Homocysteine is elevated in children under treatment. Homocysteine is elevated

The materials are published for informational purposes only and are not a prescription for treatment! We recommend that you consult a hematologist at your medical institution!

Homocysteine is an important blood indicator. The level of this amino acid determines the condition of blood vessels and subsequent heart function. An increase in homocysteine is caused by poor diet, bad habits and some diseases.

Increasingly, patients are being referred to donate blood for homocysteine levels. What kind of analysis is this? This study indicates the concentration of sulfur-containing amino acids in the blood. By the amount of this substance, namely homocysteine, one can judge the health of the patient’s blood vessels and heart.

The effect of homocysteine on blood vessels

Homocysteine is called a derivative of protein metabolism. It is formed during metabolic processes from substances that enter the body along with animal food. What does a homocysteine blood test show? If the study revealed a high level of this substance, the risk of developing cardiovascular diseases, atherosclerosis and venous thromboembolic complications increases significantly.

Important! Excess homocysteine is dangerous for blood vessels, as it can damage their walls. In places of such damage, cholesterol clots form, which contribute to the formation of a blood clot.

Acute homocysteine molecules damage the walls of blood vessels. In such places cholesterol easily “sticks”, clogging the lumen

Normal indicators

To find out your level of homocysteine in the blood, you need to undergo a certain test. How to get tested? Typically, blood is drawn in the morning after 8-14 hours of fasting. Before the procedure, the patient is allowed to drink a small amount of still water. The day before the test, you should not eat fatty foods or exercise. After passing the test, the attending doctor must give a transcript of it.

The concentration of this amino acid in the blood depends on the age and gender of the patient. This indicator is measured in micromoles per liter of blood.

Note. It has been proven that the concentration of homocysteine in the blood of boys is higher than that of girls.

Wonderful video webinar by Kristina Robertovna Davtyan “Homocysteine. The importance of determining homocysteine in therapy and cardiology"

If homocysteine is increased by at least 5 µmol/l, the likelihood of developing vascular atherosclerosis in women increases by 80%, in men - by 60%. Homocysteine levels usually decrease during pregnancy; the value returns to normal a few days after birth.

Causes of increased homocysteine levels

An increase in homocysteine levels can have various causes. The most common:

smoking, drinking alcohol;
renal failure;
severe psoriasis;
lack of vitamin B;
hypothyroidism;
hormone-dependent diseases;
physical inactivity;
taking certain medications (immunosuppressive and anticonvulsants, oral contraceptives, etc.).

Important! Elderly people who have undergone surgery on the gastrointestinal tract are at risk.

Treatment of pathology

If the level of homocysteine in the blood is elevated, first of all you need to reconsider your daily diet - avoid drinking coffee and alcohol, and eat right. But this method of treatment is suitable for patients with a slight increase in the amino acid in the blood, since it is difficult to reduce homocysteine at high levels using diet alone. What to do if your homocysteine level is higher than normal?

Quit smoking;
Increase physical activity on the body - move more, walk, play sports;
Limit the consumption of foods rich in methionine (cottage cheese, eggs, etc.) and caffeine-containing drinks;
There are foods high in vitamin B and omega-3 (seafood, fish, legumes, nuts, tomato juice, kefir, buckwheat, oats, beef liver, caviar, rice, millet, etc.);
Additionally, take brewer's yeast and fish oil.

The treatment regimen is individual in each individual case. Most often, the doctor prescribes folic acid, aspirin, heparin drugs and other medications. Signs of elevated homocysteine:

weight gain;
swelling;
decrease in the volume of urine excreted.

Homocysteine during pregnancy

A blood indicator such as homocysteine is very important when planning pregnancy. On the eve of conceiving a child naturally or during IVF, you should definitely take a blood test. It is important that homocysteine is not elevated. The optimal amino acid level is 10-11 µmol/l. An increase in homocysteine can lead to impaired blood circulation in the placenta, premature birth and fetal death. Women with high homocysteine give birth to children with low weight and reduced immunity.

Homocysteine is an important amino acid that affects many processes in the body. It is synthesized as a result of the metabolism of methionine, a substance found in meat, eggs and some other animal products.

