57 replies to this topic

[ta5]

Homocysteine blood tests:

• 2013: 10.7 umol/L
• 2014: 9.4 umol/L
• 2015: 10.4 umol/L

I'm within the reference range [0-15 umol/L], so I don't suspect any disease, but experts recommend less than 8, preferably 6 or less. I've been trying to get it lower, and obviously it's not working.

 

Things I take daily that might affect homocysteine:

 

Things that should help lower it:

• Folate 1600mcg (Metafolin)
• B12 2.5mg (Methylcobalamin)
• B6 256mg (Pyridoxamine)
• Riboflavin 45mg (Riboflavin-5-Phosphate)
• TMG 5600mg
• NAC 1600mg
• Taurine 1000mg
• Creatine 2500mg
• MSM 2400mg
• Magnesium 370mg (MagTein, Citrate, Taurate; Including diet: ~730mg total maybe)
• CDP-Choline 840mg
• Choline 220mg (Choline Citrate)
• Glycine 2400mg
• Omega-3s 4g (From krill and fish oil, not counting diet)
• Low Methionine (Low meat supplemented with gelatin, 1-1.2 g/kg total protein)
• No Alchohol
• No Coffee
• Normal Thyroid

Things that could raise it:

• Arginine 2500mg (Arginine AKG)
• Tyrosine 1500mg
• Niacin 164mg (Niacin)
• Selenium 100mcg (Se-Methyl-Selenocysteine)
• Iron 18mg (Ferrochel; Because of low ferritin; Stopped a few days ago since ferritin is up)
• Cacao 20-60g (Raw) (Contains Iron)
• Weightlifting 4 days/week (not a super hard workout)

I also consume green and white tea, and take grapeseed, pine bark, other polyphenols, and bioflavonoids. It's not clear to me which of those are good or bad for homocysteine.

 

Methylation Analysis report from geneticgenie.org:

 

I never know what to make of these genetic results. Some things raise risk, other things lower it, so who knows where that leaves it?

 

Gene          rsID      Alleles Result
COMT V158M    rs4680    AA      +/+
COMT H62H     rs4633    TT      +/+
COMT P199P    rs769224  GG      -/-
VDR Bsm       rs1544410 CC      -/-
VDR Taq       rs731236  AA      +/+
MAO A R297R   rs6323    T       +/+
ACAT1-02      rs3741049 GG      -/-
MTHFR C677T   rs1801133 GG      -/-
MTHFR 03 P39P rs2066470 GG      -/-
MTHFR A1298C  rs1801131 TT      -/-
MTR A2756G    rs1805087 GG      +/+
MTRR A66G     rs1801394 GG      +/+
MTRR H595Y    rs10380   CC      -/-
MTRR K350A    rs162036  AA      -/-
MTRR R415T    rs2287780 CC      -/-
MTRR A664A    rs1802059 AA      +/+
BHMT-02       rs567754  TT      +/+
BHMT-04       rs617219  CC      +/+
BHMT-08       rs651852  TT      +/+
AHCY-01       rs819147  CT      +/-
AHCY-02       rs819134  AG      +/-
AHCY-19       rs819171  CT      +/-
CBS C699T     rs234706  GG      -/-
CBS A360A     rs1801181 AA      +/+
CBS N212N     rs2298758 GG      -/-
SHMT1 C1420T  rs1979277 AG      +/-

 

From the report notes:

• I have no MTHFR mutations. So, I really shouldn't need extra folate.
• The CBS mutation should help lower homocysteine by increasing the conversion to cystathionine.
• MTR/MTRR mutations tend to use up methylcobalamin faster which can lead to deficiency. But, I already take high dose methylcobalamin, and a blood test shows B12 is off the chart at >2000 pg/mL, up from 1780 pg/mL a year ago. I think it's time to cut back.
• BHMT mutations should help lower homocysteine by increasing the conversion to methionine.
• AHCT mutations can affect homocysteine, but the report didn't explain how or what to do about it.

 

Comments? Any suggestions on how to get my homocysteine down even below 8? My plan for now is to increase methylfolate to 5-7mg and see if that does anything.

 

[aribadabar]

My 2c:

 

You can easily cut the B-vitamins by 50% and you will probably be fine, especially since you don't have the MTHFR mutation (which would have required high doses). B6 should ideally be in P5P form. TMG also looks excessive - cut that in half. Zinc is notably missing from your anti-Hcy stack.

