Homocysteine: 23 µmol/L

What does a homocysteine level of 23 mean? Are there any symptoms associated with this level?

A homocysteine level of 23 is considered high. High levels of homocysteine (an amino acid in your blood) are often related to a B vitamin deficiency, and is associated with an increased risk of blood clots, heart attacks, heart disease, stroke, dementia, and osteoporosis [1].

High homocysteine typically does not cause any symptoms in adults; however, if it’s related to a vitamin B deficiency, you may experience the following symptoms:

• Dizziness

• Weakness

• Changes in mood

• Pale skin

• Fatigue

• Weakness

• Tingling hands, arms, legs, or feet

• Mouth sores

• Swelling of the tongue (folate deficiency)

• Anemia

Learn more about homocysteine and the recommended range for homocysteine levels.

Factors that could contribute to a homocysteine level of 23

Certain factors and health conditions can increase your risk for high homocysteine levels, including [1, 2]: 

• Older age (homocysteine levels can increase as you get older)

• Menopause

• Being male (men usually have higher homocysteine levels than women)

• Drinking 4 or more cups of coffee a day

• Deficiencies in vitamins B12, B6, or folate

• Drug and tobacco use

• Excessive alcohol consumption

• Kidney or thyroid problems

• Cancer

• Psoriasis

• Diabetes

• Heart disease

• Certain variations of the MTHFR gene

• Rare inherited diseases, including homocystinuria

What to do if your homocysteine level is 23?

Increasing your intake of folic acid (folate), B12, and B6 from foods may naturally help lower your homocysteine level. Some good dietary sources include: 

• Folate: Fruits, green leafy vegetables, fortified bread and breakfast cereals, lentils, chickpeas, beans, and asparagus

• Vitamin B12: Sardines, clams (including the broth of boiled clams), tuna, trout, beef, milk, and fortified foods like breakfast cereal and nutritional yeast

• Vitamin B6: Tuna, beef, fortified cereals, milk, chickpeas, chicken, and eggs 

Quitting smoking, limiting your alcohol intake to <1-2 drinks/day, and moderating your coffee intake (3 cups or less/day) may also help lower homocysteine levels.

Medications and supplements used to improve homocysteine levels

In addition to making these diet and lifestyle changes, your healthcare provider may recommend certain medications or supplements to help lower your homocysteine level. 

Medications

• Levothyroxine: For high homocysteine levels caused by hypothyroidism, levothyroxine may be prescribed alongside a folic acid supplement to improve thyroid function and lower homocysteine levels [3].

• Betaine: Also known as betaine anhydrous, or trimethylglycine (TMG), betaine is often prescribed to individuals with homocystinuria along with B vitamin supplements to help control homocysteine levels [4].

Supplements

If you have high homocysteine caused by a deficiency of B vitamins, you will likely need to take vitamin B supplements. The common dosage to treat low vitamin B is [2]:

• 2,400 µg (2.4 mg)/day of folic acid, split into three doses

• 50 mg/day of vitamin B6

• 1,000 µg (1 mg)/day of vitamin B12

How Elo can help

If you have high homocysteine or suspect you may have a B vitamin deficiency, you may want to give Elo Health a try. Elo provides curated nutrition recommendations based on your biomarker scores (which include homocysteine and B12) to create personalized supplements that fit your needs. Elo also provides 1:1 dietitian coaching to further help you reach your health goals. Learn more about how we can help you reduce your homocysteine level and optimize your nutrition here.