blood throughout your body). High levels of homocysteine can also lead to blood clots or blood vessel blockages. Artery damage or blood clots significantly raise your risk of heart attack.

Common Conditions & Disorders

What conditions and disorders affect homocysteine?

Typically, homocysteine breaks down into other substances, and only small amounts of homocysteine remain in your blood. Some conditions interfere with this process and leave you with high homocysteine levels.

You may have too much homocysteine in your blood if you have:

Deficiencies in vitamins B12, B6 or folate.
Heart disease.
Rare inherited diseases, such as homocystinuria (when your body can’t process methionine).

What are the risks of high homocysteine levels?

Without treatment, elevated homocysteine levels can lead to severe health complications. Too much homocysteine increases your risk for:

How do I know if I need a homocysteine test?

You may need a homocysteine test if you have a high risk of heart disease. You may also need a homocysteine blood test if you have symptoms of a vitamin B deficiency. Common symptoms of vitamin B deficiencies include:

Dizziness.
Fatigue.
Muscle weakness.
Pale complexion.
Tingling in your feet, arms or hands.
Tongue or mouth soreness.

What do the results of a homocysteine blood test mean?

Unusual homocysteine levels do not necessarily mean you have a medical condition. Other factors can affect your homocysteine blood levels, including:

Caring for Your Homocysteine Levels

How can I keep my homocysteine levels healthy?

If you have high homocysteine levels, your healthcare provider may recommend taking supplements of:

Vitamin B6.
Vitamin B12.
Folic acid (the human-made form of folate).

Increasing your vitamin intake alone does not reduce your risk of heart disease. You can lower your risk of heart disease by:

Avoiding or quitting smoking.
Consuming less than 2,300 milligrams of sodium daily.
Exercising at least three to five times weekly.
Managing your blood pressure.

When to Call a Doctor

What should I ask my doctor about homocysteine levels?

You may want to ask your healthcare provider:

What is the most likely cause of high homocysteine levels?
How can I lower my homocysteine?
How can I prevent my homocysteine levels from increasing again?
What are the risks of elevated homocysteine levels?

A note from Cleveland Clinic

Homocysteine is an amino acid. Vitamins B12, B6 and folate interact with homocysteine and create other proteins that your body needs. Typically, very little homocysteine stays in your blood. High homocysteine levels could mean you have an underlying condition such as heart disease or homocystinuria. Your healthcare provider may order a homocysteine blood test. Based on the test results, your healthcare provider can recommend the best treatment option.

How It Affects Your Blood Vessels

What is homocysteine?

Homocysteine is an amino acid (a building block of protein) that is produced in the body.

How is a high homocysteine level harmful?

High homocysteine levels in the blood can damage the lining of the arteries. High levels may also make the blood clot more easily than it should. This can increase the risk of blood vessel blockages. A clot inside your blood vessel is called a thrombus. A thrombus can travel in the bloodstream. From there, it can get stuck in your:

Lungs (called a pulmonary embolism).
Brain (which can cause a stroke).
Heart (which can cause a heart attack).

Some people have very high levels of homocysteine. They are at an increased risk for heart disease.

What causes a high homocysteine level?

Homocysteine is normally changed into other amino acids for use by the body. Vitamin B helps your body use the homocysteine. If your homocysteine level is too high, you may not be getting enough B vitamins.

Most people who have a high homocysteine level don’t get enough folate (also called folic acid), vitamin B6, or vitamin B12 in their diet. Replacing these vitamins often helps return the homocysteine level to normal. Other possible causes of a high homocysteine level include:

Low levels of thyroid hormone.
Kidney disease.
Psoriasis.
Some medicines.
When the condition is common in your family.

How is the homocysteine level measured?

Homocysteine is measured using a simple blood test. If your homocysteine level is too high, you need to lower it. This is especially important if you have blockages in your blood vessels. Sometimes your doctor may take a watchful waiting approach. This means he or she will monitor your level closely but not take steps to lower it. Your doctor may do this if you have no other major risk factors for cardiovascular disease and you don’t have atherosclerosis (a buildup of plaque in your arteries). If your homocysteine level increases further, you may need to lower it.

No studies have shown that lowering homocysteine levels helps reduce strokes, heart attacks, or other cardiovascular conditions. But a high homocysteine level is a risk for heart disease. So it’s a good idea to lower it if you can.

Path to improved health

How can I lower a high homocysteine level?

Eating more fruits and vegetables can help lower your homocysteine level. Leafy green vegetables such as spinach are good sources of folate. Other good sources of folate include:

Many breakfast cereals.
Fortified grain products.
Lentils.
Asparagus.
Most beans.

You may need to increase the amount of vitamin B-6 in your diet. Foods that are rich in vitamin B-6 include:

Fortified breakfast cereals.
Potatoes.
Bananas.
Garbanzo beans (chickpeas).
Chicken.

You also may need to increase the amount of vitamin B-12 you eat. Good sources of vitamin B-12 include:

Dairy products.
Organ meats (such as liver).
Beef.
Some types of fish.

Adjusting your diet may not be enough to lower your homocysteine level. If it’s not, your doctor may suggest that you take a folate supplement. You may also need to take a vitamin B-6 and vitamin B-12 supplement.

Things to consider

If you start taking folate or vitamin B supplements, you should have your homocysteine level rechecked after 8 weeks. If your homocysteine level remains high, your doctor may have you try a higher dose. You may need to have some tests to see if you have another health condition that causes high homocysteine levels. If you have had a high homocysteine level, you may need to have your level checked more regularly (2 or 3 times a year).

Questions to ask your doctor

What is causing my homocysteine level to be high?
Could a high level be the sign of another condition?
Can I lower my homocysteine level through diet alone?
Should I take a supplement?
Can I ask my doctor to check my homocysteine level even if I have no symptoms?

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Gender- and age-related differences in homocysteine concentration: a cross-sectional study of the general population of China

This study was conducted to investigate the distribution of plasma Hcy concentrations in males and females in China and its change with age and to explore independent factors affecting the Hcy concentration. A total of 7872 individuals from among a total of 116,940 people participated in this study. The proportion of males participating was higher (63% of the cohort) than in the general Chinese population, which is about 51.1% according to the National Bureau of Statistics (https://www.stats.gov.cn). This may be because some of the people who visited the hospital for a routine health check-up were referred by their employers and men have higher employment rates than women.

The results of the data analysis showed that the plasma Hcy levels first decreased and then increased, in both males and females, being lowest at 30–50 years of age and increasing significantly after 50 years of age. The trend differs from studies of the white and black populations in the United States, which showed that Hcy concentrations increase with age throughout adulthood¹⁵. The mean Hcy concentration levels also showed racial and ethnic differences. The geometric mean plasma tHcy level (13.5 umol/L for males and 9.7 umol/L for females) for our subjects tended to be higher compared with the geometric mean values in the U. S. NHANES report¹⁵ (9.6 and 7.9 umol/L in non-Hispanic white males and females, respectively, 9.8 and 8.2 umol/L in non-Hispanic black males and females, respectively, and 9.4 and 7.4 mmol/L in Mexican American males and females, respectively), geometric means in the Hordaland Homocysteine Study for Norway⁵ (10.8 umol/L for men and 9.1 umol/L for women), and geometric means reported in Korean adults¹⁸ (11.18 umol/L for men and 9.20 umol/L for women). The data indicate that the reference range of Hcy concentration in Western countries may not be applicable to Chinese people.

