Vascular Endothelial Growth Factor Test

Your body is constantly deciding where to build new blood vessels. That decision is driven largely by a single molecule: VEGF (vascular endothelial growth factor). When tissue is injured, starved of oxygen, or growing rapidly, cells release VEGF to recruit new blood supply. In healthy circumstances, this is how wounds heal and damaged tissue recovers. But when the signal stays on too long or gets too loud, it can feed conditions you would rather catch early, from tumor growth to vision-threatening eye disease.

What makes VEGF valuable as a blood test is that it offers a window into active blood vessel construction happening inside your body right now. Standard lab panels do not measure it. If new vessels are forming somewhere they should not be, or if chronic inflammation or metabolic dysfunction is pushing VEGF higher than normal, this test can surface that signal before symptoms appear.

What VEGF Does in Your Body

VEGF belongs to a family of growth factors, with VEGF-A being the most studied and the form most blood tests measure. It works by binding to specialized receptors on the inner lining of blood vessels, triggering those cells to multiply, migrate, and form new vessel branches. This process, called angiogenesis, is how your body delivers oxygen and nutrients to areas that need them.

The strongest trigger for VEGF release is low oxygen. When a patch of tissue is not getting enough blood flow, cells in that area activate a molecular alarm system (hypoxia-inducible factor, or HIF) that ramps up VEGF production. Inflammation does the same thing: immune signaling molecules like IL-1, IL-6, and TNF-alpha all stimulate VEGF release from white blood cells, smooth muscle cells, and the platelets circulating in your blood.

In adults, VEGF activity is normally low. It spikes when needed for wound healing or tissue repair, then quiets down. Sustained elevation suggests something is driving ongoing vessel formation, and that something is often worth investigating.

Cancer and Tumor Growth

Tumors cannot grow beyond a few millimeters without building their own blood supply, and VEGF is the primary molecule they use to do it. The majority of human cancers overexpress VEGF, which is why drugs that block it (like bevacizumab) have become a cornerstone of cancer treatment. From a screening perspective, elevated circulating VEGF has been linked to worse outcomes across many cancer types.

In lung cancer, a meta-analysis of 19 studies covering 2,890 patients found that high circulating VEGF predicted about a 29% increase in the risk of death. In ovarian cancer, a pooled analysis of 16 studies with 1,111 patients showed that those with elevated serum VEGF were roughly twice as likely to die from their disease compared to those with lower levels. When researchers looked at VEGF measured directly in tumor tissue rather than blood, the association was even stronger in early-stage ovarian cancer, where high tissue VEGF predicted more than a fivefold increase in the risk of disease progression.

Sources: Hu et al., J Cancer Res Clin Oncol, 2013; Yu et al., Gynecol Oncol, 2013; Schoenleber et al., Br J Cancer, 2009.

What this means for you: an elevated VEGF level does not diagnose cancer. Many non-cancerous conditions raise VEGF (infections, inflammation, wound healing). But in the context of other risk factors or symptoms, a persistently high VEGF reading adds a data point worth discussing with a physician, particularly for cancers where early detection changes outcomes.

Cardiovascular Disease

The relationship between VEGF and heart disease is not straightforward. The Framingham Heart Study followed 3,041 participants for an average of 8.8 years and found an inverted U-shaped pattern: people with intermediate VEGF levels (second and third quartiles) had the highest cardiovascular risk, while those at the low and high ends had lower risk. The second quartile carried about 34% higher risk than the lowest quartile, and the third quartile carried about 59% higher risk.

A separate study of 2,321 community participants in southeastern New England found a more linear relationship with coronary heart disease death specifically. Over 13 years, people in the highest third of VEGF levels were about 3.9 times more likely to die from coronary heart disease compared to the lowest third, even after adjusting for standard risk factors like smoking, blood pressure, and cholesterol. The average VEGF level in people who died from coronary heart disease was 400 pg/mL, compared to 303 pg/mL in controls.

What this means for you: VEGF may reflect vascular stress or active plaque remodeling in the arteries. The non-linear pattern from Framingham suggests that context matters. A very high reading alongside other cardiovascular risk markers (elevated hs-CRP, high ApoB, abnormal lipids) should prompt further evaluation.

Kidney Disease

In people with advanced kidney disease starting dialysis, elevated VEGF carries serious prognostic weight. A study of 211 patients beginning dialysis found that those with high VEGF levels were roughly 3 times more likely to die from any cause over a median follow-up of 29 months, even after adjusting for age, inflammation markers, and kidney function. VEGF levels also correlated inversely with kidney filtration rate in earlier-stage kidney disease, meaning the worse your kidneys are functioning, the higher VEGF tends to climb.

