Hyperhomocysteinemia
Supplements studied for Hyperhomocysteinemia.
Overview
SupplementDEX lists 4 supplements studied for hyperhomocysteinemia across 70 trials. The strongest indexed signals include Vitamin B6, Vitamin B9, N-Acetyl Cysteine. See the heatmap and evidence reviews below for full ratings across all supplements.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Vitamin B6 | ★★★★★ | High |
| Vitamin B9 (Folate) | ★★★★★ | Medium |
| Vitamin B2 (Riboflavin) | ★★★★★ | Medium |
| N-Acetyl Cysteine (NAC) | ★★★★★ | Medium |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
4 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Vitamin B6View supplement →
Proven purchase·★★★★★
How we scored this▸
- Vitamin B6, especially when taken with folic acid and vitamin B12, helps lower homocysteine, a substance in the blood linked to heart and blood vessel diseases.
- Taking vitamin B6 100 mg daily with folic acid 0.5 mg can lower homocysteine by around one-third.
- This may help people who have higher homocysteine after meals.
- Vitamin B6 also helps people with kidney problems or those who have received kidney transplants.
- Having high homocysteine may increase the chance of heart attacks, strokes, and blood clots, but it is not clear if lowering it lowers these risks.
- Taking B vitamins can lower homocysteine, but has not been proven to stop heart problems or early death in everyone.
- Some studies show small benefits in reducing stroke risk, especially for people with previous strokes or cardiovascular disease.
Browse 29 studies·9 meta-analyses
RCTEffect of Vitamin B6, B9, and B12 Supplementation on Homocysteine Level and Cardiovascular Outcomes in Stroke Patients: A Meta-Analysis of Randomized Controlled Trials2021n=8,513
A meta-analysis of 8513 participants found that risk ratio (RR) was calculated for determining the risk of stroke, major cardiovascular disorder, and vascular death by using a fixed-effect model.
- Effect
- Benefit
- Population
- Men
- Participants
- 8,513
MetaB vitamins in stroke prevention: time to reconsider2017
A meta-analysis found that the potential benefits of B vitamin therapy with folic acid and methylcobalamin or hydroxycobalamin, instead of cyanocobalamin, to lower homocysteine concentrations in people at high risk of stroke warrant further investigation.
- Effect
- Benefit
MetaHomocysteine-lowering interventions for preventing cardiovascular events2017n=3,929
A meta-analysis of 3929 participants found that compared with placebo, homocysteine-lowering interventions were associated with reduced stroke outcome (homocysteine-lowering = 4.3% versus comparator = 5.1%, RR 0.90, 95% CI 0.82 to 0.99, I 2 = 8%, 10 trials, N = 44,224; high-quality evidence).
- Effect
- Benefit
- Dose
- 12 g/day
- Population
- Patients With And Without Pre-Existing Cardiovascular Disease
- Participants
- 3,929
MetaEfficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials2013n=294,478
A meta-analysis of 294478 participants found that in a fixed effect meta-analysis of the 50 trials, supplementation with vitamins and antioxidants was not associated with reductions in the risk of major cardiovascular events (relative risk 1.00, 95% confidence interval 0.98 to 1.02; I(2)=42%).
- Effect
- No Benefit
- Participants
- 294,478
Systematic reviewThe effect of micronutrient supplements on female fertility: a systematic review2012
A systematic review of 13 studies found that emphasized results, for example, were an association between multivitamin substitution on pregnancy rate as well as higher vitamin B6 levels in fertile women compared to infertile women.
- Effect
- Benefit
- Population
- Women
MetaCombined analyses and extended follow-up of two randomized controlled homocysteine-lowering B-vitamin trials2010n=6,837
A meta-analysis of 6837 participants found that 40 mg for 1–2 months folic acid plus vitamin B12 treatment lowered homocysteine levels by 25% but did not influence MACE incidence (hazard ratio, 1.07; 95% CI, 0.95-1.21) during 39 months of follow-up, or cardiovascular mortality (hazard ratio, 1.12; 95% CI, 0.95-1.31) during 78 months of.
- Effect
- No Benefit
- Duration
- 1–2 months
- Dose
- 40 mg
- Population
- Patients With Ischaemic Heart Disease
- Participants
- 6,837
RCTHomocysteine lowering and cardiovascular events after acute myocardial infarction2006n=3,749
A randomized trial of 3749 adults found that 0.8 mg folic acid + 0.4 mg vitamin B12 + 40 mg vitamin B6/day the mean total homocysteine level was lowered by 27 percent among patients given folic acid plus vitamin B12, but such treatment had no significant effect on the primary end point (risk ratio, 1.08; 95 percent confidence interval, 0.93 to 1.25; P=0.31).
