Low Homocysteine? Not Good. 5/5 (7)

low homocysteine

What do you think of when you hear the word – homocysteine?

Bad. Cardiovascular disease. High blood pressure. Toxic. Lower the better.

I am challenging this thinking right now.

When I think of homocysteine, I think of this:

The body has to make homocysteine. It’s an important building block for two very important compounds in our body. It must be balanced. Too low homocysteine is bad and too high homocysteine is bad.

When was the last time a health professional said, “Hmm. You have low homocysteine levels. We need to increase your homocysteine to help you feel better!”

This is a very rare occurrence.

If your health professional has said this to you, my hat is off to them!

Most research and, as a result most health practitioners and patients, focus on normal to high homocysteine.

Low homocysteine isn’t even on their radar.

Medically speaking, low homocysteine doesn’t really even exist.

I used the medical term for low homocsyteine, hypohomocysteinemia, in the National Library of Medicine to search for published papers on low homocysteine.

Here is what I got: (they wondered if I meant something else!)

low homocysteine research

Only 8 results for hypohomocysteinemia (low homocysteine) compared to nearly 8,000 for hyperhomocysteinemia (high homocysteine).

I reviewed the one and only abstract on low homocysteine. Here is what they found:

“There is a striking relationship between hypohomocysteinemia and the incidence of idiopathic peripheral neuropathy.”(2)

This makes total sense.

If one has low homocysteine, then how can they make glutathione?

If they cannot make glutathione well, then their nerves are very susceptible to oxidative stress and damage.

There it is.

We need a lot more research on the impact of low homocysteine on human biochemistry and physiology.

When research does publish findings on low homocysteine, they are confused or misinterpret it:

“Children with diabetes, in view of their higher future risk of cardiovascular disease, are characterized by a higher concentration of protective adiponectin and paradoxically lower blood concentrations of some other possible risk markers of atherosclerosis, i.e. ADMA and homocysteine compared to healthy children.”(1)

To me, children with diabetes have higher reactive oxygen species which requires glutathione to neutralize them. Thus, a lower homocysteine level in a person with high free radical / reactive oxygen species tells me that their body is trying to fight it by producing glutathione.

Simple steps:

High free radical / reactive oxygen species -> increases demand for glutathione -> increases utilization of homocysteine especially in low sulfur diets

A Low Homocysteine is NOT Good.

First we have to define a ‘low homocysteine’.

There are many papers which demonstrate that homocysteine around 6 or 7 is quite healthy for lowering cardiovascular risk.

low homocysteine range

Is homocysteine only related to cardiovascular risk?


Homocysteine is needed to help produce our body’s primary:

  • methyl donor, SAMe.
  • antioxidant, Glutathione.


So why is it ok to have no homocysteine as shown here?

It’s not!

Who comes up with these things?

It is common sense that if we are low in a specific ingredient, we cannot make something.

If you’re trying to make a romaine salad and the recipe calls for romaine, yet you don’t have any romain lettuce, can you make it?


You need to make a different type of salad or just go without it.

In the case of producing your body’s primary methyl donor, SAMe – you need homocysteine.

In the case of producing your body’s primary antioxidant, glutathione – you need homocysteine.

In short:

No to low homocysteine translates to . . .

low homocysteine

Causes of Low Homocysteine and How to Increase It

  1. Low protein intake: need to make sure you are eating adequate protein. Approximately 1 gram per 2 pounds of body weight is a rough guideline.
  2. Low sulfur intake: if one does not consume enough sulfur-containing foods, homocysteine will break down in order to provide much needed cysteine for the body. Cysteine is very important for many reactions. If cysteine levels are low, the body will break down glutathione in order to provide it! So not only does one become low in homocysteine, but also glutathione. Eating your cruciferous vegetables is very important as they contain sulfur. You can also support with MSM or NAC. If you don’t do well with sulfur-containing vegetables or other foods – or sulfur-containing supplements, then you may have a molybdenum deficiency for various reasons. Molybdenum is the mineral needed to breakdown sulfites. Consider taking a molybdenum supplement and also determine why you need to. I prefer liposomal glutathione most the time to replenish lost sulfur levels. This is for many reasons.
  3. Poor digestion and absorption of protein: eating protein is step one. Being able to digest it and absorb it is important. Consider chewing your food (shocker), reducing stress before and during eating (shocker), not drinking a ton during meals as it may dilute your digestive powers. You can support your digestive enzymes with a digestive enzyme supplement and increase stomach acid with a HCL supplement. If taking antacids, your stomach acid is lower and that is going to impact your protein and nutrient absorption. Fix your gastritis and acid reflux.
  4. High demand for glutathione: if you are struggling with high amounts of inflammation, stress or free radicals, you are going to require a high amount of glutathione. Producing glutathione requires homocysteine. One can minimize their need of glutathione by reducing or minimizing stress with adaptogens, improving deep sleep, reducing inflammation and reducing exposure to chemicals. One can also reduce their demand for glutathione production indirectly by taking liposomal glutathione. Taking liposomal glutathione is helpful for many but if they are deficient in selenium, riboflavin or molybdenum or have high oxidative stress, it may backfire. This is why I formulated a liposomal glutathione with needed cofactors.
  5. Too much methylation support. I’m a fan of methylation support. However, when it is not needed, it can lower your homocysteine levels too much. Maybe this is yet another reason why some people do not feel good from taking methyl donors? If your homocysteine level is too low, talk with your health professional about reducing your methylation support. You can use a multivitamin without any folate or B12 – called Optimal Start. Or you can use a multivitamin without any methyl donors yet contains folinic acid and hydroxocobalamin – called Optimal Multivitamin Minus One. If you are taking a B Complex with methylfolate and methylcobalamin, you should consider switching to one without these for a bit or just stop if possible. I formulated a B complex without folate and without B12 – called B Minus.

Who else is thinking the same way I am about low homocysteine?

I scoured the research again to see if anyone else is thinking that low homocysteine is a problem.

It turns out that the only other one that I see out there is another naturopathic physician – and a well known one at that. Dr Joseph Pizzorno, one of the founders of Bastyr University, wrote a paper called: Homocysteine: Friend or Foe?


It’s a must read.

Do you have low homocysteine?

Is your homocysteine lower than 6?

Share your story below.

Did your doctor say anything?

Work with you to correct it?



  1. https://www.ncbi.nlm.nih.gov/pubmed/18830896
  2. https://www.ncbi.nlm.nih.gov/pubmed/22239874

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Comments 115

  1. Hi Dr! I’m homozygous c677T in September my homocysteine level was 8.6. Do you still recommend supplementing with Glutathione & if so how often?

    1. Post

      Eliza – fantastic question.

      Yes. This is because methylation can be SLOWED by hydrogen peroxide. Hydrogen peroxide is neutralized to water by glutathione.

      If one takes liposomal glutathione (preferred over just reduced capsule of glutathione), then the body will just push out the homocysteine as cysteine and pee out the excess cysteine as sulfate. This requires vitamin B6 and molybdenum to happen.

      I actually recommend liposomal glutathione to people with stubborn high homocysteine and it does seem to help some.

  2. Very interesting, I’m homozygous MTHFR C766T and docs tested me for high homocystein, which I don’t have. Are there any other symptoms.you know of? I get pins and needles down the pinky edge of each hand pretty much every time I lay down or sit down for a while. Pinky fingers can go totally numb. Thanks again Dr Lynch.

    1. Post

      Katy –

      That sounds more like nerve compression to me – thoracic outlet syndrome or disc compression. Please get evaluated by a chiropractor or one who understands physical medicine.

    1. Post

      Hi Emily –

      Great question. It can be yes. The trick though is identifying why homocysteine is low in the first place. I suspect most common reason are those mentioned in the article.

      Instead of taking SAMe, I’d consider: liposomal glutathione, eating more protein, absorbing protein better, reducing stress –

      SAMe can get stuck and not be used – thus staying as SAMe and not really converting to homocysteine. However, SAMe does increase the speed of the CBS enzyme so it may indirectly – but not as fast as liposomal glutathione or protein intake.

      I’m unsure positively here – so bouncing thoughts around while writing.

      In short – yes a SAMe supplement could raise homocysteine. 😉 – in some people and others it may take awhile.

  3. Hello Dr. Lynch,

    My husband and I are 36 and preparing for conception. I have two mutations, one copy C677T and one copy A1298C. I am taking your exact recommended prenatal supplements as I’ve read and followed your other work. I’ve been taking methylfolate for 3 years now (usually about 3-4 mg a day, along with the other recommended B-vitamins in HomocysteX Plus or MethylGuard Plus.) I haven’t felt much of a difference with them.

    My homocysteine labs just came back at 4.5 and still chronic EBV this month.

    Genova Micronutrient testing also showed continued microbiome dysbiosis and recommended 50 billion probiotics and pancreatic enzymes. I’ve been working with gut health, probiotics, etc for years. The only symptom I have is persistent acne.

    I read in one of your articles that low homocysteine could be related to Downs Syndrome.

