Is Homocystein useful for Wechseljahre?

Homocysteine is a biomarker linked to cardiovascular risk, cognitive decline, and bone health – all areas that become more relevant during menopause due to estrogen decline. Elevated homocysteine may indicate deficiencies in vitamin B12, folate, or B6, which are needed for its metabolism. However, homocysteine is not a specific menopause test. The evidence for routine use in menopause is moderate: studies show associations but no clear causal role. It can serve as an additional risk marker but does not replace hormone or bone density assessments. Lowering homocysteine via B-vitamin supplementation is debated, as randomized trials have not shown clear cardiovascular benefit. Therefore, homocysteine may be useful if deficiency is suspected or to assess cardiovascular risk, but not as a standalone menopause marker. Caution against overinterpretation – levels fluctuate with diet, kidney function, and genetics.