Homocystine , Antrim #30380, EPIC: LAB5072, SOFT: HCY


A fasting specimen is preferred, but not required.

Specimen Collection Criteria

Collect: One Gold-top SST tube. (Minimum Whole Blood: 4.0 mL)

SST tubes should be centrifuged within 1 hour of collection.

Physician Office/Drawsite Specimen Preparation

Let SST specimens clot then immediately centrifuge to separate serum from cells within one hour of collection. Refrigerate (2-8°C or 36-46°F) the centrifuged SST tube within two hours of collection.

Preparation for Courier Transport

Transport: Centrifuged SST tube, refrigerated (2-8°C or 36-46°F). (Min: 0.5 mL)

Rejection Criteria

  • Hemolyzed specimens.
  • Specimens not collected and processed as indicated.


Plasma separated from cells.
Ambient: 24 hours
Refrigerated: 2 weeks
Frozen: at least 1 year


Sunday - Saturday, 24 hours a day.
Results available within 24 hours of receipt in the Laboratory.

Reference Range

4-10 micromoles/L: Desirable Level.
11-14 micromoles/L: Intermediate Level.
15-29 micromoles/L: High Level.
30 micromoles/L or Greater: Very High Level.

Test Methodology



Total homocysteine is considered to be a risk factor for cardiovascular disease. The risk increases progressively with homocysteine concentration. Maintenance of homocysteine levels below 10 micromoles/L is suggested by some investigators and levels greater than 15 micromoles/L are considered abnormal in patients under evaluation for cardiovascular and neurovascular disease.

In addition to recognized disease states, increased homocysteine levels have been reported in patients receiving a variety of drugs - includes S-adenosyl-methionine, methotrexate, nicotinic acid, theophylline, nitrous oxide, and L-dopa.

Homocysteine results may be falsely elevated when the sample is not handled correctly. Serum must be separated promptly from cells within one hour of blood collection.

Blood samples obtained after an individual has consumed a heavy meal (particularly if rich in protein) have been associated with a 15-20% increase in homocysteine. Therefore heavy meals should be avoided 6-12 hours before blood sampling. A light meal has not been shown to affect the homocysteine level.

Clinical Utility

Elevated homocysteine levels are found in patients with recessively inherited metabolic defects such as cystathionine ß-synthase deficiency and decreased methyl tetrahydrofolate reductase activity. Individuals with cystathionine ß-synthase deficiency may have serum homocysteine levels up to 200 micromoles/L.

Homocysteine levels may be elevated in vitamin B6, B12, and folate deficiencies.

Homocysteine has been shown to be an independent risk factor for atherosclerotic vascular disease. Homocysteine levels greater than the 90th percentile of normal are associated with increased risk for acute myocardial infarction. The risk for coronary vascular disease increases progressively with homocysteine concentration. There is a 13-fold increase in risk associated with a level of 19 micromoles/L as compared to a 9 micromoles/L homocysteine concentration.


Welch, GN, Loscalzo J. Homocysteine and atherothrombosis. New Eng. J. Med 338:1042-1050;1998.

CPT Code


Test Codes

Antrim #30380, EPIC: LAB5072, SOFT: HCY

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