Based on the analysis of Hcy levels in men and women in this study, the results showed definite differences by gender. In comparison with females, Hcy levels in males were significantly higher at each age range, and the trend did not abate with age. In addition, the percentage of males with hyperhomocysteinemia was also higher than that of females at all ages. Previous studies have reported possible associations between various endogenous sex hormones and Hcy levels. Studies have shown that males have higher concentrations of Hcy than females, but the difference diminishes after menopause¹⁹. However, our study shows that gender-related differences persist over the lifespan, eliminating the beneficial effects of estrogen. This is consistent with the results reported by Cohen et al.¹⁴, which indicates that these gender-related differences persisted in a subgroup analysis of the subjects above the age of 55 years. In another study on sex hormones and the Hcy level in older males, the results did not support a direct role of circulating sex hormone levels in regulating the fasting Hcy concentration in middle-aged and older males²⁰. Our collinearity analysis showed independent effects of age and gender in the relationship with Hcy.

It is well known that vitamin B12 deficiency is a major contributor to elevated Hcy levels. Deficiency of vitamin B12, an important methyl-cobalamin synthesis enzyme, can lead to impaired Hcy re-methylation and Hcy accumulation¹⁷. Additionally, vitamin B12 deficiency was found to be significantly associated with gender, and the mean values of serum vitamin B12 concentration for men are lower than those for women^21,22. The above suggest that vitamin B12 may explain the relationship between gender and Hcy concentration. The values of serum vitamin B12 in this study were not recorded, which limits the current study. However, according to one previous study, men still had a higher OR (3.44; 95% CI, 2.89–4.09) for hyperhomocysteinemia compared to women, after adjusting for vitamin B12 and some other related confounders (age, smoking status, kidney function and folate). Even if vitamin B12 plays a role in the relationship between gender and Hcy concentration, it seems that the findings of the current study cannot be explained solely by vitamin B12.

These highlight that gender per se is a possible unique independent factor in Hcy concentration and perhaps the difference in Hcy concentration between males and females can be explained by gender-related differences in Hcy metabolism. We noticed that males need to produce creatine more often than females because they have more muscle mass²³. Part of the methyl donor needed for creatine synthesis comes from s-adenosyl methionine conversion to s-adenosyl homocysteine. S-adenosyl homocysteine is the precursor of Hcy²⁴, as shown in Fig. 4. Contrarily, studies have shown that females have a greater Hcy flux through the transsulfuration pathway, which lowers the Hcy concentration²⁵.

Figure 4

Pathways of homocysteine metabolism.

According to the data analysis, age also has a significant effect on serum Hcy concentration. After 50 years of age, the Hcy concentration is significantly higher than in other age groups. We speculate there are two reasons for this: first, decreased liver and renal function induce decreased Hcy metabolism in the elderly, resulting in increased serum Hcy concentration; second, the digestive and absorption dysfunction of the elderly lead to vitamin B12 and folate deficiencies, which affects Hcy metabolism. This suggests that clinicians should pay special attention to elderly patients, especially those with cardiovascular and cerebrovascular diseases, as an elevated plasma Hcy level has been reported to be associated with major components of the cardiovascular risk profile^5,26 and endothelial dysfunction²⁷. However, it is worth noting that in the multivariate regression analysis of males and females, age is an independent risk factor for homocysteine only in females. In males, age is significant only before the confounders were adjusted, which seems inconsistent with the relationship between age and Hcy concentration shown in the figures.

Independent factors affecting the Hcy concentration in males and females were explored. The results showed that these factors were different in males compared to females. In males, factors associated with Hcy concentration were eGFR, BUN, cystatin C, DBP, smoking status, fT3 and K, while in females, factors associated with Hcy concentration were, cystatin C, albumin, fT4, fT3, age, and K. Additionally, a previous study found that high Hcy levels were negatively associated with cardiovascular health in females, but not in males²⁸. This indicates that not only are the factors affecting Hcy in males and females different, but also, the effects on the body are different, which is very interesting and worth further study.

A previous study showed a negative linear association between the plasma Hcy level and GFR²⁹. Hyperhomocysteinemia occurs when the GFR is about 60 mL/min, and the possibility of hyperhomocysteinemia in end stage renal disease is 85–100%³⁰. Proposed mechanisms for the relationship between renal function and Hcy include reduced renal elimination of Hcy and damaged non-renal disposal³¹. Damaged non-renal disposal includes the inhibition of crucial enzymes in Hcy metabolism³¹ and abnormal folate metabolism when in renal failure³⁰. There was one notable contradictory result in that BUN was negatively correlated with Hcy, which should be positively correlated according to the above theory. Urea is the main end product of protein metabolism and Hcy is a methionine metabolism intermediate, which mainly binds to albumin by the disulfide bond. We hypothesized that BUN levels increase when the body is in a high catabolic state, and Hcy levels decrease as a result of decreased protein levels. This assumption, however, was not confirmed.

fT3 was negatively correlated with Hcy in both men and women. Increased fT4 was associated with increased Hcy in women. Studies on thyroid function and Hcy have shown increased Hcy levels in patients with hypothyroidism and subclinical hypothyroidism^32,33, and low Hcy levels in patients with hyperthyroidism³⁴. A study³⁵ reported negative correlations between Hcy and TSH and fT3, and a positive correlation between fT4 and Hcy. However, only the data exists and no theory was proposed. Whether there is a causal relationship between Hcy concentration and thyroid function needs further investigation. It is interesting that the average fT3 level of men is higher than that of women³⁶, but the higher fT3 levels do not help men have a lower Hcy level than women. It may be that other factors that increase Hcy in men mask this effect.

In addition, multiple linear regression analysis showed that the Hcy concentration was positively correlated with albumin levels in females. Hcy is an intermediate product of methionine metabolism. In vivo, it is mainly bound to albumin by the disulfide bond, and very little Hcy is in the free state. Table 2 shows that the average albumin level in females is lower than in males. Whether the lower Hcy level is related to the low albumin level remains to be confirmed. Furthermore, according to the molecular studies on Hcy toxicity, protein N-homocysteinylation is one of the important pathogenic and toxic mechanisms of hyperhomocysteinemia³⁷. It has been proved that Hcy and its derivatives can modify protein targets including albumin, hemoglobin, low density lipoprotein, cytochrome C, C-reactive protein, etc.^38,39,40,41. Protein N-homocysteinylation provided another perspective for us to analyze the gender difference in hyperhomocysteinemia.

Serum potassium was negatively correlated with Hcy in both men and women. As far as we know, there is no research showing that serum potassium has a biological effect on Hcy concentrations. But when potassium was added to the multiple regression model, the regression coefficients of the other variables in the model changed greatly and the goodness of fit of the model improved. Even with a sample of such magnitude, significant associations might be random, particularly for associations which carry no biological plausibility. Considering that the inclusion of potassium to the model only affects the size of the regression coefficient of other variables, but not its significance, we displayed the results that contained potassium just in case there are biological processes associated with potassium and Hcy that we don’t know yet.

