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Why Is It Important To Know Your Homocysteine Level?

Written by

Deborah Freudenmann BHSc

Measuring your homocysteine levels is recommended for the early diagnosis of several disorders. The abnormal levels of homocysteine in the blood could provide insights into the potential risks of developing certain diseases.

In healthy circumstances homocysteine is broken down, however factors such as nutritional deficiencies, certain medications or conditions can lead to excess homocysteine levels. High homocysteine has been linked to various health issues such as atherosclerosis, stroke, diabetes complications, neurological diseases, osteoporosis, depression, erectile dysfunction and pregnancy complications.

Here is a brief discussion about what homocysteine is and why it is important to know your homocysteine levels.

What is homocysteine?

Homocysteine is one of the amino acids that play a role in the metabolism of proteins. An increased homocysteine level can lead to a state called hyperhomocysteinemia that is known to contribute to the formation of abnormal clots in the blood vessels as well as arterial damage.

Homocysteine is the beginning of the methylation cycle but also the end. If your body is healthy and the methylation cycle is working properly, homocysteine gets scooped up, methylated and eventually turned into S-adenosylmethionine – and the process starts again.

Once the cycle has ended and S-adenosylmethionine has handed off all the methyl groups, what happens to homocysteine?

Homocysteine, is the left-over by-product of methylation. It can either be methylated and going back into the cycle or it is used to make glutathione a key antioxidant/detox biochemical.

The circulating level of homocysteine usually tends to be lower due to its rapid metabolism through certain pathways including the folate and cobalamin (vitamin B12) dependent re-methylation pathways that regenerate methionine, as well as the PLP (pyridoxal 5’ phosphate) dependent trans-sulphuration pathway, which involves the conversion of homocysteine to cysteine.

An abnormal level of homocysteine could indicate an abnormality related to these pathways thus pointing to the possible diagnosis of diseases linked to abnormal methylation.

What is the optimal level of homocysteine?

In functional medicine we strive for optimal values of homocysteine between 6-8 umol/L for males and females.

However, the level of homocysteine lower than 15 mcmol/L (micromoles per liter) of blood is considered normal in conventional practices. In some clinics they start questioning anything above 11 umol/L as the upper end of what is considered acceptable.

If you have low homocysteine, you won’t have enough homocysteine for both methylation and glutathione. If your homocysteine is too high, this blocks methylation which affects numerous pathways and thus is correlated to many disease states.

Studies have revealed that men are more likely to have an increased level of homocysteine than women. Research studies have also revealed that homocysteine levels may also rise due to aging.  This is a critical factor that links the increased homocysteine levels to the higher risk of Parkinson’s and Alzheimer’s through the abnormalities in the methylation processes.

These findings suggest that it is important to avoid and correct the disturbances in the methylation processes in order to maintain normal levels of homocysteine in the blood.

What can cause a disrupted homocysteine metabolism?

The deficiencies of vitamin B6, B12, and folate are the common cause of increased homocysteine levels.

  • Inflammation
  • Oxidative stress
  • Medications
  • Heavy metals and toxins
  • Folic acid (this synthetic form blocks your folate receptors)
  • Yeast overgrowth
  • Gastrointestinal issues such as SIBO
  • Infection
  • Lack of needed nutrients
  • Psychological stress
  • Diet
  • Alcohol
  • Other diseases/conditions (diabetes, Crohn’s disease, rheumatoid arthritis, thyroid function)
  • MTHFR impairement

Consequences of high homocysteine

The increased homocysteine level is associated with a higher risk of mortality. It is estimated that every 5 µmol rise in the homocysteine levels per liter of blood can lead to a 33.6% increase in the mortality risk.

