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Parameter Concentration
Interpretation Information
Homocysteine (Hcy) < 5 Low concentration It may result in higher susceptibility to oxidative stress. It is suggested to enrich the diet with products rich in methionine, or alternatively, supplementation with methionine, N-acetylcysteine, or taurine is recommended [1].
5 - 15 Optimal concentration Balanced cycle of homocysteine metabolism.
> 15 Elevated concentration (HHcy) [2, 3]

Elevated levels of homocysteine in the body are referred to as hyperhomocysteinaemia (HHcy).

Depending on the cause, hyperhomocysteinaemia can be classified as:

  • Primary, resulting from genetically determined deficiencies of enzymes involved in homocysteine metabolism.
  • Secondary associated with deficiencies in B-group vitamins, excessive consumption of methionine, renal or hepatic insufficiency, diabetes, hypothyroidism, certain medications, high coffee or alcohol consumption, and smoking.

According to the severity of the condition, hyperhomocysteinemia can be classified based on the levels of homocysteine as:

  • moderate - Hcy in the range of 15-30 µmol/L
  • moderately severe - Hcy in the range of 30-100 µmol/L
  • severe - Hcy above 100 µmol/L.

It is recognised that hyperhomocysteinaemia is an independent risk factor for the development of cardiovascular disease, including thrombosis and atherosclerosis, ischaemic and haemorrhagic stroke, as well as a prognostic factor of mortality from coronary heart disease. The correlation between homocysteine and folic acid levels is significant during pregnancy. Furthermore, in specific cases, homocysteine levels are associated with the occurrence of depressive states and migraine episodes. Some studies also show a link between elevated homocysteine levels and the risk of Parkinson's disease, Alzheimer's disease, and age-related dementia.

In case of detecting hyperhomocysteinaemia, modification of the diet, further tests assessing the body's supply of B-group vitamins, and in special cases, diagnosis of genetic defects in methionine and homocysteine metabolism should be considered.

[1] „Homocysteine: Friend or Foe?"
Integr. Med. (Encinitas), 2014, 13(4), 8-14
[2] „Causes of hyperhomocysteinemia and its pathological significance"
Archives of Pharmacal Research, 2018, 41(4), 372–383, doi: 10.1007/s12272-018-1016-4
[3] „Hyperhomocysteinemia"
StatPearls Publishing, 2021