Myths vs facts: Homocystein and Wechseljahre

Homocysteine is a byproduct of amino acid metabolism that can rise during menopause due to declining estrogen levels, which normally help keep homocysteine in check. **Myth:** Homocysteine directly causes hot flashes or mood swings. **Fact:** Elevated homocysteine is a well-established cardiovascular risk marker, and menopause increases cardiovascular risk. It may also indicate deficiencies in vitamin B12, folate, or B6. Testing homocysteine can be useful for assessing overall risk, but there is limited evidence that lowering homocysteine (e.g., with B-vitamin supplements) alleviates menopause-specific symptoms. The relationship is associative, not causal. Evidence from randomized trials does not support routine supplementation for symptom relief. Caveat: Do not self-prescribe high-dose B vitamins without a blood test and medical guidance.