 

I am guessing your slightly elevated homocysteine is due to somewhat elevated (animal?) protein (i.e. methionine) intake and the significant arginine supplementation. Could the creatine intake also contribute to higher Hcy?

 

Could it be that the elevated homocysteine was transient due to recent exercise activity:

 

 

 In conclusion, although intense exercise acutely increased the Hcy levels, chronic endurance exercise was not associated with higher Hcy concentrations. Moreover, athletes with the highest training volume, exhibiting also the highest plasma folate levels, showed a decrease in Hcy levels following the training period as well as a much lower increase of the Hcy concentration after acute intense exercise.

 

Edited by aribadabar, 26 May 2015 - 04:51 AM.

[OneScrewLoose]

You have slightly elevated Homocysteine. This is way, way overboard. Half of these wouldn't even affect Hcy levels. The most common cause of elevated HCy is one of two abnormal polymorphisms of 5-MTHFR, which can now be tested for through a blood test. If this is the issue, 800mcg of Methylfolate alone will fix this. The rest is just throwing your money away. A lot of it, it seems. Just get the methylfolate and retest.

[albedo]

Ta5,

 

Your situation is almost a copy/past of mine as reported several times on this Board.

 

I am back to about 10 (from 16!) after having cut on Niacin (and R-Lipoic and Chlorogenic Acid, both confounding though). I am supplementing some of your stack but in much lower quantities (and no TMG, Taurine, MSM, Glycine) and have a very similar SNP profile, also using geneticgenie (in particular for MTHFR, BHMT, CBS). Therefore, I am afraid I expect you will cut down a lot of your stack and still have homocysteine at similar levels. You are also using already a good dose of l-methylfolate (metafolin) but I agree it is worth to make a test with a 5000 mcg and see what happens. However, I would not use that dose too long!

 

In my case cutting down on some supplement worked to lower homocysteine but I am likely to make a test with 1000-2000 mcg of l-methlyfolate after the next test. Many comments on this Board in other threads went along the same lines as here: 10 is only moderately elevated and probably we should not bother much.

 

The only think that I suggest is to check your RBC Magnesium to test for absorption. I have (and it is very common) a very low RBC Magnesium despite supplementation, even at high doses, so I am not absorbing well. It might explain my moderately high homocysteine level and possibly yours! I am working on that.

 

Please keep feeding this thread with your results as it is very interesting.

Edited by albedo, 26 May 2015 - 07:39 AM.

[ta5]

Thanks for the replies.

 

The list of "Things I take daily that might affect homocysteine" are what I have been taking (most of it) since the last test a year ago. I've been taking all of it, with some things in different doses or forms, for years. I doubled the TMG a year ago. Folate was 1.2mg, then 400 mcg, and 1.6mg has only been for the last 4 months.

 

I had a RBC Magnesium test in 2012 that was 5.7 mg/dL [ref range: 4.2-6.8]. Though, I was maybe taking close to twice as much Mg back then, and no Magtein. Maybe a good idea to retest.

 

I agree with cutting down the Niacin.

 

I wonder if switching to P-5-P would help.

 

I guess I did lift weights the evening before the blood draw. I wonder how transient the increase is?

 

I forgot to list that I take 16mg Zinc (Zinc-L-Carnosine).

[OneScrewLoose]

I honestly recommend using just methylfolate for a trial. HCy isn't going to have any immediately damaging effects, it takes a long time. I am 80% sure that a sufficient dose of this will fix the problem by itself. Just recognize that methylfolate is different from every other form of folate; the other forms won't help.

Wanna give it a shot?

[albedo]

...

 

I guess I did lift weights the evening before the blood draw. I wonder how transient the increase is?

 

...

I also do weight training and it might be just before blood draw. Do you happen to have the evidences this can increase homocysteine? In any case I will also research on this and will also look more carefuly at magnesium. If I were you, I would not change my stack (maybe beside niacin) and just do the test with the 5mg l-methylfolate.

 

[OneScrewLoose]

Here's my recommendations for the different aspect of your regimen.

