Homocysteine Levels: Normal Range, Test, and Causes of High Levels
Homocysteine is an amino acid naturally produced in the body and is a part of the body’s metabolic process. A healthy human body converts it into other substances through different biochemical pathways. Although the presence of amino acids in the body is not a concern, their high levels are. Homocysteine has a vital role in cardiovascular and brain health. High levels of homocysteine can be associated with certain health conditions and a higher risk of heart disease, which may necessitate a homocysteine test performed.
Importance of Tracking Homocysteine Levels with the Homocysteine Test
Doctors usually recommend a homocysteine blood test to evaluate the levels in the blood and assess your risk, which is crucial for assessing risk of developing cardiovascular disease of developing cardiovascular disease and other health conditions. Generally, the test is prescribed for people with a family history of blood clots or with certain conditions that may influence homocysteine metabolism. Getting tested for homocysteine levels is essential to monitor the changes in their levels and take suitable measures to manage them better.
What is Homocysteine?
Homocysteine, the amino acid produced, is like a building block of proteins. It is produced during methionine metabolism which is an essential amino acid. Methionine is transformed into homocysteine and then recycled back to methionine. Raise homocysteine levels in the blood may be associated with a greater risk factors of developing cardiovascular and cerebrovascular diseases. may be associated with a greater risk of developing cardiovascular and cerebrovascular diseases.
The Process of Homocysteine Formation
Metabolism of Methionine: Homocysteine is produced when methionine undergoes demethylation. Methionine is an essential amino acid commonly found in protein-rich foods and is measured through a blood sample .
Remethylation: The body can transform homocysteine again into methionine through the process known as remethylation which needs specific vitamin b such as B1, B6, and folate.
Transsulfuration: On the other hand, homocysteine can be transformed into cysteine through the process of transsulfuration which also requires B Vitamins, and vitamin b supplementation can help in this transformation .
Uses of Homocysteine Test
A homocysteine test is primarily used to detect the homocysteine test measures the amount of homocysteine in the body, however, it can also be suggested along with other blood tests to assess health conditions., however, it can also be suggested along with other blood tests to assess health conditions.
Diagnose homocystinuria, an uncommon genetic condition that prevents the body from using certain amino acids to create essential proteins.
Determine the deficiency of B Vitamins including Vitamin B6, vitamin b12, and Vitamin B9, which can lead to elevated homocysteine levels.
Understand the risk of heart attack or stroke particularly if you have an existing heart condition that can increase your chances of getting heart and blood vessel-related diseases due to high levels of homocysteine that may damage the blood vessels. (high cholesterol, high blood pressure, or diabetes).
Connection to Methionine Metabolism
The serum homocysteine test assesses the homocysteine level in blood that is used by the body as an intermediate in cysteine metabolism, and understanding the homocysteine test results is crucial for health . Methionine is a crucial amino acid and antioxidant that helps in protein synthesis. Cysteine is a non-essential amino acid that is produced by methionine. It promotes liver health, communication between immune cells, and reduces inflammation.
Role of Vitamin B6, B12, and Folate in Processing Homocysteine
Homocysteine is a chemical in the body that aids protein production. Vitamins B6, folate, and B12 play a significant role in processing homocysteine which can be harmful if the levels are too high in the body, potentially leading to cardiovascular disease . Vitamin B6, B9, and B12 break down homocysteine to produce other chemicals that are required by the body. High homocysteine levels are dangerous for the lining of artery walls and it may also lead to blockages in blood vessels and cause problems such as heart attack or stroke, especially for individuals with nutritional deficiencies.
Health Risks of Elevated Homocysteine
Usually elevated levels of homocysteine are associated with an increased risk of acquiring certain conditions like coronary heart disease and stroke. Increased homocysteine levels primarily influence cardiovascular health and neurological function. If your doctor has recommended the test, get tested without a delay for a thorough evaluation, prevention, and better management of the possible problem and to identify potential risk factors. It can increase the likelihood of myocardial infarction, stroke, blood clots, and many other cardiovascular problems. Moreover, it is associated with dementia, cognitive impairment, and Alzheimer’s disease.
Homocysteine Test (Serum Homocysteine Test or Plasma Homocysteine Test)
A homocysteine test be it serum or plasma, is a blood test performed to measure the amount of homocysteine (amino acid) in the blood. Elevated levels of this amino acid indicate more likelihood of certain health problems including cardiovascular disease. The test is primarily recommended to evaluate the risk, diagnose certain health conditions, and monitor patients with existing health conditions, ensuring accurate test results .