POEMS Syndrome: Where VEGF Testing Is Most Definitive

VEGF testing has its clearest diagnostic role in POEMS syndrome, a rare but serious disorder involving nerve damage, organ enlargement, hormonal disruption, and skin changes driven by an abnormal blood cell clone. Elevated VEGF is one of the major diagnostic criteria. In patients presenting with acquired nerve damage (neuropathy), serum VEGF showed 100% sensitivity and 91% specificity for POEMS, meaning it catches virtually every case and rarely flags someone who does not have it.

This matters because POEMS is frequently misdiagnosed as CIDP (chronic inflammatory demyelinating polyneuropathy), a more common nerve condition treated differently. Early VEGF testing in patients with unexplained neuropathy can prevent years of ineffective treatment. If you have been diagnosed with an inflammatory neuropathy that is not responding to standard therapy, asking for a VEGF level is reasonable.

Reference Ranges

VEGF does not have universally standardized clinical cutpoints the way cholesterol or blood sugar does. The ranges below are drawn from research studies and population data. Your lab's specific numbers may differ depending on the assay used and whether the sample is serum or plasma. Because serum levels are about 7 to 10 times higher than plasma levels (platelets release VEGF during clotting), the specimen type matters enormously. Plasma is the preferred specimen for clinical measurement.

These ranges are drawn from published research. Your lab may use different assays and cutpoints. Compare your results within the same lab over time for the most meaningful trend.

For cancer-related interpretation, various studies have proposed prognostic cutoffs: above 108 pg/mL in plasma for gastrointestinal cancers, above 180 pg/mL in serum as a general cancer threshold, and above 825 pg/mL in serum for colorectal cancer prognosis. These are research-derived values, not clinical guidelines, and should be interpreted alongside other findings rather than in isolation.

Why One Reading Is Not Enough

VEGF has one of the highest biological variability rates of any commonly tested biomarker. Studies of healthy people measured repeatedly over weeks found that plasma VEGF levels can swing by 35 to 69% from one draw to the next, even when nothing has changed clinically. This means a single reading is inherently noisy. A value that looks elevated today might fall within normal range next month, and vice versa.

The good news is that under stable clinical conditions, VEGF levels appear relatively consistent over months. A controlled study of both healthy adults and people with well-managed type 2 diabetes found no significant intraindividual variance in VEGF-A over a six-month period when samples were collected consistently. The key is standardizing how and when you collect: same time of day, same lab, same specimen type, and no recent exercise.

Get a baseline reading, then retest in 3 to 6 months if you are making lifestyle changes or monitoring a specific concern. For ongoing tracking, at least annual measurement gives you a trend line that is far more informative than any single data point. Given the high biological variability, a change needs to exceed roughly 70 to 140% from your personal baseline before it is clearly meaningful rather than normal fluctuation.

When Results Can Be Misleading

The biggest source of error in VEGF testing is the sample itself. When blood clots to form serum, platelets and white blood cells dump their stored VEGF into the sample, artificially inflating the reading by 7 to 10 fold. One landmark study using special collection methods to block platelet activation found that in most cancer patients (except kidney cancer), the elevated VEGF levels previously reported were largely an artifact of the blood collection process, not true circulating levels. If your test uses serum rather than plasma, keep this in mind when interpreting results.

Other factors that can distort a single reading:

• Recent exercise: high-intensity activity can spike VEGF immediately after a workout, though levels typically normalize within 1 to 4 hours. Avoid drawing blood within 4 hours of exercise.
• Acute infection or inflammation: an immune challenge like a bacterial infection can increase plasma VEGF fivefold within hours. Wait until you are fully recovered before testing.
• Kidney dysfunction: impaired kidney function raises baseline VEGF, likely through reduced clearance and increased oxidative stress. If your kidney markers (creatinine, eGFR, cystatin C) are abnormal, interpret VEGF in that context.
• Corticosteroids: dexamethasone, prednisone, and related drugs suppress VEGF expression. If you are taking these medications, your reading may be artificially low without reflecting true angiogenic activity.

Proton pump inhibitors (omeprazole, lansoprazole, esomeprazole) may push VEGF levels higher, based on studies showing they increase VEGF expression. If you take a PPI daily, mention it when interpreting your results.