• Folate 1600mcg (Metafolin) Keep this
• B12 2.5mg (Methylcobalamin) Keep this
• B6 256mg (Pyridoxamine) No harm here.
• Riboflavin 45mg (Riboflavin-5-Phosphate) Just fine.
• TMG 5600mg There are some possible issues with using TMG to manage HCy levels, that can lead to certain health issues. I'll look for the data, but I recommend dropping this one.
• NAC 1600mg There are a good amount of possible adverse effects. I would hold off on this for now.
• Taurine 1000mg Do you take this for energy? Do you know why it was first put in Red Bull? Because it's a sedative that can reduce caffeine jitters. You can actually take this to help you sleep. But everyone thinks it gives them energy, so it does.
• Creatine 2500mg Sounds fine
• MSM 2400mg Why this?
• Magnesium 370mg (MagTein, Citrate, Taurate; Including diet: ~730mg total maybe) I would stick to a fully chelated magnesium.
• CDP-Choline 840mg Unlike regular choline bitartrate/citrate, this can be quite psychoactive and produce anxiety. Especially considering how high this dose is.
• Choline 220mg (Choline Citrate) Looks good.
• Glycine 2400mg No harm here. Why do you take it though?
• Omega-3s 4g (From krill and fish oil, not counting diet) Make sure your Omega 3s specify EPA and DHA levels.
  

 

[albedo]

 

Here's my recommendations for the different aspect of your regimen.
 

Magnesium 370mg (MagTein, Citrate, Taurate; Including diet: ~730mg total maybe) I would stick to a fully chelated magnesium

 

Sorry, a bit off topic: I am taking this form of magnesium. Any comment, considering I am geting consistently a low level of RBC value? Should I change? The (prescribed) dose contains:

 

1 stick (5 g) contains as active ingredient:

• magnesium citrate (calc. anhydrous) 1856,6 mg
• magnesium content: 300 mg

[OneScrewLoose]

 

 

Here's my recommendations for the different aspect of your regimen.
 

Magnesium 370mg (MagTein, Citrate, Taurate; Including diet: ~730mg total maybe) I would stick to a fully chelated magnesium

 

Sorry, a bit off topic: I am taking this form of magnesium. Any comment, considering I am geting consistently a low level of RBC value? Should I change? The (prescribed) dose contains:

 

1 stick (5 g) contains as active ingredient:

• magnesium citrate (calc. anhydrous) 1856,6 mg
• magnesium content: 300 mg

 

Seems like an expensive version of any magnesium citrate you could get online. Magnesium citrate is magnesium citrate. Citrate may or may not be superior to chelate, but it's definitely a stronger laxative.

Here's a chelate: http://amzn.to/1FOpHcB
Here's a citrate that has 119 of the same dose your brand has, for only $10: http://amzn.to/1LIGuPb

Attached is some info on Magnesium. The journal only has an impact factor of 1.5 though, so double check any conclusions you see there.

Is your RBC count always low? Do you take anything else?

[aribadabar]

Speaking of folate and MTHFR - if one is homozygous MTHFR (rs1801133 AA +/+) does one need minimum 1333 mcg (i.e. ~3x the normal 400mcg dosage) to compensate for the 70% loss of function due to having this mutation and more if they are to lower homocysteine level?

 

 

 

 

 

Sorry, a bit off topic: I am taking this form of magnesium. Any comment, considering I am geting consistently a low level of RBC value? Should I change? The (prescribed) dose contains:

 

1 stick (5 g) contains as active ingredient:

• magnesium citrate (calc. anhydrous) 1856,6 mg
• magnesium content: 300 mg

 

Seems like an expensive version of any magnesium citrate you could get online. Magnesium citrate is magnesium citrate. Citrate may or may not be superior to chelate, but it's definitely a stronger laxative.
 

Agree with OSL - chelated magnesium is the way to go. The others are just overpriced options.

 

• NAC 1600mg There are a good amount of possible adverse effects. I would hold off on this for now.

 

 

I think most of NAC fears are overblown due to massive dosages and primarily in mouse models.

I see ta5 and I participated in this NAC discussion , also here, and probably derived similar conclusions (on NAC being net positive). I opted for intermittent dose of 600mg/d every 2-3 days so cutting the dose in half would be preferable than eliminating it altogether.

 

 

...

 

I guess I did lift weights the evening before the blood draw. I wonder how transient the increase is?

 

...

Do you happen to have the evidences this can increase homocysteine?

 

The study I referenced in my first reply: http://www.ncbi.nlm....pubmed/12743461

Edited by aribadabar, 27 May 2015 - 08:35 PM.

[albedo]

 

 

 

Here's my recommendations for the different aspect of your regimen.
 

