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Homocysteine May Be the Most Ignored Blood Test That Can Save Your Life

Updated: Jul 24, 2023

This simple blood test, homocysteine, can be used to detect dementia, heart disease and stroke before they happen.

Woman holding a blood collection vial

Lipoprotein (a), hsCRP, HbA1c, the list could go on and on in search of the proverbial most important predictive blood biomarker. In the days of jumping through hoops and fighting insurance to pay for medical procedures, including laboratory tests, providers and patients alike want to get the biggest bang for their buck. Because of this it only makes sense to determine what blood tests are a must for their yearly physical.

Though a close runner up is fasting insulin, which is gaining popularity in lab panels, virtually all physicals will include fasting glucose. Depending on comorbidities, they may even contain HbA1c helping to keep an eye on that metabolic parameter. For this reason homocysteine, which once held a more important spot in the yearly physical but seems to have fallen from grace, comes in first as the most ignored blood test that can save your life.

What is Homocysteine?

Homocysteine is a non-essential amino acid; it is involved in vitamin B-dependent methylation cycles that generate and break down the universal methyl-group donor, S-adenosyl-methionine (SAMe).

High homocysteine levels can present secondary to vitamin deficiency as it is broken down by folate and vitamins B6 and B12. However, the cause of elevated levels may not be that clear cut as we will discuss below. Of note, when homocysteine interacts with the aforementioned B vitamins, it is broken down and converted into two substances:

  • Cysteine, a nonessential amino acid synthesized from methionine that reduces inflammation, increases communication between immune cells and increases liver health, and

  • Methionine, an essential amino acid and antioxidant that synthesizes proteins

Without treatment, elevated homocysteine increases your risks for dementia, heart disease and stroke (Son & Lewis 2020). It has also been linked to endocrine-related conditions, such as diabetes, hypothyroidism, insulin resistance, and osteoporosis among other diseases like end-stage renal disease, various cancers, schizophrenia, and complications in pregnancy (Azzini et al. 2020).

What are appropriate blood levels of homocysteine?

Conventional medicine will tell you that homocysteine levels should fall between five to 15 micromoles per liter (umol/L). But Iso et al. (2008) will tell you reasons why the optimal range for homocysteine should be < 7 umol/L. This is also the range that we teach practitioners in our functional lab interpretation course.

Homocysteine and Coronary Artery Disease chart
Homocysteine and Coronary Artery Disease

Unlike hypertension, there is not a noninvasive test or symptom to know when someone has a higher than optimal homocysteine level. It must be discovered through blood biomarker testing.

Experts will tell you that symptoms of vitamin B deficiency (dizziness, pale complexion, fatigue, muscle weakness, tingling extremities) is a sign that you should be tested for high levels of homocysteine. However, that leaves millions of people in the dark and not knowing their homocysteine level – putting them at risk for heart disease, stroke and early death. Levels can increase naturally with age, and males have higher homocysteine than women; caffeine intake, smoking and alcohol use can also increase blood levels. Some pharmaceuticals currently in clinical practice such as lipid lowering, and anti-Parkinsonian drugs are known to elevate levels as well (Kumar et al, 2017).

Homocysteine and Stroke chart
Homocysteine and Stroke

What can you do to lower homocysteine levels?

Understanding that elevated homocysteine levels could be the result of specific vitamin B deficiencies that are a primary focus of nutritional supplement therapy, however, there are a few other options that you can explore. To learn more about those options and to get fully referenced specific dosing recommendations please visit:

Homocysteine ebook to claim our free Homocysteine special report.


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