This study is the first statistical analysis of the Hcy concentration over the lifetime in males and females, separately, and the first investigation of the factors associated with the Hcy concentration. We found significant differences in Hcy level between males and females, which differences did not diminish in old age. At the same time, the relationship of thyroid function and albumin with Hcy was confirmed for the first time, providing abundant reliable data for further understanding Hcy and clues and ideas for further exploration of the effects of Hcy on the body.

Our study has some limitations that deserve mentioning. First, we were unable to infer causality because this was a retrospective cross-sectional study. However, the examined association implies causation. Second, important parameters (vitamin B12 and folate levels, sex hormones, etc.) should be framed as residual confounding to avoid a false positive (Type I) error. However, we can only discuss confounding factors qualitatively rather than quantify their effects because they were not recorded during the health checks. The third limitation concerns the external validity of the study. Because Hcy tests are only given to individuals or groups that have purchased more expensive medical checkup packages, the subjects in this study may not be a good representation of different socioeconomic classes. However, although the external validity of the study is limited, it is not expected to influence the examined associations. Last, the relationship between serum potassium and Hcy concentration may be only at the analytical level.

Why High Homocysteine is Bad + Should You Decrease It? SelfDecode Labs

High homocysteine can be a marker of vitamin deficiency. It has been linked to many health problems including heart disease, dementia, and Alzheimer’s. However, studies have shown that lowering homocysteine with vitamin supplements doesn’t necessarily produce desired health benefits and may even be harmful. This post explains homocysteine, reviews the factors that influence its levels, including diet, lifestyle, and genetics (i.e. MTHFR mutation), and discusses the best ways to optimize your levels in ways that are actually conducive to better health.

What is Homocysteine?

Homocysteine is a sulfur-containing amino acid that the body produces from another amino acid, called methionine. Foods that are high in methionine include meat, egg whites, and seafood.

Homocysteine is usually found in very small amounts in your body. That’s because your body converts it efficiently into other products with the aid of B vitamins. Higher homocysteine levels can indicate a deficiency of these vitamins [1].

Apart from vitamin deficiency, higher homocysteine levels have been linked to heart disease, cognitive dysfunction, and dementia.

The Breakdown of Homocysteine

Homocysteine is converted into less toxic and more useful amino acids via two biochemical pathways, i.e. remethylation or transsulfuration:

Remethylation – A methyl group from 5-MTHF, a breakdown product of dietary folate, or betaine is added to homocysteine to convert it back to methionine. Vitamin B12 is needed in this process, as are the enzymes methionine synthase MTHFR [2, 3].
Transsulfuration – Homocysteine is converted to cystathionine by cystathionine β-synthase. Vitamin B6 is needed for this conversion [2, 3]. Cystathionine can then be converted into cysteine and subsequently glutathione (a very powerful antioxidant) [4].

When homocysteine can not be converted to other compounds, it builds up in the body and may cause damage. B vitamins play a very important role in this balance.

Homocysteine Blood Test

A doctor may order a homocysteine test to:

Find out if there is vitamin B12, folate, or vitamin B6 deficiency
Check for heart disease in people at high risk
Help diagnose homocystinuria, a rare genetic disorder

Homocysteine is not a commonly used test. It’s relatively expensive and rarely covered by insurance. Ranges and results may slightly vary from lab to lab, due to differences in equipment, techniques, and chemicals used.

A high-protein meal can significantly increase homocysteine levels. Therefore, fasting throughout the night before a blood test is recommended to ensure the most accurate results [5].

Reference Ranges

The normal range of homocysteine is usually below 15 micromoles per liter (µmol/L).

Elevation in homocysteine can be [2]:

Moderate: 15 – 30 µmol/L
Intermediate: 30 – 100 µmol/L
Severe: > 100 µmol/L

High Homocysteine Levels

Factors That Increase Homocysteine Levels

A result that is higher than normal doesn’t necessarily mean that you have a medical condition needing treatment. Your doctor will interpret a high homocysteine result together with your medical history, signs and symptoms, and other test results.

Causes listed below are commonly associated with elevated homocysteine. Work with your doctor or another health care professional to get an accurate diagnosis.

1) B Vitamin Deficiency

Homocysteine levels increase if there is:

Vitamin B12 deficiency [6, 7]
Vitamin B6 deficiency [6]
Folate (vitamin B9) deficiency [6, 7]

Several studies that looked at people with different dietary patterns, found that people who were on a vegetarian or a vegan diet had significantly higher homocysteine levels, likely due to lower vitamin B12 levels [8, 9, 10, 11].

2) Smoking

Studies suggest that both smoking and exposure to second-hand smoke can increase homocysteine levels [12, 13].

3) Alcohol

Daily alcohol consumption can increase homocysteine levels, likely by lowering vitamin B12 and folate levels [14, 15].

4) Stress

Several studies suggest that stress may increase homocysteine levels [16, 17, 18].

5) Medication

Several drugs can increase homocysteine levels, including:

Methotrexate, an immunosuppressant [19, 20]
Metformin, used in diabetes [21]
Cholestyramine, used to lower cholesterol [22]
Antiepileptics [23, 24, 25]

6) Kidney Disease

Kidneys help transform homocysteine into other amino acids [26]. Therefore, a decrease in kidney function can cause an accumulation of homocysteine.

This explains why those with kidney disease have high homocysteine levels [27, 28, 29].

7) Hypothyroidism

Several studies have found higher homocysteine levels in hypothyroidism [30, 31, 32].

A meta-analysis of 17 studies found that hypothyroid people not treated with levothyroxine (synthetic T4) had increased homocysteine levels, associated with the severity of hypothyroidism. Further, levothyroxine treatment was effective in reducing homocysteine levels [33].

8) Dental Health

Chronic periodontitis (inflammation of the teeth and gums) has been linked to elevated homocysteine levels in studies. This elevated homocysteine level returns to normal after the periodontal diseases are treated [34, 35].

9) Genetics

Homocysteine levels increase in a rare inherited condition called homocystinuria [36, 37]. If severely elevated homocysteine levels are found, your doctor will usually do more testing to rule out or confirm a diagnosis.

Other than homocystinuria, slight elevations in homocysteine can be caused by relatively common mutations in the MTHFR gene [38, 39, 40].

Every individual has 2 MTHFR alleles (1 from each parent). Mutation in just one MTHFR alleles is referred to as “heterozygous”; mutations of both is called “homozygous”. Approximately 10% of people of European descent have two mutations in this gene (homozygous form).

The two most common MTHFR mutations (polymorphisms) found in humans are:

MTHFR C677T (Rs1801133). This mutation (the A allele) is associated with reduced enzyme activity, elevated total homocysteine levels and altered distribution of folate [41]. People with one “A” allele for this mutation have a 35% lower and people with “AA” genotype 68% lower enzyme activity [42].
MTHFR A1298C (rs1801131). This mutation also impacts the MTHFR activity and homocysteine levels but to a lesser extent than C677T [41].

