Homocysteine is an amino acid — a building block of protein — that naturally exists in your blood. Think of it like a chemical your body makes while processing the food you eat.
Here’s the problem: When homocysteine levels get too high, it acts like sandpaper on your artery walls, causing damage that can lead to heart disease and stroke. It can also affect your brain, making it harder to think clearly or remember things.
The frustrating part? Most doctors don’t check homocysteine unless you specifically ask. It’s not included in regular blood work, even though it’s an important piece of your heart health puzzle.
Why It Matters for South Asians
For many South Asians, high homocysteine is a hidden problem with a simple cause: not getting enough B vitamins.
Many people in our communities follow vegetarian diets for religious, cultural, or personal reasons. While plant-based eating has many benefits, it can lead to deficiencies in:
- Vitamin B12 (mainly found in meat, eggs, and dairy)
- Folate (also called B9)
- Vitamin B6
When you don’t get enough of these vitamins, homocysteine builds up in your blood. This is especially common if you:
- Follow a strict vegetarian or vegan diet
- Don’t eat many dairy products
- Have digestive problems that affect vitamin absorption
High homocysteine doesn’t just affect your heart. It can also cause:
- Brain fog and difficulty concentrating
- Memory problems
- Mood changes and irritability
- Fatigue that doesn’t improve with rest
When to Ask for This Test
Consider asking your doctor for a homocysteine test if you:
- Follow a vegetarian or vegan diet
- Have a family history of early heart disease or stroke
- Experience unexplained fatigue, brain fog, or memory issues
- Have been diagnosed with B12 deficiency
- Have high blood pressure or diabetes
- Have family members who had strokes or mini-strokes
- Take certain medications that affect B vitamins (like metformin for diabetes)
The test is simple — just a regular blood draw, no fasting required.
What the Results Mean
Homocysteine is measured in micromoles per liter (μmol/L):
- Less than 10 μmol/L: Optimal range — your levels are healthy
- 10–12 μmol/L: Borderline — worth watching and improving
- 12–15 μmol/L: Mildly elevated — time to take action
- Above 15 μmol/L: High — requires immediate attention
The good news? Unlike many risk factors for heart disease, high homocysteine is one of the easiest to fix. Most people can lower their levels significantly within a few months.