Homocysteine is an amino acid found in the blood.
A healthcare practitioner may order a homocysteine test to determine if a person has a vitamin B12 or folate deficiency, because homocysteine concentrations may become elevated before B12 and folate tests are abnormal.
There is an association between serum homocysteine concentration and cardiovascular disease, but it is not known whether the association is causal. [L]
Symptoms of B12 / folate deficiency are initially subtle and nonspecific but may include:
– Fatigue, weakness
– Loss of appetite
– Rapid heart rate
– Shortness of breath
Frequently, this test is also recommended for malnourished individuals, the elderly (who often absorb less vitamin B12 from their diet), and individuals with poor nutrition—such as drug or alcohol addicts. Although the role homocysteine plays in the progression of cardiovascular disease has not been established, it may be used to screen individuals at high risk for heart attack or stroke. Finally, a homocysteine blood test can be used to identify a rare, inherited disease called homocystinuria, which causes a deficiency of one of several enzymes needed to convert food to energy.
What does it mean if your Homocysteine result is too high?
A high level of homocysteine may indicate malnutrition or vitamin B12 / folate deficiency. When we don’t get enough vitamin B12 / folate in our diet our bodies may not be able to convert homocysteine to forms that can be used, causing the level of homocysteine in the blood to increase. There are also some studies that suggest that high intake of coffee may contribute to elevated homocysteine levels [L]
There is some evidence to suggest that people with elevated homocysteine levels have a much greater risk of heart attack or stroke than those with average levels [L]; however, the use of homocysteine levels for risk assessment of cardiovascular disease is uncertain [L]. In newborns, greatly increased concentrations of homocysteine in the urine and blood are likely indicative of homocystinuria.
In the The Hordaland Homocysteine Study elevated plasma homocysteine level was associated with major components of the cardiovascular risk profile, ie, male sex, old age, smoking, high blood pressure, elevated cholesterol level, and lack of exercise.
It is worth noting that women going through menopause typically have abnormal homocysteine levels and hence a mildly increased risk for cardiovascular disease [L].
Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
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