Pernicious Anaemia Society
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Homocysteine result just in - opinions please

Hi, the Hommocysteine result has come in (has taken a week) but still waiting on MMA result which will likely take several weeks.

Previous tests - Folate high/out of range; B12 low/just out of range

HOMOCYSTEINE 14.6 umol/L [0.0 - 16.0] Needless to say, this is classified as 'Normal'. To me, it's at the high end of normal, so could this be significant? I'm not sure what sort of levels one would get if B12 deficient so maybe they need to be further out of range?

As mentioned, still awaiting MMA result so I appreciate the Homocysteine on it's own may not be sufficiently indicative.

Many thanks, again

7 Replies

I am not an expert but I have read that a Homocysteine result should be in single figures and 5/6 is ideal. In my non medical opinion your result denotes B12 deficiency - confirming your blood result.

Hopefully your treatment will improve levels for you .....

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Thanks Marz

I still waiting for MMA result, so that could be a few weeks as yet.

Then, if indicated, I can only hope the GP will agree to some treatment.

Many thanks


Reading through your other posts I see you are taking levothyroxine/T4. This too could be affected by the Metformin I have read. Do you have any thyroid results with ranges you could post - perhaps your treatment is not optimal - and you may need an increase. Often Us Hypo folk have LOW stomach acid which can present with similar symptoms to high acid. Being optimally treated for the thyroid may alleviate so many other symptoms you are experiencing.

So do you have Thyroid anti-bodies ? Maybe the dose of T4 you are taking is not converting into the Active thyroid hormone T3 - the thyroid blood test results should reveal if you are converting.

Hypo and B12D share many similar symptoms. Have you tested your VitD ?

I am a Hashi's gal with a B12 issue - so just sharing experiences :-)

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Hi Marz

Many thanks for your response. OK, so here are some of the more recent results

Feb 2016 -

TSH - 0.64 mui/L (0.25-5.0)

Free T4 - Not done

Vit D - 69.81 (50.0-140.0) (Take 5,000 iu daily)

Oct 2016 -

TSH - 0.03 miu/L (0.25-5.0)

Free T4 - 31.0 pmol/L (9.0-23.0)

As a consequence, Levithyroxine has been reduced from 125/150mcg alt days to 125mcg daily. As far as I know, this is the one and only time the Free T4 has been checked, and afaik, Free T3 never!

Serum Vit B12 - 165.3 ng/L (197.0-1-771.0)

Serum Folate - >20ug/L (4.6-18.7)

Feb 2017 -

Serum Vit B12 - 199 ng/L (197.0-771.0)

Serum Folate - 17.5 ug/L (<3 ug/L sugg def)

Mar 2017

Serum Vit B12 - 215 ng/L (197.0-771.0)

Serum Folate - 18.5 ug/L (<3 ug/L sugg def)

Serum Magnesium - 0.75 mmol/L (0.7-1.0)

Homocysteine - 14.6 umol/L [0.0 - 16.0]

Awaiting MMA result

AFAIK, I've never been tested for thyroid antibodies and Hashimotos has never been mentioned.

Soon after diagnosis of Hypothyroid, I was taking 175mcg Levithyroxine and TSH was below range, as intended, and I seem to remember I was feeling well at that time. Gradually, dose has been decreased over the years but, thinking back, I haven't felt as well and, at the moment, very tired, easily exhausted, in addition to many other symptoms which could be thyroid or B12, to my mind.

Thanks for your interest. I appreciate any thoughts on the above. I was deficient in Vit D a couple of years ago and was prescribed the course of high dose tabs, then I've continued to take 5,000 daily (self-funded) I'm inclined to increase Vit D to x2 daily (=10,000) as I am closer to lower limit than mid-range ;)

I agree the Levithyroxine probably isn't optimum so, with the low Vit B12, things are probably not working well.

Thanks for any thoughts :) I appreciate you're not a medic etc so always take advice in the spirit of it being given :)


VitD - I have read that being around 100 is good - so continuing with your dose should be fine. You could add VitK2 MK7 to the D3 as D improves the uptake of calcium from foods and the K2 directs the calcium away from the arteries and soft tissues into bones and teeth. Magnesium is also another co-factor and most of us are low. Testing of little value as most of the magnesium resides in the cells.

Talking with my Thyroid hat on - I would say your B12 is VERY low - it would seem thyroid sufferers need optimal levels in order for the T4 to convert well. Raised Folate is not something I am familiar with - am sure others here will have some answers for you.

Your FT4 is over range as you can see - but without the FT3 test it doesn't show the full story. T4 is a storage hormone and converts into the active thyroid hormone T3 - needed in every cell of your body. So it could be you are converting well - or maybe not. Only having the FT3 test will show that.

If T4 does not convert into T3 - then it can become rT3 which then blocks the T3 receptors in the cells. If your GP will not test the full thyroid Profile then you can have a Home Testing Kit sent to your home - results sent to you by e-mail. Then you could also have the Anti-bodies tested - TPO and Tg - to rule out Hashimotos. Do you know your Ferritin level ?

Medichecks currently have a Special Offer.

The above link also has information about the good levels of vitamins and minerals required for optimal thyroid function.

I think when you have the low B12 treated you will feel loads better :-)


need to be careful in evaluating results that ranges are being expressed in the same units, so it is probably better to go by the range that is quoted as for some things different assay methods can have different ranges.

I would also be inclined to wait for the MMA result before drawing any conclusions

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Many thanks Gambit62

Yes, I realise ranges are necessary but assumed (maybe incorrectly) that the figures Marz suggests are likely to be in the same range as my results quoted, otherwise would hope the range would have been given. However, I certainly appreciate what you are saying.

Definitely, I will be wanting the MMA result before attempting to draw any conclusions. I was merely asking if the Homocysteine result was high enough to indicate 'high' or did this need to be out of range to be considered significantly 'high'.

So, I'm in for a few weeks waiting, it seems, for the MMA result. Also, my GP is on holiday now but have an appt in a few weeks time. If the MMA result isn't back, then I'll just have to keep moving the appt back as best I can, given that he gets booked up very quickly

Thanks again for all advice

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