Magnesium 370mg (MagTein, Citrate, Taurate; Including diet: ~730mg total maybe) I would stick to a fully chelated magnesium

 

Sorry, a bit off topic: I am taking this form of magnesium. Any comment, considering I am geting consistently a low level of RBC value? Should I change? The (prescribed) dose contains:

 

1 stick (5 g) contains as active ingredient:

• magnesium citrate (calc. anhydrous) 1856,6 mg
• magnesium content: 300 mg

 

Seems like an expensive version of any magnesium citrate you could get online. Magnesium citrate is magnesium citrate. Citrate may or may not be superior to chelate, but it's definitely a stronger laxative.

Here's a chelate: http://amzn.to/1FOpHcB
Here's a citrate that has 119 of the same dose your brand has, for only $10: http://amzn.to/1LIGuPb

Attached is some info on Magnesium. The journal only has an impact factor of 1.5 though, so double check any conclusions you see there.

Is your RBC count always low? Do you take anything else?

 

Thank you. I will retest soon and if RCB is still out of range, I will give a try to the chelate form (I think TRAACS is patented from Albion right?). Regarding price, what I am taking is Rx and I get reimbursed by my insurance so I spend very little only. Yes, I take quite a lot of stuff. One suspect would be IP6 (which very successfully lowered my ferritin) but I take it very away from magnesium. Also Zinc, but I take 50mg every two days. I also read that stomach acidity would enhance absorption (see also here) so I will start taking my supplement between meals. I do not want to hijack thisTA5's thread and the magnesium discussion should probably be continued here.

(BTW, I think you forgot to include the attachment you mention)

[albedo]

.....

 

 

...

 

I guess I did lift weights the evening before the blood draw. I wonder how transient the increase is?

 

...

Do you happen to have the evidences this can increase homocysteine?

 

The study I referenced in my first reply: http://www.ncbi.nlm....pubmed/12743461

 

Thank you. To keep in mind: avoid acute training before blood draw.

[OneScrewLoose]

BTW, because of the RBC thing, test your iron levels, you may be a type of anemic.

[aribadabar]

BTW, because of the RBC thing, test your iron levels, you may be a type of anemic.

 

I think he meant RBC magnesium levels, not RBC cell count.

Edited by aribadabar, 28 May 2015 - 12:01 AM.

[OneScrewLoose]

 

BTW, because of the RBC thing, test your iron levels, you may be a type of anemic.

 

I think he meant RBC magnesium levels, not RBC cell count.

 

OK, that makes A LOT more sense.

[pbandy1]

your homocysteine levels are not even excessive. But alas...

 

B6

B12 (methyl B12, hydroxyl B12, or a combo of both)

Methylfolate

3-4 grams fish oil

TMG

creatine

foods high in taurine: salmon, grass-fed meats, Greek yogurt

source of choline: GPC or cdp-choline, or eggs

avoid methionine-rich foods: i.e. excessive red meat and dairy

don't smoke, don't drink alcohol excessively

lose weight, exercise

don't go crazy on caffeine

[albedo]

Yes, sorry, I meant RBC Magnesium level in my post #12.

[aribadabar]

Something I ran across to be mindful of when doing homocysteine testing:

http://mthfr.net/ele...ror/2012/03/02/

 

 

Properly prepare yourself to get your homocysteine level measured.

• You should be fasting. Do not eat anything prior to testing. Ideally get tested in the morning to make this easier.
• Many foods contain protein and most protein contains methionine.
• High-methionine containing foods can falsely elevate your homocysteine levels.

Ensure the lab handles your blood sample properly.

• Within 30 minutes of drawing your blood, the sample must be placed on ice and spun down.
• Red blood cells continue to release homocysteine so they must be removed.
• Homocysteine levels increase by 10% per hour if the red blood cells are not removed.
• Once red blood cells and serum are removed, the remaining plasma remains stable at room temperature for 4 days.

 

[caruga]

While I haven't had a gauge on my homocysteine levels I have found myself very sensitive to the ratio of b2 to b3.  I've found the sweet spot is a 40:1 niacinamide:riboflavin ratio (per weight).  The amount of riboflavin you're taking is totally unnecessary.

 

Also supplemental taurine would, I think, raise homocysteine levels, as it is a byproduct of homocysteine degradation, or at least emburden one of the other pathways that degrade homocysteine.

 

Folate is one of the few 'stored' (or at least, aggressively retained and cycled) water-soluble vitamins; it's a bad idea to supplement it for prolonged periods unless you're correcting an acute deficiency.

