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Also Known As: Total Plasma Homocysteine, Homocysteine, Homocysteine Cardiac Risk, Total Homocysteine

What Is A Homocysteine Test?

A Homocysteine Test helps measure the amount of homocysteine in your blood. Homocysteine is an amino acid, i.e., a chemical in your body that helps build proteins. Vitamin B6, B9 folate, and B12 break down homocysteine in your body to generate other chemicals needed to perform bodily functions. After interacting with the B vitamins, the homocysteine is converted into two substances, i.e.

Methionine: Essential amino acid and antioxidant that helps synthesize and create proteins.

Cysteine:  A nonessential amino acid that is synthesized from methane to reduce inflammation, improve liver health and promote better contact between your immune cells

The standard homocysteine levels in a normal healthy adult are about 5-15 micromoles per liter. If you have excessive homocysteine in your blood, it can damage your arteries and the lining of your blood vessels that carry oxygen-rich blood to all parts of the body. The high levels of this amino acid can also cause blood clots or blood vessel blockage. With artery damage and blood clots, you are at a greater risk of developing heart conditions like a heart attack.

What Is The Test Used For?

Your doctor or health care provider can recommend this test for the following purposes:

Nutritional Deficiencies

They can perform this test to determine if you have a deficiency related to vitamin B6, folic acid, and Vitamin B12.


This test is also helpful in diagnosing this rare inherited disorder that prevents your body from breaking down certain proteins. It can lead to serious health concerns as the progression begins early in childhood. Due to this reason, many countries have now made it a law to get newborns tested for a homocysteine blood test as a part of routine screening to prevent life-threatening conditions of the babies.

Heart Diseases

Another major reason for carrying out this test is to screen you for possible heart conditions like heart attack and stroke. Apart from diagnosis, the homocysteine test also serves to monitor people with an existing heart condition.

Why And When Do You Need A Homocysteine Test?

Usually, a doctor or medical professional recommends this test to an individual after suspecting Vitamin B12 or folate deficiency. The signs and symptoms of abnormal levels are often subtle and non-specific initially, but if left untreated, it can lead to more serious complications than expected. You can easily be diagnosed with an early deficiency even before the symptoms appear. However, it is still essential to keep a close eye on the following signs and symptoms:

  • Dizziness and unexplained fatigue
  • Diarrhea
  • Constant weakness and trendiness
  • Paleness
  • Loss of appetite
  • Shortness of breath
  • Rapid heartbeat
  • Sore mouth and tongue
  • Numbness, tingling, and burning of feet, hands, arms, and legs

You might also need to undergo this test as a part of routine assessments related to your cardiovascular diseases based on the age, severity of symptoms, and other risk factors. The doctor can also suggest the test following a stroke or heart attack to help with the guided treatment plan.

What Kind Of Sample Is Required For The Test?

A professional lab technician or doctor will take a blood sample from a vein in your arm during the test. The process is similar to any other standard blood test. They will insert a small needle in your arm and take the recommended amount of blood in a vial or test tube. Once adequate blood is taken, they send your sample to the laboratory for further examination.

Do You Need To Prepare For The Test?

Some of the preparatory instruction before the homocysteine test include:

  • Fasting for at least 10 hours is required.
  • Fasting samples must be collected only after a minimum of 10-12 hours of overnight fasting.
  • You can consume clear liquids like water in your fasting period but refrain from drinking your early morning beverages like coffee, milk, or tea until the sample collection is taken.
  • People with diabetes on oral or injectable medicines should consult their physician regarding their consumption before the homocysteine test.

Are There Any Risks To This Test?

Since the homocysteine test is just like any other routine blood screening procedure, it carries almost little to no risks. Some people complain about pain or bruising at the injection site, but the symptoms are often mild and quickly go away.

What Do The Test Results Mean?

If your test results suspect malnutrition or folate/Vitamin B12 deficiency, it means that the homocysteine levels are elevated. It can occur when you are not taking enough vitamins or folate through food, diet, or supplements. When it happens, your body becomes unable to covert homocysteine into other forms that are beneficial for your body, ultimately giving rise to serum homocysteine levels.

Studies and research suggest that people with excessive homocysteine levels are at a greater risk of developing a heart attack or stroke than those with average results. If your results also show high homocysteine levels, it can be due to:

  • Nutritional deficiencies of vitamin B16, B12, or folate in your diet
  • Higher risk of heart conditions
  • Homocystinuria (after abnormal results, the doctor will ask for additional tests to rule out the potential cause or confirm the diagnosis)

However, abnormal homocysteine levels are not always a major cause of concern. Some other factors can also impact your results, including:

  • Your age (the levels get higher with age)
  • Your gender (men are likely to have higher levels compared to women)
  • Excessive smoking
  • High alcohol use and abuse
  • Unnecessary use of vitamin B supplements

Related Tests: Folate (Folic Acid) Serum Test, Vitamin B12 and Folate Blood Test Panel, Vitamin B12 Blood Test, Fibrinogen Antigen Blood Test.

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