Homocysteine levels increase during pregnancy. This is very dangerous and sometimes ends tragically for the mother and the fetus she is carrying. In older people, this amino acid becomes a catalyst for severe vascular diseases.

Should I be concerned about elevated homocysteine levels?

Homocysteine is a very toxic substance. Its excess in the blood (homocysteinemia) causes vascular damage, which in turn leads to the development of many serious diseases. Take, for example, atherosclerosis. Homocysteinemia is one of the main factors in the development of this difficult-to-treat disease. The mechanism of its appearance is as follows: the walls of the vessels through which blood flows are damaged due to excess homocysteine. Cholesterol plaques then begin to form in the areas where the damage occurred. Over time, they turn into blood clots. This is how atherosclerosis appears.

In addition, a large number of serious illnesses of the cardiovascular system can increase homocysteine levels. Due to the growth of the amino acid, Alzheimer's disease develops, senile dementia, myocardial infarction and heart failure occur. So you really should be afraid of homocysteinemia.

Why high concentrations of homocysteine in the blood are dangerous for pregnant women

Today, many women experience miscarriages due to homocysteinemia. If it occurs in the 3rd–9th months of pregnancy (2nd–3rd trimesters), then there is a danger of asphyxia (suffocation) of the fetus or the formation of late toxicosis (preeclampsia).

Also, pregnant women with elevated levels of homocysteine have a high likelihood of developing problems with the heart and blood vessels, which can cause childbirth to end tragically.

For women with this disorder, trouble awaits them even after childbirth, since their newborn child may suffer from dystrophy and have a weakened immune system.

What Causes High Homocysteine Levels

It is caused by extremely many factors, and not just pregnancy or old age. We list only the most common of them:

Dependence on harmful substances (drugs, alcohol, cigarettes and coffee). However, it should be noted that small doses of alcohol and no more than one cup of coffee per day even reduce homocysteine levels.
Postoperative period (in people who have undergone surgery on the gastrointestinal tract).
Problems with excess weight (even the initial stages of obesity).

Vitamin deficiency is another reason for elevated homocysteine levels. It increases if the body lacks vitamins B1, B6 and B12. Insufficient absorption of folic acid ends in the same way. To get rid of such vitamin deficiency, you need to take care of your stomach and intestines, because it is problems with the absorption of the above substances that lead to homocysteinemia.

There are a number of diseases that provoke an increase in homocysteine levels. These include:

congenital genetic pathologies (mutations of enzymes whose task is to synthesize methionine);
hormonal imbalance;
kidney problems (primarily kidney failure);
endocrine diseases (mainly diabetes);
heart and vascular diseases;
leukemia;
skin diseases (psoriasis and some others).

It also happens that the appearance of homocysteinemia is caused by the use of drugs. This is especially true for anticonvulsants, drugs for the treatment of autoimmune disorders (immunosuppressants), antimetabolites and folic acid antagonists, which are prescribed for psoriasis.

Pregnant women are often advised to take methionine tablets to help the liver cope better with additional stress. But it is undesirable to do this, since it may result in homocysteinemia.

Recent studies have shown that hormonal contraceptives also increase homocysteine.

Diagnostics

To find out the level of homocysteine in the body, blood is taken from a vein for analysis. The doctor may also prescribe it with a so-called methionine load. Here we mean a comparison of two blood tests: taken on an empty stomach and after a meal (it is this that “loads” the body with methionine).

An analysis that determines the level of homocysteine would not hurt anyone who is predisposed to cardiovascular diseases. It is also advisable to give it to diabetics.

Checking your homocysteine levels is especially important for pregnant women who have had problems during a previous birth. Women expecting a child, whose relatives have had heart attacks, strokes or suffered from thrombosis, also need to be tested for homocysteine.

Ways to normalize homocysteine levels

If homocysteine is slightly elevated, then it is enough to change your living habits so that the level of this dangerous amino acid drops to normal levels. You just need:

stop using harmful, addictive substances (alcohol, nicotine, coffee);
start leading an active lifestyle (walk a lot in the fresh air, regularly engage in gentle exercise, visit the pool and jog).

You will also have to radically reconsider your menu and sharply reduce the amount of food high in methionine. This includes any meat, eggs and cheese.