- Effect
- No Benefit
- Duration
- 40 months
- Dose
- 0.8 mg folic acid + 0.4 mg vitamin B12 + 40 mg vitamin B6/day
- Population
- Adults
- Participants
- 3,749
MetaDose-dependent effects of folic acid on blood concentrations of homocysteine: a meta-analysis of the randomized trials2005n=2,596
A meta-analysis of 2596 participants found that after standardization for sex and to pretreatment plasma concentrations of 12 micromol homocysteine/L and 12 nmol folate/L, daily doses of 0.2, 0.4, 0.8, 2.0, and 5.0 mg folic acid were associated with reductions in homocysteine of 13% (95% CI: 10%, 16%), 20% (17%, 22%), 23%.
- Dose
- 0.4 mg/day
- Participants
- 2,596
RCTLowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial2004n=1,853
A randomized trial of 1853 adults found that 2.5 mg folic acid + 25 mg vitamin B6 + 0.5 mg vitamin B12/day for 2 years a 3- micromol/L lower total homocysteine level was associated with a 10% lower risk of stroke (P =.05), a 26% lower risk of CHD events (P<.001), and a 16% lower risk of death (P =.001) in the low-dose group and a nonsignificantly lower risk in the high-dose gro
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 2.5 mg folic acid + 25 mg vitamin B6 + 0.5 mg vitamin B12/day
- Population
- Adults
- Participants
- 1,853
The challenge of stroke prevention2004
A study found that the challenge of stroke prevention..
Diagnosis and treatment of hyperhomocysteinemia2001
A study found that vitamin therapy, particularly with folic acid, reduces plasma homocysteine significantly and improves other surrogate markers of cardiovascular risk such as endothelial function.
- Effect
- Benefit
RCTHomocysteine lowering effect of different multivitamin preparations in patients with end-stage renal disease2001
A randomized trial in healthy adults found that 800 µg folic acid + 6 µg vitamin B12 + 10 mg vitamin B6, 3×/week preparation A reduced the tHcy concentration significantly by nearly 50%, whereas preparation B did not change the tHcy concentration in comparison with placebo.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 800 µg folic acid + 6 µg vitamin B12 + 10 mg vitamin B6, 3×/week
- Population
- Healthy adults
RCTLow-dose vitamin B-6 effectively lowers fasting plasma homocysteine in healthy elderly persons who are folate and riboflavin replete2001n=10
A randomized trial of 10 healthy adults found that 1.6 mg/day for 18 weeks low-dose vitamin B-6 effectively lowers fasting plasma tHcy in healthy subjects who are both folate and riboflavin replete.
- Effect
- Benefit
- Duration
- 18 weeks
- Dose
- 1.6 mg/day
- Population
- Healthy adults
- Participants
- 10
- Ages
- 63–80
RCTPreoperative oral B vitamins prevent nitrous oxide-induced postoperative plasma homocysteine increases2001
A randomized trial found that 2.5 mg folate + 25 mg B6 + 500 µg B12/day for 5 days the Placebo group had a mean increase in tHcy concentration from baseline of 15% +/- 31% compared with the Vitamin group, which had an initial decrease of 9.1% +/- 11% (P = 0.035).
- Effect
- Benefit
- Duration
- 5 days
- Dose
- 2.5 mg folate + 25 mg B6 + 500 µg B12/day
- Population
- Surgical patients
RCTHyperhomocysteinemia in hemodialysis patients: effects of 12-month supplementation with hydrosoluble vitamins2000n=168
A randomized trial of 168 found that after six months, the mean reduction in tHcy was slightly but significantly greater for patients receiving intravenous folic acid (12.2 +/- 18.5 micromol/L) compared with patients not receiving it (8.3 +/- 9.8 micromol/L, P < 0.05).
- Effect
- Benefit
- Duration
- 12 months
- Population
- Hemodialysis patients
- Participants
- 168
ObservationalLow serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study2000n=734
An observational study of 734 men found that in a Cox model adjusting for age, examination years, and plasma lycopene concentration, in men with higher serum folate concentrations the relative risk for an acute coronary event was 0.31 (95% CI 0.11-0.90, P=0.031) when compared with men with lower serum folates.
