Homocysteine Report

Referral: ABC Clinic

Name: John Citizen

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: µmol/L

Status Reference: Optimal Elevated High

Homocysteine Level

Accredited By

8.9

OPTIMAL

µmol/L

Target: 5 – 15 µmol/L

8.9

0 15 20 25

Optimal

Optimal: <15 µmol/L | Elevated: 15–20 µmol/L | High: >20 µmol/L

Summary

Current Level

8.9 µmol/L

Within optimal range

Optimal Range

<15 µmol/L

Lower is better

Current Status

OPTIMAL

No action required

📅 Monitoring & Retesting

Optimal (<15 µmol/L): Retest in 1 year to ensure levels remain stable.
Elevated (15–20 µmol/L): Retest in 2–3 months after starting B-vitamin supplementation.
High (>20 µmol/L): Retest in 2–3 months. Consult your healthcare provider.
B-vitamin supplementation typically lowers homocysteine within 6–8 weeks.

📍 Recommended Retest: April – May 2026

Homocysteine Report

Referral: ABC Clinic

Name: John Citizen

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: µmol/L

Your Progress Over Time

Test-by-Test Breakdown

Understanding Your Homocysteine Zones

OPTIMAL

Below 15

Healthy cardiovascular and neurological risk profile. Maintain current approach.

ELEVATED

15 – 20

Mildly elevated. Increase B-vitamin intake (folate, B12, B6) and retest.

HIGH

Above 20

Significantly elevated. Medical assessment and B-vitamin intervention recommended.

Homocysteine Report

Referral: ABC Clinic

Name: John Citizen

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: µmol/L

What We Test & Why It Matters

● Homocysteine

Homocysteine is an amino acid produced during the metabolism of methionine, an essential amino acid obtained from protein-rich foods. The test measures total homocysteine in dried blood spot using LC-MS/MS. Levels below 15 µmol/L are considered optimal, while levels above 15 µmol/L may indicate deficiencies in B vitamins (B6, B12, and folate) or other metabolic factors.

The body relies on two key pathways to clear homocysteine: the remethylation pathway (which converts it back to methionine using folate and B12) and the transsulfuration pathway (which converts it to cysteine using B6). When either pathway is impaired — due to nutrient deficiency, genetic variants such as MTHFR, or lifestyle factors — homocysteine accumulates in the blood.

Elevated homocysteine is associated with increased cardiovascular risk, cognitive decline, and bone health concerns. It can damage the endothelial lining of blood vessels, promote inflammation, and impair nitric oxide production. Maintaining optimal levels through adequate B vitamin intake, a balanced diet, and regular monitoring supports long-term cardiovascular and neurological health.

Why Optimal Homocysteine Levels Matter

🫀

Heart Health

Lower homocysteine supports cardiovascular health

🧠

Brain Function

Associated with cognitive health and memory

🦴

Bone Health

Supports bone density and reduces fracture risk

🧬

DNA Methylation

Supports healthy gene regulation processes

🩸

Blood Vessels

Protects arterial lining and reduces inflammation

⚡

Energy Metabolism

Supports methionine cycle and cellular energy

😊

Mood & Wellbeing

Linked to mental health and neurotransmitter balance

🤰

Pregnancy Health

Healthy levels support fetal development

Common Causes of Elevated Homocysteine

B-Vitamin Deficiency

Insufficient folate, B12, or B6 intake is the most common cause. These vitamins are essential cofactors in homocysteine metabolism.

MTHFR Gene Variants

Genetic variants in the MTHFR gene can reduce folate metabolism efficiency, leading to higher homocysteine levels.

Kidney Function

Impaired kidney function can reduce homocysteine clearance, resulting in elevated blood levels.

Lifestyle Factors

Smoking, excessive alcohol or caffeine, sedentary lifestyle, and certain medications can contribute to elevated levels.

Homocysteine Report

Referral: ABC Clinic

Name: John Citizen

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: µmol/L

How To Improve Your Results

🥬

B-Vitamin Rich Diet

ESSENTIAL NUTRIENTS

Eat plenty of leafy green vegetables (spinach, kale, broccoli), legumes, and fortified cereals — these are rich in folate, a key nutrient for lowering homocysteine.
Include good sources of Vitamin B12 such as meat, fish, eggs, and dairy products. For those on plant-based diets, fortified foods or B12 supplements are recommended.
Consume foods rich in Vitamin B6 including poultry, fish, potatoes, bananas, and chickpeas.
Include choline-rich foods such as eggs, liver, and soybeans. Choline is converted to betaine, which provides an alternative pathway for lowering homocysteine independent of B vitamins.