    What should I do to prepare for a baby or do you think we’re ready now?

    Thank you so much!

    1. Post

      Hi Nicole –

      I’m impressed you’re working so hard preparing yourself for a healthy pregnancy!

      I would hold off a bit until you are feeling good and healthier.

      Persistent acne can be many issues:
      – liver
      – microbiome
      – stress
      – hormones
      – low digestive enzymes / acid
      – combination of all the above

      Taking that much methylfolate is likely not that beneficial – especially if you are not feeling much different.

      I’d work with a doc to get those chronic infections under control.

      Lack of deep restorative sleep, stress, nutrient deficiencies – all can increase risk of infections.

      Consider a vacation as well once you get a treatment plan in place 😉

      Infections are typically causing many of your underlying issues – or an environmental exposure – such as household chemicals, new construction, mold..

  4. This sounds like me. I have been low glutathione for about 10 years and do not tolerate glutathione supplements in any form. I am not able to eat much in the way of cruciferous vegetables as I have low tolerance for oxalate. Am I understanding correctly that the way to increase homosycystein is to reduce the demand for it or is there a way to directly increase homosycystein itself. I’m wondering because at one time or another I have taken NAC, reduced stress, taken Same, adaptigens, molybdenum, eaten cruciferous veggies, Epsom salt, antioxidants etc many at the same time and still can’t get glutathione to rise or my symptoms to improve.

    1. Post

      Hi Keri –

      I’d consider looking into molybdenum and also your gut health. If your GI health is not right, you’ll be using up a lot of glutathione plus not tolerating sulfur or oxalates.

      You can try a molybdenum supplement by itself for a week or so and see how your symptoms improve. It’s only a band-aide though as you need to find out why your sulfites are high.

      Then after you do this, you can try a liposomal glutathione that has added cofactors to it so it gets used and recycled and limits sulfite production. Optimal Liposomal Glutathione Plus offers these.

      Evaluate your GI, liver, gallbladder,etc – with a good health professional. Infections should be sussed out, too.

  5. Hi thank you for all your writing and answers and your “out of the box” thinking! I so wish you would practice in Canada and could review my medical file. I will keep on reading and bringing new path of ideas to my practice era (conventional and natural).

  6. I have a homocysteine of 5.

    I have lots of inflammation ad just diagnosed with Polymyalgia Rheumatica.

    LDN and turmeric seem to be keeping it unde4 control.

    Think i will try your glutathione product, if it delivers to UK

    1. Post

      Hi Alyson – I’d look into your microbiome and digestion – and underlying infections and environmental exposures.

      We have Seeking Health for sale in the UK – via Detox Doctors and Amazon UK.

      Seeking Health also ships worldwide.

      Glad you have it under control – now let’s have it go away 🙂

  7. Thanks for a great article Dr Lynch. I’m curious if a homocysteine level of 6.8 might be borderline low – or is it ideal as per your article & Dr Pizzorno.
    I am in the initial stages of advising a lady (in her mid 40s, has had 12 miscarriages in less than 5 years!) – she has been through the mill and yes has been dosed to the eyeballs with folic acid etc. On my advice she got her genetic profile – shes hetero 677T, CBS & COMT; Homo – PEMT, MTHFD etc – so I advised her to get homocysteine levels checked and was surprised that its 6.8 (I was expecting it would be high) – this result only last week.
    I wonder if low(ish) homocysteine can also be a factor in a history of pregnancy loss. No doubt removing folic acid was the absolute biggest 1st step for her, Shes starting to take seeking health prenatal, plus other dietary / nutrient changes etc
    Thanks for your work

    1. Post

      Hi Mary –

      I’d say 6.8 is pretty good for homocysteine.

      However, I’d like to see:
      – lipid peroxides
      – RBC fatty acids
      – amino acids
      – organic acids

      Her homocysteine isn’t elevated likely as it is busy burning it up for methylation support (cell membrane production, creatine synthesis) and glutathione production.

      She also may not be eating that much protein – so a methionine loading test may push her homocysteine up quite high. Not saying that’s needed – but could be a way to check how her system is doing.

      I’ve seen many recurrent miscarriages resolve with using extensive nutrition – as I’ve outlined here in my prenatal supplementation and MTHFR article.

      Yes – low-ish homocysteine is definitely a risk factor for pregnancy loss – and also having increased risk for the newborn developing autism (along with low vitamin D)

      here is a paper on glutathione and pregnancy issues

  8. My sons homocystiene was undetected in his amino acid labs. But did not indicate it was a problem. The range stated 0-2 umol/L. I don’t understand why 6 is good if lab stated 0-2?
    What lab do I need to ask for to have this checked again

    1. Post

      Amy – kids have a lower homocysteine than adults because they are using it so much faster. All the more important to make sure they are eating enough protein and getting liposomal glutathione.

      Support with these first – and then recheck in a month.

  9. Thank you, Doctor. I appreciate your response. I’m a little heartbroken but I know it’s the right answer. EBV has been chronic for me since I got mono 7 years ago. I’ve tried different anti-viral and immune-boosting approaches with my Naturopath but to little improvement. I’ll start again… 🙁

    Since you’re no longer taking patients and I’m in the Seattle area, is there a local doctor you’d recommend for EBV/mthfr/gut dysbiosis/prenatal care?

    Thank you again.

    1. Post

      Nicole –

      I hear you – truly.

      The way to combat an infection is not to kill it.

      The way is to nourish yourself – mentally, emotionally and physically.

      Find out what is blocking you from this and replenish.


      Forget the fighting infections for now – and focus on restoring on a deeper level.

      If the deeper level has to do with having a beautiful pregnancy and lovely child so you can be an incredible mother, know that this will come when you are stronger mentally, physically and emotionally.

      I’m absolutely confident in you to take this to heart.

      I’ve seen many struggle with fighting infections – only to realize that it was something deeper that was missing.

      Meditate on this – even if for a few moments a day.

      That will drive clarity for you – as it likely is buried.

  10. Should those of us trying to raise our low homocysteine avoid taking methyl folate? Are there other supplements that should be avoided for those with low homocysteine?

    1. Post

      Amanda – great question. I’d say yes to limiting methylfolate when trying to raise homocysteine. Avoid it – no – that wouldn’t be good.

      If taking a methylfolate supplement, then consider reducing or stopping it. Only use a multivitamin that has it in it. I have multivitamins that contain non-methylated nutrients – such as Optimal Multivitamin Minus One. It’s a one capsule a day – easy to take and only has folinic acid and hydroxocobalamin.

      If you want to avoid folate and B12 completely – you can do that with Optimal Start.

      I also formulated a B complex without folate and B12 – called B Minus.

      Instead of worrying too much about what to avoid, I’d focus more on what to add.

      However, you are very correct one should reduce their methylated nutrients in order to raise their homocysteine back up to a healthy level – say 7 umol.

  11. Hello Dr Lynch,

    I am homozygous C677T and slow COMT. My homocysteine is at 4. I have continuous low ferritin. So tired all the time. Just found out I have acid reflux AND mild sleep apnea which is causing my nightly heart palpitations. I was told after wearing a take home sleep monitor twice that I had no sleep apnea. I got a question through to you on your recent FB live and you said get checked for sleep apnea so I requested an overnight study this time. I have it! Thank you! An answer.

    I take your Hydroxy B12/Folinic Acid and eat higher protein amounts as of recently. I just ordered liposomal glutathione. I’m working on a real food only lifestyle change and feeling better already.
    Should my homocysteine levels improve with all these changes?
    Thank you!

    1. Post

      Hi Jenny –

      Awesome!! You rock! Well done and taking action and figuring this out! Huge find 😉

      Now – how are you addressing the sleep apnea?

      For your homocysteine – you appear to doing the right things and taking the right nutrients. I would not recommend MTHF and methylcobalamin.

      You could likely check your homocysteine in a month since you’re really making some changes.

      High 5! 🙂

  12. I had high homocystine until I started taking metanx and deplin. Now it’s low and I was ok with that. Not sure now. Homozygous C677T and I need every bit of both the supplements along with 100 mg pristiq to maintain mood and function in fibro/ME/CFS. Adding LDN this week and exploring lowering oxalates. I usually eat a whey protein isolate bar for breakfast and am heavy on protein overall but not afraid of good fats (saturated, long chain omega 3s and mct) but also not terrified of sugar. Thoughts?

    1. Post

      Hi Patricia –

      When you say you have ‘low homocysteine’ – what do you mean? Lower than 6 umol?

      If so, then I’d say I’m with you on re-evaluating your intake of Metanx and Deplin.

      That’s a ton of methylfolate.

      Maybe you can add in folinic acid and reduce the use of methylfolate.

      Using liposomal glutathione could be a boon -but make sure you use the one with the cofactors so you reduce the potential of side effects – and start low – few drops.

  13. Should people with peripheral neuropathy have their homocysteine tested? Can it be reversed with dietary adjustments recommended in this article?