- Duration
- 5 years 3 months
- Population
- Men
- Participants
- 734
- Ages
- 46–64
Potential clinical and economic effects of homocyst(e)ine lowering2000
A study found that sensitivity analysis showed that cost-effectiveness ratios for the screen and treat strategy remained less than $50,000 per life-year saved under several unfavorable scenarios, such as when effective homocyst(e)ine lowering was assumed to reduce the relative risk of coronary.
- Effect
- Benefit
- Population
- Adults
MetaPreventive health care, 2000 update: screening and management of hyperhomocysteinemia for the prevention of coronary artery disease events. The Canadian Task Force on Preventive Health Care2000
A meta-analysis found that if population-based studies are correct, tHcy may be responsible for up to 10% of CAD events and thus may represent an important and potentially modifiable risk factor for cardiovascular disease.
- Population
- Older adults
ObservationalRelationship between plasma homocysteine and vitamin status in the Framingham study population. Impact of folic acid fortification2000
An observational study found that prevalence of stenosis > or = 25% was 43% in men and 34% in women, with an odds ratio of 2.0 for individuals in the highest homocysteine quartile (> or = 14.4 mumol/L) compared with those in the lowest quartile ( 13 mumol/L) decreased from 18.7 to 9.8% (P < 0.001) between.
- Population
- Adults
RCTThe controversy over homocysteine and cardiovascular risk2000
A randomized trial in children/adolescents found that thus, only placebo-controlled intervention studies with tHcy-lowering B vitamins and clinical endpoints can provide additional valid arguments for the debate over whether tHcy is a causal CVD risk factor.
- Population
- Children/adolescents
RCTThe effect of different treatment regimens in reducing fasting and postmethionine-load homocysteine concentrations2000
A randomized trial found that 5 mg/day all regimens, except pyridoxine 200 mg, significantly reduced fasting tHcy without differences in the percentage reduction (32-38%).
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 5 mg/day
- Population
- Hyperhomocysteinaemic adults
Therapeutic potential of total homocysteine-lowering drugs on cardiovascular disease2000
A study in patients with impaired renal function found that total homocysteine plasma levels can be lowered or normalised by folic acid and/or vitamin B(6) and vitamin B(12) supplementation.
- Population
- Patients With Impaired Renal Function
Controlled trialTreatment of mild hyperhomocysteinemia in renal transplant recipients versus hemodialysis patients2000n=39
A study of 39 hemodialysis patients found that 2.4 mg/day the mean percent (%) reductions (+/-95% confidence interval) in tHcy were: RTR=28.1% (16.2-40.0%); HD=12.1% (6.6-17.7%), P=0.027 for comparison of between-groups differences by analysis of covariance adjusted for baseline tHcy levels.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 2.4 mg/day
- Population
- Hemodialysis patients
- Participants
- 39
ObservationalVitamin supplements and cardiovascular risk: review of the randomized trials of homocysteine-lowering vitamin supplements2000
An observational study found that after standardization for a pretreatment homocysteine concentration of 12 micromol/L and folate concentration of 12 nmol/L (approximate average concentrations for western populations), dietary folic acid reduced homocysteine levels by 25% (95% confidence interval [CI]: 23 to.
- Dose
- 16.5 mg/day
Clinical trialCombination of low-dose folic acid and pyridoxine for treatment of hyperhomocysteinaemia in patients with premature arterial disease and their relatives1999n=33
A study of 33 patients with premature arterial disease and their relatives found that 100 mg low-dose vitamin therapy significantly reduced fasting tHcy concentration (median 13.9 to 9.3 micromol/l, reduction 32% (95% CI: 27-37%)) and post-load tHcy concentration (median 55.2 to 36.5 micromol/l, reduction 30% (95% CI: 25-35%)).
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 100 mg
- Population
- Patients With Premature Arterial Disease And Their Relatives
- Participants
- 33
ObservationalWhole blood folate, homocysteine in serum, and risk of first acute myocardial infarction1999n=107
An observational study of 107 found that an increase of 50 nmol/l whole blood folate was associated with an OR for MI of 0.75, and an increase of 5 micromol/l tHcy with an OR for MI of 1.57.
- Population
- Patients with acute myocardial infarction
- Participants
- 107
MetaLowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. Homocysteine Lowering Trialists' Collaboration1998n=1,114
A meta-analysis of 1114 participants found that 16.5 mg/day typically in Western populations, daily supplementation with both 0.5-5 mg folic acid and about 0.5 mg vitamin B-12 would be expected to reduce blood homocysteine concentrations by about a quarter to a third (for example, from about 12 mumol/l to 8-9 mumol/l).
