What do you suggest if my serum homocysteine test result is 18 umol/l and my ldl cholesterol is 4.52 mmol/l. its bad or not?

Depends . . .: Jury is still out re homocysteine (HCY) . Some research suggests that high HCY is bad for heart disease. Yet there is no evidence that lowering HCY will reduce risk. LDL of 4.52mmol/L = 174.8mg/dL which is high but not horribly so. As of 11/13, we consider 4 groups who might benefit from statins so talk w/your family doc to see if you qualify. In meantime, focus on lifestyle modifications.