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J Clin Endocrinol Metab (2003) 88(5):192732
These genes affect pathways involving: methylation folate metabolism redox balance the transsulfuration pathway glutathione production When certain variants occur in a homozygous state , they can significantly increase a persons baseline homocysteine levels
However, certain symptoms require prompt evaluation: Trouble breathing, noisy breathing, or choking sensations Inability to swallow liquids or solids Rapidly enlarging neck mass, visible swelling, or redness Unexplained weight loss, persistent pain, or bleeding Hoarseness lasting more than two weeks How Clinicians Evaluate a Lump-in-the-Throat Sensation Evaluation begins with a careful history and physical exam
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