You will need to eat more foods with omega-3 and vitamin B. Fish, vegetables, nuts and brewer's yeast are rich in them. As for omega-3, there is a lot of it in any seafood, especially in fish oil, which is sold in pharmacies.

If the excess of homocysteine in the blood is large, then the above measures will not be enough and treatment cannot be avoided. It is strictly individual and depends on many related factors.

Usually the doctor prescribes taking vitamin B or folic acid. If the patient has vitamin deficiency, that is, his stomach and intestines do not normally absorb vitamins and acids, then the above-mentioned substances are administered using intramuscular injections.

In addition to vitamin B and folic acid, blood thinners may be prescribed to prevent blood clots from forming. Most often, in this case, the doctor prescribes the use of aspirin.

High levels of homocysteine in the blood are fraught with insidious atherosclerosis and other life-threatening diseases. Therefore, you need to keep it normal and for this purpose follow a special diet, do not abuse harmful substances and do not forget about physical exercise.

Photo: Edgar181 - own work, Public domain

By definition, homocysteine is an amino acid synthesized from methionine, which is an essential amino acid. It enters the body from animal proteins and is involved in the conversion of proteins into energy. Homocysteine is a by-product of methionine processing. Under normal conditions, there is little of it in the body; when there is an excess, the amino acid is converted into cystathionine and excreted.

What does homocysteine show in the blood?

The metabolism of homocysteine is carried out with the participation of folic acid, cyanocobalamin (vitamin B12) and pyridoxine (vitamin B6). With a lack of B vitamins, amino acid levels can become dangerously elevated. If this happens, the cells will suffer from high toxicity. To prevent this, the body neutralizes the amino acid and releases it into the blood. When defenses are disrupted, the concentration of homocysteine increases, which can lead to the development of diseases. The amino acid level indicates the presence of possible diseases.

Norm

The level of homocysteine differs depending on gender and age; as the latter increases, the concentration of the amino acid also increases. In men, the level of the substance in the blood will always be higher, and in pregnant women a slight decrease is allowed depending on the trimester. Indication standards:

When planning a pregnancy

The norm of homocysteine during pregnancy planning and in the condition itself is different. With a base rate of 5–12 µmol/L, the level then changes by trimester: 4–12 µmol/L for the first trimester, 5.7–12.4 for the second and 6–12 for the third. After childbirth, the amino acid level returns to normal within 4-5 days. When planning a pregnancy and in the first time after conception, it is very important to monitor the indicator. If the level increases, severe pathologies may develop in the newborn or even a miscarriage may occur.

Before pregnancy, you need to bring your methionine levels back to normal. A balanced diet, inclusion of B vitamins, folic acid, and simple sports exercises will help with this. Particular attention is paid to checking the indicator for women with a history of miscarriages, stillbirths, and premature placental abruption.

Hyperhomocysteinemia can damage and activate endothelial cells (the lining of blood vessels), which increases the risk of developing thrombosis. It's connected:

with damage to endothelial cells;
selective suppression of prostacyclin synthesis;
inhibition of the activation of certain proteins;
blockade of tissue activator binding.

A high level of amino acid increases platelet aggregation due to a decrease in endothelial production of relaxing factor, nitric oxide, induction of tissue factor, and stimulation of smooth muscle cell proliferation. The formation of microthrombi and impaired microcirculation leads to reproductive failure; pregnancy can result in miscarriage, infertility due to impaired implantation of the embryo.

If homocysteine concentrations are elevated during pregnancy, conditions are created to increase the risk of spontaneous miscarriages, premature birth, venous thromboembolism, eclampsia and preeclampsia in the expectant mother. A high level of methionine has a negative effect on the fetus: the embryo may develop intrauterine anomalies, it may suffer from oxygen starvation. Hypoxia leads to the birth of children with low body weight.

Hyperhomocysteinemia is one of the causes of the development of generalized microangiopathy in the second trimester of pregnancy. This is manifested by late toxicosis (preeclampsia), nephropathy. If the baby is born, there is a high chance of death or neonatal complications, For example:

anencephaly;
non-closure of the bone marrow canal;
intoxication of the nervous system;
vitamin deficiency.