    1. Post

      Hi Robin –

      I say most people should have their homocysteine checked – yes.

      Peripheral neuropathy has many causes – some improve a lot with:
      – chiropractic adjustments – if compression or impingement
      – vitamin B12 – especially methylcobalamin
      – L-methylfolate
      – vitamin B6
      – vitamin B1
      – liposomal glutathione
      – alpha r lipoic acid

      These are all available at http://www.seekinghealth.com – well – not the chiropractor 🙂

      Also reducing carbohydrate intake is important – replace it with vegetables or healthy fats / protein.

      Also limit snacking – only eat a few meals a day ideally. This isn’t easy –

      Acetyl-L-Carnitine, Biotin, Niacin and 5-HTP may help support your healthy eating choices and being able to burn fat.

  14. Last time my homocysteine level was checked it was 5.The doc said she thought that wasn’t right and could mean methylation issues. I’m the one who lives in the Midwest. Functional medicine practitioners are hard to come by and they just don’t have the experience because many people in the Midwest only know conventional medicine. I keep my health to myself – most of my friends think I a looney health nut…I have searched for info on low homocysteine and found nothing helpful for me. I have Hashimoto’s and have been working with a practitioner for almost 4 years and I still don’t feel very good. I’ve been doing many of the things you talk about. Food, air, water, environment – reducing stress, and on. I have been taking liposomal glutathione. I plan on sending this article to my doc and have her help me know how to proceed. I know you gave suggestions – some are counter to what they say is good for Hashi patients- like cruciferous veggies, but I’m going to start eating them.. And you suggested three supplements. With my history I have to start slowly, one at a time or I won’t know which one is causing problems, if something causes a problem. I know every body is different so it’s hard to say where to start but if you had to…where would you tell a person to start? Molybdenum? Thank for this article. Appreciate all you do.

    1. Post

      Hi Kristin –

      First place I have people start is fundaments – like the Dirty Genes Course

      Sounds like you have been doing those which is great.

      Only then do supplements actually seem to work as they should – or least a much higher chance of it.

      Supplementing too early will be frustrating, expensive and worthless.

      One supplement I recommend right out of the gate though for most people is Optimal Electrolyte. Most are deficient in all the ingredients listed and they feel much better right away.

      I would then look into why your homocysteine is low and consider adding in more protein. Using the Optimal Prenatal Protein Powder may be a wise addition because it is so comprehensive. I use it most mornings -and you can adjust the serving easily – say 1/2 scoop etc.

      These three – prenatal protein powder, electrolytes and glutathione – are pretty solid.

      The other one would be ProBiota HistaminX – but it’s not out yet – soon – very soon.

      Molybdenum is pretty solid recommendation as well – especially if intolerant to sulfur, sulfites or have gas / bloating.

  15. Dr Lynch,
    I suspect my son has low stomach acid as he doesn’t really absorb nutrients. Can apple cider vinegar help or you would recommend Betaine HCL supplement?
    Thank you very much!

    1. Post

      Hi Gal –

      Apple cider vinegar diluted with warm filtered water can be great! So can a bit of lemon juice in water as well. He needs to chew…chew…chew. Make a game out of it.

  16. Thanks Dr. Lynch,

    I’ve got great health professionals on my team using innovative and integrative methods. What I really was looking for was double checking that I’m understanding correctly. Is there a way to directly raise homocystein or is it done only as you mentioned by reducing the demand for it?

    1. Post

      You can directly raise homocysteine by the methods I mentioned in the article.
      – eat more protein
      – supplement with liposomal glutathione
      – exercise will also help

  17. Hi Dr Lynch, I’m just starting to explore my own situation so please bear with me! I’ve been feeling rubbish for a while so had standard blood tests and I was found to have low folate. I have PCOS but have had no fertility issues, I’ve had 3 healthy children. I’ve sent off samples for MTHFR testing as I’m suspicious something may be going on there. What is causing the low folate and what is the impact of this? I’m now supplementing with L-methylfolate, calcium d-glucarate, vit c, k2, fermented cod liver oil, kelp, methylcobalamin, gluthione, zinc/copper, Vit A and magnesium following the test results. I’m just trying to work out what’s going on?
    I’m suspicious Estrogen dominance is at play too? I’m a yoga teacher and my diet is along the lines of keto. I feel much better when I’m strict with this!!! Thank you 🙂

    1. Post

      Hi there – not sure beyond there is a demand for folate in your body. Needs to be evaluated. It is tough being strict with a diet – I, too, go on and off fat adapted – it’s very easy to do – just one day of poor choices and it takes a week or two to get back! 😉

  18. Thank you 🙂 yes it is tough! I wondered if the low folate was being caused by a faulty mechanism somewhere? I will keep exploring. Looking forward to getting my MTHFR results back and reading your book!!

    1. Post

      It could be – I know of someone who has to take folinic acid daily in order to keep her MCV and MCH levels down. It could be a genetic thing but it could easily be high demand – such as leaky gut, infections, inflammation

  19. Dr Lynch,
    Thanks a lot! Most of the time My son is tube fed:( i put some lemon juice in his water but i don’t see any difference. Please see my first question.

    Thanks a lot!

  20. Thank you, Dr. Lynch!!! perfect article I have been in dire need of, puts together so many pieces for me as I have peripheral neuropathy (sudden onset) with 4 range of homocysteine. It has been a very debilitating long year process (walking is a struggle) this makes a lot of since to me along with your dirty genes course. again thank you!

  21. Dear Dr Lynch,
    Please, excuse me for repeating my questuon!
    Thank you so much for your brilliant work and for sharing your knowledge with us!
    I have a 2 years old son suffering from severe genetic epilepsy. He has Homozygous MTHFR A1298C, Homozygous VDR, Homozygous GSTP1 and a heterozygous COMT.
    He has a stubborn Candida infection which so far i couldn’t eliminate with botanicals. He gets about 300 mg of Niacinamide because of other issues. We tested his homocysteine and it’s just 4.5, so low. He is on the ketogenic diet but lower ratio (2:1).
    I started giving him methylfolate 200 mcg and hydroxy B12 about 1000 mcg. I don’t see any improvement:( his gluthathione levels are fine (he gets lyposomial gluthatione and before starting him on it his levels were very low) and i supplement him with electrolytes. Am i on a good way?
    I plan giving him some medication to eliminate his Candida issue. Does it mean that because of his Candida infection and the fact that he gets Niacinamide he has reduced (blocked) methylation? Can i do anything to help him? He is non verbal so it’s not that easy to get a feedback from him. We have a holistic practitioner but i feel that he doesn’t have enough knowledge to lead us through this complicated situation…
    Thank you from the bottom of my heart!

    1. Post

      Hi Gal –

      It seems you are doing a pretty thorough job with your son – well done.

      Yes – I would consider using a medication to eliminate his candida. There is also a product called Biocidin which is pretty effective – just tastes quite badly. Candida medications are typically pretty safe – just start low and work up so the die-off doesn’t make him sick.

      I see a lot of results from treating yeast overgrowth.

      I would also consider ProBiota HistaminX when it becomes available – which is any day now. That will help restore his microbiome and reduce histamine.

      Consider a urinary organic acids test (OAT) to spot other deficiencies.

      Thiamine has been seen at times to be low in those with seizures.

      Do you know which genetics he has for his epilepsy? There are genes associated with sulfites, folate, thiamine, B6, glutamate…ammonia..

      So many things to evaluate and consider.

  22. This explains a lot. My GP said my homocysteine was perfect, 0,7! My feeling is that it’s really low. And it would explain why I felt good taking methyl B12 for a while but now I do not anymore and started to feel really weird, headaches, heart racing…I now switched to folinic acid and hydroxo B12 but so far doesnt help much either with feeling bad. Should I use other supplements? Try Sam-e? I am also COMT +/+
    Thank you dr Lynch for this article!

    1. Post

      Hi Jessica – that does seem pretty low 🙂

      This is why I always recommend pulsing supplements – starting, stopping and using only when needed vs all the time. I never take a supplement continuously – start / stop all the time.

      I’m all for lifestyle changes first prior to supplementing. I am not sure what fundamentals you’re doing / not doing. I highly recommend the Dirty Genes Course Bundle – and then proceed with the courses.

      SAMe can help to raise homocysteine – but if glutathione is low, SAMe won’t help much. Need to replenish with liposomal glutathione first. If you do want to try supplements, the key is to start with electrolytes. Most are deficient in them – I’d say everyone frankly.

  23. Also to share my doctors have done nothing with the homocysteine level (or neuropathy for that matter), said oh your homocysteine is low that’s really good with MTHFR. Here is Metanx and Gabapentin, don’t need to change your diet after specifically asking about Folic Acid.

  24. Hi Dr. Lynch

    Thank you so much for all your great work, you are amazing. A few years ago I did my genetic testing and did both your online courses (the long ones I believe you get acreditation throuh bastyr). There’s lot of questions that I had for you and one of them was with regards to low homocyteine. My test results indicated it was 5. I am also compound heterozygous for MTHFR and have slow COMT, slow MAOA, and fast CBS. I always thought that that the CBS upregulation was what was draining my homocysteine. Would that be correct? And would taking the optimal glutathione be helpful in this case?

