When I encounter patients with elevated homocysteine levels above 10 or 12 micromols/L, I encourage them to start high quality, complete and balanced nutritional supplements that contain at least 1,000 mcg of folic acid, 100 to 200 mcg of vitamin B12, and at least 50 mg of vitamin B6. If my patients are already taking this level of these B vitamins and their homocysteine levels are still elevated, I will add Betaine or Trimethylglycine (TMG). I will gradually increase the dose from 1 gram to even 6 grams in order to get their homocysteine levels at least below 8 micromols/L and hopefully below 6.5 micromols/L.
Some physicians who understand the seriousness of elevated homocysteine levels will sometimes prescribe very high doses of B vitamins. I have not had that much success with this approach. However, I don’t mind increasing the B vitamins as long as they also are adding significant levels of Betaine (TMG). You should have your homocysteine rechecked after 2 to 3 months on either B vitamins or Betaine to be sure your homocysteine level has come down into that safe range. If not, you need to add more Betaine (TMG) up to 6 grams daily in order to reach that goal.
Source: Dr. Strand Health Nuggets (newsletter@Bionutrition.org)