Homocysteine test

Blood tests for homocysteine are given according to indications. These include risk factors for elevated amino acid levels:

dysfunctions of the cardiovascular system;
arterial, venous thrombosis;
heredity in the form of heart attacks or strokes;
diabetes;
renal failure;
endocrine, genetic diseases;
old age after 60 years;
pregnancy;
alcohol, drug addiction;
previous gastric surgery;
Alzheimer's disease, senile dementia;
homocystinuria is a disease caused by a disorder of homocysteine metabolism;
lack of folate, B vitamins, excess methionine;
long-term deficiency of thyroid hormones, hypothyroidism, deficiency of sex hormones;
psoriasis;
hyperproliferative processes;
treatment with immunosuppressants, antiepileptics, sulfur-containing drugs, antiphospholipid drugs, antimetabolites (Methotrexate, Cyclosporine, Phenytoin, Eufillin, Metformin);
smoking, excessive caffeine intake.

An increase in homocysteine in the blood may not manifest itself in any way, but leads to the development of dangerous diseases. To check, a diagnosis is carried out: a person donates blood from a vein:

It is taken on an empty stomach.
The day before, the patient is instructed to exclude fatty and meat foods from the diet, and is allowed to take only water from the liquid.
Alcohol is strictly prohibited before the analysis.
20 minutes before the plasma test, the patient must be provided with complete emotional and physical rest.

The doctor also has the right to conduct a biochemical analysis with a methionine load - a second time, blood is taken after a meal, after which the two indicators are compared. You can also check freshly excreted urine - in a healthy person it does not contain homocysteine. If the analysis showed the presence of an amino acid at a level above 1 mg/ml, this indicates the pathological development of diseases. It is important to take freshly excreted urine for analysis, because over time the amino acid is converted to a salt and cannot be detected, which will complicate the diagnosis.

Elevated homocysteine

If high homocysteine is found in the blood, the condition is called hyperhomocysteinemia. The substance accumulates excessively on the walls of blood vessels, is toxic and damages cells. The body tries to protect the damage with calcium or cholesterol deposits, which leads to vasoconstriction, plaque blockages, and blood clots.

A blood test helps determine the risk of developing cardiovascular diseases and prevent complications in future pregnancies. An increase in homocysteine levels may indicate the development of homocystinuria, a rare hereditary disease associated with a disorder of amino acid metabolism. The cause of the disease is the absence of the synthetase enzyme. The disease manifests itself:

mental retardation, mental retardation;
convulsions;
skeletal abnormalities, scoliosis, high growth;
tendency to thromboembolism, thrombosis;
optic nerve atrophy, cataracts, glaucoma;
hypertension;
redness of the cheeks.

Causes

An increase in amino acid levels by 5 µmol/l increases the risk of vascular damage, which is life-threatening. The reasons for increased homocysteine levels are:

lack of folic acid and B vitamins in the diet and the body as a whole;
smoking, excessive alcohol consumption;
excessive caffeine consumption;
renal dysfunction;
homocystinuria;
sedentary lifestyle;
hormone-dependent diseases;
avitaminosis;
enzyme mutations;
diabetes;
leukemia;
diseases of the heart, blood vessels, skin;
taking anticonvulsants, immunosuppressants, antimetabolites and folic acid antagonists, hormonal contraceptives;
taking methionine tablets during pregnancy.

Why is an elevated level dangerous?

If hyperhomocysteinemia is detected in children or adults, serious consequences may develop. Doctors warn about the dangers of:

Alzheimer's disease;
senile dementia (dementia);
myocardial infarction, thrombosis (formation of blood clots);
heart failure;
atherosclerosis of the brain, atherosclerotic vascular lesions.

If hyperhomocysteinemia is detected, complex therapy is indicated, including the introduction of B vitamins and folic acid into the diet (preferably from cereals, nuts, vegetables, legumes, spinach, seafood). If vitamin deficiency is associated with intestinal dysfunction, intramuscular injections are given and blood-thinning drugs are prescribed. It is useful to exercise and avoid high consumption of meat, eggs, and milk.