 

One thing I don't see mentioned is l-serine.  You need 1 l-serine to synthesise/metabolise 1 homocysteine, and 1 l-serine for it to enter transsulfuration.

Edited by caruga, 07 June 2015 - 09:24 AM.

[FrankEd]

Caruga, could you, please, elaborate yourt comment about taurine raising homocysteine levels?

 

Please, see below LEF protocol:

 

http://www.lifeexten...duction/Page-01

 

In 2008, I suffered a myocardial infarction, and my cardio doctor put me at 4g Taurine daily trying to reduce my hypertension meds.

[caruga]

Caruga, could you, please, elaborate yourt comment about taurine raising homocysteine levels?

 

Please, see below LEF protocol:

 

http://www.lifeexten...duction/Page-01

 

In 2008, I suffered a myocardial infarction, and my cardio doctor put me at 4g Taurine daily trying to reduce my hypertension meds.

 

Well, seems we both learned something.  The page you linked suggests that dietary taurine will block methionine absorption in the gut.  Fair enough.  If said taurine was injected it might be a different story?  All I know is that taurine spares cysteine, which in turn spares homocysteine, forcing another catabolism route, at least theoretically.  I don't have the expertise to say if it would work out that way in practice.

[FrankEd]

My cardio doctor show me the PUBMED paper below, to put me on Taurine:

 

http://www.ncbi.nlm....pubmed/19239173

[OneScrewLoose]

My cardio doctor show me the PUBMED paper below, to put me on Taurine:

 

http://www.ncbi.nlm....pubmed/19239173

 

I would be skeptical of that study. The impact factor for it is 1.9, which is on the low side. Not low enough to be disregarded, but low enough to take it with a grain of salt.

Here's a study with an IF of 3.4:
http://www.ncbi.nlm....pubmed/10574504

If you want to see the IF right away as you search pubmed, download "the paper link" extension.

[ta5]

I had another blood test this week. It has been over two months since my last blood test.

 

Changes since the last blood test:

 

• Increased Methylfolate to 4.8mg/day (was 1.6mg)
• Decreased Methylcobalamin to 1.25mg/day (was 2.5mg)
• Stopped taking iron (continued taking cacao powder) (was 18mg Iron as Ferrochel and cacao)

 

No other changes. The above changes have been constant for 2 months.

 

Before the blood test, I did my usual workout (weight lifting) the night before. I worked out because I worked out the night before the last test and I wanted to keep as many things the same as the last test, with the main difference being the increased folate.

 

Results:

• Homocysteine 10.2 umol/L (down from 10.4 umol/L) ref range: [0-15]
• B12 1195 pg/mL (down from >2000 pg/mL - off the chart) ref range: [211-946]
• Ferritin 29 ng/mL (down from 48 ng/mL) ref range: [30-400]

Homocysteine is basically unchanged, unfortunately. It seems that the methylfolate was mostly ineffective.

 

B12 is much lower, maybe in half, but still above the reference range. It's possible the lower dose of B12 has worked against the higher dose of folate, but I didn't want to stay so high.

 

Ferritin is lower than last time, but still higher than it was earlier in the year when it got down in the teens, which is why I started taking iron. It looks like the cacao by itself is not enough iron for me.

 

I'm considering what to try next, and I'm reading though some of the interesting points in this thread again... And I appreciate everyone's comments.

[albedo]

I cannot understand why the previous post from ta5 has been scored so bad as pointless and time wasting. Here is a user trying the best to monitor his markers and his supplementation and willing to share his experience with all of us. I liked it.

[OneScrewLoose]

It's time-wasting because his HCy levels are well within the reference range. I don't know what he expects to get by lowering it.

Perhaps that is a question OP could answer?

[albedo]

It's time-wasting because his HCy levels are well within the reference range. I don't know what he expects to get by lowering it.

Perhaps that is a question OP could answer?

 

I do not want to highjack Ta5's thread but I tend not to agree.

 

We have sometime biomarkers well within the reference range (or marginally high or low), which is based on statistics of a population considered as "healthy", but which do not correspond to what some people consider as “optimal”. Reference ranges are also regularly updated and you might fall outside the range during time. Finally, monitoring biomarkers regularly, under the same conditions, and extracting trends is a valuable information independently on the absolute values. We might discuss what is the evidence for a specific biomarker to be at its “optimal” (e.g. for homocysteine I have seen an “optimal” range of 4-8 (1) or at about 7-8 (2)) but IMO it is not a good reason to consider the post pointless and time wasting.

