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Not just cholesterol: THIS overlooked blood test can signal stroke risk
ETimes | October 16, 2025 11:39 PM CST

While cholesterol levels often dominate heart-health discussions and routine blood tests, research has highlighted another important predictor of strokes. The sulfur-containing amino acid called Homocysteine , is often overlooked. However, many studies, including ones from , suggest that high levels of it can damage blood vessels, promote clot formation, and contribute to cognitive decline.

Homocysteine is a normal amino acid produced during the body’s breakdown of methionine from protein. Under usual conditions it’s quickly converted back to other useful compounds with the help of folate, vitamin B12 and vitamin B6.



Most routine heart-health panels focus on LDL, HDL, triglycerides and blood pressure, while homocysteine is not included in standard lipid testing and is therefore measured far less frequently.




Testing Homocysteine Levels



Homocysteine levels can be measured through a blood test called total plasma homocysteine test .



Normal vs risky levels



As per , the normal reference range for homocysteine levels varies slightly depending on age, sex, and laboratory methods, but generally, levels between 5 and 15 micromoles per liter are considered normal. Levels above 15 µmol/L are classified as elevated and are associated with an increased risk of ischemic stroke and other vascular events, according to NIH studies.


High levels of Homocysteine and its risks



Homocysteine increases when its metabolism is impaired due to insufficient vitamins, genetic variants, kidney problems, certain medications, or unhealthy lifestyle habits. Decades of research shows higher blood homocysteine is associated with greater risk of:

  • Ischemic stroke: link rising homocysteine levels are linked with higher ischemic stroke risk .
  • Cognitive decline: reported higher homocysteine in people who develop dementia versus those who do not.
  • Endothelial injury: As per , elevated homocysteine promotes oxidative stress, inflammation and endothelial dysfunction. These changes increase the risk of atherosclerosis.


Lowering homocysteine is possible



The good news is that homocysteine levels can be reduced through dietary changes, supplementation, and lifestyle amendments. show that B-vitamins, folate (B9), vitamin B12, and vitamin B6, play a central role in metabolizing homocysteine and lowering its levels.

One may follow these practical ways to reduce homocysteine:

  • Increase folate intake by eating green leafy vegetables, legumes etc.
  • Boost vitamin B12 by consuming dairy, eggs, fish, poultry.
  • Consume whole grains, potatoes, bananas for vitamin B6.


  • Monitoring homocysteine can be an effective way to monitor heart-health. Along with tracking traditional heart-health markers, tracking homocysteine can help prevent strokes and cognitive decline before they occur.

    Disclaimer: This article is for informational purposes only and does not substitute for professional advice.


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