Soumen Bhattacharyya: Hyperhomocysteinemia and Thrombosis – What Clinicians Should Know
Soumen Bhattacharyya, College Teacher in the Department of Physiology at RBC College for Women, shared a post on LinkedIn:
“Hyperhomocysteinemia and Thrombosis – What Clinicians Should Know
Hyperhomocysteinemia continues to sit in that interesting grey zone between biochemical abnormality and clinical significance.
What’s happening?
Elevated homocysteine levels can:
- Damage vascular endothelium
- Increase oxidative stress
- Promote a pro-thrombotic state
Clinical relevance:
Strongly associated with thrombosis in severe elevations (e.g., genetic disorders)
In mild-to-moderate cases, the evidence is inconsistent and debated
Treatment paradox:
While folate, Vitamin B12, and B6 effectively reduce homocysteine levels…
This doesn’t consistently translate into reduced thrombotic events.
Takeaway for practice:
Hyperhomocysteinemia is best viewed as a modifiable risk marker rather than a standalone cause of thrombosis.
It reminds us of a broader principle in medicine:
Not everything we can measure needs to be aggressively treated in isolation.
Curious to hear from fellow clinicians – Do you routinely screen for homocysteine in thrombotic workups?”

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