What Does It Mean?
High homocysteine, also known as hyperhomocysteinemia, is a metabolic dysfunction where homocysteine levels in the blood become elevated due to inefficient methylation, nutrient deficiencies, or impaired detoxification. Elevated homocysteine is associated with an increased risk of cardiovascular disease, neurodegenerative disorders, and endothelial dysfunction.
Root Causes & Imbalances
- Methylation dysfunction due to deficiencies in B vitamins (B6, B12, Folate)
- Genetic mutations (MTHFR variants) affecting homocysteine metabolism
- Oxidative stress and inflammation, impairing homocysteine clearance
- Poor liver detoxification pathways, reducing methylation efficiency
- Kidney dysfunction, impairing homocysteine clearance
- Dysregulated folate and B12 metabolism, leading to impaired conversion of homocysteine to methionine
How Did We Get Here?
Signs & Symptoms
Patients with elevated homocysteine may present with:
- Cardiovascular issues (hypertension, arterial stiffness, increased clotting risk)
- Neurological symptoms (brain fog, memory loss, mood disturbances, neuropathy)
- Fatigue and weakness due to impaired methylation and detoxification
- Headaches and dizziness from vascular dysfunction
- Joint pain and inflammation due to oxidative stress
- Increased risk of miscarriage or pregnancy complications
Lab Test Findings
| Lab Test | Expected Changes | Optimal Range |
| Folate, Serum (Folic Acid) | Decreased | 15.00-27.00 ng/mL |
| Homocysteine | Elevated | 5.00-7.20 µmol/L |
How Do We Treat It?
Functional Medicine Approach
Treatment focuses on optimizing methylation, reducing oxidative stress, and enhancing detoxification pathways.
Supplement Protocol
| Supplement | Function | Dosage & Frequency |
| Vita B Methyl | Provides bioavailable methylated B vitamins (B6, B12, Folate) to support methylation | 1 capsule without food, daily |
Additional Lifestyle Interventions:
- Increase folate-rich foods (leafy greens, legumes, avocado)
- Avoid synthetic folic acid and opt for methylated folate (5-MTHF)
- Consume high-quality protein sources (supports methionine metabolism)
- Manage oxidative stress with antioxidants (Vitamin C, NAC, Glutathione)
- Regular exercise to improve vascular function and circulation
- Reduce alcohol and caffeine intake, which can deplete B vitamins