Homocysteine Blood Test

Homocysteine blood test measures the amount of amino acid homocysteine in the blood. High level of homocysteine is associated with low level of vitamin B6/ B12, and folate. This blood test helps us to identify the deficiency and get treated accordingly. The results of the blood test are generally ready within 24 to 72 hours. Homocysteine is measured in micromoles per liter of blood.

Homocysteine (HCY) is considered as the main biochemical marker of several primary and secondary disorders of methionine metabolism. Methionine is one of the essential Amino acids and sweeps the blood stream of heavy metals. It plays a major role in protecting the liver. Poor Methionine Metabolism can result in Homocysteinemia, Cystathionine Synthase (CS) deficiency (Homocystinuria) and Methylenetetrahydrofolate reductase (MTHFR) deficiency.

Homocysteine is a non protein amino acid that is produced by the body and is present in small levels in the blood. Amino acids are the building blocks of all proteins in the body. In our body, vitamins B6, B12 and folate convert homocysteine into other usable substances. A deficiency in these vitamins may cause an elevated level of homocysteine. Elevated levels in infants can prove fatal as the infant may be highly prone to develop heart or blood vessel diseases at an early age.

Reference Level of Homocysteine : Less than or equivalent to : 13 µmol/L (micromoles per liter)

Elevated levels of homocysteine could be due to genetic causes (a rare disorder called Homocystinuria that is caused by a dysfunctional enzyme that is essential for metabolism in the body) or due to other causes like atherosclerosis.
In addition to be the important marker for inherited disorders of methionine metabolism, the total homocysteine (HCY) level can accurately predict conditions such as cardiovascular disease (atherosclerosis, thromboembolism). Besides it can also indicate acquired folate or cobalamin deficiency - a contributing factor in the pathogenesis of neural tube defects.

Homocysteine is measured using a simple blood test. This blood test is done to identify

• B12 deficiency or folic acid deficiency
  
• Cause for blood clots
  
• Rare inherited disease that causes deficiency of enzymes needed to convert food to energy.

What causes high/low homocysteine value in blood ?

High values in blood may be caused by:

• Vitamin B12, B6 or folic acid deficiency
  
• Homocysteine value is usually high in men than in women. However post-menopause the levels tend to match. But during middle age women record low levels of homocysteine when compared to men.
  
• Consuming too much alcohol, smoking
  
• Other diseases like hypothyroidism, Alzheimer's disease, kidney disease, certain cancers can influence the homocysteine level.
  
• Advancing age, reduced appetite leads to inadequate vitamin intake thus leading to the condition.
  
• Lifestyle factors also contribute to the surge in homocysteine levels in the blood.

How is high level of homocysteine harmful ?

Higher levels of homocysteine can point to an underlying Cardiovascular disease or a Neuro vascular disease.
Elevated levels of homocysteine can:

Damage artery lining: Arteries tend to become damaged and begin to clog, thicken and become inflexible thus leading to atherosclerosis.

Create blood clots: Homocysteine can elevate the cholesterol levels thus clogging the arteries and thickening them thus leading to atherosclerosis. Blood clots form easily thus leading to heart attack.

Strokes: Elevated level of homocysteine can affect the arteries leading to and from the brain thereby causing a blood clot or a rupture in the blood vessel. This in turn can cut off/reduce the oxygen supply to the brain thereby starving the brain cells of nutrition and oxygen thus leading to a stroke.

Osteoporosis: Density of the bone mass reduces thus leading to fragile and weakened bones.

Cause infertility: Women with high level of homocysteine find it difficult to conceive and are at the risk of repeated miscarriages.

Cause dementia and Alzheimer's: Old age can contribute to high levels of homocysteine thus damaging the brain cells. Over time memory is lost thus killing more and more cells.

Homocysteine level in the blood can be lowered by:

1. Consuming more fruits and vegetables, as it can help increase the folate level in the blood. Green leafy vegetables like Brussels sprouts, broccoli, spinach, asparagus, etc contribute largely in increasing the folate level.

2. Fortified grain products, lentils, spinach, asparagus, and breakfast cereals also are a good source of folate.

3. Consuming citrus fruits like oranges and grapefruit can help.

4. Potatoes, breakfast cereals, chickpeas (garbanzo beans), bananas, and chicken are a good source of Vitamin B6 which help improve the homocysteine level in the blood.

5. Beef, organ meats, dairy products and fish are a great source of Vitamin B12 which in turn can increase the homocysteine.

6. Apart from folate in the diet, Vitamin B6 and B12 supplements help in raising the homocysteine level.

Who should get this test done?

People who have a history of heart diseases and are at a high risk for heart disease should get their homocysteine level checked. People who are at risk for stroke also need to get this check done.

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