Testing and re-testing your Homocysteine level
Knowing your blood (plasma) homocysteine level is as important, if not more so, than knowing your cholesterol level. GPs can commission this test for you but few do. If it were widely tested it need not cost much. This is because it uses standard equipment that any hospital laboratory has already.
There have been almost 27,000 studies published on homocysteine (Hcy) and over 1,000 on its link with dementia and cognitive decline in the past twenty years – so it’s no ‘new kid on the block’. As well as predicting risk for cognitive decline, it also predicts risk for stroke, cardiovascular disease, depression, osteoporosis, school performance and pregnancy problems.
Your Hcy level tends to go up with most factors we associate with poor health – smoking, drinking too much alcohol, not exercising, poor diet – so, to some extent, it’s a great marker for your overall health. Even in cancer patients, if homocysteine is going down they tend to be doing well, and if going up they tend to be doing badly.
All GPs can refer people for homocysteine testing but few do. Also, their guidelines specifiy that this is relevant if you have cardiovascular disease or dementia so they may not test otherwise. Also, it costs the practice and it doesn’t seem possible to offer to pay the cost. if you did score in the red or orange you will have received a letter you can print out or send to your GP to encourage them to test your homocysteine level.
We wish you could walk into a lab in any major city, or send off for a home-test kit, to find out your level. It is especially wise to know your level if you’re over 50. You may find your level is fine – e.g. below 10 and ideally 7 or less. The thing about homocysteine, is that probably a third over 60 and half of those over 70 have a level above 11mcmol/l, which is the level that correlates with accelerated brain shrinkage.
What makes homocysteine is a little tricky compared to some other blood tests is that a) it’s the plasma level, in the clear part of the blood and b) it’s prone to degradation after taking the sample. So it has to be ‘separated’ on taking the sample. Our goal early next year is to make it easy to test, using a home test collection kit,
Private labs that offer private homocysteine testing require referral by a healthcare practitioner. You’ll still need to go to the lab or find a local phlebotomist to take the blood sample. If you live in the UK we hope to have an option for you in early 2023. Please email us at firstname.lastname@example.org saying ‘test my homocysteine’ and we’ll get back to you as soon as there is a viable option.
If you’ve had a homocysteine test, and if was high, it comes down quickly, so testing after 3 or 4 weeks of making changes is viable. Otherwise, it remains reasonably stable such that, if your level is good, you could check it every three or so years.
It is best to a) stop your B vitamin supplements for at least 2 days (48 hours) before testing, b) test on an empty stomach, only having drunk water. Some labs tell you to ‘load up’ with a protein-based meal but this is a ‘challenge’ test which would slightly raise your homocysteine level. It is still valid but most research carries out testing on an empty stomach, so this is preferable.