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Elevated Homocysteine Levels or Lab Error?

Elevated Homocysteine Levels or Lab Error?

Elevated Homocysteine Levels Need to Be Corrected

Before I detail how to correct a high homocysteine level, we must first define what actually constitutes an elevated homocysteine level.

The typical lab reports that homocysteine is elevated once it passes 11 umol/L.

Lab results

However, there are many labs that say only after 15 umol/L is it considered elevated.

more lab results

At 11 umol/L, the risk of death associated with high homocysteine is significantly higher than if homocysteine was between 5 umol/L to 10 umol/L.(1)

Lab results scale

In my book, based on this meta-analysis of 11 studies and 27,737 individuals, it's safe to say that an elevated homocysteine level is one that increases all-cause mortality. That appears to start around 6 or 7 umol/L, not 11 or 15 umol/L.

An elevated homocysteine level, then, is one that is greater than 7 umol/L.

Elevated Homocysteine Levels and Dementia

This was so significant that I want to bring it to your attention:(2)

"The results of our prospective, observational study indicate that there is a strong, graded association between plasma total homocysteine levels and the risk of dementia and Alzheimer's disease. An increment in the plasma homocysteine level of 5 μmol per liter increased the risk of Alzheimer's disease by 40 percent. A plasma homocysteine level in the highest age-specific quartile doubled the risk of dementia or Alzheimer's disease. A similar result was found when the single criterion of hyperhomocysteinemia (base-line plasma homocysteine, >14 μmol per liter) was used."

Let’s Make Sure That Your Homocysteine Level Is Actually Accurate

It's essential to ensure your homocysteine level is not erroneously elevated due to laboratory error.

Is Laboratory Error an Issue?

Yes, it can be. It’s important that you know how your blood sample should be processed.

Steps for Accurate Homocysteine Blood Test

  1. Schedule your homocysteine blood draw in the morning.
  2. Enjoy your dinner, but don’t go overboard on too much protein.
  3. After dinner, stop eating until you get your blood drawn the next morning.
  4. Wake up, have a glass of filtered water.
  5. Get your blood drawn.
  6. Make sure you talk with the lab tech about how they handle your sample.

Proper Handling of Your Homocysteine Blood Sample(3)

The following steps should be followed for accurate results:

  • You must be fasted. Do not eat after dinner, and do not eat until after your blood is drawn.
  • The lab tech should spin down your sample in the centrifuge.
  • Your sample must be placed on ice within 30 minutes of being drawn from you.

Red blood cells continue producing homocysteine at 10% more per hour once blood is drawn. This is why they must be removed by the centrifuge. The remaining plasma remains stable at room temperature for up to 4 days.

Is Your Homocysteine Level Elevated?

If you had your homocysteine levels properly checked and they are greater than 7 umol/L, then you need to take some action.

What Contributes to Elevated Homocysteine?(4)

  • High protein diet
  • Fasting (< 75 grams of protein per day)
  • High intensity exercise
  • Lack of exercise
  • Smoking
  • Males > Females
  • Postmenopausal females
  • Diabetes
  • Hypothyroidism
  • Kidney disease
  • Increased age
  • Caffeine
  • Low choline
  • Low glutathione
  • Low vitamin B6
  • Low vitamin B12 (especially methylcobalamin)
  • Low folate (especially methylfolate)

Support Healthy Homocysteine Levels

Adjust your lifestyle and dietary choices accordingly:

  • Stop smoking.
  • Reduce caffeine intake.
  • Support healthy blood sugar.
  • Exercise moderately.
  • Eat a healthy amount of protein, which is essentially 1 gram of protein per 2 pounds of body weight.
  • Support your thyroid by reducing stress, filtering your water, reducing chlorine exposure, and cutting out gluten.

As you’re working on these, consider adding supplements to further support healthy homocysteine levels:

Supplement Recommendations

  • Homocysteine Nutrients: Take 1 capsule with a protein-based breakfast. This contains folate as methylfolate, B12 as methylcobalamin, TMG (trimethylglycine), vitamin B2, and vitamin B6 (as pyridoxal-5-phosphate).
  • Glutathione Plus Lozenge: Take 1 lozenge by mouth upon waking up. This supports healthy methylation so that vitamins B12 and folate can recycle homocysteine properly.
  • Optimal Electrolyte: Proper hydration is essential for healthy homocysteine levels. Drink 1 to 3 servings a day in filtered water to support hydration and kidney health.
  • Pre-Workout Nutrients: Take 1 serving 30 minutes before working out to support healthy homocysteine levels during exercise.