    I have made all the lifestyle changes you recommended in your course prior to getting pregnant (through IVF due to endometriosis). Still take your optimum prenatal but can only take btwn 4-6 capsules a day, otherwise I don’t feel good. CBS i feel plays a role in that as well. Unfortunately I am unable to take most of the test you recommend as I live in Canada. In addition I am unable to find a practioner in the area familiar with all these pathways. My background is in biochemistry so I love how detailed you get into things. Really looking forward to your new book. Hopefully it could help me answer more questions. Please don’t mind my being all over the place as I have baby brain right now.

    1. Post

      Hi Alina –

      Great to hear you love biochemistry and have taken those courses!

      It’s hard to say what is draining your homocysteine – possibly a faster CBS – but why is it faster? A SNP is not the only cause. I’d say evaluate your glutathione levels if possible.

      – lipid peroxides
      – RBC fatty acids

      Or you can just supplement with liposomal glutathione along with molybdenum to help offset the increased sulfite load.

      4-6 capsules of Optimal Prenatal is plenty especially for those who are quite healthy already. Always take what makes you feel good – not what the bottle serving size is.

      With a slow MAOA and slow COMT and slow MTHFR, you’re at risk for anxiety and irritability with a higher protein intake. So consider a higher protein breakfast, some at lunch and less at dinner.

      The Optimal Prenatal Protein Powder would be perfect if you can get it – as it provides the most comprehensive amount of nutrients and bioavailable protein. You can also adjust the serving size. This morning I used about 2/3rds serving as I felt I didn’t need all those nutrients this morning.

      I’d highly consider adding in electrolytes too if you can access them.

  25. My homocysteine was 5.8. My doctor was very pleased with that number. Since the test I added in electrolytes and a multi with methyl b’s. I feel a little better, a bit more energy and clarity of thought even though my latest labs show my iron levels are in the toilet and thyroid ft3/rt3 of 10. I’ve been working for years to clean up my environment, diet, improve digestion and such but I’m obviously missing something. I’m compound hetero mthfr. I was relieved when my homocysteine levels weren’t high or really low but I’m concerned that adding the methylated multi will drop it lower.

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  26. What a fantastic article, Dr Lynch. I have shared it on my professional FB pages (including Functional Nutrition Australia). I test serum homocysteine routinely – where Medicare and/or budget allows! – and see low homocysteine, albeit less commonly than high. I have two questions. One: why don’t you recommend N-acetyl cysteine, for its ability to increase glutathione levels – why only liposomal glutathione? Two: children! I do find kids with low homocysteine more challenging, especially when they are not good at taking tablets like SAM-e, which can’t be cut or crushed. I have trialled L-methionine as a powder, crossing my fingers but compliance is poor as it tastes terrible. Even digestive support is tricky – betaine HCl tablets are huge and herbal bitters and ACV are heartily rejected. I take your point about chewing, but the early teen age group is particularly challenging as they don’t want to be told, or treated like a child. Upregulated CBS seems to make homocysteine more resistant to rising. (Can we assume that low Hcy in upregulated CBS means glutathione production will be impaired? I must admit, I had wondered whether actually fast CBS would preferentially promote the transsulfuration pathway, thereby producing adequate GSH. But I take your point that inadequate substrate -> inadequate product.) What would your key recommendations be to promote a healthier Hcy level in kids or teens at levels of 4-5, especially when they have upregulated CBS? Thanks a heap.

    1. Post

      Hi Alyssa –

      Great – thank you!

      1) NAC – I used to LOVE NAC – until I realized how DRYING it makes people – eyes (dry eyes), gut (constipation, dries out mucous membranes), nose (nosebleeds).

      Also – NAC is only one step in making glutathione. There are other steps involved too – using vitamin B6, glycine, glutamine and epigenetic controls of these genes. Mold actually inhibits a gene which has a major involvement in producing glutathione.

      So – yes – I recommend liposomal glutathione because I want to make sure people get it vs thinking they are.

      Then the cysteine that is conserved upstream will go towards taurine, sulfate and other things as needed.

      2) Kids have a naturally lower homocysteine than adults – because they are growing so fast (using more methylation) and burning up homocysteine. I give liposomal glutathione to my three boys about 3x a week – with grumbling. They don’t like it but I tell them – hey – you want to be smart, good looking, fast and healthy? Ughh – they open their mouths and take a shot. Kids tend to like the tropical flavor of our Optimal Glutathione. Personally, I like the mint flavor.

      You know you have sulfate issues in people when they smell like sulfur – gas, armpits, breath, skin. There are bacteria which produce hydrogen sulfide – and they also can tend to looser stools. If this is the case, have to limit sulfur containing foods and supplements, use molybdenum and also kill the hydrogen sulfide bacteria and replace with other bacterial strains like bifidobacter.

      I’d use more protein in kids – again – as they are growing. Many chow on carbs.

      1. Thanks very much for your reply. Yes, I imagine that would be the mucolytic effect of NAC. I will look out for this side effect more closely. I did have a patient recently where we used NAC to try to prevent the detox headache she would get when using acetaminophen by providing her with some more sulfur to make up for what she was using up, and unfortunately she had to stop the NAC after a little while as it made her gastritis worse. I’m sure it was compromising the mucus lining of the stomach. Thank you, this gives me some justification for the use of liposomal glutathione instead. Your kids are tough 🙂

  27. YI have small fiber peripheral neuropathy-etiology unknown 😐. Getting results from homocysteine levels next week. Will be interesting to see.

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  28. I’ve had homocysteine levels around 5.2 if I remember right. They were under 6 so the doctor automatically said it was good but as with cholesterol I knew that anything too low wasn’t always good. I’ve also tested significantly low for niacin, and way higher than normal b6. When I have taken methylfolate or methylcobalamin, I’ve reacted poorly feeling extremely irritable and anxious. I’m like the exact opposite of usual problems low cholesterol, low blood pressure, and low homocysteine. I’m currently pregnant and have removed alcohol and caffeine from my diet, and I’m currently taking your optimal prenatal.

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  29. Thank you Dr Lynch, great article and replies.

    Could MSM also help to raise/support bioavailable sulfur levels while improving digestion of protein/addressing gut issues?

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  30. I was treating pyroluria for about three years and then something shifted. Checked my homocysteine levels and it was down to 3. I stopped taking supplements and tested for pyroluria. I didn’t have pyroluria anymore. Thankfully my homocysteine went back up to a normal range.

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  31. My homocysteine levels last year (while pregnant) were 3.1. I was taking a prenatal from NeuroBiologix with methyl folate and wonder if that lowered them? I do know they made me extremely anxious and I developed a painful, visible lump in my armpit that stayed for over a month. When I tried a glutathione cream on my feet by the same company, my feet were on fire and I was up til 3 or 4 AM with my mind racing. What in the world?? I was told to use it on our special needs child, but after that, I was concerned, esp. since they have no way of telling me if it makes them feel that crazy.

    After delivery, I scanned for sulfur, so started taking a supplement and felt MUCH better. Nails got stronger and my hands looked human again (eczema). I tried the prenatal again as well and guess what, another lump under my arm. I stopped within a week this time and it disappeared quickly.

    Maybe I should have it checked again sometime to see if it’s still low… I couldn’t find any info last year about low levels and any concerns. Thank you!

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  32. Thanks for sharing. I am compound heterozygous and my hymociestine is only 4.2 i am overwhelmed with health, gut and fatigue issues that started after miscarriages (I’ve had 4 in a row) and had no idea they could be associated with these levels. Working on folate levels, mythelation cycle, thyroid, iron and vitamin D. Also suspected liver issues (low ceruolplasmin). The list goes on. I will continue trial and error with your products! Thank you for publishing your knowledge!

    1. Post

      Hi Megan –

      Sorry about your recurrent miscarriages. Let’s get you feeling optimal again!

      Vacation? Can you just walk away for a bit – say a week or two? Seriously – vacation. Beach. Nice weather. Great people, food, nature…

      This article is great on prenatal supplementation and MTHFR. It has helped many women with recurrent miscarriages – many many. I wish I kept a running list.

  33. Dear Dr Lynch,

    Thank you so much for replying! We run regular OAT and supplement as needed. There we discovered his Candida overgrowth, very high oxalates, very low glutathione levels, very low serotonine, high ammonia, other nutritional deficiencies,etc… and we started targeted supplimentation. Since then the “only” issues left are high Arabinose level (Candida) and high oxalates. I know about Biocidin but it contains grapefruit seed extract which can excarbate seizures:( and can intetfere with AEDs…we have tried Candex, Allimax, Caprilic acid, probiotics, etc with no effect. He is on low oxalate diet too. I guess our final choice will be medication. Do you recommend Nystatin or Difulcan please?
    Do you think that the Candida issue could be the blockage of seeing good results with all other supplements especially with the addition of methyl folate and hydroxy b12?