- Dose
- 16.5 mg/day
- Population
- Adults
- Participants
- 1,114
RCTTreatment of hyperhomocysteinemia in renal transplant recipients. A randomized, placebo-controlled trial1997n=8
A randomized trial of 8 found that 50 mg/day these results occurred after adjustment for age; sex; and pretreatment levels of total homocysteine, B vitamins, and creatinine.
- Effect
- Benefit
- Dose
- 50 mg/day
- Population
- Renal transplant recipients
- Participants
- 8
MetaA quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes1995
A meta-analysis of 27 studies found that the odds ratio (OR) for CAD of a 5-mumol/L tHcy increment is 1.6 (95% confidence interval [CI], 1.4 to 1.7) for men and 1.8 (95% CI, 1.3 to 1.9) for women.
- Effect
- Benefit
Vitamin B9 (Folate)View supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking folic acid supplements of about 0.4 to 5 mg daily lowers blood levels of homocysteine, a substance linked to heart disease, by 20 to 30 percent.
- Around 0.8 to 1 mg daily is usually enough for the best effect.
- Adding vitamin B6 and B12 can lower homocysteine even more and helps prevent side effects from low B12.
- Eating folic acid supplements or fortified foods lowers homocysteine better than eating folate-rich foods alone.
- High homocysteine is linked to higher risk of heart and blood vessel diseases.
- However, it is not clear if lowering homocysteine with folic acid reduces the risk of heart attacks or strokes in most people.
- Some studies show a small reduction in stroke risk, but folic acid does not seem to prevent heart disease.
- Genetics may play a role, and new forms of folate might work better, but more research is needed.
Browse 34 studies·9 meta-analyses
RCTVitamin B Supplementation and Homocysteine Reduction in Nigerian Children with Nephrotic Syndrome: A Randomized Controlled Trial2025
A randomized trial in children/adolescents found that 5 mg folic acid + 50 mg vitamin B6 + 1 mg vitamin B12/day vitamin B supplementation significantly reduced plasma homocysteine and improved lipid profiles in children with NS.
- Effect
- Benefit
- Dose
- 5 mg folic acid + 50 mg vitamin B6 + 1 mg vitamin B12/day
- Population
- Children/adolescents
RCTEffect of Vitamin B6, B9, and B12 Supplementation on Homocysteine Level and Cardiovascular Outcomes in Stroke Patients: A Meta-Analysis of Randomized Controlled Trials2021n=8,513
A meta-analysis of 8513 participants found that risk ratio (RR) was calculated for determining the risk of stroke, major cardiovascular disorder, and vascular death by using a fixed-effect model.
- Effect
- Benefit
- Population
- Men
- Participants
- 8,513
MetaFolic Acid Supplementation for Stroke Prevention in Patients With Cardiovascular Disease2017n=65,790
A meta-analysis of 65790 participants found that folic acid supplementation was associated with a significant benefit in reducing the risk of stroke in patients with CVD (RR = 0.90; 95% CI: 0.84-0.97; P = 0.005).
- Effect
- Benefit
- Dose
- 2 mg/day
- Population
- Patients with cardiovascular disease
- Participants
- 65,790
MetaHomocysteine-lowering interventions for preventing cardiovascular events2017n=3,929
A meta-analysis of 3929 participants found that compared with placebo, homocysteine-lowering interventions were associated with reduced stroke outcome (homocysteine-lowering = 4.3% versus comparator = 5.1%, RR 0.90, 95% CI 0.82 to 0.99, I 2 = 8%, 10 trials, N = 44,224; high-quality evidence).
- Effect
- Benefit
- Dose
- 12 g/day
- Population
- Patients With And Without Pre-Existing Cardiovascular Disease
- Participants
- 3,929
RCTEffects of 2-year vitamin B12 and folic acid supplementation in hyperhomocysteinemic elderly on arterial stiffness and cardiovascular outcomes within the B-PROOF trial2015n=569
A randomized trial of 569 older adults found that 500 µg vitamin B12 + 400 µg folic acid/day for 2 years analysis of covariance showed no effect of supplementation on PWV levels, and this was not different for patients without increased arterial stiffness at baseline.
