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HOMOCYSTEINE

About the test
What is this test done for?
Homocysteine is a blood test that measures the amount of amino acid homocysteine in the blood.
Why is it Done?

This is a specialized blood test conducted for assessing homocysteine levels in blood for the following reasons:

  • Ruling out risk of diseases related to atherosclerosis, like
    • Heart attack
    • Stroke
    • Clot formation
  • Ruling out risk of Alzheimer’s disease
  • Identifying a rare inherited disease i.e. homocysteinuria, which causes deficiency of several enzymes that are required to convert food into energy
  • Getting assistance in identifying vitamin B12 or Folic acid deficiency
When should it be performed?

This test is performed when a patient has

  • Symptoms of atherosclerosis
    • In Coronary artery
      • Chest pain or angina
      • Shortness of breath
      • Nausea and/or vomiting
      • Shortness of breath
    • In Peripheral artery
      • Pain in the legs, arms or anywhere else that has a blocked artery
      • Fatigue
    • Carotid artery
      • Confusion
      • Giddiness
      • Head heaviness or sudden severe headache
      • Tingling numbness of one or both arm(s) and leg (s)
      • Trouble in speaking and understanding speech
  • Symptoms of homocystinuria
    • Abnormal blood clotting
    • Dislocation of lenses in eyes
    • Nearsightedness
    • Weakening of bones (osteoporosis)
    • Learning disabilities
    • Scoliosis
    • Long, spindly arms & legs
  • Abnormal lipid levels in blood i.e. high levels of LDL, low levels of HDL
  • Low level of Vitamin B12 & folic acid
How is it done
A blood sample will be collected from a vein in your arm. Eight hours of fasting is required and drugs like methionine are to be avoided for a day prior to testing.
Results

The test result is normal, if levels are 4-17 µmol/L or 0.53-2.3 mg/L. It means

  • Low risk or no risk of atherosclerosis
  • Vitamin B12 & folic acid levels are normal
  • Absence of homocystinuria

The test results are moderately elevated, if levels are 15-30 µmol/L. It means

  • Low levels of Vitamin B12 and folic acid
  • High risk of atherosclerosis
  • Risk of Alzheimer’s disease
  • Chronic intake of alcohol

The test results are moderately elevated, if levels are 30-100 µmol/L. It means

  • Very low levels of Vitamin B12 and folic acid
  • Very high risk of atherosclerosis
  • Very high risk of clot formation
  • Mild to moderate homocystinuria
  • High risk of stroke or heart attack (if lipid levels are also elevated)
  • Post stroke or attack scenario

The results are severely elevated, if levels are > 100 µmol/L. It means

  • Immediately post stroke or attack scenario
  • Gross homocystinuria
  • High risk of DIC or peripheral vascular disease
Other Tests
  • Vitamin B12 levels
    • It is a specialized blood test carried out to evaluate vitamin B12 levels in the blood
    • Low levels of B12 can raise homocysteine levels
  • Folic acid levels
    • It is a blood test carried out to evaluate folic acid levels in the blood
    • Low levels of folic acid are associated with high levels of homocysteine
  • Lipoprotein levels
    • It is a specialized blood test that evaluates the amount of lipoproteins in the blood
    • High levels of lipoproteins indicate risk of atherosclerosis
  • Lipid profile
    • It is a routine blood test that evaluates cholesterol fragments in the blood (Total cholesterol, LDL, HDL, Triglycerides & VLDL)
    • High levels of LDL and low levels of HDL are associated with risk of cardiac atherosclerosis
  • Apolipoprotein levels (Apolipoprotein A1 & B)
    • It is a specialized blood test that measures apolipoprotein levels in blood
    • High levels of apolipoproteins are associated with risk of atherosclerosis
    • Apolipoproteins are better indicators then LDL & HDL
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