These factors include. 1  Living at high latitudes (closer to the polar regions), particularly during winter months. 2  Air quality conditions: high levels of air pollution. 3  Weather conditions: dense cloud covering. 4  The degree to which clothing covers the skin. 5  Use of sunscreen. 6  Skin pigmentation: darker skin types.
A few cases of severe homocysteinemia have been due to rare MTHFR gene mutations (sometimes in combination with a second common MTHFR gene mutation). Symptoms in these patients varied greatly but often involved pronounced neurological symptoms and blood vessel disease.
The methylenetetrahydrofolate reductase (MTHFR) mutation test is used to detect two relatively common mutations in the MTHFR gene that are associated with elevated levels of homocysteine in the blood. It is not routinely ordered.