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Advice for High Homocystein& Cholesterol
Hello Doctor,
My recent reports show:
Homocysteine: 63.6
LDL: 148
Non-HDL: 168
I also have a history of gastritis.
I have been taking Neurobion Forte and Folic Acid tablets for the last 45 days.
Please let me know if these medicines are appropriate and when I should repeat the tests. My last test was done on 25 March 2026, and the above values are from that report.
Please also suggest any other medicines/supplements or precautions.
Thank you.
Answers (17)
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A homocysteine level of 63.6 is significantly elevated and should not be ignored. Most commonly, this happens due to:
* Vitamin B12 deficiency
* Folate deficiency
* Vitamin B6 deficiency
* Gastritis-related poor absorption (especially if chronic acidity medicines are used)
* Less commonly kidney disease, hypothyroidism, smoking, genetics, etc.
Your LDL 148 and non-HDL 168 are also elevated and increase long-term cardiovascular risk, especially when combined with high homocysteine.
Neurobion Forte + folic acid can help, but in many people with gastritis/absorption issues, oral B12 alone may not be sufficient, especially if the deficiency is significant.
Next Steps
1. Important tests to do now (if not already done):
* Vitamin B12 level
* Folate level
* CBC with MCV
* Vitamin D
* Thyroid profile (TSH)
* Creatinine/kidney function
* Iron profile/ferritin
2. Gastritis-related evaluation:
If gastritis is chronic or severe:
* Consider testing for H. pylori
* Long-term antacid/PPI use can reduce B12 absorption
3. Repeat homocysteine:
* Usually after 6–8 weeks of proper treatment
4. Discuss with your doctor whether you need:
* Methylcobalamin (higher dose)
* Combination of B12 + folate + pyridoxine (B6)
* Sometimes injectable B12 if levels are low or symptoms are significant
5. Lipid management:
* Reduce fried food, processed food, smoking/alcohol if applicable
* Regular exercise and weight management
* Depending on risk factors, some patients may eventually need cholesterol-lowering medication
Health Tips
* Elevated homocysteine can contribute to fatigue, tingling, brain fog, headaches, and increased clotting/cardiovascular risk over time.
* Do not rely only on folic acid without checking B12, because folic acid can sometimes partially “mask” B12 deficiency.
* Include protein-rich foods, green leafy vegetables, eggs/dairy (if tolerated), and hydration.
* If you have numbness, burning feet, memory issues, imbalance, or severe fatigue, B12 deficiency becomes even more likely.
* Since your level is quite high, follow-up testing is important rather than assuming supplements alone have corrected it.
A proper online consultation with an internal medicine specialist can help identify the exact cause of such a high homocysteine level and create a targeted plan for vitamin replacement, gastritis management, and cardiovascular risk reduction.
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Any kidney disorders shud be ruled out..increased cholestrol..cud lead to gall bladder and pancreatic disorders....kindly consult a physician for thorough examination and investigation...
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Detailed history is required,,you should consult rehmatology is these level are always low for gentic counselling.
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Hello. Your laboratory reports show significantly elevated levels of Homocysteine (63.6) and borderline high LDL Cholesterol (148). Both of these are independent risk factors for cardiovascular health, and they require a structured management plan.
1. Addressing High Homocysteine
A level of 63.6 is considered severely elevated (the normal range is typically below 15). This is often linked to deficiencies in B-vitamins or genetic factors.
Current Medications: Taking Neurobion Forte and Folic Acid is the correct first step, as these provide Vitamin B12, B6, and B9 (Folic Acid) which are essential to break down homocysteine.
A Note on Gastritis: Since you mentioned a history of gastritis, your body may have difficulty absorbing Vitamin B12 orally. If your levels do not drop significantly in the next report, you should discuss B12 injections with your doctor to bypass the digestive tract.
2. Cholesterol Management
Your LDL and Non-HDL are above the optimal range.
Dietary Precautions: Focus on a 'heart-healthy' diet by reducing saturated fats (red meat, full-fat dairy) and eliminating trans fats. Increase your intake of soluble fiber (oats, beans, lentils).