    I saw your comments for kids having notmally lower homocysteine than adults. Is 4.5 mmol/l a good value or is it low?

    He has a deletion of 28 genes in total but the ones related to his refractory epilepsy are SCN1A, SCN2A and possibly SCN3a. Do you have any idea if they are related to other issues?

    Thank you so much!

    1. Post

      I cannot recommend medications. I do believe candida to be significant if he actually has an overgrowth. Organic acid testing for yeast overgrowth is not the best way to detect – a stool test is. I question the yeast markers in OAT testing.

      Homocysteine of 4.5 in a child seems pretty good to me.

      Not sure about SCN1,2,3 genes. I haven’t looked into them.

  34. Dr. Lynch, my homocysteine was 5.8 last year. I haven’t had it checked recently because I thought that was normal but will ask for the labs again. At the time, I was having a lot of problems from too much B6 in my blood serum and lowish SpectraCell B6, and low glutathione- yet P-5-P flared up my symptoms. I just cannot take anything with B6 in it, so now I get my B6 from high B6 foods. I used what you had said a while ago about clearing SUOX with B1 and molybdenum (I already have highish selenium) and taking N-A-C to raise glutathione. I did this because I suspected that a possible issue with SUOX might have been slowing down my CBS- hence the low glutathione and build up of B6. (I was also having symptoms of B1 deficiency at the time even though I had normal serum and SpectraCell B1). I tried this approach, and bingo! My serum B6 went down, my functional SpectraCell B6 went up, and my glutathione went up (although that and my cysteine are still borderline low), and my nystagmus, POTS symptoms, and peripheral neuropathy improved. I know this is off topic but might be somehow related, but although my neuro symptoms are better, I’m still fatigued- I think due in part to my SpectraCell B12 being low despite taking plenty of good sublingual methyl B12. My SpectraCell folate level is really good. Are cyanocobalamin injections ever okay, as they are the only thing that has raised my B12 levels in the past, and I’m afraid that methyl B12 injections might be too strong. Note: I have a connective tissue disorder (Ehlers-Danlos syndrome), which I’m pretty sure increases my oxidative stress and need for antioxidants. Another side note: I need carbs, B5, and magnesium before bed to sleep through the night, probably because the constant physical stress from the EDS steals away my B5 and magnesium.

  35. I am so grateful for your work! I have had low homocysteine, low inflammation and low liver enzymes for quite a long time and my doc has never been concerned, even though I have had significant health challenges. After having my genetics done, MTHFR C677t and MTHFR A1298C, as well as CBS, BHMT, CYP2D6 and others are present. I am enjoying learning about all this so much. It has helped me greatly understand the multiple organ failures that I have had over the years, as well as other health issues. Thank you for your tireless work. I, for one, am truly grateful. I honestly cannot understand how any practitioner would not utilize genetic information when designing healing plans for their patients. Genetics has confirmed the fact that there is no such thing as an optimal broad blanket protocol (or supplement) for such unique individuals.

  36. This information is very consistent and important for the Down syndrome population. My 7 year old grandson reacts strongly negatively to methyl donors particularly folate, has a 1298c variation, low homocysteine, and practically non-existent glutathione. He sleeps poorly, is so tiny he needs human growth hormone, but eats like a 250 pound adult. He is frequently agitated (lack of restorative sleep?) . Doctors are working on zinc/copper balance but not homocysteine. What are your recommendations?

  37. Yes. My homocysteine is low at 4.7. My dad passed at 67 from a first time heart attack. I got very concerned and looked at his health record. I knew he was type 2 diabetic. But I didn’t know he had been anemic the month before he died. He had also been on thyroid medication for a while but my mom doesn’t know why. My sons and I are both MTHFR, anemic, struggle with vitamin D, and have hashimotos. I measured my homocysteine thinking at least I got that under control at 4.7. But reading this looks like I have more work to do. I’m taking 5MTHF daily and getting by B12 shots quarterly. I just started liposomal glutathione.

  38. Hi Dr Lynch.
    I’m enjoying your Dirty Genes course and videos. This post has struck a chord with me. My husband started with peripheral neuropathy in his feet. He isn’t diabetic. The cause seems to be a mystery to his doctors. After a few years of this he developed a tremor in his hand. They diagnosed him with Parkinson’s. I always felt it was connected in some way to the neuropathy but his neurologist dismissed my suggestion in a condescending way. “Stay off of the Internet”. I’ve been researching more ever since. There was no treatment effective for his foot pain and the Parkinson’s treatment is just not improving his tremor and general condition. I have been trying to clean up our diet and air and water with very little results. I’m not even sure if a homocysteine level was ever done on him. This is so frustrating when you have nuggets of information and no doctor who will help you explore it.
    So do you think low homocysteine could be his problem and could this treat and or reverse his symptoms?

    1. Post

      Hi Susan –

      The low homocysteine is not causal for neuropathy – it’s a result.

      Homocysteine may be low because there is a higher need for glutathione production – to help offset the oxidative stress he may have.

      Supporting with liposomal glutathione, ensuring sufficient protein but not excessive, deep sleep (measure it using OURA ring) and limiting carbohydrates (refined ones) are great starts.

  39. Hi Dr Lynch. This is a very interesting article for me as my homocysteine level is somewhere between 0 and 4. I believe this is because of 5 years of supplementing with sublingual methylcobalamin most days, and eating foods containing a good amount of the other b vitamins. I have been unwell for over 18 months now (mainly daily headaches and fatigue) following some toxin exposure (mercury and concentrated diesel emissions), and given my homocysteine result, I suspect it is the effects of a SAMe and glutathione deficiency that I am feeling (though liposomal glutathione hasn’t helped). My question is, given that I eat plenty of protein (80-100g daily), don’t seem to have digestive problems (I’ve tried betaine hcl and apple cider vinegar), exercise a good amount and don’t have stresses or known ongoing toxin problems, where would the methionine I eat daily be going other than being turned into SAMe/ glutathione which I appear to be needing? And how can someone really be deficient in SAMe/ glutathione when they eat their building blocks and have methylation working well? Shouldn’t I have rapid daily doses of SAMe/ glutathione when I eat methionine?

    1. Post

      Hi Chris –

      Producing SAMe from methionine is not simple. Your body could be diverting it down a pathway called dcSAM. This is commonly occurring during chronic infections or autoimmunity. You could consider the combination of SAMe and liposomal glutathione. I am not sure which company you are using to supplement but these two nutrients require specific packaging and preparation or they are worthless. I highly recommend you consider Seeking Health as we put care into how we source and package our SAMe and our liposomal glutathione has won an award for best antioxidant at a major supplement conference. Not easy making effective supplementation – you could have been using ‘duds’.

      Perhaps you are exercising too hard? Maybe reduce a bit – need to evaluate your training and sleep / rest / recovery.

  40. Dr. Ben,

    Appreciate you making finally a post about low homocysteine. My blood test results just came out, and it is at 3.4 umol/L. I am based in Australia, just as a reference because I don’t know if it is different measurement in the US.

    I have been supplementing with SAM-e for maybe 3-4 years now. I take magnesium supplements, experiment on different vit B (Thorne brand).

    I have heterozygous C677T. Hubby is homozygous A1298C. Prior to seeing a naturopath, our homocysteine levels hover around 5-6. Stopped seeing the naturopath as, homocysteine kept going lower. And, we did not achieve what we want, which is a pregnancy.

    Any assistance would be appreciated. Thanks.

    1. Post

      Hi Jeanne –

      That is the same units as in USA. That is quite low and likely contributing to your pregnancy difficulties.

      I would highly consider:
      – liposomal glutathione
      – Optimal Prenatal Protein Powder – this is the best formulation out there by far and provides additional protein which you absolutely need. Plus it has additional carnitine, carnosine, taurine, choline – which are never found in other prenatals.

      Watch the video and read the article in full – prenatal supplementation and MTHFR – – pls do also consider the must consider supplements. I know they seem like a lot but you definitely need them during this time.

      Your husband needs to take the exact same things as you – seriously.

      – liposomal glutathione
      – prenatal protein powder
      – fish oil
      – liposomal vitamin c
      – probiota histaminX
      – optimal iron plus cofactors

      those are the key ones

      I take the prenatal protein powder nearly every morning – it’s been my breakfast smoothie base for over 3 years now.

      Let’s get you both super healthy and proud parents!

      1. Thank you for your response Dr Ben. Sadly our dreams of becoming parents are over. I am over 40 now and, having gone through multiple miscarriages and IVF, hubby and I needed to put that behind us. 🙁

        Now, the aim is to become healthy again. Apologies if I had not made it clear earlier. It is still a difficult topic to share.

        What modifications would we need for the supplements you indicated, plus how long for?

        Thank you.

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          Hi Jeanne –

          I hear you. Let’s get you healthy 😉

          Regarding supplements – based on the limited information you shared with me, I’d say you could likely benefit from those but I would rather you start at the foundations and work this way and forward.