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 500 µg vitamin B12 + 400 µg folic acid/day
- Population
- Older adults
- Participants
- 569
- Ages
- 65+
MetaEffect of folic acid supplementation on the progression of carotid intima-media thickness: a meta-analysis of randomized controlled trials2012n=2,052
A meta-analysis of 2052 participants found that consistently, a greater beneficial effect was seen in those trials with baseline CIMT levels ≥0.8 mm (WMD: -0.14 mm; 95%CI: -0.19, -0.08; P<0.0001), and a reduction in the homocysteine concentration ≥30% (WMD: -0.22 mm; 95%CI: -0.38, -0.06; P=0.009).
- Effect
- Benefit
- Participants
- 2,052
MetaEfficacy of folic acid supplementation in cardiovascular disease prevention: an updated meta-analysis of randomized controlled trials2012n=58,804
A meta-analysis of 58804 participants found that pooling the RRs showed that folic acid supplementation was not associated with any significant change in the risk of CVD (RR 0.98, 0.95 to 1.02; p=0.36), CHD (RR 1.03, 0.98 to 1.08; p=0.23), and all-cause mortality (RR 1.00, 0.96 to 1.04; p=0.92), but was linked to a.
- Effect
- No Benefit
- Participants
- 58,804
MetaReconciling the evidence on serum homocysteine and ischaemic heart disease: a meta-analysis2011n=39,597
A meta-analysis of 39597 participants found that meta-analysis of the MTHFR studies showed a statistically significantly increased risk of ischaemic heart disease in TT compared with CC homozygotes; odds ratio 1.16 (1.04 to 1.29) for a 1.9 µmol/L homocysteine difference (TT minus CC).
- Effect
- No Benefit
- Participants
- 39,597
MetaEffects of lowering homocysteine levels with B vitamins on cardiovascular disease, cancer, and cause-specific mortality: Meta-analysis of 8 randomized trials involving 37 485 individuals2010n=485
A meta-analysis of 485 studies found that there was no significant effect on the rate ratios (95% confidence intervals) for overall cancer incidence (1.05 [0.98-1.13]), cancer mortality (1.00 [0.85-1.18]) or all-cause mortality (1.02 [0.97-1.08]) during the whole scheduled treatment period or during the later years.
- Effect
- No Benefit
- Population
- Adults
- Participants
- 485
- Ages
- 18+
RCTHomocysteine lowering and cardiovascular events after acute myocardial infarction2006n=3,749
A randomized trial of 3749 adults found that 0.8 mg folic acid + 0.4 mg vitamin B12 + 40 mg vitamin B6/day the mean total homocysteine level was lowered by 27 percent among patients given folic acid plus vitamin B12, but such treatment had no significant effect on the primary end point (risk ratio, 1.08; 95 percent confidence interval, 0.93 to 1.25; P=0.31).
- Effect
- No Benefit
- Duration
- 40 months
- Dose
- 0.8 mg folic acid + 0.4 mg vitamin B12 + 40 mg vitamin B6/day
- Population
- Adults
- Participants
- 3,749
MetaDose-dependent effects of folic acid on blood concentrations of homocysteine: a meta-analysis of the randomized trials2005n=2,596
A meta-analysis of 2596 participants found that after standardization for sex and to pretreatment plasma concentrations of 12 micromol homocysteine/L and 12 nmol folate/L, daily doses of 0.2, 0.4, 0.8, 2.0, and 5.0 mg folic acid were associated with reductions in homocysteine of 13% (95% CI: 10%, 16%), 20% (17%, 22%), 23%.
- Dose
- 0.4 mg/day
- Participants
- 2,596
RCTLowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trial2004n=1,853
A randomized trial of 1853 adults found that 2.5 mg folic acid + 25 mg vitamin B6 + 0.5 mg vitamin B12/day for 2 years a 3- micromol/L lower total homocysteine level was associated with a 10% lower risk of stroke (P =.05), a 26% lower risk of CHD events (P<.001), and a 16% lower risk of death (P =.001) in the low-dose group and a nonsignificantly lower risk in the high-dose gro
- Effect
- No Benefit
- Duration
- 2 years
- Dose
- 2.5 mg folic acid + 25 mg vitamin B6 + 0.5 mg vitamin B12/day
- Population
- Adults
- Participants
- 1,853
The challenge of stroke prevention2004
A study found that the challenge of stroke prevention..