In a study of 872 healthy people, those who were homozygous for the MTHFR mutation (MTHFR 677TT genotype) were 10 times more likely to have high homocysteine levels compared to those with normal MTHFR [40].

Other genes that can impact homocysteine levels are genes that encode methionine synthase (MTR; rs1805087) and cystathionine-β-synthase (CBS; rs5742905, rs121964962) [40].

Diseases Associated with High Homocysteine

Elevated homocysteine levels have been linked to a number of diseases.

However, if you have high homocysteine levels it doesn’t mean you have any of the below-listed diseases!

High homocysteine levels are also encountered in:

Sleep apnea [43]
Autism [44, 45]
Gut disorders [6]

It is important to correct your homocysteine levels if possible. High homocysteine increases the risk of:

Heart disease [6]
Hardening of the arteries [6, 46]
Cognitive decline and dementia [46, 47]
Alzheimer’s [6]
Osteoporosis and bone fractures [6, 48, 49]
All-cause mortality [50, 51, 52, 53, 54, 55]

1) Heart Disease

High homocysteine (hyperhomocysteinemia) has been suggested as a potential risk factor for heart diseases since the early 90s [56, 57].

Studies have shown that higher fasting blood homocysteine levels are linked to a higher risk of heart disease and stroke [56, 58, 59].

However, the exact role homocysteine plays in heart disease has not yet been confirmed. Some scientists suggest that higher levels of homocysteine contribute to the narrowing and hardening of the arteries (atherosclerosis) [6, 60, 61, 59].

On the other hand, a large study of over 115k people suggests that lifelong moderate homocysteine elevation (based on genetics) had little or no effect on heart disease and calls previously published studies into question [62].

In addition, there is some controversy when it comes to lowering homocysteine levels using supplements. Large-scale studies have shown that using combined vitamin B supplements to lower homocysteine was ineffective in preventing heart disease, and even harmful in some cases [63, 64, 65]!

A meta-analysis of 15 studies with over 71k people has found that homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination had no effect on preventing heart attack or all-cause mortality compared to placebo, although there was a very small benefit when it came to preventing stroke [66].

Therefore, homocysteine may not actually be a risk factor but a risk marker for heart disease, harmful when elevated due to other factors that increase heart disease risk, such as a diet rich in red meat and low in fruits and vegetables or smoking [67].

Because of the discrepancies listed above, the American Heart Association doesn’t consider homocysteine a major factor for heart disease. That’s also why routine testing is not recommended [68, 67].

Technical: Homocysteine may cause an inflammatory response in vascular smooth muscle cells by stimulating CRP production. However, this is based on animal research and has yet to be confirmed in humans [69]. CRP or C-reactive protein is a well-known marker of chronic inflammation that can increase the hardening of the arteries and heart disease risk.

2) Insulin Resistance

A study has found that people with insulin resistance tend to have higher homocysteine, likely due to the effects of insulin exerts on homocysteine metabolism and kidney clearance [70].

3) Depression

A study with 924 men found that those in the upper third of homocysteine levels were more than twice as likely to be depressed than those in the lowest third [71].

A second study found that individuals with the highest homocysteine levels (>12 µmol/L) tended to have lower levels of SAMe, a nutrient that is vital for the production of neurotransmitters associated with mood-enhancement [72].

In a study in 236 hospitalized acutely ill older patients, supplementation with vitamins B2, B6, B12, and folic acid decreased homocysteine levels and reduced depressive symptoms [73].

4) Cognitive Function, Dementia, and Alzheimer’s Disease

A systematic review and meta-analysis of 111 articles found an association between cognitive decline and increased plasma homocysteine levels. However, treatment with vitamin supplements failed to prevent cognitive decline [74].

Similarly, a meta-analysis of 10 studies with 1.9k people with cognitive impairment and 21 studies with over 15k people without cognitive impairment found that higher homocysteine was associated with an increased risk of cognitive impairment and dementia. But there was no obvious cognitive benefit of lowering homocysteine using B vitamins [75].

In a study of 1.9k people without dementia, higher homocysteine levels were associated with an increased risk of developing dementia and Alzheimer’s disease over the following 8 years. Homocysteine levels above 14 µmol/L were associated with nearly twice higher Alzheimer’s disease risk [76].

Cell and animal models suggest that homocysteine may be able to trigger neuronal damage through oxidative stress, DNA damage and activation of pro-apoptotic (pro-cell death) factors in cell and animal models [77]. However, these findings don’t necessarily apply to humans.

5) Autoimmune Disease

Homocysteine levels can be higher in some autoimmune diseases such as

Rheumatoid arthritis patients [78]
Lupus [79, 80]
Psoriasis [81]

Homocysteine levels are only elevated in some cases of multiple sclerosis, but not others [82].

6) Osteoporosis

Higher homocysteine has been associated with a higher risk of osteoporosis [6, 83].

However, treating high homocysteine with vitamin B supplements is unlikely to help. A study in over 75k women found that vitamin B6 and B12 supplements, alone or combined, increased the risk of hip fractures by up to 50% [84].

7) Migraine

While we still don’t completely understand the causes of migraines, some clinicians speculate that homocysteine may cause migraines by inflaming the blood vessels and contributing to the blood clotting cascade (thrombosis).

The concentration of homocysteine in cerebrospinal fluid that bathes the brain is increased in migraine patients [85].

People who have mutations in genes that are involved in homocysteine metabolism, such as MTHFR mutation rs1801133, are more likely to get a migraine [86].

B vitamin supplementation decreased the severity and frequency of migraine attacks in some studies [85, 87, 88].

However, the association between migraine and homocysteine levels is speculative and further research is needed to confirm it.

Low Homocysteine

Although much rarer, and generally less of an issue than high levels, low homocysteine levels may also cause problems.

For example, adequate homocysteine levels are necessary for the production of factors important for detoxification (e.g. glutathione production), such as cysteine, taurine, and sulfate. Thus, low homocysteine levels can restrict detoxification pathways that respond to oxidative stress [89].

Low homocysteine has been associated with nerve damage of unknown cause (idiopathic peripheral neuropathy) [90].

How to Decrease Homocysteine Levels

The most important thing is to work with your doctor to find out what’s causing your high homocysteine levels and to treat any underlying conditions.

Discuss the lifestyle changes listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!

1) A Healthy Diet

The best way to prevent homocysteine from increasing is to ensure your diet contains adequate amounts of folate (vitamin B9), vitamin B12, and vitamin B6.

Folate is abundant in fresh fruits and vegetables, while vitamin B12 is found in animal products, including meat, fish, cheese, and milk. The richest sources of vitamin B6 include fish, beef liver, potatoes and other starchy vegetables, and fruit (other than citrus).

Studies suggest that simply supplementing with these vitamins to lower homocysteine levels doesn’t prevent diseases and disorders associated with high homocysteine, such as heart disease, impaired cognitive function, dementia, and osteoporosis. In fact, taking combined vitamin B supplements may even be harmful [84, 65].

In other words, homocysteine is likely a marker of a healthy diet and lifestyle, and not a target to address in its own right. So it’s important to check your vitamin levels and correct any deficiencies, but ultimately, it’s best to prevent deficiencies by having a healthy balanced diet.