Reasons for the downgrade

A decrease in homocysteine levels is less common compared to an increase. The reasons for such indicators may be dysfunction of enzymes involved in amino acid synthesis(cystathione synthase, methylenetetrahydrofolate reductase, methionine synthase, methionine synthase reductase), multiple sclerosis. In case of multiple sclerosis, a hemostasiogram and coagulogram are indicated. It is recommended to start leading a healthy lifestyle, walking a lot, walking more often in the fresh air, doing simple exercises, visiting the pool, jogging.

If the amino acid level increases, you need to reconsider your diet and reduce the amount of food rich in methionine. These are meat, eggs, cheese, milk and dairy products. It is necessary to include in the diet foods rich in omega-3 and B vitamins. These include fish, vegetables, nuts, seeds, brewer's yeast, and seafood. It is useful to drink fish oil.

If the level of homocysteine in the blood and urine is significantly higher, these measures will not be enough. You will have to undergo specific treatment with medications. Doctors prescribe B vitamins and folic acid tablets. For vitamin deficiency associated with intestinal or stomach dysfunction, intramuscular injections of vitamins and vitamin-like substances are prescribed. Similarly, Aspirin or other drugs that thin the blood and prevent the formation of blood clots can be prescribed.

High levels of methionine in the blood can lead to atherosclerosis and threaten the development of other dangerous diseases. You should keep it normal, follow the diet prescribed by your doctor, do not abuse nicotine, alcohol and coffee, and do simple but effective physical exercises. If homocysteine in the blood decreases, it is recommended to review the diet, on the contrary, in favor of foods richer in methionine. No special therapy is prescribed for reduced amino acid concentrations.

Video

Synonyms: Homocysteine

Homocysteine is the most important sulfur-containing amino acid that is part of the body's cells. This component is involved in general metabolism, ensures normal blood flow and the functioning of the cardiovascular system.

A blood test for homocysteine allows you to identify the risk of developing pathologies of the heart and blood vessels, and assess the degree of absorption of vitamins and microelements. This study is also used in the diagnosis of homocysteinuria.

General information

Homocysteine is not found in any food, i.e. does not enter the body with food, but is produced during the breakdown of methionine (one of the 11 essential amino acids), which is found in meat, dairy and fermented milk products, and offal (eggs). Once released, homocysteine enters the blood plasma, with most of it bound to proteins. Homocysteine analysis involves assessing it in free and bound forms.

In healthy cells of the body, homocysteine breaks down into glutathione and cysteine. B vitamins (B6 and B12) and folic acid take an active part in this process. If a patient is deficient in these vitamins, homocysteine levels may increase and lead to the development of atherosclerosis (deposition of cholesterol on the walls of blood vessels), damage to the vascular walls and the formation of blood clots.

An increase in the concentration of homocysteine in urine and blood plasma is also accompanied by a rare genetic disease - homocystinuria. The pathology develops against the background of a mutation of one or more genes, resulting in the formation of a defective enzyme that prevents the breakdown of methionine. As a result, cells accumulate both methionine and homocysteine, which in patients, mainly children, is manifested by the following symptoms:

displacement of eye lenses;
rapid growth of the body and limbs;
pathological thinness;
long and thin fingers and toes;
skeletal pathologies, against which osteoporosis may develop;
early atherosclerosis;
tendency to form blood clots;
cardiovascular disorders.

Without supportive therapy, the disease progresses: mental retardation, mental and physiological abnormalities, and convulsive syndromes (seizures) are observed.

An analysis of homocysteine levels is necessary for diagnosing cardiovascular pathologies. Based on its results, the risks of developing peripheral vascular diseases, stroke, myocardial infarction, Alzheimer's disease, osteoporosis, etc. are determined.

Indications for analysis

Determination of deficiency in the body of B vitamins (B12, B6) and folic acid;
Identification of the risk of damage to the cardiovascular system;
Determining the risk of heart attack or stroke, blood clots, etc.;
Examination of newborns with pathologically small height and weight;
Examination of patients with a genetic predisposition to coronary artery diseases;
Diagnosis of pregnancy pathologies in women at risk;
History of diabetes mellitus (impaired glucose metabolism);
Senile dementia;
Examination of patients with Alzheimer's (age-related death of brain neurons).
Diagnosis of a genetic disease - homocystinuria (mainly in children);
Homocystinuria in the family history in the absence of symptoms of the disease (preventive examination);

The results can be interpreted by an endocrinologist, gynecologist, therapist and pediatrician.