When is it Recommended?
Generally, a healthcare professional may recommend a homocysteine test if a person has symptoms indicating vitamin B deficiency and inadequate vitamin intake. Some of the signs and symptoms that necessitate a homocysteine test include fatigue, headache, dizziness, sore mouth, heart palpitations, and numbness or tingling in hands and feet. Elevated levels of homocysteine usually don’t cause visible symptoms.
Cardiovascular Risk: Symptoms associated with cardiovascular problems include chest pain, breathing difficulty, and peripheral vascular disease. These symptoms prompt healthcare professionals to recommend homocysteine tests to evaluate risks. However, it does not confirm cardiovascular condition but assesses the risk, especially for those on certain medications.
Vitamin Deficiency: Certain vitamin deficiencies necessitate a homocysteine test. Individuals with signs of B Vitamin deficiency (Vitamin B6, B9, and B12) that may affect homocysteine metabolism. including weakness, unexplained fatigue, and neurological symptoms, or those with a rare genetic disorder may be recommended to get tested.
Unexplained or Recurrent Blood Clots: If blood clots are unexplained, occur at a younger age or you have a history of recurrence of blood clots, your doctor may suggest a homocysteine test that requires a blood sample o determine potential risks associated with the increased levels of homocysteine.
Kidney Function: Elevated homocysteine can indicate kidney problems. Your doctor may advise this test to monitor patients with chronic kidney disease.
Detect Genetic Disorder: A homocysteine test is suggested to diagnose homocystinuria. It is an uncommon genetic disorder that contributes to too high levels of homocysteine in the body.
Monitor Treatment: Homocysteine tests can help monitor the effectiveness and progress of ongoing treatments such as vitamin supplementation for people with increased homocysteine levels, aiming at lowering homocysteine levels.
Fasting requirements and Sample Collection
Make sure you follow the instructions given by your healthcare provider to get accurate test results. Homocysteine test does not need any special preparations, you need to follow general guidelines. This test does not require fasting. Inform your doctor if you are taking any medications. Avoid drinking alcohol or smoking for a certain period before the test to ensure correct results. Inform your healthcare provider if you are suffering from any chronic illness or if you are pregnant before the test.
Homocysteine Test Price
In India, the cost of a homocysteine test usually ranges between INR 600 to INR 2700. The exact homocysteine test cost, which is a simple blood test, depends on the location, lab, health package insurance coverage, etc. Some laboratories including My Diagnostics offer reasonable health packages and home collections.
Normal Homocysteine Levels by Age
The typical normal range of homocysteine levels is 5-15 micromoles per liter (mcmol/L). Homocysteine levels vary depending on your age as mentioned below.
Males
12-29 years: 4.3-9.9 mcmol/L, which is part of the homocysteine level test.
45-54 years: 9.8 mcmol/L
55-64 years: 10.4 mcmol/L
65 years and above: 5.9-15.3 mcmol/L
Females
12-29 years: 3.3-7.2 mcmol/L, within the normal range for healthy individuals.
Below 47 years: 7.8 mcmol/L
60 years and above: 4.9-11.6 mcmol/L
Generally, normal homocysteine levels increase age you age. A healthy level in adults is below 15 mcmol/L. However, studies state that the normal range may slightly vary depending on age and gender.
Optimal Vs. Borderline Vs. High-Risk Levels
Typically homocysteine levels are measured in micromoles per liter. Generally, optimal homocysteine levels are considered less than 10 mcmol/L. Borderline levels are considered between 10-15 mcmol/L and high-risk levels of homocysteine are considered above 15 mcmol/L.
High Homocysteine Levels (Hyperhomocysteinemia)
High homocysteine levels indicate the amino acid homocysteine in the blood above the normal range (15 micromol/L). Higher levels of homocysteine are associated with an increased risk of cerebrovascular, cardiovascular, and thromboembolic diseases. Although the exact mechanisms are being explored, high levels of homocysteine may harm blood vessels, increase the likelihood of blood clots, and lead to the development of atherosclerosis.
Normal homocysteine levels
Generally considered between 5-15 micromol/L. These levels indicate that homocysteine metabolism is functioning appropriately with no risk of health conditions associated with high homocysteine levels.
