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Homocysteine

Inflammatory Unit: μmol/L

Amino acid; elevated levels indicate methylation issues and CV risk

Also known as: Hcy,Plasma Homocysteine

Reference Ranges

Clinical Reference 5.0 – 15.0 μmol/L

Optimal Range 5.0 – 10.0 μmol/L

Elevated >15 = hyperhomocysteinemia; CV risk

Related Conditions

Cardiovascular Disease High

Depression High

Food & Lifestyle Recommendations

🍎 Food Increase folate-rich foods (leafy greens, legumes), B12 (animal products), and B6 (fish, potatoes, bananas) B vitamins are the primary treatment for elevated homocysteine

💡 Other Reduce coffee intake (>4 cups/day can raise homocysteine) and quit smoking Smoking and excessive coffee raise homocysteine levels

Evidence-Backed Supplements

When High

Vitamin B12 Tier A May Decrease

Strong evidence; B12 lowers homocysteine via methylation

Methylcobalamin or cyanocobalamin 1000–5000 mcg/day (sublingual preferred) Morning

PMID 40147066 PMID 30431328 PMID 29543316
Folate Tier A May Decrease

Strong evidence; folate lowers homocysteine via methylation

Methylfolate (5-MTHF) 400–1000 mcg/day Morning

PMID 28816346 PMID 25803792 PMID 32770489
Vitamin B6 Tier A May Decrease

Moderate evidence; B6 cofactor in transsulfuration

Pyridoxal-5-phosphate (P-5-P) 25–50 mg/day Morning

PMID 23335472 PMID 19821378 PMID 30431328

Questions to Ask Your Doctor

Could my elevated homocysteine be contributing to cardiovascular risk, and can it be lowered? B12, folate, and B6 can lower homocysteine
Should I be tested for MTHFR gene variants given my high homocysteine? MTHFR C677T variant impairs homocysteine metabolism

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