Normal Homocysteine Values

Note: Homocysteine in pregnant women is normally slightly lower and amounts to 4.6-12.4 µmol/l. If the patient additionally consumes folates (water-soluble B vitamins), then the reference values change downwards.

Factors of influence

A temporary increase in homocysteine concentration is facilitated by:

regular fasting, diets, fasting, fasting days, changes in diet (veganism, fruitarianism, etc.);
predominance of protein foods in the diet;
lack of B vitamins;
long-term nicotine addiction (tobacco smoking);
physical inactivity (sedentary lifestyle);
abuse of caffeinated drinks;
taking medications (methotrexate, carbamazepine, phenytoin, etc.).

In these cases, competent correction of lifestyle and nutrition will help normalize homocysteine levels.

Increasing values

Diabetes ;
Hypothyroidism (underfunction of the thyroid gland);
Psoriasis (non-infectious dermatosis);
Kidney dysfunction;
Disorders of the gastrointestinal tract, due to which vitamins are poorly absorbed and their deficiency occurs;
Gene mutation, as a result of which the body produces defective enzymes;
Homocystinuria.

These pathologies require timely and effective treatment - only in this case can homocysteine levels return to normal levels.

On a note: if homocysteinuria is suspected, an additional examination is performed - a biopsy of liver tissue and skin to determine the enzyme cystathionine beta synthase. Its absence in tissue cells confirms the preliminary diagnosis. Genetic tests may also be prescribed to clarify the diagnosis of homocysteinuria.

Reduced homocysteine

A pathologically low level of homocysteine can indicate only one disease - multiple sclerosis (autoimmune damage to nerve fibers).

Preparing for analysis

Biomaterial for research: venous blood.

Research method: chemiluminescence immunoassay.

Method of collecting biomaterial: venipuncture of the ulnar vein (according to the standard algorithm).

Blood collection time: from 8.00 to 11.00.

Mandatory condition: you must donate blood strictly on an empty stomach!

Preparation rules

For 3 days, fatty, spicy, fried and smoked dishes are excluded from the menu;
For 1-2 days, drinking alcohol and any energy drinks is prohibited;
It is recommended not to smoke 1 hour before.

The test is not performed during drug therapy, including vitamins, or immediately after other studies (CT, MRI, X-ray, fluorography, ultrasound, physiotherapy, etc.).

Homocysteine is a low molecular weight organic compound, a non-protein sulfur-containing amino acid that does not come from food, but is obtained as a result of certain biochemical processes that constantly occur in the human body. The synthesis of this substance is carried out during the multi-stage metabolism of an amino acid called methionine, which is classified as an essential amino acid. Since the human body cannot synthesize it on its own, it is forced to take methionine from products of animal origin (meat, eggs, cottage cheese products). At the same time, with a sufficient amount of folic acid and B vitamins (B6, B12) in the body, which are actively involved in the metabolism of homocysteine, the latter is able to re-enter the metabolic process and become methionine again.

Undoubtedly, methionine is an essential amino acid and very useful for the body, but can you imagine how much its metabolic product, homocysteine, will be increased if a person starts eating only meat and consuming methionine in excessive quantities? This is why doctors strongly recommend that some patients limit their consumption of animal products - high homocysteine creates conditions for the formation of certain pathological conditions. The reader will find out which ones in the following sections.

The importance of homocysteine...

The average normal values of homocysteine in the blood of a healthy adult are 10 - 11 µmol/l, in children, regardless of gender - up to 5 µmol/l, in adolescents who have begun puberty - up to 6 (girls) - 7 (boys) µmol/l .

In the blood, this non-protein sulfur-containing amino acid (homocysteine) can be present in three molecular variants, but most often (up to 80%) it can be found in the form of a compound associated with plasma proteins (mainly with). A certain genetic pathology, as well as some acquired diseases that lead to enzyme defects and a decrease in the level of vitamins, cause a violation of the metabolism of this metabolic product. This leads to its excessive accumulation in cells, intercellular and interstitial fluid and, finally, in plasma.

