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The Most Important Blood Test That Is Rarely Ever Run!

The Most Important Blood Test That Is Rarely Ever Run!

The simple blood test that could save your life and why it is rarely ever performed.

Did I get your attention?

The simple test that could save your life and give you a better indicator of your current state of health is one that is rarely ever performed. What is it? It’s called homocysteine. Most patients have never heard of it. Most doctors never run the test even with their sickest patients.

So if doctors don’t run the test, and most people have never heard of it, why would I say getting this test performed could save your life? Read on!

Homocysteine_Part_1What Is Homocysteine?

Homocysteine is an amino acid that is broken down from the proteins in our foods directly or made as a result of methylation reactions involving S-adenosylmethionine (SAM).

Homocysteine is a critical amino acid needed for multiple processes in the body. One of the most important uses for homocysteine is it’s conversion to methionine which is the substrate for SAM. SAM is the main methyl donor in the body and responsible for 200 plus reactions in the body that occur millions of time per second in our body. I’ve written about methylation and it’s role in body function, dysfunction, disease, and degeneration in other posts.

Today I want to discuss homocysteine. It’s importance in our health function and the rate at which we age is so important that this one post may actually wind up being a 2 or 3 post series.

Homocysteine plays a pivotal role in the balance between two important pathways in the body; the methionine cycle and the Transsulfuration pathway.

The methionine cycle drives our SAM production and the Transsulfuration pathway is important for glutathione production, detoxification, and multiple other functions.

Based on body demands homocysteine needs to be regulated pretty closely by the body. While there is some dispute as to what the lab range should be, most progressive doctors especially those in the functional medicine community would suggest the optimal level is 7 with an optimal range of 6-8. Most laboratory ranges are 5 -15 which is way too broad of a range. Homocysteine is causing damage well before it falls outside that range.

So what is the problem if homocysteine becomes too high?

Elevated homocysteine levels have proven to be a reliable risk factor for the following:

  • Myocardial infarction (heart attack)
  • Cerebrovascular accident (stroke)
  • Cancer
  • Diabetes
  • Thyroid-related health challenges
  • Neurological conditions like Parkinson’s and Alzheimer’s
  • Depression
  • Infertility
  • Chronic Pain
  • Digestive Disorders

While we are still learning the exact mechanisms of how homocysteine is linked to all these disorders, most would agree that elevated homocysteine’s levels vessels damaging inflammatory effect is the major problem.

So, do we want our homocysteine to be as low as possible as some have suggested?

No. low homocysteine is a problem as well. It is a substrate for multiple reactions in the body. Homocysteine levels need to be right around 7. Too high or too low can compromise our health. Low homocysteine levels can contribute to reduced methylation capacity, reduced antioxidant capacity, reduced detoxification, and even autism.

It’s not just as simple as saying if homocysteine is too high or too low. What’s most important is to know that the value is out of range. Next we need to determine why it is out of range high or low. Once we understand why, we can then provide a solution to bring it back in range.

But, to know if it is high or low we actually need to run the test. You might ask, “If it’s a high or low level that is associated with so many of our chronic health conditions, especially the three leading causes of death in the United States why isn’t it run on every standard blood panel?”

I mean it’s one of the leading factors tied to high cholesterol, high blood pressure, cardiovascular disease, stroke, alzheimer’s, autism, and dementia, wouldn’t you think it should be run every time your blood is drawn?

I can feel you nodding yes.

So what gives? Here are a few possible reasons:

  1. Many doctors don’t understand it’s significance and impact of health and disease
  2. There is no drug to lower it. If there is no drug treatment, than no medical necessity
  3. Many doctors don’t have the training to know what to do if it is too high or too low. They didn’t learn about it in school and the pretty big pharma rep isn’t educating them on it
  4. There are plenty of drugs to treat the damage caused by elevated homocysteine so the focus is on treating the effect and not the cause
  5. Many of the drugs people have been put on are actually the cause of elevated homocysteine. If your doctor ran it all the time they might actually see their treatment was the cause.

Those are just a quick couple thoughts. What I do know is that if you don’t run the test, you don’t have to worry about knowing the proper range, what the cause might be or, how to fix it. What gets measured gets managed as they say.

What can you do to find out your homocysteine levels? Next time you are in for your labwork ask your doctor to add homocysteine to the panel he is ordering. If they won’t order it, demand it. If you are on any kind of medication, you need to know this number because as I hinted in this post, medications are a leading cause of homocysteine problems. So demand it, it’s your health!

Read Part 2

Dr Eric Balcavage


  1. This is actually a fact because homocystine levels can also be used to determine clinical conditions like mental retardation,Marfan’s syndrome,osteoporosis,thromboembolic accidents,and even hepatocellular dysfunction. In some cases when urine excretion of Homocystine is is increased that could also indicate a positive nitroprusside screening test.When levels of homocystine and methionine is increased in serum, it can also increase in CSF. Therefore it is very significant to run these text at some point when evaluating patients.

  2. I appreciate this information, as there are several conditions especially digestive issues that are in my family.
    If the levels are high, what is the option to adjust , if any

    • Andrea, There are multiple reasons that Homocysteine would be high. Once the mechanism is identified it can usually be corrected with appropriate dietary, lifestyle and supplemental changes. Call my office (610) 558-8920 to schedule an appointment if you need help.



  1. Part 3: (Homocysteine) The BHMT Pathway | The Methylation Doctor - […] Part 1:  The Most Important Blood Test That Is Rarely Ever Run […]
  2. Part 5: Homocysteine and the Reverse Reaction Back to SAH | The Methylation Doctor - […] Part 1: The Most Important Blood Test You Will Ever Run […]

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