Dr. Thiyagarajan. T
Diabetology
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Patient's Query
Hello doctor,
This inquiry is for my sister-in-law. Three four years back, she had a problem with her eye. On consulting, they told due to some type of stroke, her vision has been affected. They started giving him Ecosprin, and a special injection to protect her eye vision. During this period her retina specialist suggested she have homocysteine reading at regular intervals. She had the test and her reading was found to be 19.7 H (range is 0.0 to 15.00). She is non-diabetic, has no hypothyroidism, and has no hypertension. At present she is taking the following medicines, Ecosprin, Shelcal, and Neurobion, Her gynecologist advised her Primosa and Evion capsules, as they are seeing some fibroids in a mammogram. My query is:
1. Which medicine she has to take for high homocysteine and for how many days and when it has to be repeated?
2. How this hormone is related to eye problems, as it was advised by a retina specialist? Please guide.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern. If It was a type of stroke, I suggest you also check the fasting lipid profile and start either Rosuvastatin (Rosuvastatin calcium) or Atorvastatin (Atorvastatin calcium trihydrate). Homocysteine (amino acid cysteine) is a marker for endothelial damage or inflammation. It is not a problem by itself and it denotes that blood vessels may be at high risk for damage or clot formation or blocks. High homocysteine may be due to low Folic acid or B12 and a mutation in a gene called MTHFR. So it is not directly related to the eye problem but may increase the risk of another stroke. Usually, we treat this with a 'statin' medicine, Ecospirin (Atorvastatin and Aspirin), and also Folic acid, B12, and B6. So I suggest taking a tablet of Homin D3 (Mecobalamin, Pyridoxine, Folic acid, and Vitamin D3) once daily. There are no clear guidelines to repeat the test. So, arbitrarily can take medicine for six months and repeat the test. I hope I have cleared all your doubts.
Thank you.
Patient's Query
Thank you doctor for the reply,
Recently, she had her lipid profile, and the following are the results:
Please review. Thank you.
Hello,
Welcome back to icliniq.com.
LDL (low-density lipoprotein) is 82 mg/dL; I recommend it to be less than 70. If she is taking plain Aspirin, add a tablet of Rosuvastatin 10 mg daily at night along with vitamin supplements as recommended earlier.
I hope your queries are resolved, and any further queries are welcome. Thank you.
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Diabetology
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