RCTFolic acid and reduction of plasma homocysteine concentrations in older adults: a dose-response study2003
A randomized trial in adults found that in older adults, daily supplementation with folic acid effectively lowers plasma homocysteine concentrations, and a daily dose of approximately 400 micro g is the minimum dose required for adequate homocysteine reduction.
- Effect
- Benefit
- Duration
- 12 weeks
- Population
- Adults
- Ages
- 50–75
RCTSecondary prevention with folic acid: effects on clinical outcomes2003n=593
A randomized trial of 593 found that 0.5 mg/day the primary end point (all-cause mortality and a composite of vascular events) was encountered in 31 (10.3%) patients in the folic acid group and in 28 (9.6%) patients in the control group (relative risk 1.05; 95% confidence interval: 0.63 to 1.75).
- Effect
- No Benefit
- Duration
- 24 months
- Dose
- 0.5 mg/day
- Population
- Patients with stable coronary artery disease
- Participants
- 593
ObservationalDietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-up Study. National Health and Nutrition Examination Survey2002
An observational study in adults found that incidence data for stroke and CVD were obtained from medical records and death certificates.
- Effect
- Benefit
- Population
- Adults
- Ages
- 25–74
RCTEffect of low doses of 5-methyltetrahydrofolate and folic acid on plasma homocysteine in healthy subjects with or without the 677C-->T polymorphism of methylenetetrahydrofolate reductase2002
A randomized trial in healthy adults found that 400 µg/day folic acid or 5-methyltetrahydrofolate for 7 weeks after folic acid for 3 and 7 weeks, values fell from 12.6 +/- 3.3 to 9.2 +/- 2.9 and 9.2 +/- 2.7 (P < 0.005) and from 15.6 +/- 4.9 to 11.7 +/- 3.9 and 9.1 +/- 2.4 mumol L-1, mean +/- SD (P < 0.005) in wild-type and homozygous subjects, respectively.
- Effect
- Benefit
- Duration
- 7 weeks
- Dose
- 400 mcg/day
- Population
- Healthy adults
Clinical trialLong-term improvement in homocysteine levels and arterial endothelial function after 1-year folic acid supplementation2002n=29
A study of 29 healthy adults found that 10 mg/day for 1 year flow-mediated dilation also improved significantly, from 7.4% +/- 2.0% to 8.9% +/- 1.5% (P <0.0001), but there was no change in nitroglycerin-induced (endothelium-independent) responses.
- Effect
- Benefit
- Duration
- 1 year
- Dose
- 10 mg/day
- Population
- Healthy adults
- Participants
- 29
RCTA randomized double-blind placebo-controlled trial of the effect of homocysteine-lowering therapy with folic acid on endothelial function in patients with coronary artery disease2001n=90
A randomized trial of 90 patients with coronary artery disease found that 5 mg folic acid/day for 12 weeks at the end of the study, plasma homocysteine was lower in the folic acid group compared with the placebo group (mean [95% confidence interval] 9.3 (8.5 to 10.1) vs. 12.3 [11.3 to 13.4] micromol/l, p < 0.001).
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 5 mg folic acid/day
- Population
- Patients With Coronary Artery Disease
- Participants
- 90
- Ages
- 46–79
Diagnosis and treatment of hyperhomocysteinemia2001
A study found that vitamin therapy, particularly with folic acid, reduces plasma homocysteine significantly and improves other surrogate markers of cardiovascular risk such as endothelial function.
- Effect
- Benefit
RCTPower Shortage: clinical trials testing the "homocysteine hypothesis" against a background of folic acid-fortified cereal grain flour2001
A randomized trial in women found that large randomized, controlled trials of total homocysteine-lowering therapy for the potential reduction of cardiovascular disease outcomes are ongoing in the United States and Canada.
- Population
- Women
RCTRandomized trial of folic acid supplementation and serum homocysteine levels2001n=151
A randomized trial of 151 adults found that 1 mg/day for 3 months serum folate level increased approximately linearly (5.5 nmol/L for every 0.1 mg of folic acid).
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 1 mg/day
- Population
- Adults
- Participants
- 151
RCTDietary strategies for lowering homocysteine concentrations2000
A randomized trial found that the reduction in tHcy was significantly negatively correlated with the increase in serum folate, which may be a useful marker for measuring dietary change.
- Effect
- Benefit
- Ages
- 36–71
RCTEffect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease2000n=75
A randomized trial of 75 patients with coronary artery disease found that folic acid plus antioxidants increased plasma folate by 438% (p < 0.001), reduced plasma homocysteine by 9% (p = 0.56) and insignificantly improved FMD from 2.6 +/- 2.4% to 4.0 +/- 3.7% (p = 0.45), as compared with placebo.
