What does high homocysteine mean?

Homocysteine is an amino acid present in the body in very small amounts.

It is produced during the metabolism of methionine, an essential amino acid obtained from the diet, primarily through the consumption of meat, eggs, milk, and legumes. Under normal physiological conditions, homocysteine is converted into other compounds with the help of vitamins B6, B12, and folic acid.

Homocysteine is considered high when it exceeds 16 µmol/L. Hyperhomocysteinemia can distinguish 3 risk classes, depending on the levels of homocysteine in the blood:

• 16-30 μmol/L: moderate risk;
• 31-100 μmol/L: medium risk;
• >100 μmol/L: severe risk.

Hyperhomocysteinemia occurs due to the interaction of several factors:

• genetic factors (inherited or acquired diseases);
• environmental factors (such as a diet low in vegetables);
• use of certain medications.

An elevated homocysteine value may be linked to some diseases, including:

• pregnancy complications;
• certain forms of cancer;
• coronary artery disease;
• atherosclerosis and peripheral vessel thrombosis;
• deficits in cognitive function (especially in the elderly).

It is important to monitor the level of homocysteine as it is implicated in numerous disease processes including endothelial damage (it may in fact cause damage to vessel walls, causing structural and functional problems), which is of considerable clinical importance.

Excess homocysteine in the blood, or hyperhomocysteinemia, does not result in any clinical symptoms or signs. Therefore, the only way to detect an increase in homocysteine levels is through a blood test.

A blood test from a vein should be taken on an empty stomach, after 10-12 hours of fasting. Before the blood draw, it is necessary to rest and refrain from smoking for at least 15 minutes.

If hyperhomocysteinemia is not caused by genetic or other diseases, but by insufficient intake of folic acid and vitamins B6 and B12, it is necessary to supplement these elements by correcting the diet. 

In particular, the diet to combat hyperhomocysteinemia should be rich in raw fruit and vegetables. It is important that vegetables are fresh because the folates and vitamins they contain deteriorate quickly and with cooking. Homocysteine levels can also be normalized by taking dietary supplements of folate, vitamin B12 or vitamin B6 (singly or in combination).