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What Does A Homocysteine Test Measure?

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Homocysteine test results with blood vial

Homocysteine is a naturally occurring amino acid that can be used as one indication of cardiovascular health. But what, exactly, is the link between homocysteine and heart health? When would a provider order a homocysteine test? Read our blog to learn more. 

What Does Homocysteine Do In The Body?

Homocysteine is a byproduct of the metabolism of methionine, an essential amino acid required for protein synthesis in the body. Under normal circumstances, homocysteine is converted into other substances essential for bodily functions. However, disruptions in this process can lead to an accumulation of homocysteine in the bloodstream, a condition known as hyperhomocysteinemia.

Hyperhomocysteinemia has been linked to a host of negative health outcomes, the most researched of which is coronary artery disease via atherosclerosis (plaque build-up in the arteries). This is because homocysteine degrades important structural components of the arteries: collagen, elastin, and proteoglycans. Individuals with elevated homocysteines may be twice as likely to develop cardiovascular disease.  

What Is The Procedure For A Homocysteine Test?

The homocysteine test is a simple blood draw that takes no more than five minutes. Measuring homocysteine levels through blood tests can provide valuable insights into an individual’s risk of developing cardiovascular disease and other associated conditions. 

When Would A Provider Order A Homocysteine Test?

A healthcare provider might order a homocysteine test as part of assessing a person’s risk for heart disease or stroke, especially if they have other risk factors such as high cholesterol, high blood pressure, or a family history of cardiovascular disease.

What Happens When Your Homocysteine Is High?

In addition to being a risk factor for cardiovascular disease, elevated homocysteines in the blood have been linked to other medical conditions, including:

  • Blood clots (thrombosis)
  • Neural tube defects
  • Vascular dementia and Alzheimer’s Disease
  • Increased risk of fracture in older patients

However, just because your homocysteine is high does not mean you will develop any of these conditions. It is a risk factor, meaning you have a higher potential for certain medical issues if it is left untreated. Treatment for high homocysteine is often as simple as supplementation or dietary modifications (see below). Your provider will work with you to determine the cause and treatment plan for your elevated levels. 

What Causes Elevated Homocysteine?

Elevated homocysteine levels can be caused by various factors, such as:

Nutritional Deficiencies

One of the most common causes of high homocysteine in the blood is Vitamin B deficiency. Vitamins B6, B12, and folate help recycle homocysteine back to methionine or convert it into cysteine, another amino acid. Inadequate levels mean there can be an excess of free homocysteine in the body. 

Genetic Factors

Genetic conditions, such as cystathionine beta-synthase deficiency, methylenetetrahydrofolate reductase (MTHFR) deficiency, and cobalamin (vitamin B12) metabolism disorders can impair the body’s ability to metabolize homocysteine.

Lifestyle Factors

Certain lifestyle habits can influence homocysteine levels such as smoking tobacco, excessive alcohol consumption, and a sedentary lifestyle.

Age and Gender

Homocysteine levels tend to increase with age, with higher levels observed in older adults compared to younger individuals. Additionally, men generally have higher homocysteine levels than premenopausal women. However, after menopause, women’s homocysteine levels may increase and become comparable to those of men.

Certain Medical Conditions

Several medical conditions can be associated with elevated homocysteine levels, including chronic kidney disease, hypothyroidism, psoriasis, and rheumatoid arthritis. 


Certain medications can also interfere with homocysteine metabolism or reduce the absorption of vitamins involved in its metabolism. Examples include anticonvulsants, methotrexate, proton pump inhibitors, and some cholesterol-lowering drugs.

High Protein Diet

Consuming a diet high in animal protein may increase homocysteine levels, as methionine, an amino acid found in high-protein foods, is a precursor to homocysteine. However, the impact of dietary protein on homocysteine levels may vary depending on other dietary factors and individual metabolism.

How Do You Treat High Homocysteine Levels?

The exact treatment plan for elevated homocysteine will depend on the underlying cause. As a functional medicine provider, Modern Health uses these measurements as only one part of the bigger picture in your holistic treatment plan. We will complete a thorough history and physical exam, along with other testing as-needed to formulate the treatment that is right for you. This may include one or more of the following: 

Dietary Changes 

If we suspect your elevated homocysteine is related to a B vitamin deficiency, we will help you develop a nutritional plan that incorporates foods naturally rich in these vitamins. Leafy greens, poultry, eggs, and certain nuts and legumes are fantastic sources of Vitamin B.


If dietary intake is insufficient, your provider may recommend supplementation with vitamins B6, B12, and folate. If your high levels are related to a MTHFR mutation, your provider will likely start you on a course of 5-methyltetrahydrofolate (5-MTHF). This is a biologically active form of folate recommended specifically for patients with a MTHFR mutation who cannot process inactive folate. 

Please remember that it is not recommended that you begin a supplementation course on your own. Vitamins are not regulated by the FDA and, as such, vary considerably in quality and efficacy. Your functional medicine provider will have a vetted brand for you to try. 

Lifestyle Modifications

Your provider may recommend certain lifestyle changes that will help lower your homocysteine levels and improve health overall. Quitting smoking, reducing alcohol consumption, and maintaining a healthy weight can all contribute to lowering homocysteine levels. 


If an underlying medical condition is contributing to your high homocysteine levels, your provider may suggest medication to treat it. Hypothyroidism may be a factor, for example; balancing your thyroid hormones will be an important step in remedying elevated homocysteine associated with an underactive thyroid. 

Hormone Specialist in Jackson, MS

Visiting Modern Health is a proactive step towards maintaining balanced homocysteine levels and overall well-being. At Modern Health, we have services designed to address individual needs and promote optimal health outcomes.

Jackie McDonald, NP, will work closely with you to assess your health status, including evaluating factors that may influence homocysteine levels such as diet, lifestyle, and medical history. Through personalized consultations and diagnostic testing, we can identify any imbalances or risk factors and develop tailored strategies to optimize your homocysteine metabolism. Contact Modern Health to schedule your consultation.

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Heart Health

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