Increased homocysteine levels, if not detected and treated early, may lead to serious complications such as:

  • Heart attacks
  • Aortic aneurysm that occurs due to the development of an abnormal bulge in the aorta
  • Inhibiting antioxidant enzyme activity
  • Atherosclerosis
  • Hypothyroidism
  • Increased oxidative stress
  • Inflammation
  • End-stage renal disease
  • Osteoporosis that occurs due to the weakness of the bones with loss of bone density
  • Dementia
  • Parkinson’s disease, a disorder affecting the central nervous system
  • Multiple sclerosis, an autoimmune disorder that causes damage to the brain and spinal cord
  • Mitochondrial dysfunction
  • Cerebrovascular stroke
  • Damage to the structure and function of proteins
  • Epilepsy
  • Eclampsia characterized by the onset of seizures in pregnant women due to high blood pressure


The elevated homocysteine level may also enhance the complications linked to hypertension, smoking, and chronic inflammation thereby contributing to the risk of mortality.

Functional medicine approach to the management of high homocysteine


B vitamins are the main therapeutic agents used to treat elevated or high levels of homocysteine. In general, the combined use of vitamin B12, folate and B6 is effective in lowering homocysteine levels. It is important to note that B vitamins should be taken in the methylated form and not synthetic.

In addition to a methylated vitamin B complex, other nutrients which have been shown to be effective include choline, betaine, omega-3 fatty acids, N-acetylcysteine and magnesium.

The role of diet

Poor dietary nutrition and unhealthy lifestyle habits such as smoking and alcohol consumption are closely linked to the increased homocysteine levels in the blood. The homocysteine levels have been found to be higher in patients who have suffered a heart attack and stroke indicating the importance of measuring homocysteine levels to predict the risks of these diseases.

The lack of nutrients in the diet and unhealthy lifestyle habits may also play a role in triggering abnormal homocysteine metabolism in patients with Turner syndrome.

The results of these studies have suggested that improving dietary and lifestyle habits and ensuring that your body is not deprived of essential nutrients could help to avoid the rise in homocysteine levels. This would protect you against the disorders linked to the increased homocysteine level and reduce the risk of complications including mortality.


Regular exercise, especially resistance exercises has been found to be beneficial for maintaining normal homocysteine levels in the blood. Resistance exercises may reduce plasma homocysteine levels and inhibit the development of diseases caused due to abnormal homocysteine metabolism.


Chronic stress results in methyl group depletion which can interfere with optimal methylation and thus contribute to elevated homocysteine levels. Therefore, it is important to address stress through lifestyle means and often with some supportive supplementation.


Measuring your homocysteine levels at regular intervals is recommended for assessing the body’s nutritional status and predicting the risk of diseases linked to abnormal homocysteine levels and methylation issues.

6 Responses

  1. Great information . I have been aware of our homocysteine levels playing a big role in our heart health, I enjoyed seeing this explanation. Thank You

    1. Hello Randy, you can test your homocysteine levels via a blood test. This can be requested at every GP! It is good to be tested as it can give you insights in your methylation. Warmest regards, Deborah

    1. Hello Skye,

      Excellent question. If you have low homocysteine, this means you may not have enough homocysteine for both methylation and making glutathione.

      It’s important to look at why your body has low homocysteine in the first place?

      – High demand for glutathione is a factor to consider. Are you struggling with high amounts of inflammation, chronic stress or free radical exposure?
      If yes, it’s important to balance this overuse of glutathione. Minimising stress levels, supporting your adrenals, improving sleep and reducing inflammation.
      Of course, you can consider taking liposomal glutathione complex (quicksilver scientific has a great one with all the appropriate co-factors) if this is a major culprit but again, remember the ask “WHY”

      – Do you consume a limited or low amount of protein? Protein is really important to ensure you are getting enough building blocks. Then it’s important not only to consume quality protein but also be able to digest, breakdown and absorb these nutrients. Stress, and eating while on the go are two common culprits. However, digestive function should be analysed properly, how is your microbiome functioning, do we have pathogenic overgrowth? You can support through digestive enzymes and herbs to help with digestion and nutrient uptake.

      – Cysteine, cysteine, cysteine! Cysteine is very important for many reactions. If cysteine levels are low, the body will break down glutathione in order to provide it! So not only does one become low in homocysteine, but also glutathione. Therefore it is important to consume sulfur rich foods.

      – Are you over methylating??? Sometimes individuals can be taking too much or doing too much which results in over-methylation and can lower your homocysteine levels too much.

      I hope this has provided you with a little further clarification on how to address or look at why your homocysteine is low and also how to start raising it.

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