However, in some cases, vitamin deficiencies can have non-dietary causes, such as bleeding or gut issues (malabsorption), in which case they can’t be corrected by simple dietary adjustments. Work with your doctor to address such underlying issues.

And if you do need to take supplements, it’s best if you can take active forms of vitamins, such as methylcobalamin, or 5-MTHF.

2) Regular Exercise

Although exercise increases homocysteine short-term, in the long term, it is associated with lower homocysteine levels.

A systematic review of 34 studies found that regular exercise may be able to decrease homocysteine levels [91].

A study in Parkinson’s disease patients found that those who regularly engage in exercise had lower homocysteine levels [92].

3) Managing Stress

Although the link between stress and homocysteine is not quite clear, several studies have found that stress can increase homocysteine levels [16, 17, 18].

Therefore, finding ways to avoid or cope with stress can be beneficial to decrease homocysteine but also to improve health in general.

A study has shown that yoga may help reduce elevated homocysteine levels [93].

4) Quitting Smoking

Both smoking and exposure to second-hand smoke can increase homocysteine levels [12, 13].

If smoking, quitting may help decrease homocysteine levels.

5) Alcohol

Daily alcohol increases homocysteine levels [14, 15].

Discuss your alcohol consumption with your doctor. Avoid heavy drinking.

6) Supplements

The following supplements have been found to decrease homocysteine in small-scale clinical trials:

Omega-3 [94, 95]
N-acetylcysteine [96, 97]
Probiotics (L. plantarum) [98]
Beta-carotene [99]
Betaine [100]

However, as lowering homocysteine with vitamins has shown little clinical benefit, using other supplements for the same purpose will likely also be clinically ineffective.

Remember, always speak to your doctor before taking any supplements, because they may interfere with your health condition or your treatment/medications!

Homocysteine – Lab Tests Online AU

How is it used?

A doctor may order a homocysteine test to determine if a person has B12 or folate deficiency. The homocysteine concentration may be elevated before B12 and folate tests are abnormal. Some doctors may recommend homocysteine testing in malnourished patients, the elderly, who often absorb less vitamin B12 from their diets, and those with drug or alcohol addictions.

A doctor may order both a urine and blood homocysteine to help diagnose homocystinuria if there is suspicion that an infant may have this inherited disorder. In some states, babies are tested for excess methionine as part of their newborn screening. If a baby’s test is positive, then urine and blood homocysteine tests are often performed to confirm the findings.

Homocysteine may also be ordered as part of a screen for people at high risk for heart attack or stroke. It may be useful in someone who has a family history of coronary artery disease but no other known risk factors. Its utility for this purpose, however, continues to be questioned because the role, if any, that homocysteine plays in the progression of cardiovascular disease (CVD) has not been established. Routine screening, such as that done for total cholesterol, is not yet recommended.

When is it requested?

This test may be ordered when a doctor suspects that a person may have a B12 and/or folate deficiency or when a baby has signs or symptoms that suggest that he or she may have homocystinuria.

Homocysteine may be ordered as part of a cardiac risk assessment, depending on the patient’s age and other risk factors. It may also be used following a heart attack or stroke to help guide treatment.

What does the test result mean?

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

In newborn testing, greatly increased concentrations of homocysteine in the urine and blood mean that it is likely that an infant has homocystinuria and indicates the need for further testing to confirm the cause of the increase.

Older studies (1995 to 1999) suggested that people who have elevated homocysteine levels have a much greater risk of heart attack or stroke than those with average levels. At present, however, the use of homscysteine 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. The American Heart Association does acknowledge strong evidence of a relationship between homocysteine levels and heart attack/stroke survival rates but stops short of calling elevated homocysteine a major risk factor for cardiovascular disease. Blockage of a coronary artery, a precursor to a heart attack, occurs with more than double the average frequency in people with homocysteine levels in the highest 25% as compared to those in the lowest 25%.

At present, a direct correlation between homocysteine levels and heart attacks has not been established but there does seem to be strong evidence of a relationship between homocysteine levels and heart attack/stroke survival rates.

Since measuring homocysteine levels to determine cardiac risk is a relatively new use for the test, the exact reference range has yet to be determined.

Is there anything else I should know?

There is a hereditary (genetic) form of homocystinuria – an increase of homocysteine in the urine – that causes a form of mental retardation, skeletal abnormalities, and premature cardiovascular disease. A prevents an enzyme from breaking down homocysteine into products that can be excreted through the kidneys. The build-up of homocysteine thus becomes toxic to the body. The most common hereditary form results in both an increase in homocysteine and a decrease in folic acid. When test results suggest homocystinuria, liver or skin samples are sometimes tested to determine whether the enzyme cystathionine beta synthase (CBS) is present. The absence of this enzyme is the most common cause of homocystinuria. Genetic tests may be ordered to test for one or more of the most common gene . If the patient has a strong family history of early atherosclerosis or a family member has been diagnosed with homocystinuria, then the patient should be tested for the gene mutation that was found in the family member.

Homocysteine levels can increase with age, when a patient smokes, and with the use of drugs such as carbamazepine, methotrexate and phenytoin. Homocysteine levels are lower in women than in men. Women’s concentrations increase after menopause, possibly due to decreased estrogen production.

Homocysteine Levels: What They Mean + Why They Matter

What your homocysteine level means for your health

Homocysteine is regulated during a biochemical process known as methylation. Methylation acts like a big biochemical superhighway, influencing and helping to regulate your immune system, brain, hormones, and gut. The methylation process occurs about a billion times every second in your body, and if it isn’t working as well as it should, chances are, you will feel it. Methylation gene mutations, such as the MTHFR variation, are closely associated with autoimmune-inflammation spectrum issues, and keeping homocysteine at a healthy level (not too high).

If you have one or two mutations at the MTHFR C677t gene, your body is not as efficient at managing homocysteine. For example, I have a double mutation of this gene, so I have to be extra diligent in supporting that genetic weakness. Fortunately there are some things you can do to keep your homocysteine in check, even if you are genetically predisposed to have problems in this area.

When homocysteine is too high

In addition to the influence of genetic mutations, such as the MTHFR mutation, that can cause elevated homocysteine levels, (1) homocysteine can also rise too high due to lifestyle. Certain medications, a poor diet, toxin exposure, hormone imbalances, and stress can all influence homocysteine. Another major contributor is a deficiency in B vitamins.

B vitamins from food and supplements act as methyl donors that help keep your body’s homocysteine at a healthy level and methylation working optimally. Homocysteine will use these methyl donors to produce the über-beneficial compounds SAMe and glutathione, which is extremely important for your health. Your body needs SAMe and glutathione to put autoimmune symptoms into remission. This happens through glutathione’s role as the body’s most powerful antioxidant and SAMe’s ability to protect nerves and support neurotransmitters like serotonin and dopamine. When methyl donors are inadequate, homocysteine can build up and continue to increase.

The optimal range for homocysteine in functional medicine is less than 7 μmol/L. When homocysteine is higher than this, you can see it play out in a multitude of seemingly unrelated health problems, including those related to autoimmunity and chronic inflammation.