- Effect
- Benefit
- Population
- Patients With Coronary Artery Disease
- Participants
- 75
RCTEffect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial2000n=10
A randomized trial of 10 patients with premature atherothrombotic disease found that 5 mg folic acid + 250 mg vitamin B6/day for 2 years it was also associated with a decreased rate of abnormal exercise electrocardiography tests (odds ratio 0.40 [0.17-0.93]; p=0.035).
- Effect
- Benefit
- Duration
- 2 years
- Dose
- 5 mg folic acid + 250 mg vitamin B6/day
- Population
- Patients With Premature Atherothrombotic Disease
- Participants
- 10
Endpoints for homocysteine-lowering trials2000
A study found that endpoints for homocysteine-lowering trials..
ObservationalRelationship between plasma homocysteine and vitamin status in the Framingham study population. Impact of folic acid fortification2000
An observational study found that prevalence of stenosis > or = 25% was 43% in men and 34% in women, with an odds ratio of 2.0 for individuals in the highest homocysteine quartile (> or = 14.4 mumol/L) compared with those in the lowest quartile ( 13 mumol/L) decreased from 18.7 to 9.8% (P < 0.001) between.
- Population
- Adults
RCTThe effect of different treatment regimens in reducing fasting and postmethionine-load homocysteine concentrations2000
A randomized trial found that 5 mg/day all regimens, except pyridoxine 200 mg, significantly reduced fasting tHcy without differences in the percentage reduction (32-38%).
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 5 mg/day
- Population
- Hyperhomocysteinaemic adults
ObservationalVitamin supplements and cardiovascular risk: review of the randomized trials of homocysteine-lowering vitamin supplements2000
An observational study found that after standardization for a pretreatment homocysteine concentration of 12 micromol/L and folate concentration of 12 nmol/L (approximate average concentrations for western populations), dietary folic acid reduced homocysteine levels by 25% (95% confidence interval [CI]: 23 to.
- Dose
- 0.5 mg/day
Endothelial dysfunction by acute hyperhomocyst(e)inaemia: restoration by folic acid1999
A study in healthy adults found that 0.1 g/kg recent evidence demonstrates that hyperhomocyst(e)inaemia is a novel risk factor for cardiovascular diseases.
- Effect
- Benefit
- Dose
- 0.1 g/kg
- Population
- Healthy adults
RCTEnhanced reduction of fasting total homocysteine levels with supraphysiological versus standard multivitamin dose folic acid supplementation in renal transplant recipients1999n=29
A randomized trial of 29 found that 50 mg/day for 12 weeks moreover, a chi(2) analysis of participants with pretreatment tHcy levels >/=15 micromol/L (n=29) indicated that a significantly greater proportion of those in group 1 achieved posttreatment levels <12 micromol/L: group 1, 5 of 10 (50%); group 2, 1 of 11 (9%); and group 3, 0.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 50 mg/day
- Participants
- 29
RCTEffects of folic acid and combinations of folic acid and vitamin B-12 on plasma homocysteine concentrations in healthy, young women1998n=150
A randomized trial of 150 women found that the effect observed with the combination of folic acid + 400 microg vitamin B-12 (total homocysteine, -18%) was significantly larger than that with a supplement containing folic acid alone (total homocysteine, -11%) (P < 0.05).
- Effect
- Benefit
- Duration
- 4 weeks
- Population
- Women
- Participants
- 150
MetaLowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. Homocysteine Lowering Trialists' Collaboration1998n=1,114
A meta-analysis of 1114 participants found that 16.5 mg/day typically in Western populations, daily supplementation with both 0.5-5 mg folic acid and about 0.5 mg vitamin B-12 would be expected to reduce blood homocysteine concentrations by about a quarter to a third (for example, from about 12 mumol/l to 8-9 mumol/l).
- Effect
- Benefit
- Dose
- 16.5 mg/day
- Population
- Adults
- Participants
- 1,114
RCTTreatment of hyperhomocysteinemia in renal transplant recipients. A randomized, placebo-controlled trial1997n=8
A randomized trial of 8 found that 50 mg/day these results occurred after adjustment for age; sex; and pretreatment levels of total homocysteine, B vitamins, and creatinine.