          The Dirty Genes Course Bundle is where you should start – it sets you up for long term success.

          Start there and then you’ll have more insight to know what to do next. 😉

          1. Hi Dr Ben,

            I’ve already purchased the bundle 🙂
            I think the book is due around early next year? I have not logged on to any of the courses tho.

            Thank you for taking the time out to respond.


  41. Hi Dr Lynch
    You mention that low homocystein in children is ok. Wondering if 3.4 & 3.7 is too low for my 8 & 11 year olds? Thanking you.

    1. Post

      I’m still learning about this range for kids – just make sure they are eating enough protein and support with liposomal glutathione as well. We lose a lot of homocysteine to glutathione production.

  42. Hi, Dr. Lynch,
    My Dr. had me test my sulfates and sulfites on test strips. I also tested my two boys. We were all in the very high range for both. (they were hard to read but near the top of the measured range) I am borderline low homocysteine, I believe it was about 5. My SAMe level was fine. My biggest problem is sleep. I have added Moly-b and liposomal glutathione. I eat plenty of protein, fat, and mostly low carb diet. Other than the Moly-b glutathione, and diet, is there anything else I should do to decrease the sulfites and sulfates?

    Even if you don’t get to reply, I am so thankful for all of the information you have made available!

    1. Post

      Hi Karen –

      I am not a fan of testing urinary sulfate. This is natural by the body to eliminate. If sulfites were high – than that is an issue. Which strips are you using? Please provide a link.

      Boys will have a lower homocysteine such as 5 – that is pretty normal for kids.

      Sleep has many factors – can be slow COMT, slow MAOA or fast MAOA or a dirty DAO or MTHFR. Depends. I’d reduce your protein in the evening a bit and add in some healthy carbohydrate.

      Many do well with Optimal Sleep – I typically just use 1 capsule most evenings or I will also use SAMe at times also if I am wired. It helps me calm down.

      Have you ordered the Dirty Genes Course Bundle? That may help you a lot with your sleep.

      Supplements are useful – but they will not address the underlying problem if the fundamentals are not in check.

      This article on sleep and melatonin is also useful.

      For the sulfites, be careful with liposomal glutathione as it can increase sulfites and sulfate. Be sure to use a liposomal glutathione with molybdenum built into it like Optimal Liposomal Glutathione Plus.

      To reduce sulfate, one would need to evaluate how much protein is being consumed and how much sulfur-containing veggies and foods and supplements.

      1. Sulfite and sulfate strips…..from Amazon
        SEOH Indicator to Detect Sulfite Quantofix 100 Analytical Strips
        SEOH Indicator to Detect Sulfate Quantofix 100 Analytical Strips

        I’m a little afraid of the Optimal Sleep, it is similar to a glutamate scavenger my doctor had me try. It ZAPED my desire to do anything. (you responded to my comment on miscarriages and birth defects…Niacin) But I will, and pulse.

        Melatonin only works for 4-5 hours. I will read that artilce

        Drinking my electrolytes now….. delicious!

        yes… Glutathione with moly-b. learned that the hard way at my sons expense. Had horrible detox reaction! Nasty rash. Pulsing 1every 4 days now

        I have purchased the bundle. Love it!! It has really helped me step back to take a look at all of the things that are in my control. And make good choices because I can CHOOSE to make the time to exercise and take care of myself. Ordered the book Essentialists too.

        You rock! Thank you.

  43. Hi Dr. Lynch, I am writing to you from Germany, glad that I found your site! Since three years my daughter (now 19) deals with heath issue problems, skin, fatigue, hormones, organ problems (lung, stomach, heard, head, muscels and joints etc.), her lab tests showed elevatated ANA (1:640) and low Leucocytes. We discovered by hazard that Sulforaphane immediadly stops her symptoms and the Lab results after six weeks taking it, came out without any ANA!
    From that point I started a lot of research on PubMed and the internet. I assumed that her detoxification system and her methylation doesn’t work well enough. I remembered that without Sulforaphane her homocysteine was below 4! We checked again and with sulforaphane she got 5 – still low, but higher than without. It makes sense to me as the S. helps with methylation and detoxification of phase II.

    The question, I still don’t understand, is: what might be the reason(s) for the low homocysteine? It may be due to high oxidative stress and a high need for gluthatione. What other reasons could be and how can we find that out? What kind of tests would you recommend (gluthation? what else?) We don’t find a physician who knows about these things – we looked and tried in whole Germany. I hope to get an answer with some ideas from you as you got so much expertise in this field.
    Should we try to give s-gluthation and SAMe (Methionin itself made heard problems to her after taking it for a week)?

    Btw: by starting with Sulforaphane her usually high levels of Selenium and Molybdaen fell down and her long term deficites in Phosphat came up to a normal level, that was interesting for me to. It seems that the Sulforaphane made the detoxification work (so selenium was able to be used) and the molybdaen also maybe for the sulfur breakdown of the sulforaphne itself. Why the low phosphat came up – no idea.

    Sorry for my long text and my mistakes in the English language! Thank you for your ideas on our problem! Bea

    1. Post

      Bea –

      You are sharp 😉 Well done. Love your thinking – you’re right on.

      Regarding other causes of low homocysteine – they are mentioned in the article. Please refer back to it.

      I do not like using SAMe in people if they are not responding well to it.

      It seems she needs more antioxidant support – so I’d actually consider Optimal Liposomal Glutathione

      We also have a liposomal glutathione with added cofactors of molybdenum, selenium, PQQ and riboflavin – but she seems already high in those so I wouldn’t use this.

      I’d also consider PQQ as it is a potent antioxidant. Use only 1/4 lozenge to start with as it is potent.

      The low phosphate coming up – that is interesting.

      Perhaps vitamin D was working better and was able to increase her phosphate? Did you supplement her with more vitamin D?

      I just took a moment to look into this and appears I may be right:
      “In vivo, cysteine supplementation increased glutathione and protein and mRNA expression of vitamin D binding protein and vitamin D 25-hydroxylase (CYP2R1) in the liver, and simultaneously resulted in elevated blood levels of cysteine and glutathione, as well as increases in VDBP and 25(OH) vitamin D levels, and decreased inflammatory biomarkers in ZDF rats compared with those in placebo-supplemented ZDF rats consuming a similar diet.”

      If this happens – then by giving glutathione, you are increasing vitamin D transport, binding and levels which then increase phosphate levels.

      Plus – indirectly:
      ‘The present study demonstrates that VDR inactivation has a
      negative effect on sulfate status; sulfate wasting as a result of
      increased sulfate excretion leads to sulfate deficiency. Given
      the roles that sulfate plays, the physiological impact of sulfate
      deficiency can be multiple. Here we showed that VDR defi-
      ciency causes a dramatic reduction in sulfated proteoglycan
      synthesis in the skeleton and a moderate decrease in hepatic
      glutathione levels. The former may represent a direct effect of
      a decreased inorganic sulfate pool, inasmuch as decreased
      availability of sulfate may affect intracellular sulfation of
      cellular components such as proteoglycans. It has been reported
      that proteoglycan sulfation in articular cartilage is dependent
      on the inorganic sulfate concentration in the media
      (42). The latter finding suggests that chronic sulfate wasting
      may ultimately cause a reduction in the organic sulfate pool,
      because methionine and cysteine can be metabolized to glutathione,
      taurine, or inorganic sulfate (21). Glutathione is an
      antioxidant critically involved in cellular detoxification and
      reduction-oxidation processes (11, 34), and the consequence of
      its diminution remains to be determined.’

      ‘A hallmark of vitamin D deficiency is the development of
      rickets and osteomalacia. A typical characteristic of rachitic
      bones is disorganization and expansion of the chondrocyte
      columns in the growth plate and accumulation of unmineralized
      bones. These phenotypes are commonly attributed to
      abnormal calcium and phosphate metabolism caused by impaired
      vitamin D function (2). Because sulfation is essential for
      the formation and biological properties of proteoglycans, the
      major extracellular component of cartilage, it was argued that
      abnormal sulfate metabolism in vitamin D-deficient animals
      may contribute to development of rickets and osteomalacia
      (14). However, our observation that serum sulfate and skeletal
      proteoglycan levels in normocalcemic VDR/ mice remained
      reduced, even in the absence of rickets and osteomalacia,
      argues against the above notion. That is, the role of sulfate in
      the development of rickets and osteomalacia is minimal, if any.
      Certainly, this does not exclude the possibility that the reduction
      in sulfated proteoglycans may contribute to other, more
      subtle, bone abnormalities. Further investigations are needed to
      elucidate the exact role of sulfate in bone growth and remodeling.’


  44. My combination of A1298C and C677T reduces my MTHFR activity 53%. I am also homozygous for a mutation in the enzyme that precedes MTHFR called MTHFD1 that reduces its activity by 34%. Theoretically, these add together to lead to an 87% reduction in methylfolate production.