Lifestyle: Since you are 37, regular aerobic exercise (30 minutes a day) can significantly help improve your lipid profile.
3. Follow-up and Recommendations
Repeat Testing: You should repeat your Homocysteine and Lipid Profile tests 3 months after starting your supplements (around late June 2026) to assess how well you are responding to the current dosage.
Additional Screening: Given the high homocysteine level, I recommend checking your Vitamin B12 and Vitamin D levels during your next blood draw.
Please consult your local physician to see if a low-dose statin or a change in the B-vitamin dosage is necessary based on your physical examination and family history.
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-Homocysteine 63.6 is significantly elevated and is commonly associated with Vitamin B12/Folate deficiency
-LDL and Non-HDL cholesterol are also mildly elevated, increasing long-term cardiovascular risk
Next Steps
-Continue Neurobion Forte + Folic Acid as advised
-Add Methylcobalamin 1500 mcg once daily after food for 2–3 months if not already included adequately
-Follow low-fat diet, regular exercise, smoking/alcohol avoidance
-Repeat Homocysteine, Vitamin B12, Folate, and lipid profile after 8–12 weeks
Health Tips
-Gastritis and long-term acidity medicines can contribute to B12 deficiency
-Contact me anytime on Practo for further consultation
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Yes
Cap Pantaprazole DSR 1 cap x od
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Kindly do connect and consult
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Do consult
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Your reports show a significantly elevated Homocysteine level of 63.6 μmol/L (Normal is usually <15). High homocysteine is an independent risk factor for cardiovascular diseases and can damage the lining of your arteries. Your LDL (148) and Non-HDL (168) are also above the optimal range, which increases the risk of plaque buildup. Since you already have a history of gastritis, we need to balance your supplement intake to ensure it doesn't irritate your stomach while effectively bringing these levels down."
Next Steps
Dietary Focus: "Increase intake of green leafy vegetables, beans, and citrus fruits. These are natural sources of Folate which helps lower homocysteine."
Lifestyle: "If you smoke or consume excessive alcohol, strictly stop or limit it, as both significantly raise homocysteine levels and worsen heart risk."
Caution: "Do not ignore high homocysteine even if you feel fine. It is often a 'silent' marker that needs long-term monitoring to prevent future vascular complications."
Health Tips
DO CONNECT AND CONSULT WITH ME FOR BETTER TREATMENT PLAN AND ADVICE......
63.6 is a level that requires active clinical management and regular follow-ups.book a
full session once your new reports are ready so we can finalize your long-term plan.
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Your homocysteine level is elevated and does need proper follow up, but in many cases it improves well with the right vitamin correction and lifestyle measures 👍 Since you already have gastritis and are on treatment, a detailed review of your reports, diet, B12 status and risk factors would help guide you more accurately you can book a consultation with me for a complete assessment and follow up plan.
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Continue this medications for atleast 3 months.
Then we can repeat the tests for it.
Need further more evaluation and detailed history.
Kindly consult for further treatment .
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Continue these meds and when 12 weeks are over, repeat tests.
Avoid high fat dairy products, spicy food, processed meat, sugary items, refined grains, excess of alcohol, caffeinated products.
Take small, frequent, meals.
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Homocheck, rosuvas
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Dr. Ayush Khandelwal
General Physician
1 yrs exp
Delhi
Your reports suggest elevated homocysteine and mildly raised cholesterol, which are commonly manageable with proper treatment and lifestyle correction. Gastritis can sometimes affect Vitamin B12 absorption and may be contributing to this.
Next Steps
Continue the current medicines for now and repeat Homocysteine, Vitamin B12, and Lipid Profile after 6–8 weeks. A detailed review of your reports and symptoms would help decide whether any treatment modification is needed.
Health Tips
Maintain regular exercise, good hydration, proper sleep, and avoid smoking/fried foods. There is no need to panic, but timely evaluation and follow-up are important — you may consult for a more personalised assessment and long-term prevention plan.
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Dr. Shreya Pradip Gudka
General Physician
9 yrs exp
Mumbai
Need complete evaluation of you and your history
What’s your cbc report vit d and b12 levels
Are you taking antacids
Also need to know your routine and overall health
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