Elevated homocysteine levels (Mild)
Mildly elevated levels are considered between 15-30 micromol/L that may indicate a nutritional deficiency (Vitamin B6, B12, or folate).
Elevated homocysteine levels (Moderate)
Moderately elevated levels are considered between 30-100 micromol/L which may indicate a greater risk of cardiovascular disease, stroke, and other health concerns.
Elevated homocysteine levels (Severe)
Homocysteine levels above 100 micromol/L are considered severe and may indicate a genetic disorder (homocystinuria) or advanced kidney disease.
Difference Between High and Higher Levels (in terms of cardiovascular risk)
Homocysteine levels slightly above the normal range are considered high levels. However, significantly elevated levels are considered higher levels potentially signifying an extreme risk of cardiovascular conditions.
Causes of High Homocysteine
High homocysteine levels can be caused by various factors. For instance, if you have Vitamin B deficiency, you may have hyperhomocysteinemia, which can significantly affect homocysteine levels. Some risk factors are psoriasis, low thyroid hormone levels, kidney disease, genetics, and certain medications.
Nutritional deficiencies (Vitamin B6, folate, and Vitamin B12): B Vitamin deficiencies contribute to elevated levels of homocysteine in blood. These vitamins are essential for homocysteine metabolism. When these vitamins are lacking in the body, the body is unable to break down homocysteine properly, leading to accumulation and increased levels of homocysteine.
Kidney dysfunction: Kidney dysfunction is a crucial factor leading to hyperhomocysteinemia. Kidneys play a major role in homocysteine metabolism and elimination. When kidney function is impaired, it leads to the accumulation of homocysteine in the blood. This buildup is directly associated with an increased risk of health complications (cardiovascular disease) resulting from potential blood vessel disease .
Genetic conditions (MTHFR mutations): Genetic conditions such as MTHFR mutations can cause increased homocysteine levels. MTHFR (methylenetetrahydrofolate reductase) enzyme has a significant role in processing folate which is involved in homocysteine metabolism. MTHFR gene mutations can impair enzyme function causing a rise in homocysteine levels.
Hypothyroidism (underactive thyroid): Hypothyroidism is associated with high homocysteine levels in the blood. Studies revealed that people with underactive thyroid have considerably elevated homocysteine levels as compared to healthy people.
Certain medications (methotrexate, phenytoin): Certain drugs including phenytoin and methotrexate can contribute to high homocysteine levels in blood. These medicines can meddle with folate metabolism which is vital for maintaining normal homocysteine levels.
Lifestyle factors (alcohol, smoking, and poor diet): Unhealthy lifestyle habits including excessive alcohol, smoking, and poor diet contribute to elevated homocysteine. These factors influence homocysteine metabolism probably increasing the risk of associated health issues.
High Homocysteine levels: Symptoms
Elevated homocysteine levels may not cause any symptoms always. However, the symptoms may vary in every individual. Common symptoms include:
Fatigue
Dizziness or shortness of breath
Mouth sores
Tingling sensations
Mood changes
Swelling in tongue
Yellowish or pale skin
Irregular heartbeat
How to Lower Homocysteine Levels
If you have been diagnosed with increased levels of homocysteine in your blood, you can reduce it by increasing the intake of Vitamin B6 (pyridoxine, Vitamin B12 (cobalamin) and Vitamin B9 (folate). Add more fortified foods, green leafy vegetables, fish, and eggs to your diet. Follow your doctor’s recommendations to manage underlying conditions such as thyroid or kidney problems. Adapt healthy lifestyle habits such as increased physical activity, reduced alcohol consumption, and quit smoking. Your healthcare provider may recommend some supplements or prescribe intervention if necessary depending on your overall health, symptoms, and other essential factors.
Conclusion
You should be aware of your homocysteine levels as high levels may signify potential health issues including vitamin deficiency and the likelihood of developing cardiovascular disease. Elevated homocysteine levels can indicate heart disease, stroke, and vascular problems alerting you and your healthcare provider to take proactive measures for better management. Early intervention can significantly help avert the progression of these medical conditions and contribute to better health.
Frequently Asked Questions
***Medical Disclaimer: All the information provided here is for educational purposes only. Any information provided on this website, including text, images, and graphics, is not intended as a substitute for professional medical advice. Kindly visit your healthcare provider concerning your particular health condition(s).