- Effect
- Benefit
- Dose
- 50 mg/day
- Population
- Renal transplant recipients
- Participants
- 8
N-Acetyl Cysteine (NAC)View supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking N-acetylcysteine by mouth may help lower high homocysteine levels, including in people with kidney failure on dialysis.
Browse 3 studies
RCTEffects of folic acid and N-acetylcysteine on plasma homocysteine levels and endothelial function in patients with coronary artery disease2007n=60
An RCT of 60 CAD patients found both folic acid and NAC (600 mg/day for 8 weeks) lowered homocysteine and improved endothelial function versus placebo.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 600 mg/day
- Population
- Adults with coronary artery disease
- Participants
- 60
RCTIntravenous N-acetylcysteine during haemodialysis reduces the plasma concentration of homocysteine in patients with end-stage renal disease2006n=60
An RCT of 60 dialysis patients found IV NAC during hemodialysis reduced plasma homocysteine by 88% versus 24% with dialysis alone.
- Effect
- Benefit
- Population
- Patients with end-stage renal failure
- Participants
- 60
Clinical trialLack of effect of oral N-acetylcysteine on the acute dialysis-related lowering of total plasma homocysteine in hemodialysis patients1996n=11
A trial of 11 hemodialysis patients found oral NAC (1200 mg predialysis) did not augment dialysis-related homocysteine removal but lowered pre-dialysis levels by 16%.
- Effect
- Benefit
- Dose
- 1200 mg
- Population
- Hemodialysis patients
- Participants
- 11
Vitamin B2 (Riboflavin)View supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking riboflavin (vitamin B2) by mouth can lower homocysteine levels, a chemical linked to heart health, but this benefit is mostly seen in people with a specific genotype called MTHFR 677 TT.
- Studies show that people with this genetic type who take 1.6 mg of riboflavin daily for 12 weeks can reduce their homocysteine levels by about one-fifth to two-fifths.
- People with other genetic types do not seem to get the same benefit from riboflavin supplementation.
Browse 4 studies
RCTRiboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphism https://pubmed.ncbi.nlm.nih.gov/16380544/2006n=28
A randomized trial of 28 healthy adults found that 1.6 mg/day for 12 weeks individuals homozygous for the methylenetetrahydrofolate reductase (MTHFR) 677C-->T polymorphism have reduced MTHFR enzyme activity resulting from the inappropriate loss of the riboflavin cofactor, but it is unknown whether their typically high homocysteine levels are.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 1.6 mg/day
- Population
- Healthy adults
- Participants
- 28
- Ages
- 18–65
Controlled trialEffect of riboflavin status on the homocysteine-lowering effect of folate in relation to the MTHFR (C677T) genotype https://pubmed.ncbi.nlm.nih.gov/12560354/2003n=126
A study of 126 (ages 20–63) found that plasma tHcy was 2.6 micromol/L higher in the lowest plasma riboflavin quartile compared with the highest (P or =1.4 from 52% to 65% after supplementation (P <0.05).
- Effect
- Benefit
- Participants
- 126
- Ages
- 20–63
Clinical trialImpaired functioning of thermolabile methylenetetrahydrofolate reductase is dependent on riboflavin status: implications for riboflavin requirements https://pubmed.ncbi.nlm.nih.gov/12145019/2002n=286
A study of 286 healthy adults found that this may have important implications for governments considering new fortification policies aimed at the prevention of diseases for which this genotype is associated with increased risk.
- Effect
- Benefit
- Population
- Healthy adults
- Participants
- 286
- Ages
- 19–63
Clinical trialRiboflavin as a determinant of plasma total homocysteine: effect modification by the methylenetetrahydrofolate reductase C677T polymorphism https://pubmed.ncbi.nlm.nih.gov/10926884/2000
A study found that riboflavin determined tHcy independently in a multiple linear regression model with adjustment for sex, age, folate, cobalamin, creatinine, and MTHFR genotype (P = 0.008). tHcy was 1.4 micromol/L higher in the lowest compared with the highest riboflavin quartile.
- Effect
- Benefit
- Ages
- 19–69
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Vitamin B9 (Folate) | ★★★★★68% | 34 | 9 | 49% |
| Vitamin B6 | ★★★★★88% | 29 | 9 | 41% |
| Vitamin B2 (Riboflavin) | ★★★★★60% | 4 | 0 | 6% |
| N-Acetyl Cysteine (NAC) | ★★★★★60% | 3 | 0 | 4% |