Hyperhomocysteinaemia

Hyperhomocysteinaemia refers to an elevated level of homocysteine in the blood — an amino acid that, at high concentrations, is linked to an increased risk of stroke, cognitive decline, and other vascular complications.

At The Royal Buckinghamshire Hospital, we provide specialist neurorehabilitation for patients recovering from stroke or neurological symptoms linked to vascular and metabolic risk factors such as hyperhomocysteinaemia.

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What Is Homocysteine?

Homocysteine is produced when the body breaks down proteins. Normally, it is converted into other substances with the help of B vitamins, including folic acid, vitamin B6 and B12. When these nutrients are deficient — or when a person has a genetic predisposition — homocysteine can build up to harmful levels in the bloodstream.

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What Are the Risks?

High homocysteine levels are considered an independent risk factor for:

• Ischaemic stroke
• Transient Ischaemic Attack (TIA)
• Vascular dementia
• Cerebral small vessel disease
• Cognitive impairment or “brain fog”
• Peripheral neuropathy
• Cardiovascular disease

Homocysteine is believed to damage the lining of blood vessels, promote clot formation, and impair circulation — all of which can contribute to serious neurological outcomes if left unmanaged.

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Causes of Hyperhomocysteinaemia

• Vitamin B12 or folate deficiency
• Genetic mutations (e.g. MTHFR gene)
• Chronic kidney disease
• Hypothyroidism
• Methotrexate or anti-epileptic medications
• Poor diet
• Smoking and excessive alcohol intake

In many cases, the condition is asymptomatic until a vascular event (such as a stroke) occurs.

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Symptoms Linked to Neurological Events

When hyperhomocysteinaemia contributes to stroke or cognitive decline, patients may experience:

• Weakness or numbness on one side of the body
• Difficulty speaking or understanding speech
• Loss of balance or coordination
• Memory issues or cognitive slowing
• Visual disturbances
• Fatigue or difficulty concentrating

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Rehabilitation at The Royal Buckinghamshire Hospital

Patients recovering from homocysteine-related neurological events may benefit from inpatient neurorehabilitation, especially if their condition has resulted in:

• Stroke or TIA
• Brain fog or cognitive impairment
• Difficulty walking or with balance
• Fatigue and reduced confidence
• Secondary complications (e.g. anxiety, depression, spasticity)

Our multidisciplinary support includes:

• Neurophysiotherapy for movement, strength and coordination
• Occupational therapy for daily living and fatigue management
• Speech and language therapy, if affected
• Education on stroke prevention and vascular risk management

See Our Rehabilitation Centre