Folate-Rich Foods (typical serving)

Lebensmittelquelle	Portion	Folate (µg)	Niveau
Hähnchenleber	100g	578	High
Linsen (gekocht)	1 cup	358	High
Spinat (gekocht)	1 cup	263	High
Schwarze Bohnen (gekocht)	1 cup	256	High
Spargel	1 cup	243	High
Brokkoli (gekocht)	1 cup	168	Moderate
Avocado	1 whole	163	Moderate
Angereichertes Getreide	1 serving	100–400	High

Vitamin B12 & B6 Sources

Lebensmittelquelle	Portion	Clé Nutrient	Niveau
Rinderleber	100g	B12: 70.7 µg	High
Muscheln	100g	B12: 84.1 µg	High
Lachs	100g	B12: 3.2 µg, B6: 0.6 mg	High
Thunfisch	100g	B12: 2.9 µg, B6: 0.5 mg	High
Hähnchenbrust	100g	B6: 0.6 mg	Moderate
Kichererbsen	1 cup	B6: 1.1 mg	High

Choline & Betaine Sources (supports alternative homocysteine pathway)

Lebensmittelquelle	Portion	Choline (mg)	Niveau
Rinderleber	100g	418	High
Eier (ganz)	2 large	294	High
Hähnchenleber	100g	290	High
Lachs	100g	91	Moderate
Sojabohnen (gekocht)	1 cup	107	Moderate
Quinoa (gekocht)	1 cup	43	Moderate

* Values are approximate. Source: USDA FoodData Central.

💊

Supplementation

A B-complex supplement containing folate (400–800 µg), B12 (500–1,000 µg), and B6 (10–25 mg) can effectively support healthy homocysteine levels.
Methylfolate (5-MTHF) may be more effective than folic acid for individuals with MTHFR gene variants.
Always consult a qualified healthcare professional before starting supplementation.

🏃

Lifestyle Factors

Regular physical activity supports healthy homocysteine metabolism.
Limit excessive alcohol and caffeine intake, which can elevate homocysteine levels.
Manage stress through regular exercise, adequate sleep, and relaxation techniques.

Homocysteine Report

Referral: ABC Clinic

Name: John Citizen

DOB: 01/01/2000

Collection Date: 01/01/2026

Received Date: 05/01/2026

Report Date: 08/01/2026

Sample Type: Dried Blood Spot

Analysis: LC-MS/MS

Measurement Unit: µmol/L

Important Information

🔬

About Homocysteine Testing

METHODOLOGY

Our Homocysteine test measures total plasma homocysteine from a dried blood spot (DBS) sample using isotope dilution liquid chromatography with tandem mass spectrometry (ID LC-MS/MS). Two 3mm discs (~6.2 µL of capillary blood) are extracted using a deuterium-labelled internal standard (²H₈-homocystine), ensuring highly accurate and reproducible quantitation.
Sample collection requirements: Patients should fast for a minimum of 12 hours prior to sample collection and refrain from taking any supplements for at least 24 hours before testing to ensure accurate results.
The assay has been clinically validated against serum reference methods in 117 patients, demonstrating a diagnostic sensitivity of 91.7% and specificity of 97.1% at a cut-off of 10 µmol/L. The functional sensitivity (LOQ) is 2 µmol/L with an upper limit of quantification of 44.8 µmol/L.

📚

References & Quality Assurance

EVIDENCE BASE

Our laboratory participates in the ERNDIM (European Research Network for evaluation and improvement of screening, Diagnosis and treatment of Inherited disorders of Metabolism) external quality assurance programme. Our Homocysteine assay is certified under the Special Assays in Dried Blood Spots (SADB) scheme, independently validated for accuracy and reliability through international proficiency testing.
Refsum, H., Smith, A.D., Ueland, P.M., et al. (2004). Facts and recommendations about total homocysteine determinations: an expert statement. Clinical Chemistry, 50(1), 3–32.
Collaboration, H.L.T. (2002). Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. BMJ, 325(7361), 1512.
Selhub, J. (1999). Homocysteine metabolism. Annual Review of Nutrition, 19, 217–246.
Smith, A.D. & Refsum, H. (2016). Homocysteine, B Vitamins, and Cognitive Impairment. Annual Review of Nutrition, 36, 211–239.

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Disclaimer

IMPORTANT

This report is provided for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. The results and recommendations should not be used as a substitute for consultation with a qualified healthcare provider. Individual results may vary based on dietary intake, genetics, medications, and other metabolic factors. Masdiag does not accept liability for any actions taken based on the information in this report. Always consult your healthcare provider before making changes to your diet, supplementation, or lifestyle.

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Questions About Your Results?

CONTACT US

If you have any questions about your results, would like help interpreting your report, or need guidance on next steps, our team is here to help. Please don’t hesitate to reach out — we’re happy to assist you on your health journey.

📧 support@masdiag.com

We aim to respond within 1–2 business days.