Analysis index

2 ml sodium fluoride blood

Ideally empty-stomached (a light breakfast usually only has a minor influence on the test results). Divide plasma from the cells within 1 hour after blood extraction (to avoid homocysteine release from the erythrocytes) and transfer into a tube without additives. Mark tube with “sodium fluoride plasma”. When sending serum, please ensure immediate centrifugation after clotting, then decant the upper layer and transfer into a separate serum-monovette. At room temperature, whole blood samples (without additives) can be expected to increase by an average concentration of 10 % per hour. In sodium fluoride plasma, the sample is stable for 4 days at 20°C – 25°C.

< 10 µmol/l (target value)

Estimation of atherosclerotic risk (CHD, peripheral occlusive arterial disease). Transient ischemic attacks. Osteoporosis with increased fracture risk. Slight risk factor for thrombosis.

Hyperhomocysteinemia is a certain risk factor for arterial and venous thrombosis. Healthy persons often have a homocysteine level below the detection limit. Already at levels > 10 µmol/l, an increased risk for atherosclerotic vascular changes has to be assumed. 10 – 25 % of patients with venous thrombosis show homocysteine concentrations of over 17 – 22 µmol/l. The most common hereditary cause of hyperhomocysteinemia is the MTHFR-polymorphism (see there). Acquired causes are especially folic acid deficiency, vitamin B12 deficiency and vitamin B6 deficiency, to a lesser extent kidney insufficiency, hypothyroidism,  malignoma (breast, ovaries, pancreas), psoriasis, chronic alcoholism, zinc deficiency, medication (such as methotrexate, theophylline, phenytoin, carbamazepine, antiepileptics, oral contraceptives, corticosteroids, cyclosporine A, L-dopa, cholestyramine). Slight hyperhomocysteinemia as vitamin deficiency syndrome (folic acid deficiency, vitamin B12 deficiency, vitamin B6 deficiency) is very common in elderly patients. Thus, homocysteine is a marker for vitamin B12 deficiency. During pregnancy, the homocysteine evaluation has prophylactic relevance, as it was shown, that hyperhomocysteinemia, most likely due to placental changes, is associated with lower birth weight, increased miscarriages and premature placental abruption.