Thanks, Dr. Yildiz, for this bird's eye view on TMG in the homcysteine context. Fortunately, homocystinuria is a relatively rare inherited disorder that is nowadays picked up by tests at birth. Hyperhomocysteinemia is, as you rightly point out, a different ballgame. When my clients or study participants ask me about homocysteine as a potential risk signal to look out for, I give them the numbers to decide for themselves: From prevalence studies in the U.S. we know that approximately 1 out of 10,000 adults have elevated tHcy levels (>30micromol/L), So, unless they also have other risk factors that place them in the category of elevated CVD risk, the benefits of testing will be marginal. The USPSTF similarly recommends against screening for hyperhomocysteinemia in the context of primary prevention. It really is up to the individual whether they want to shell out Euro 50.- (the price for a test here in Germany). Another thing is supplementation with TMG or Vit B. No harm trying.