 

Yes, I would be interested to have the OP opinion on why homocysteine is considered “optimal” when below 8 or even 6.

 

(1) min 12:47 at https://www.youtube....h?v=Ns02zKEb7mM

(2) http://www.lef.org/P...duction/Page-01

 

[albedo]

I had another blood test this week. It has been over two months since my last blood test.

 

Changes since the last blood test:

 

• Increased Methylfolate to 4.8mg/day (was 1.6mg)
• Decreased Methylcobalamin to 1.25mg/day (was 2.5mg)
• Stopped taking iron (continued taking cacao powder) (was 18mg Iron as Ferrochel and cacao)

 

No other changes. The above changes have been constant for 2 months.

 

Before the blood test, I did my usual workout (weight lifting) the night before. I worked out because I worked out the night before the last test and I wanted to keep as many things the same as the last test, with the main difference being the increased folate.

 

Results:

• Homocysteine 10.2 umol/L (down from 10.4 umol/L) ref range: [0-15]
• B12 1195 pg/mL (down from >2000 pg/mL - off the chart) ref range: [211-946]
• Ferritin 29 ng/mL (down from 48 ng/mL) ref range: [30-400]

Homocysteine is basically unchanged, unfortunately. It seems that the methylfolate was mostly ineffective.

 

B12 is much lower, maybe in half, but still above the reference range. It's possible the lower dose of B12 has worked against the higher dose of folate, but I didn't want to stay so high.

 

Ferritin is lower than last time, but still higher than it was earlier in the year when it got down in the teens, which is why I started taking iron. It looks like the cacao by itself is not enough iron for me.

 

I'm considering what to try next, and I'm reading though some of the interesting points in this thread again... And I appreciate everyone's comments.

 

I have the same experience with l-methylfolate which did not change my homocysteine level. I am just curious to know if you tried or considering to remove entirely niacin. It worked for me but I was taking 3x more than your 164 mg dose though.

 

Btw, I cannot understand why my post here (http://www.longecity...ndpost&p=729487) was scored "irresponsible". I was only and cautiously suggesting to test removing some supplement (such as niacin) which worked for me to lower homocysteine and testing RBC Magnesium as the mineral is involved in homocysteine metabolism (I have an issue with absorbing it). Honestly, what is wrong with it? And without any explication?
 

[ta5]

 

It's time-wasting because his HCy levels are well within the reference range. I don't know what he expects to get by lowering it.

Perhaps that is a question OP could answer?

 

I do not want to highjack Ta5's thread but I tend not to agree.

 

We have sometime biomarkers well within the reference range (or marginally high or low), which is based on statistics of a population considered as "healthy", but which do not correspond to what some people consider as “optimal”. Reference ranges are also regularly updated and you might fall outside the range during time. Finally, monitoring biomarkers regularly, under the same conditions, and extracting trends is a valuable information independently on the absolute values. We might discuss what is the evidence for a specific biomarker to be at its “optimal” (e.g. for homocysteine I have seen an “optimal” range of 4-8 (1) or at about 7-8 (2)) but IMO it is not a good reason to consider the post pointless and time wasting.

 

Yes, I would be interested to have the OP opinion on why homocysteine is considered “optimal” when below 8 or even 6.

 

(1) min 12:47 at https://www.youtube....h?v=Ns02zKEb7mM

(2) http://www.lef.org/P...duction/Page-01

 

 

Thanks Albedo. I agree with what you wrote. The LEF article basically covers my reasons for wanting to lower my homocysteine. I don't have a lot to add.

 

I had not seen that youtube video before. It was interesting. 

 

Unlike most doctors, I want to optimize my health, not just be within the reference range for things. If there's some parameter that I can improve, then I want to do that. I have a family history of cardiovascular disease, stokes, hypertension, Alzheimer's, etc., and homocysteine could contribute to those. I'm also aware of the evidence that lowering homocystine doesn't show much benefit. I can't refute that. It's puzzling why lowering it doesn't seem to help when the evidence of it being harmful is so strong. The LEF article argues that in the studies that failed to show benefits, they simply didn't lower it enough. I'm not sure about that. But, in any case, if I can safely lower it, then I want to. I'm trying. If I can't, I can't.