    I’ve been told this might be one of the worst possible combinations for methylfolate production. I did start taking methylfolate last month where my homocysteine was 8. Had it recently tested last week at it’s at 6.6.

    My main problem is insomnia so getting a good night’s sleep is difficult and I assume cranks up my need for glutathione? However, a serum amino acids analysis came back abnormal–high ornithine, high aspartate, and borderline low arginine (could be consistent with decreased ammonia disposal) and high leucine and isoleucine could reflect an impairment in branched chain amino acid metabolism that could cause an impairment in ammonia disposal. I’m waiting on the ammonia lab.

    Could glutathione provide me any help in the sleep arena?

    1. Post

      Hi Laura –

      MAY.. May reduce – not does.

      It is not the worst combination – and statements like that are not supportive. They are scary and do no good.

      Nonsense I say.

      Glutathione could help yes – as liposomal form. And so could SAMe. I’d also reduce down on the methylfolate.

  45. Hi Dr. Lynch,
    I’m also writing from Germany. I got tested by my OBgyn after 3 miscarriages. My homocysteine was 13 and then they tested for MTHFR. I’m homozygous c677t, and also have low COMT variants.
    Unfortunately the recommendation from the geneticists was to take 5mg Folic Acid and from the hematologist to take just 150 picograms Folic acid.
    I didn’t follow their adviced and started with 400 mcg Methylfolate, active B6, B2, B12 and TMG. I have been doing terrible tolerating the Methyl forms, I didn’t do well either with TMG, Glutathione and Choline. All give me terrible headaches and tiredness. Even just 1-2 pills of the Optimal prenatal daily is too much.
    I’ve tried and keep trying everything possible to tolerate it.
    I got pregnant again and my homocysteine was 5,4, reduced mostly with Folinic Acid, Hydroxy B12, B6, B2 and eating plenty of beets. But I miscarriaged again.

    Is it possible to reduce the homocysteine so much within Methylfolate?

    If so, should I completely avoid B9?

    I’m also worried that just taking Folinic alone is not enough for a pregnancy being homo c677t.

    Thank you!

    1. Post

      Hi Sonja –

      If you are eating leafy green vegetables, salads and your homocysteine levels are down, then you may be doing ok with folinic acid.

      However, since you miscarried again, it does seem to be insufficient.

      I’m sorry you are struggling with this.

      Are you taking electrolytes?

      Having MTHFR and slow COMT is a tricky combination and methylfolate/choline will push more neurotransmitter formation – and thus excitation – leading to headaches.

      Please read this on reducing methylfolate side effects.

      I’d seriously consider the electrolytes and the other steps I discuss in that article.

      Then try the Optimal Prenatal Protein Powder – in a smoothie with frozen berries, milk of your choice (almond, goat, etc).

      Yes, you can really lower homocysteine levels with too much methylfolate and B6.

      I’d also consider liposomal glutathione – as discussed in the article.

  46. Hello from Canada 🙂

    What is the range one should shoot for then? Of course not feasible to keep taking blood tests, for homocysteine levels but to base off the efficacy of supplementation with the symptoms going away/new ones coming up…

    I haven’t tried a methylated form of anything before, but will be taking it once it comes in (ordering from pure encapsulations)…also will be going to my doctor and hopefully he agrees to run a test just to see where I’m at…

    The reason I’m commenting is that I’ve been starting to detox/got rid of my candida overgrowth (using timed release oregano capsules from ADP (that’s the brand) and trying to support methylation by getting my leafy greens in (uncooked) and taking phosphatidylcholine….but this is what’s happening:

    My hormonal acne actually went away! I didn’t breakout at the usual time in my menstrual cycle (used homeopathics to help get rid of estrogen and of course the candida cleanse helped as well) however, the cystic acne is still there….and the brain fog, that’s a big big big issue with me.
    Over the past 5-7 years I feel like I’ve just been getting stupid, feel like my brain isn’t as sharp as it used to be. Since my health journey and discovering my mutations, I’m trying to fix things (i.e. candida cleanse, soon a parasite cleanse – confirmed I have them) but the brain function is getting worse and really freaking me out….
    I’m having weird neuro symptoms as in messing up spelling (never happened before) and memory issues….
    to revisit brain fog, its more associated with SOD2 I’m finding through research which I’m homozygous for…I know supporting the mitochondria is crucial here as that mutation is related to ALS which really freaks me out…and brain fog is a big sign of oxidative stress…yes I know not to treat the SNP – obviously! in this regard I’m paying attention to the symptom, so the brain fog and decreasing cognition….
    also, I’m using as clean natural health products as possible to avoid xenoestrogens etc, eating organic and grass fed meat when I can, using DIY washing machine ‘detergent’ etc so I don’t think that’s an issue…but here are the allergies that seem to be popping up:
    ASA and caffeine will give me an ulcer caffeine makes me jittery and I can feel my heart racing/beating harder
    right shoulder pain (I know this is associated with gallbladder and liver issues)
    persistent cystic acne that I thought would go away with candida cleanse

    And I think I’ll stop there because I’m pretty sure I’m leaving the longest comment on here….feeling lost and a bit scared and honestly can’t wait to get your book in the new year I feel like I really need help, want to learn and use my new nutrition education to help people….but I’m reaching out to you because I need to help/heal myself before I can move on to others

    Best Wishes,

  47. Hi there , I have been having strange problems lately .. feeling as if I will pass out randomly .. numbness in my nose, hands and feet that comes and goes . My homocysteine levels were at 3 in 2013 after I thought I experienced a mini stroke , the Dr. Just told me “well this is something that may affect you or you could live a long healthy life with ” whatever that means !!! So now I am wondering if these new strange symptoms have to do with low levels .

  48. Hi Dr.,

    I am 4 weeks pregnant. (i know so early) I did some testing and I have a copy of C677t mthfr. My homocysteine was 3.5. My dr said it was great but looks like its not so much. My vitamin B levels she said were way too high at 1889 and to stop taking my methyl b 12. Should I? Vitamin D she said was way too low at 22 so I am going to start taking 3000 iu of vitamin D. Does that sound optimal? My prenatal has 800 mcg of methyl folate. Let me know how this all sounds please. I want to ensure I have a healthy pregnancy and baby and my dr doesnt seem to know much about this kinda stuff…

    1. Post

      Hi Aubrey –

      You’re correct that your homocysteine is too low. High vitamin B levels can be for many reasons. I suspect you may have low glutathione levels. It is not proven to be safe during pregnancy but if my wife had a low glutathione level, I would recommend she take liposomal glutathione – 1/4 teaspoon upon waking in the morning.

      Vitamin D – I think 3,000 iu is too low. I’d consider 6,000 units.

      Pregnancy requires more than just l-methylfolate. The focus is on folate during pregnancy but it is wholly inaccurate.

      I highly highly recommend you switch to Optimal Prenatal Protein Powder and make morning smoothies with it. You can also use the Optimal Prenatal capsules as well but the powder is the most comprehensive and easiest to take. It also provides additional protein which is much needed for those with low homocysteine and pregnancy.

      I’d also add in ProBiota HistaminX as high histamine levels are associated with pre-term infants and pregnancy complications. Consider 1 capsule after dinner.

      If you are nervous about the liposomal glutathione, then use the Optimal Liposomal Vitamin C at 1 teaspoon a day with breakfast.

      Also make sure you are taking fish oil and sleeping well 😉

      Have a fantastic pregnancy!

  49. Hello Dr. Lynch,
    I’m compound hetero MTHFR. My homocysteine is 5.4, has been that exact same number over two measures 6 months apart. I started seeing a functional medicine doctor 7 months ago after having a miscarriage (went on to have a 2nd miscarriage). I would like to try to conceive again & wondering if my homocysteine is too low. I’ve been taking 2.4-4 mg of methylfolate a day. Is that too much? I handle them very well. No symptoms of being unwell, but functional med doctor did discover mild hypothyroid & possible hashimotos as I do have some antibodies. I’m on NDT now. We are now trying to figure out why my oxidative stress is high. Suspect some sort of underlying infection. We are at the point where we need to TTC soon or give up on the dream.

    1. Post

      Hi Breanna –

      I think that is a lot of methylfolate. Many people – docs included – think that pregnancy has to do with folate only. It’s not.

      Please read this article fully – and share with your doctor – about NADH/NAD ratio and pregnancy

      This article is also useful about folic acid and pregnancy.

      I really dive deep here and give you a lot of information regarding prenatal supplementation.

      I highly encourage you to switch to Optimal Prenatal Protein Powder along with other supportive nutrients like Optimal Liposomal Vitamin C, Optimal Iron Plus Cofactors (if needed), fish oil, vitamin D and also ProBiota HistaminX. Optimal Liposomal Glutathione is also needed prior to pregnancy. These nutrients will greatly support your oxidative stress. I do agree looking for infections is important – but so is environmental causes (air, food, water, shelter).

      The Dirty Genes Course will give you deeper insights as well.

