What recommendations are there for hyperhomocysteinemia in patients with ischemic stroke or TIA?
In patients with ischemic stroke or TIA with hyperhomocysteinemia, supplementation with folate, vitamin B6 , and vitamin B12 is not effective for preventing subsequent stroke. Challenges in understanding the relationship between vitamin supplementation and secondary stroke prevention stem from limitations in trial design, for example, including patients with both cardiovascular and and enrollment from countries with varying levels of folate supplementation of foods.