The homocysteine-autoimmunity connection

One of the most important things methylation does is keep the good genes turned on, and keep the bad genes turned off. When methylation isn’t working correctly, genes that can trigger autoimmune issues can get turned on, leading to serious health problems. High homocysteine levels are associated with incredibly common autoimmune diseases like Hashimoto’s disease, rheumatoid arthritis, and psoriasis. So to avoid a higher risk of these conditions, it’s best to keep methylation working and homocysteine in normal range.

The homocysteine-heart disease connection

Homocysteine is most notorious for its link to an increased risk of cerebrovascular, heart, coronary, and peripheral artery diseases. (2) Especially high homocysteine levels have been connected to coronary artery disease and higher risk of hardening of the arteries. Even moderate levels can increase risk.

Heart attack and stroke can be brought on by autoimmune conditions—lupus and autoimmune thyroid disease, in particular—which we have seen are also affected by homocysteine levels, creating a double whammy of dysfunction. I’ve written many articles before about how low cholesterol is not a good indicator of a healthy cardiovascular system, but homocysteine is. In fact, research shows that not only is it more important than cholesterol, but inflammatory markers like homocysteine are actually a better indicator of heart disease than other well-known risks like smoking and high blood pressure. (3)

The homocysteine-cognitive decline connection

If you are like most people, you fear dementia, and high homocysteine levels can affect the brain because it can be toxic to neurons (4) and other cells. (5) Normally, old and damaged cells do get flushed out of our systems from the autophagy process (which is our cells’ way of self-cleaning) to keep our brains healthy and avoid the premature death of healthy cells associated with cognitive decline. But did you know that many diseases that cause cognitive decline also have an autoimmune component?

Parkinson’s disease, Alzheimer’s, and multiple sclerosis are all neurological autoimmune spectrum diseases and can be linked to high homocysteine levels. As homocysteine rises, it can start to destroy the blood-brain barrier, which can cause “leaky brain syndrome.” According to recent research, when homocysteine levels increase to 14 µmol/L or higher, the risk of Alzheimer’s doubles. (6) This is especially important considering the growing rate of Alzheimer’s in the U.S.: Over 5.7 million Americans suffer from Alzheimer’s today, and that number is expected to rise to 14 million by 2050. But you can decrease your chances of succumbing to cognitive decline, dementia, and the epidemic of Alzheimer’s disease by keeping methylation pathways healthy. Lowering homocysteine is crucial to protect your brain from dementia.

The homocysteine-depression connection

Homocysteine can also affect the brain in less severe but debilitating ways, particularly by increasing the risk of depression. Various studies have connected depressive thoughts to higher homocysteine levels. High homocysteine has been correlated with low serotonin levels, which are a known contributor to depression. According to some experts, the high homocysteine levels present in women after giving birth contribute to postpartum depression. (7) Men are not immune, however. A recent study involving a large group of men showed that those with the highest homocysteine levels (in the top third of those studied) were twice as likely to struggle with depression than those in the lowest third.

Getting your homocysteine tested

If you think high homocysteine levels could be an issue you deal with, the first step is to ask your doctor to run a homocysteine lab test, along with a methylation genetic test. Note that conventional doctors and laboratories have a higher number for what they consider to be a normal homocysteine level than what is considered healthy in functional medicine. If your homocysteine level is elevated, the genetic test can give you and your doctors more insight into why your homocysteine levels might be higher than normal.

The more gene polymorphisms you have, the more susceptible you will be to methylation issues. When you know that you’re at a higher risk for autoimmune disorders from genetic predisposition, you and your doctor can understand your health case better and take more targeted and personalized steps to overcome your particular deficiencies. This can include making sure you’re correcting any nutrient deficiencies, supporting the health of your immune system by eating an anti-inflammatory diet, getting plenty of sleep, moving your body regularly, and repairing your gut health.

Another helpful step is to see a functional medicine practitioner. Along with the homocysteine and methylation labs, a functional medicine practitioner will find out all about your health history and lifestyle, and will order additional labs that seem appropriate for your unique situation, to get a better understanding of your entire health case. Lab testing will help bring any other underlying health issues to light, to help you reach optimal health.

But you don’t have to wait for an appointment with your doctor. If you want to start lowering your homocysteine levels right away, you can begin by ensuring that you’re consuming enough B vitamins. Activated forms of folate (methylfolate), B6 (oyridoxyl-5-phosphate), and B12 (methylcobalamine) are the best options to ensure healthy methylation pathways. The best way to get these vitamins is through food, so focus on vitamin-B-rich, methylation-supporting foods like green leafy vegetables, sulfur-rich vegetables like cabbage and broccoli sprouts, wild-caught fish, grass-fed beef, and organ meats like grass-fed liver. (8) The healthier your diet and lifestyle, the lower your homocysteine, and the lower your homocysteine, the better that all-important methylation process will work for you.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

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Homocysteine Blood Test | Walk-In Lab

Homocysteine is an amino acid that can be linked to several vitamins like folic acid, B6 and B12. Deficiencies of these vitamins may cause elevated levels of homocysteine. Research suggest that people with elevated homocysteine levels have a much greater risk of heart attack or stroke than those with normal levels. Additionally, increased concentrations of homocysteine have been linked to an increase in blood clots, which can lead to strokes, heart attack and blood vessel blockages in any part of the body.

Homocysteine is a sulfur-containing amino acid, which is a metabolic product of the amino acids methionine and cysteine. Homocysteine is usually found in the cells of the body in very small concentrations. Methionine is one of the eleven essential amino acids, that is, those that are not formed in the body and enter it only with food. In healthy cells, homocysteine is rapidly transformed into its metabolic products.

An excess of homocysteine is dangerous for the development of atherosclerosis due to damage to the walls of blood vessels and the formation of blood clots, although there is no direct connection between these two events. The feasibility of using homocysteine indicators in order to assess the risk of cardiovascular diseases, peripheral vascular diseases and strokes is questionable, since, according to clinical studies, the introduction of folic acid and B vitamins into the organisms of patients did not reduce the number of cardiovascular diseases among them. …

The level of homocysteine in the blood and urine can rise sharply with homocysteinuria, a rare inherited disease. It causes changes in one or more genes. In a person suffering from homocysteinuria, a defective enzyme is formed, which does not allow the cleavage of methionine. Because of this, homocysteine and methionine accumulate in the body. A child born with homocysteinuria looks healthy the first time after birth, but after a few years he shows signs of the disease: the eye lenses are displaced, the child becomes tall and thin, and his fingers become long and thin, he begins to suffer from skeletal anomalies, osteoporosis, except in addition, he has a greatly increased risk of thrombosis and atherosclerosis, which can lead to early cardiovascular disease.Further development of the disease threatens with mental retardation, behavioral abnormalities and epilepsy.

Floor	Reference values , μmol / L
Female	4.44 – 13.56
Male	5.46 – 16.20

Retrospective and prospective studies show a close relationship between hyperhomocysteinemia and cardiovascular diseases: venous and arterial thrombosis, pulmonary embolism, stroke and myocardial infarction [5, 6].People with elevated homocysteine levels increase the risk of Alzheimer’s disease and senile dementia [11]. With a combination of hyperhomocysteinemia and diabetes mellitus, vascular complications often occur – peripheral vascular diseases, nephropathy, retinopathy. During pregnancy, elevated levels of homocysteine lead to impaired fetoplacental circulation, which can lead to miscarriage and infertility as a result of defects in the implantation of the embryo.

