Evidence check: Homocystein in the context of Wechseljahre

Homocysteine is an amino acid whose elevated blood levels are considered an independent risk factor for cardiovascular disease. During menopause, cardiovascular risk naturally increases due to estrogen decline, and elevated homocysteine may compound this effect. However, the evidence is mixed: some studies show an association between homocysteine and menopause-related vascular changes, but clear clinical intervention data recommending routine measurement or lowering of homocysteine in menopause are lacking. Lowering homocysteine with folic acid, B12, and B6 is possible, but it is not proven to reduce cardiovascular risk. MyBody-X tests can measure homocysteine, but interpretation is limited: single values without considering kidney function, thyroid status, and medications are of little value. Caveat: Do not self-supplement with high-dose B vitamins without medical advice. Evidence: unclear – based on mechanistic and observational data, not on randomized trials in this specific group.