Uncontrolled homocysteine can lead to stroke

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Uncontrolled homocysteine can lead to stroke
Uncontrolled homocysteine can lead to stroke
Anonim

Monitoring the level of homocysteine in the body is extremely important for a person's he alth. In addition to being a predisposing factor to various diseases, homocysteine is also an important marker that "predicts" diseases and conditions and enables their timely treatment and prevention. What exactly does high homocysteine in the body lead to, what does it indicate, can we control it? We are talking about these issues today with Dr. Plamena Haralanova.

Dr. Haralanova, for which patients is it recommended to have homocysteine screening?

- Homocysteine screening is recommended for people with cardiovascular risk - hypertension, disturbed lipid profile, sedentary lifestyle, past heart attacks. It is also good for people who have relatives with cardiovascular diseases to monitor their homocysteine levels.

For people with a hereditary predisposition to cardiovascular diseases, at what period of time should they have such a screening?

- He althy people who have relatives with cardiovascular disease should have their homocysteine monitored at three years of age. And those who already have any cardiovascular disease should be screened once a year, at least to monitor the effect of their prescribed therapy.

What is homocysteine?

- Homocysteine is an amino acid that contains sulfur. Amino acids are the building blocks of all proteins in the body, therefore they are extremely important for its proper functioning. Some of the amino acids cannot be synthesized by the body and must be obtained through food. These amino acids are called essential and in humans they are eight in number. One of them is methionine. It is a powerful antioxidant, neutralizes free radicals formed in the body under the action of a number of toxic and inflammatory agents, has a protective effect on the liver, and also has an antisclerotic effect. Many studies indicate that this amino acid has a beneficial effect on lipid metabolism and lowers cholesterol. I pay attention precisely to methionine, because homocysteine, the object of our conversation, is an intermediate product in the metabolism of methionine. In this transformation, the body needs certain B vitamins such as folic acid, vitamin B12, vitamin B6 (pyridoxine) and vitamin B2 (riboflavin). Disturbances in the balance in the formation and removal of homocysteine lead to changes in its plasma concentrations.

Why is homocysteine such an important indicator of the state of he alth and, in general, of the entire biochemistry of the body?

- Plasma concentrations of homocysteine can be an indicator of several very significant deviations from the normal biochemistry of the body. At

deficiency of B vitamins,

homocysteine levels rise very quickly, even before their blood concentrations have decreased. It is a very early marker for the detection of vitamin B12 and folic acid deficiency, especially in patients at risk of developing such a deficiency. It is also a reliable indicator for monitoring the effect of the treatment of this deficiency. It has also been established that high homocysteine in the blood is an independent risk factor for the development of complications in patients with cardiovascular diseases. Its plasma levels are also associated with some congenital genetic defects, with complications during pregnancy, with some psychiatric diseases, therefore it has its importance and application in the diagnosis of a number of diseases.

When does homocysteine level rise? What does high homocysteine lead to and what organs does it affect?

- Extremely high levels of homocysteine in the blood can be seen in homocysteineuria. It is a rare inherited metabolic disorder in which there is a genetic defect affecting some of the enzymes involved in the conversion of the amino acid methionine into cysteine. As a result, homocysteine accumulates in large quantities in the blood and urine. The disease is serious and has a high mortality rate. As I already mentioned, the reason for the high levels of homocysteine can be a lack of B vitamins, as well as the lack of sufficient amounts of zinc in the body.

Increased concentrations of homocysteine lead to increased formation of free radicals - these are unstable forms of oxygen that are formed during a number of metabolic processes in the body and lead to tissue damage and biological aging of the body. It is also proved that

homocysteine damages endothelial cells

of the vessels. We are talking about a fundamental moment in the pathogenesis of atherosclerosis and its diverse manifestations on the part of the cardiovascular system and the brain - heart attack, stroke, peripheral vascular disease, etc. It is also associated with increased blood coagulability and the formation of blood clots (thrombi), with a weakening of the immune system and a number of related chronic disease processes in the body. Pregnant women have lower homocysteine concentrations. Its increase during pregnancy is associated with an increased risk of placental vasculopathy, preeclampsia, repeated abortions, premature birth, low birth weight, placental abruption. As it becomes clear, maintaining chronically high levels of homocysteine in the blood is a risk factor for our he alth.

What risk factors predispose to high homocysteine and can we control it?

- If there is no genetic cause (most often a defect in some of the enzymes involved in the conversion of homocysteine), the most common reason for its rise is a deficiency of folic acid, vitamin B6 and B12. The use of large amounts of alcohol, cigarettes and coffee, diabetes and high blood pressure. A poor cholesterol profile is also associated with high homocysteine. By paying attention to a he althy lifestyle, including good physical activity, balanced nutrition, control of chronic diseases, such as diabetes, kidney failure, hypothyroidism, we can reduce homocysteine levels in the blood.

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