High homocysteine creates a cytotoxic effect, which results in cell death, and also negatively affects the vascular walls, because, by loosening their surface, it creates conditions for attracting “harmful” endothelium (LDL, VLDL) and calcium salts, which are suitable material for “construction,” to the sites of damage. Thus, this substance takes part in the development of atherosclerosis, enhances platelet aggregation and promotes the formation. In this regard, determination of the concentration of a given amino acid, together with other laboratory indicators (,) used to assess the risk of developing cardiovascular pathology.

A blood test for homocysteine is usually not used during a routine examination (medical examination, medical examination), so most people have not even heard of its existence. But many people learn about it when planning the birth of a child. During pregnancy (in a certain category of women), increased homocysteine levels acquire particular clinical significance.

If the concentration of hymocysteine is increased during pregnancy, there is a risk of spontaneous miscarriages, premature birth,(venous), preeclampsia and eclampsia in a pregnant woman, as well as various anomalies of intrauterine development as a result of oxygen starvation of the fetus.

...and its normal level in the blood depending on age, gender and condition

The level of homocysteine in the plasma of an adult is formed over the years. Starting from childhood, it gradually (slightly) increases all the time, changing its values towards decrease only during pregnancy in women, thereby indicating that in the hemostatic system (with other normal indicators) everything is going according to plan. The lowest content of this product of methionine metabolism is observed in children, regardless of gender. Differences will only become noticeable when boys and girls reach puberty. During puberty, boys begin to outstrip girls in homocysteine levels and maintain this “superiority” throughout life due to more developed muscle mass (in men).

However, you can write as much as you like about the norm of homocysteine in the blood according to age and gender, but at the same time it will not satisfy the reader’s interest if, for clarity, you do not present its values in the table:

*Homocysteine levels during pregnancy also vary depending on the duration of pregnancy:

By the end of the first trimester, an indicator ranging from 4 to 12 µmol/l is considered normal;
In the second trimester, non-protein amino acid increases its values to 5.7 - 12.4 µmol/l;
The highest homocysteine (based on the lower limit) is observed in the third trimester and ranges from 6 to 12 µmol/l.

When planning a pregnancy, a laboratory test such as a blood test for homocysteine is taken into account without fail, where special attention is given to women with a history of miscarriages, stillbirths, premature placental abruption, etc.

Increased levels of homocysteine - hyperhomocysteinemia (HHC) during pregnancy are directly related to the state of the blood coagulation system and have a certain similarity with. Both of these pathological conditions (HHC and APS) contribute to increased platelet aggregation, provide conditions for the formation of blood clots and thereby complicate the course of pregnancy, increasing the risk of various complications and undesirable consequences. The only difference between them is that in the first case, the pathological process is triggered by homocysteine accumulated in excessive quantities, and in the second, antiphospholipid antibodies play the main (and, naturally, negative) role.

Homocysteine during pregnancy and planning

Married couples who responsibly plan the arrival of a new person into this world and dream of seeing him healthy, smart and cheerful, are examined and take the necessary tests in advance. Among other laboratory tests, as a rule, homocysteine is also present, along with other indicators, reflecting the state of the hemostatic system.

If homocysteine in a blood test is elevated, it is necessary to identify the cause of this deviation, for which the doctor will have to:

Refer the woman for additional laboratory tests: determination of plasma concentrations of thyroid-stimulating hormone (TSH), pyridoxine (vitamin B6), folic acid and inquire about the patient’s dietary preferences - perhaps the increased content of the described amino acid is due to excessive intake of methionine from food;
Find out whether the expectant mother drinks strong coffee too often to raise her vitality, whether she has such a bad habit as smoking, whether she is keen on attending entertainment events on weekends (and not only) that involve the consumption of alcoholic beverages;
Find out whether the woman has enough physical activity that she receives daily, or whether she should think about increasing activity (riding a bike, going to the skating rink, skiing, or just don’t forget about evening walks).

During pregnancy (recently experienced), there is a slight decrease in homocysteine levels, which refers to the physiological reactions of a healthy body to the changes taking place. Thus, if in the 1st trimester it suddenly turns out that this indicator is lowered, then there is no need to worry prematurely, everything will be restored over time. In addition, doctors consider this sign to be positive, because it is believed that a decrease in the indicator values indicates that everything is in order with the placental blood circulation. The only thing that can happen in the first trimester due to the fault of homocysteine is that its low level can slightly worsen the condition of the pregnant woman, but this rarely happens.