Studies of cholesterol and homocysteine levels in the blood after myocardial infarction, stroke, or in the case of dementia and attempts to reduce their levels are not particularly useful, since the degree of atherosclerotic vascular lesions can hardly be reduced.It is impossible to achieve any great success, even by constantly carrying out vitamin therapy, in 2-3 years. Therefore, it is very important to explain to patients the importance of early prevention of hyperhomocysteinemia.

It is a sulfur-containing amino acid, which is a product of the processing of the amino acid methionine in the body.Methionine is not formed in the body itself, but comes only with food (meat, dairy products – especially cottage cheese, eggs). After its assimilation by the body, homocysteine is formed from methionine. Homocysteine under the influence of folic acid and vitamin B12 is returned back to methionine, or under the influence of vitamin B6 it is converted into the next metabolic product cystothionine.

During life, the level of homocysteine in the blood gradually rises. Before puberty, homocysteine levels are about the same in boys and girls.During puberty, the level of homocysteine rises, in boys this increase is more pronounced than in girls. Adult males tend to have higher homocysteine levels than females. With age, homocysteine levels gradually increase, and in women the rate of this increase is higher than in men. The gradual rise in homocysteine levels with age is attributed to decreased kidney function, and higher homocysteine levels in men are attributed to greater muscle mass.

The most common causes of increased homocysteine levels (hyperhomocysteinemia) are vitamin deficiencies. The body is especially sensitive to a lack of folic acid and vitamins B6, B12 and B1.It is assumed that smokers have an increased tendency to hyperhomocysteinemia. Individuals who drink more than 6 cups of coffee a day have higher homocysteine levels than non-coffee drinkers. The negative effects of caffeine on homocysteine levels are thought to be related to altered kidney function. Homocysteine levels often rise with a sedentary lifestyle. Moderate exercise helps to reduce homocysteine levels in hyperhomocysteinemia. Drinking small amounts of alcohol can lower homocysteine levels, and large amounts of alcohol can increase homocysteine levels in the blood.

Accumulating in the body, homocysteine begins to attack the inner wall of the arteries. Endothelial ruptures are formed, which the body is trying to heal with something. Cholesterol and calcium are deposited on the damaged surface, forming an atherosclerotic plaque, as a result of which the lumen of the vessel narrows, and sometimes even clogs up, which can certainly lead to a blood clot or rupture of the vessel. People with elevated homocysteine levels have an increased risk of Alzheimer’s disease and senile dementia.With a combination of hyperhomocysteinemia and diabetes mellitus, vascular complications (peripheral vascular disease, nephropathy, retinopathy, etc.) occur more often. During pregnancy, elevated levels of homocysteine lead to impaired fetoplacental circulation, which can lead to miscarriage and infertility as a result of defects in the implantation of the embryo. In the later stages of pregnancy, hyperhomocysteinemia is the cause of the development of chronic placental insufficiency and chronic intrauterine fetal hypoxia.Generalized microangiopathy in the second half of pregnancy manifests itself in the form of gestosis: nephropathy, preeclampsia and eclampsia.

Homocysteine was discovered in 1931 as a marker predicting the development of cardiovascular diseases. Consequently, the audience for this marker was appropriate – people over the age of 70 (then no one measured it in pregnant women or planning pregnancy).And since the level of homocysteine increases with age, then the upper limit of the “norm” 15 turned out to be overestimated, and can in no way be considered acceptable for young people. After 50 years of research, an upper homocysteine value of <7-8 µmol / L is more practical ( and one laboratory in Odessa already uses such a limit of ).

A clear message from the new scientific findings is that is not a safe “normal range” for homocysteine. While commercial laboratories claim that normal homocysteine can range from 5 to 15 micromoles per liter of blood, epidemiological data show that homocysteine levels above 6.3 lead to a dramatically progressive risk of heart attack ( Circuit Journal of American Heart Association).Studies show that adults with a homocysteine level of greater than or equal to 6.3 μmol / L are at increased risk of atherosclerosis, heart attack and stroke (Broxmeyer 2004).

For example, study “Homocysteine, folates and pregnancy outcomes” in the journal Effective Pharmacotherapy 2014. in the tables gives data that placenta previa was observed in patients with homocysteine 7.5 and was not observed at a level of 5.9; Placental abruption was observed at a level of 6.2 and was not observed at a level of 6 (even 0.2 plays a difference !!!), low fetal body weight was noted at a homocysteine level of 6.1 and was not observed at 5.9.Preeclampsia was with homocysteine at 7.9 and not at 5.9; pregnancy diabetes was at a homocysteine level of 7.1 and not at a level of 5.9. Thus, it can be seen that the safe level is 5.9 and below.

How did I lower homocysteine, result 5.9
Increased homocysteine or laboratory error?
How to lower homocysteine in children
Lower homocysteine with methylfolate
Diet from a geneticist to lower homocysteine with an example of the diet
Homocysteine is increased during pregnancy, how to lower it? examples of reduction
How to lower homocysteine, part 1
How to lower homocysteine, part 2- dietary and lifestyle recommendations
Homocysteine is increased + ferritin is low, we solve in turn
8 reasons why homocysteine does not want to decrease

Homocysteine (Hz) is a metabolite of the essential amino acid methionine, which enters the body with animal products (meat, milk, eggs, etc.). Participates in the synthesis of a number of proteins.For the conversion and excretion of homocysteine, enzymes with coenzymes in the form of vitamins B12, B6, folic acid are required. Over the course of a person’s life, the level of Hz in the blood gradually rises, with higher levels in men associated with more muscle mass.
The oxidation of homocysteine produces a large number of free radicals that damage endothelial cells. Numerous endothelial functions are disrupted, thrombus formation processes are activated.
High homocysteine levels are the most important factor in the development of atherosclerosis and thrombosis; characterizes the risk of developing Alzheimer’s disease, senile dementia; accompanies vascular complications of diabetes mellitus.Hyperhomocysteinemia is considered as a possible cause of pregnancy pathology (spontaneous abortion, preeclampsia, eclampsia, venous thromboembolism). Elevated extracellular homocysteine concentrations are cytotoxic.

1. Determination of Homocysteine is indicated for any etiological assessment of venous or arterial thrombosis, especially at a young age. It is recommended to measure vitamin B12 and folic acid simultaneously to determine (exclude) hyperhomocysteinemia due to vitamin deficiencies.
2. Examination of patients with suspected hereditary disorders of methionine metabolism, including: deficiency of cystathionine beta-synthase (homocystinuria) and deficiency of methylenetetrahydrofolate reductase (MTHFR) and its thermolabile variants: deficiency of methionine synthase, disorders of cobalamin metabolism.

