High homocysteine levels: what are your thoughts?

I'm starting this thread because someone I know keeps insisting that measuring homocysteine is the gold standard for checking vascular health. Their argument is that high levels mean you're sitting ducks for blood clots, heart attacks, or strokes.
This guy is personally supplementing with B6, B12, a B complex, and low-dose folate.
As for me, I’ve been using folate supplements recommended by my doctor to drive my homocysteine levels down.
So, how much does this actually matter? I’ve heard that in most parts of Western Europe, checking this is just as routine as a lipid panel, whereas here in the States, general practitioners tend to brush it off. Keeping it brief—I want to hear from anyone in the medical field. What's your take?

So, you’re claiming this is a thing? Fine, then tell me—which specific countries in Western Europe actually include homocysteine in their standard blood panels? I’d love to pack my bags and head over there right now, because clearly, I’ve ended up in the wrong place. Where I am, they don't bother with it at all. Not as part of routine checkups, and certainly not even when someone actually needs it for cases where homocysteine is supposedly beneficial.

So I heard this from some guy—tell me, is homocysteine really that big of a deal for your life expectancy?

You still haven't actually answered my question about which Western European countries include homocysteine testing in their routine checkups. But honestly, whatever—you clearly misheard me. It isn't part of any standard protocol. Sure, maybe at a few specific clinics or within certain niche studies, it might be considered "standard," but in everyday clinical practice? Absolutely not. And since those very same studies produce nothing but contradictory results regarding how much you can actually infer about human health based on blood homocysteine levels, I’ll leave it up to you to decide just how (un)important this compound really is.

So, I'm reading your post and getting the impression you have no clue how homocysteine levels actually impact your health (??). As for the countries, I can't name them specifically because I was just given the vague label "Western Europe."

Exactly. I mean, his actual role in predicting any of those illnesses mentioned in the first post remains a total mystery. We’re talking about a compound where study results are completely all over the place and totally contradictory. Go ahead, do your own research and see for yourself.