Video: about homocysteine and pregnancy

When is homocysteine high and... low?

A blood test for homocysteine helps determine not only the risk of cardiovascular diseases and prevent complications during pregnancy. This laboratory test is also used in other cases when it is assumed that this indicator is elevated and has already begun to participate in the development of pathological processes in the body. The following conditions are reasons to check your homocysteine level:

(hyperhomocysteinemia in diabetes often provokes nephropathy or retinopathy);
, senile dementia (high homocysteine – increased risk of permanent memory loss);
Homocystinuria is a rare genetic (autosomal recessive) disease caused by a disorder of homocysteine metabolism, associated with a hereditary abnormality of certain enzymes (it will be briefly discussed below);
Lack of folates and B vitamins (B6, B12...) in food or excess of the essential amino acid methionine in food (the latter applies to lovers of meat dishes and is unlikely to apply to vegetarians);
Long-term lack of thyroid hormone production and decreased function (hypothyroidism);
Psoriasis (high severity);
Kidney failure;
Hyperproliferative processes;
The use of certain medications: immunosuppressants (penicillamine, cyclosporine), antiepileptic drugs (phenytoin, carbamazepine), antimetabolites (methotrexate - a folic acid antagonist);
Unhealthy lifestyle without regime and restrictions: bad habits - smoking and drinking alcohol in large quantities (small doses of alcohol, on the contrary, slightly reduce the level of this indicator), excessive caffeine loads with frequent coffee consumption, physical inactivity.

When homocystine levels are low, doctors usually do not pay close attention to this fact.– this happens rarely and has no particular clinical significance. But, for example, homocysteine levels fall at . If this is suspected, in addition to the hemostasiogram, many other laboratory (and other) studies are carried out. Homocysteine is also included in the coagulogram, which is mandatory for diabetes mellitus, but it is not the main laboratory test that establishes the diagnosis.

Homocystinuria

Returning to the pathological conditions associated with metabolic disorders of sulfur-containing amino acids, we cannot ignore the disease that is most directly related to the metabolism of homocysteine - homocystinuria. Homocystinuria is a rare hereditary (autosomal recessive) disease that is caused by the absence of one of the enzymes (synthetase) involved in metabolic reactions. Due to significant damage to vital systems (cardiovascular, musculoskeletal, nervous), this disease gives a variety of symptoms:

Mental retardation and mental retardation;
Convulsive seizures;
Various manifestations of skeletal abnormalities (tall height, chest deformity, scoliosis, etc.);
Tendency to thromboembolism, thrombosis (both venous and arterial);
Ophthalmological pathology (optic nerve atrophy, lens subluxation, cataract, glaucoma);
Hypertension;
Unnatural redness of the skin of the face (cheeks).

Among the main laboratory tests confirming the presence of severe pathology associated with the metabolism of sulfur-containing amino acids, not the least role belongs to the determination of the concentration of homocysteine in freshly excreted urine (this compound, excreted by the kidneys up to 1 mg/day in a healthy person, is not normally detected).

Finally

It is obvious that a laboratory test designed to calculate the concentration of homocysteine in biological fluids (blood, urine), despite its rather narrow popularity, is a very important diagnostic method. It is indispensable in obstetric practice when planning pregnancy, as well as during the gestational period, when it is done for the purpose of prevent serious complications, affecting the health of mother and child. In addition, this laboratory indicator provides significant assistance in determining the degree of risk of developing cardiovascular pathology, which tops the list of reasons for the premature departure of the working-age population to another world.

A blood test for homocysteine is no different from other biochemical tests. It is taken in the morning on an empty stomach as part of a coagulogram and does not require additional preparation. As for urine taken for the purpose of diagnosing homocystinuria, its analysis should begin immediately, the test should be carried out as soon as possible and work only with freshly obtained material, otherwise homocysteine, being unstable in the urine, will quickly oxidize and turn into homocysteine disulfide, and, consequently, , will not be found. And the diagnosis will remain in doubt for some time...

Homocysteine ​​is elevated in children under treatment. Homocysteine ​​is elevated

The effect of homocysteine ​​on blood vessels