Homocysteine is an amino acid, an intermediate product of the metabolism (exchange) of other amino acids – methionine and cysteine. Homocysteine does not come from food, but is formed only in the body.Normally, this amino acid “lives” in the body for a very short time, after which it turns into other compounds. To carry out such transformations, vitamins B6, B12 and folic acid are needed. In case of disturbances in the metabolism of homocysteine due to a defect in enzyme systems or due to a lack of essential vitamins, it accumulates in large quantities inside the cells, and then enters the bloodstream.

An excess of homocysteine can lead to the formation of blood clots, damage to the vascular wall, making it looser, to the deposition of cholesterol and calcium in it with the formation of atherosclerotic plaques.The vessels narrowed by atherosclerotic plaques and the tendency to form blood clots significantly increase the likelihood of complete closure of the lumen of blood vessels, in particular, of the vessels of the heart and brain with the development of myocardial infarction and ischemic stroke, respectively. The likelihood of damage to the vascular wall increases significantly with diabetes.

With a physiologically ongoing pregnancy, the level of blood homocysteine decreases almost twice, and in the first trimester by more than 30%, reaching its lowest value at the end of the second trimester. Such a decrease may be associated with an increase in the volume of circulating blood, hormonal changes.If the level of homocysteine increases, complications of pregnancy are likely to develop – miscarriages, eclampsia (seizures with loss of consciousness, a sharp rise in blood pressure and even death), venous thrombosis, etc. In this regard, the determination of the level of homocysteine is prescribed for pregnant women who have an increase in blood pressure, edema, protein in the urine – proteinuria.

Age	Floor	Homocysteine level, μmol / L
5 days – 1 year	both	2.87 – 9.99
1 year – 7 years	both	2.76 – 7.62
7 – 12 years old	both	3.43 – 8.45
12 – 15 years old	female	4.07 – 10.36
12 – 15 years old	male	4.71 – 10.40
15 – 19 years old	female	4.92 – 11.88
15 – 19 years old	male	5.5-13.39
> 19 years old	female	4.44 – 13.56
> 19 years old	male	5.46 – 16.20

Homocysteine is an intermediate product of the metabolism of the proteinogenic amino acids methionine and cysteine. It does not enter the body with food, but is formed from methionine in the course of reactions necessary for the normal functioning of our body. The resulting homocysteine can be converted either back to methionine or to another important amino acid, cysteine. These reactions occur due to enzymes, for the adequate functioning of which vitamins B6, B12, and folic acid are needed.

An inherited disorder caused by a mutation in the CBS gene is called homocystinuria.The CBS gene encodes the enzyme cystathionine beta-synthase, which converts homocysteine to cystathionine. This is one of the pathways for the metabolism of homocysteine. The presence of a defect leads to the fact that the reaction does not occur and the chain of successive transformations of amino acids is disrupted. As a result, both blood and urine levels of homocysteine and methionine increase.

Several studies show that the genetic variant C677T is associated with the development of cardiovascular and neurological diseases. However, it cannot be argued that the presence of this gene variant becomes a direct cause of diseases. A lot of the data is inconsistent and requires further study. It is also important to note that other genes, including those responsible for the transport of B vitamins, also affect the level of homocysteine. Therefore, all factors must be taken into account and an individual consultation with a doctor must be carried out.

Frequent coffee consumption is believed to increase homocysteine levels. However, the research is inconclusive. Scientists from São Paulo have found that people who consume 1-3 cups of filtered coffee a day have lower homocysteine levels than those who drink less than one cup. They speculate that caffeic acid may reduce the number of molecules that damage the inner layer of the vessel wall.

Dementia is a condition in which the ability to think occurs.Dementia manifests itself in a decrease in memory, attention, and the ability to perform daily activities. There are many forms of dementia, but Alzheimer’s is the most common. This is a disease in which there is an accumulation of abnormally folded proteins in neurons, which leads to impaired intelligence. The main reason for the development of this disease is currently unknown. Research around the world is looking for a variety of factors that may play a role in the development of Alzheimer’s disease.One of the possible reasons is a malfunction of the folate cycle. It is believed that high levels of homocysteine can damage neurons and cause them to die.

To date, the study of how the level of homocysteine affects the course of pregnancy is still ongoing. Early evidence suggested that a mutation in the MTHFR gene associated with elevated homocysteine levels could lead to complications during pregnancy. Complications such as preeclampsia, early termination of pregnancy, and impaired intrauterine development were associated with homocysteine levels.

Normal range of homocysteine levels. Understanding Homocysteine: Levels, Tests, and Health Implications

What is Homocysteine and Its Role in the Body?

The Impact of High Homocysteine Levels on Health

Conditions and Disorders Affecting Homocysteine Levels

Health Risks Associated with High Homocysteine

Homocysteine Testing: When and Why?

Managing and Maintaining Healthy Homocysteine Levels

The Role of Diet in Homocysteine Management

The Impact of Cooking Methods on Nutrient Retention

Homocysteine and Cardiovascular Health: The Connection

Homocysteine as a Biomarker for Cardiovascular Risk

Genetic Factors Influencing Homocysteine Levels

Genetic Testing for Homocysteine-Related Disorders

Homocysteine and Cognitive Health: Emerging Research

Homocysteine-Lowering Strategies for Cognitive Health

Homocysteine During Pregnancy: Special Considerations

Nutritional Strategies for Managing Homocysteine During Pregnancy

Future Directions in Homocysteine Research

Technological Advancements in Homocysteine Testing

Levels, Tests, High Homocysteine Levels

What is homocysteine?

What does homocysteine do?

What happens if I have too much homocysteine?

What conditions and disorders affect homocysteine?

What are the risks of high homocysteine levels?

How do I know if I need a homocysteine test?

What do the results of a homocysteine blood test mean?

Caring for Your Homocysteine Levels

How can I keep my homocysteine levels healthy?

When to Call a Doctor

What should I ask my doctor about homocysteine levels?

How It Affects Your Blood Vessels

What is homocysteine?

How is a high homocysteine level harmful?

What causes a high homocysteine level?

How is the homocysteine level measured?

Path to improved health

How can I lower a high homocysteine level?

Things to consider

Questions to ask your doctor

Gender- and age-related differences in homocysteine concentration: a cross-sectional study of the general population of China

Why High Homocysteine is Bad + Should You Decrease It? SelfDecode Labs

High Homocysteine Levels

Factors That Increase Homocysteine Levels

1) B Vitamin Deficiency

2) Smoking

3) Alcohol

4) Stress

5) Medication

6) Kidney Disease

7) Hypothyroidism

8) Dental Health

9) Genetics

Low Homocysteine

2) Regular Exercise

3) Managing Stress

4) Quitting Smoking

5) Alcohol

6) Supplements

Homocysteine – Lab Tests Online AU

How is it used?

When is it requested?

What does the test result mean?

Is there anything else I should know?

Homocysteine Levels: What They Mean + Why They Matter

What your homocysteine level means for your health

When homocysteine is too high

The homocysteine-autoimmunity connection

The homocysteine-heart disease connection

The homocysteine-cognitive decline connection

The homocysteine-depression connection

Getting your homocysteine tested

Homocysteine Blood Test | Walk-In Lab

Description

Homocysteine ​​

Causes of increased homocysteine ​​levels

Results of clinical trials conducted in recent years

Clinical Guidelines

Diagnosis of hyperhomocysteinemia

References