To prevent hyperhomocysteinemia, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – vitamins B6, B12 and folic acid; see Prevention with micronutrients. Pleasure food consumption Alcohol – (woman: > 20 g/day; man: > 30 g/day). Tobacco (smoking) Psycho-social situation Stress Drugs (which, among other things, interfere … Hyperhomocysteinemia: Prevention
Hyperhomocysteinemia does not cause symptoms. Only the sequelae of this disease lead to the symptoms, the respective sequelae.
Pathogenesis (disease development) The sulfur-containing amino acid homocysteine is formed in the organism as an intermediate product in methionine and cysteine metabolism. Depending on the methionine requirement, homocysteine is remethylated to methionine or degraded to cysteine by means of transsulfuration (exchange of sulfur between L-homocysteine and L-cysteine). Therefore, homocysteine plays an essential role in amino … Hyperhomocysteinemia: Causes
1st order laboratory parameters – obligatory laboratory tests. Homocysteine* * To prevent the release of homocysteine from the erythrocytes, the serum or plasma must be separated no later than 30-45 minutes after blood collection, which must be fasting.Laboratory parameters 2nd order – depending on the results of the medical history, physical examination, etc. – for … Hyperhomocysteinemia: Test and Diagnosis
Obligatory medical device diagnostics. Transcranial Doppler sonography (ultrasound examination through the intact skull for orientational monitoring of cerebral (“concerning the brain”) blood flow; brain ultrasound) – Doppler sonographic evidence of stenosis, plaques, or intima-media thickening (IMT) of the carotids (carotid arteries) signifies increased risk of myocardial infarction (heart attack)/apoplexy (stroke) Stress ECG (electrocardiogram during stress, … Hyperhomocysteinemia: Diagnostic Tests
Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for supportive therapy. Vitamin B12 Vitamin B6 Folic acid The above vital substance recommendations were created with the help of medical experts. All statements are supported by scientific studies with high levels of evidence. For a therapy recommendation, only clinical … Hyperhomocysteinemia: Micronutrient Therapy
Medical history (history of illness) represents a building block in the diagnosis of hyperhomocysteinemia. Family history What is the general health status of your relatives? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). Do you experience heart pain, chest … Hyperhomocysteinemia: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Hypothyroidism (underactive thyroid gland). Resorption disorders of vitamins B6, B12 and folic acid. Skin and subcutaneous (L00-L99) Psoriasis (psoriasis) Neoplasms – tumor diseases (C00-D48) Leukemia (blood cancer) Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99). Renal insufficiency (kidney weakness). Medication Antiepileptic drugs – medications taken to treat epileptic … Hyperhomocysteinemia: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by hyperhomocysteinemia: Eyes and ocular appendages (H00-H59). Macular degeneration – degenerative disease of the macula lutea (yellow spot of the retina). Cardiovascular system (I00-I99). Apoplexy (stroke) Atherosclerosis – Homocysteine is considered an independent risk factor for vascular disease; may lead to … Hyperhomocysteinemia: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Auscultation (listening) of the heart. Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial … Hyperhomocysteinemia: Examination
