Understand your Homocysteine Blood Test Results…

This page helps you to understand blood test results for Homocysteine and gives you the reference range to determine if your lab test results mean that you have high, low or normal Homocysteine levels. 

We outline the risk factors associated with raised Homocysteine.

Reference Ranges for Homocysteine:

Measurement unit Metric Optimal Risk
US Conventional Units umol/L <=13 >=14
Standard International Units umol/L <=13 >=14
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What is Homocysteine

Homocysteine is a Sulphur based amino acid released as the body digests dietary protein. At high levels, homocysteine can be harmful to your health.  Removing homocysteine from the body is highly dependent on vitamin B12, folate and vitamin B6, and deficiencies in these vitamins are associated with raised homocysteine levels.  These deficiencies can be caused by both diet and genetic factors [18].

Other factors thought to raise levels of homocysteine are poor diet and lifestyle – especially smoking and high coffee and alcohol intake and some prescription drugs (such as proton pump inhibitors). Diabetes, rheumatoid arthritis and poor thyroid function are also thought to raise homocysteine [18].

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Function of Homocysteine

Homocysteine is a naturally occurring amino acid produced as part of the body’s methylation process.  Methylation is the process in which small parts of molecules, called methyl groups, are passed from one molecule to another [19].

This process facilitates the production and metabolism of hormones and neurotransmitters in the body, and as such is key to physical and mental well-being.  In order for the liver to have an adequate supply of methyl groups available, an adequate intake of vitamins B6 (e.g., whole grains and legumes) and B12 (primarily from animal products), and folate (such as from green leafy vegetables) are necessary [19].

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Risk factors associated with Homocysteine

Elevated plasma homocysteine is associated with increased risk of cardiovascular disease, increased incidence of stroke, dementia and Alzheimer’s disease, bone fracture, and higher prevalence of chronic heart failure. It is also proven that elevated plasma homocysteine is a risk factor for preeclampsia and neural tube defects [20]. This multitude of relationships between elevated plasma homocysteine and disease points to the existence of a common denominator which may be responsible for these diseases. Whether this denominator is homocysteine itself or homocysteine is merely a marker, remains to be determined [20].

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Notable variations by demographic group

A Reduction in the activity of the MTHFR gene increases mean homocysteine levels by reducing the availability of the co-factors required to metabolise homocysteine.  This genetic defect is thought to be present in varying degrees in up to 30% of the world’s population, although the frequency varies widely between different ethnic populations [18].

Homocysteine Levels tend to increase with age and higher levels are more common in men than women. Levels of homocysteine can increase with oestrogen deficiency and with some long term medications, including corticosteroids.

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Diet to improve Homocysteine


  • Eat less fatty meat as it is raises homocysteine, and no more than 4 servings of lean meat per week.  Try to eat more fish and vegetable protein.
  • Eat at least five servings of fruit or vegetables a day.  Lentils and dark leafy greens like spinach are particularly high in folate which is proven to lower Homocysteine.
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Supplements for Homocysteine

  • Vitamin supplementation has been shown to be very effective in reducing plasma homocysteine levels.  The most important nutrients that help lower homocysteine levels are folate (as methylfolate), vitamin B12 (as methylcobalamin), B6, zinc and trimethylglycine [18].
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Exercise to improve Homocysteine

Duration and intensity of exercise appear to impact blood homocysteine levels differently, and is dependent on individual fitness levels.  Short periods of intense exercise has been shown to lower homocysteine levels.  However endurance exercise over long periods raises homocysteine levels in people who have is low vitamin B12 and folate levels [26].

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Sleep for Homocysteine

Try to get the required 7-9 hours sleep per night [27] – In a U.S. representative sample of adults without cardiovascular disease or other major conditions, short sleepers were at greater odds for clinical levels of Homocysteine.  Findings suggest that homocysteine may be one mechanism linking short sleep duration to cardiovascular disease [27].