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Total homocysteine is defined as the sum of all homocysteine species in plasma/serum, including free and protein-bound forms. Homocysteine is an amino acid produced when proteins are broken down. A high homocysteine level, also called hyperhomocysteinemia, can contribute to arterial damage and blood clots in your blood vessels. High homocysteine levels usually indicate a deficiency in vitamin B-12 or folate.