      I’ve helped many women nutritionally and with lifestyle recommendations – and they’ve carried to term and have healthy babies 😉 – dedicate some time to read and watch these videos.

  50. Hello Dr. Lynch,

    My son has just turned 2 and has dysbiosis/SIBO, hypothyroidism, poor appetite, failure to thrive, and is on a severely restricted diet due to his many non-ige mediated food allergies. We’re really struggling to find a doctor with experience treating these issues in a child his age. Would you consider his homocysteine, at 3.6, to be low, given his age?

    Thank you

    1. Post

      Hi Lucinda –

      Given his age, I’d consider that level to be decent.

      I’d look at consulting with Barry Smeltzer, Eric Potter, MD or David Berger, MD.

      These are great practitioners who understand my work very well and think outside the box.

  51. Hello Dr. Lynch,

    My son (3 year old) had a test result of homocysteine of 3.7. His doctor prescribed him MB12 injections every 3 days to improve his methylation.

    One concern has been that a recent test of the homocysteine showed a value of <1 (is this equivalent to undetectable?)

    What does this imply from your perspective? Thank you

  52. Hi Dr. Lynch, I have heard you on so many podcasts and love reading your website. It has definitaly enlightened me and this article really was mind blowing. My dr. said nothing and probably had literally no idea AND he is a respected integrative dr in his 60s who continues to learn constantly. of course no one can know it all. I appreciate your work he often downplays Mthfr snps and I don’t appreciate that. I was born with spina bifida and tethered cord syndrome, and also have chronic lymphedema, fibromyalgia very severely, biomechanical birth defects feet worst, severe chronic fatigue syndrome, hypothyroidism, childhood obesity (i had a nutrition snps test done this summer and I had nearly ALL the current identified snps that code for childhood and adult obesity, my score was 8.5 out of 10 for obesity,,,which I am and am always craving and always hungry, and cannot really exercise at all. I also have a terribly difficult time losing weight unless I go completely to one monofood, ie. cucumbers, white rice, grapefruit. Not exaggerating. Need to lose over 70 lbs. I have homozygous MTHFR a1298c and homozygous COMT gg rs4680. I also have heterozygous ag of BDNF rs6265. Prior I have had very difficult time with B vits. This july I discovered Thorne’s methylgaurd plus and finally can take one. I did experience a much better outcome the first week, than I do now. I am on hydroxycobalamin injections .8ml every other day. I have very low levels of ALL nuerotransmitters and have been trying to do the CHK nutrition amino acids, but every time i bump up the mucuna I throw up and am so nauseous I cannot function. I tried and tried the cysreplete and it felt like the l cysteine was eating my throat away, and increased the nausea. I have felt the mucuna very much aid my dopamine but was so miserable I had to remove the l cysteine and go back to low dose NAC and decrease the mucuna. I increased the neuroreplete. I have felt my cravings and binge eating get worse since lowering the mucuna dose, and slightly less energy and happiness. I don’t understand this very well, dr says need to keep balacncing but I told him I just couldn’t keep increasing anymore I was too miserable. And i really really wanted to get high high doses. I have had depression since I was a little girl. with periods of severe severe depression. I also have been trying vyvanse for binge eating disorder, and it has helped very little compared to when I took adderall. This article has me wondering if you could provide me any insight, I just had the boston heart panel done and found out my homocysteine level is 5.9. I have a great deal of inflammation and take TONS of supplements to try to reduce my pain without taking narcotics. I thought this was why it was low. but now I am not so sure. 12/22 I had a nerve conduction and EMG on my arms and legs and it was found I have carpal tunnel on my right arm, and widespread polyneuropathy. ( i must add that since I was 21 I have been on and off vegetarian and am currently 33. I have only added some fish and meat recently. though I much prefer fatty fish like mackeral and red meat to chicken which is what i have been eating. ) Could this neuropathy be due to my homocysteine, birth defects, mutations, and/or diet? Are there any other actions I can be taking, I try a lot of things and always want to get better. my diet is a severe downfall, especially sugar and desserts. I eat mostly organic though and no gluten/dairy/tree nuts (allergy)/shellfish. Any help is much appreciated.

  53. I also forgot to mention I have high arsenic levels, over the upper limit, and very very very high levels of uranium due to uranium in my groundwater, meaning so far off the charts it would probably be like the 200% or soemthing. I understand how these affect my mitochondria as I have been researching them, and that not a lot can detox very much of the uranium, dr confirms.

    1. I am currently taking fisetin, quercetin and bromelian, and vitamin c that contains rutin, green tea extract, and the neuroreplete contains tyrosine, and occasionally chocolate and resveratrol to lower COMT levels. but I don’t fully understand how to balance COMT and MAO, it is over my head.

      1. Post
  54. Dr. Lynch,
    Thank you and bless you for helping and providing all this on such a little known area! I could not find much when i got my result back of my homocystiene of 4.2 I am 32 yo female, I have tried so many things and so many of them do not work, I got so sick and anxious from SAMe, and b vitamins in their bioavailable form make me VERY angry and irritated, stressed to the max. i am starting to lose hope because I just dont understand, I hear one thing then I get hopeful, but then it doesn’t work not only do they not work, it makes things harder, then I miss work etc because I will be so panicy and cannot sleep. Currently on .25 clonazpam twice per day, lunesta 2 mg at night along with 15 mg benedryl and two does of 5htp, i was put on remeron for sleep and weight gain as i am underweight, and had to stop it, it was making things worse too, now they think something with comt and want me to try lamictal, but i am so worried that it will make my life worse again! I also had low cortisol (adrenal something) if you cant make sense of this that is okay! nobody else can either! But i figured it was worth a shot! Thanks again so much for all the great work you do!

  55. I have the C677t mutation homozygous. My homocysteine is 5. Doctor wanted to make sure it was not elevated but didn’t say anything about it being low. I have brain fog, mental fatigue, exercise intolerance where it makes me feel a lot worse, depression and anxiety. Poor memory and focus. Hyper-reflexes and skin sensitivity. The only labs that have come back positive are b12 off the charts, d-lactate off the chart, cortisol low, vitamin d low, and thyroid antibodies. Have elevated LFTs at times and gallbladder pain at times. I’m reading and trying to watch your videos because I am trying to figure out what the heck is going on!!!!! Got a lot worse after pregnancy.

  56. Hi Dr Lynch,

    My pre-verbal ASD son 6 years old is positive for C677t heterozygous. His recent Homocysteine results are 4.7. He is also low in glutathione. Results were 433 um. Currently he is taking NAC, Leucovorin Calcium, and B12 injections every 3 days. He seems to be a non-responder to anything we try. I’d appreciate any recommendations. I was recently told he may never be independent. He has so much knowledge there has to be a way to recover him.

    Thanks in advance!!

  57. Hi DOCTOR!I’ve been doing myers coctail IVs with B12 and mthfr in it, because i have hetherosigous mutation mthfr. After one months I went to ER with symptoms of my heart was beating too slow and i felt breathless. ER found nothing. I suspected it might be because of b vitamins and stopped them.
    Resently I started again IM injections of b 12, mthfr,and other Bs, after 2 weeks,I had the same symptoms with heart! Cardiologist found nothing! Yesterday came my bloodwork and i have B12 over 2000 ,very very high, max.is 1000,
    And homocysteine is 4!
    Should I do glutathione IV? To get rid of B12 faster? I also developed stomach ulcer recently, and probably oral form of glutathione will not help me. I also suspect an ulcer is a result of too much b12, because I already treated h-pylory and my stomach is still hearting.
    Please advise.
    Thank you!

  58. Hi Dr Lynch, thanks for this information, I have recently had homocysteine result of 3.7 , coagulation screen all normal and fbc all normal, I am 24 weeks pregnant, my obstetric consultant was concerned I may be at risk of clotting and homocystinuria due to family history and homozygous A1298C and one of the CBS which increases homocysteine, she wanted me to have clexane (enoxoparin) from week 28 as a precaution, I was not keen and requested the blood tests first to assess if there really was a need .
    I have been following an Autoimmune protocol diet for quite some time so plenty of meat, fish, fruit and vegetables; I have been supplementing with methylated B complex along with a good quality methylated prenatal, fish oil, pycnogenol nattokinase, betaine pepsin, and 5mthf.
    I have been supplementing for over a year and increased gradually, along with improving lifestyle, I have had massive improvements, having been diagnosed with M.E. (chronic fatigue syndrome) back in 2010 and being bed bound for over two years, I now feel I am functioning at a good 85-90% of my originalcapacity. I sleep plenty, I am happier, fitter and exercise and meditate regularly and had no issues conceiving, all tests have been fine, all scans good. The only issue I have is rosacea and a low grade recurrent eye infection, which has flared with pregnancy and a bit of sciatica which the Chiropractor is helping.
    I am considering reducing the extra 5mthf to improve my homocysteine levels, any other advice you may have on this would be greatly appreciated.

    P.S. I have recently purchased your Dirty genes book and look forward to learning more.

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