Homocysteine Test Price in Pakistan: Rs 1,750 at Marham Lab

Homocysteine is an amino acid, one of the molecules your body uses to make proteins. MedlinePlus explains that your levels are normally low, because your body uses vitamin B12, vitamin B6 and folic acid to break homocysteine down quickly and convert it into other substances it needs. A high level may be a sign that this process is not working properly, or that you are lacking certain B vitamins. At Marham Lab a homocysteine test costs Rs 1,750, reduced from Rs 2,500.

Most people arrive at this page thinking about the heart. MedlinePlus puts the emphasis elsewhere.

It states that a homocysteine test is most often used to measure your vitamin B6, B12 and folic acid levels, because those three vitamins break homocysteine down and not having enough of any of them causes homocysteine to rise.

It then names what a shortage of those vitamins can lead to.

• Anaemia, where you do not have enough healthy red blood cells
• Nerve damage throughout your body
• Cognitive decline, meaning loss of memory, reasoning and thinking skills over time

So a raised homocysteine is often the clue that points a doctor towards [vitamin B12](/labs/tests/vitamin-b12-test-price) rather than towards the heart. That matters in Pakistan, where B12 deficiency is widespread, particularly among vegetarians and older adults.

Read this before paying for the test on cardiovascular grounds, because the honest position is more cautious than the marketing around it.

MedlinePlus explains the mechanism first. If homocysteine is not broken down it can build up in your arteries, which can damage them and increase your risk of forming blood clots, and an increased clotting risk may raise your risk of heart attack, stroke and other heart and blood vessel disorders.

Then it qualifies that plainly. Routine homocysteine testing to screen for heart disease risk is not recommended for everyone. The reasons it gives are that it is uncertain how much homocysteine levels actually affect heart and blood vessel disease, and that even though high homocysteine can damage arteries, studies have shown that in most cases lowering homocysteine levels does not reduce the risk of heart attack or stroke.

That is a genuine limitation rather than a caveat to skim. MedlinePlus does say a provider may order the test to better understand your risk if you already have an increased risk, naming a diagnosis of heart or blood vessel disease, or conditions such as high blood pressure, high cholesterol and diabetes.

If heart risk is your concern and you have none of those, a [lipid profile](/labs/tests/lipid-profile-test-price) and a [blood sugar](/labs/tests/blood-sugar-test-price) are the better place to start.

MedlinePlus lists the symptoms of low vitamin B12 or folic acid that may prompt this test, noting they range from very mild to severe.

• Dizziness
• Fatigue or weakness
• Headache
• Heart palpitations, meaning a racing or pounding heart
• Changes in the colour of your skin or fingernails
• Sores on your tongue or in your mouth
• Tingling or numbness in your hands, feet, arms or legs

Mouth and tongue sores alongside tingling in the hands and feet is the combination most specific to B12 deficiency, and the one worth mentioning to your doctor directly.

MedlinePlus lists who is at high risk of low B12 or folic acid: people with malnutrition, older adults, who often cannot absorb enough vitamin B12 from food, and people with alcohol use disorder or drug addiction.

MedlinePlus gives three main meanings for a high homocysteine: not getting enough vitamin B12 or folic acid in your diet, having homocystinuria which would need further testing to confirm, or a higher risk of heart disease, stroke or other blood vessel disorders.

It adds that higher than normal levels may also occur with osteoporosis, chronic kidney disease, hypothyroidism, schizophrenia, or Alzheimer's disease and other forms of dementia.

And it is clear that a high level does not always mean a condition needing treatment, listing three ordinary influences.

MedlinePlus notes that if your homocysteine is high, your provider may suggest vitamin supplements or changes to the foods you eat, and that eating a balanced diet can help you get the right amount of vitamins.

It adds that a provider may recommend specific vitamins and supplements, known as homocysteine lowering therapy, if you have homocystinuria or signs of cognitive decline, and that research shows this may help slow cognitive decline and reduce heart attack or stroke risk in people who have homocystinuria.

Note how narrow that last benefit is. It applies to homocystinuria rather than to everyone with a raised number, which is consistent with the caution above about lowering homocysteine in the general population.

This test needs preparation.

MedlinePlus states you may need to fast for 8 to 12 hours before a homocysteine test. An early morning appointment is easiest, since most of the fast passes while you sleep. Water is fine.

It also says some medicines and supplements may affect your results, so tell your provider about everything you take, especially vitamin B. Do not stop any medicine unless your provider tells you to. If you have already started a B12 injection course or a B complex tablet, say so, because it will have moved the number.