Q. Is the value of Homocysteine-14. 86 too high to take Ecosprin?

Answered by
Dr. Muhammad Majid Hanif
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 23, 2016 and last reviewed on: Oct 09, 2018

Hello doctor,

My wife is 27 years old and 10 weeks pregnant now. Her last month period date (LMP) is 13/06/2015 and she had natural conception. This is her first pregnancy and she was operated for left ovarian dermoid cyst and left ovary was removed in the February 2013.

As per the blood test report done on 3/08/15, her homocysteine level is 14.86 umol/L. She is taking the following tablets as of now:

  • Tablet MCBM 69 1-0-1 from 3/8/15 till date.
  • Tablet Duphaston 10 mg 1-0-1 from 3/8/15 till date.
  • Thyronorm 50 mcg 1-0-0 (before food) from 7/8/15 till date.
  • Also she was advised to take one Ecosprin tablet 75 mg (0-0-1) after food to avoid blood clotting and miscarriage, during our visit to the doctor on 18/8/15.

Please advise on the below aspect:

  • Is the value of Homocysteine (14.86) too high to take Ecosprin tablet now in the first trimester of pregnancy?
  • Is MCBM 69 tablet sufficient enough to take care of Homocysteine level?
#

Hi,

Welcome to icliniq.com.

I have thoroughly gone through your case and can well understand your genuine concerns.

MCBM 69 is the tablet used to aid in production of blood products and also to prevent any suspected neural tube defect in baby. It contains multivitamins, for example: Mecobalamin, Pyridoxine and Folic acid. This will help your wife to improve her hemoglobin levels.

Ecosprin is pregnancy category C and D and usually dangerous to prescribe in last three months of pregnancy and lactation, as it may be a danger to the developing baby then. We may still prescribe it in first three months of pregnancy, if the benefits overweigh the risks. Homocysteine levels are not so correlated to prescribe Ecosprin tablet. Consult back the prescribing physician for time period for which he prescribed it for your wife and exact indication why he had prescribed it.

Homocysteine levels test is also advised in cases of homocystinuria. Homocysteine levels also rise in cases of decreased estrogen levels. And your wife has got her one ovary removed, so she has low estrogen and high homocysteine levels may be due to that. 14.86 is not very high levels of homocysteine, but you have to keep a check and do serial tests to keep an eye if the levels are going up or low.

Homocysteine levels in plasma may also increase in hypothyroidism, and in deficiency of folic acid, vitamin B6 and B12 deficiency. Your wife seems to be hypothyroid as she is on thyronorm.


Investigations to be done:

Thyroid profile.
Comprehensive metabolic profile.
Serial serum Homocysteine levels.

Treatment plan:

Do not stop taking any medications without actually consulting the treating physician. He has all the case details and have done complete physical examination too.

Regarding follow up:

Get back to an internal medicine physician online for further follow up --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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