High Homocysteine

Homocysteine is a compound in the blood. High levels have been linked to brain and heart problems.

Diet and healthy habits can help manage homocysteine levels. Some people use natural therapies to help with homocysteine control. They should only be used with standard treatment.

Natural Therapies

Likely Effective

These supplements are likely help control homocysteine levels:

  • Folic acid (folate) is an essential vitamin found in grains, lentils, and spinach. It is likely to provide more benefit when taken with B vitamins or omega-3 fatty acids .A1, A2, A7, A11, A12
  • Genistein is a compound found in soy products that can be taken as a supplement. ( Note : People with bone disorders or hormone problems should talk to their doctor before taking genistein. It may interact with their medicines.)A4
  • Omega-3 fatty acids are found in foods like fish can also be taken as a supplement. They help with many functions in the body.A7, A10

Unlikely to Be Effective

Soy isoflavones are compounds that mimic estrogen. They are found in soybeans and soy products. They are unlikely to help lower homocysteine levels.A5

Not Enough Data to Assess

B Vitamins A3, A6, A8, A9, A11, A12

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse. For example, genistein may interact with medicine for bone and hormone problems. Talk to your doctor before taking it.


Herbs and Supplements

A1. Sudchada P, Saokaew S, et al. Effect of folic acid supplementation on plasma total homocysteine levels and glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2012;98(1):151-158.

A2. Qin X, Huo Y, et al. Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: a meta-analysis of randomized controlled trials. Clin Nutr. 2013;32(5):722-727.

A3. Clarke R, Bennett D, et al. Effects of homocysteine lowering with B vitamins on cognitive aging: a meta-analysis of 11 trials with cognitive data on 22,000 individuals. Am J Clin Nutr. 2014;100(2):657-666.

A4. Li J, Liu Y, et al. Does genistein lower plasma lipids and homocysteine levels in postmenopausal women? A meta-analysis. Climacteric. 2016;19(5):440-447.

A5. Song X, Zeng R, et al. The effect of soy isoflavones on homocysteine levels: a meta-analysis of randomised controlled trials. J Hum Nutr Diet. 2016;29(6):797-804.(SOY ISO)

A6. Martí-Carvajal AJ, Solà I, et al. Homocysteine-lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev. 2017;8:CD006612.

A7. Dawson SL, Bowe SJ, et al. A combination of omega-3 fatty acids, folic acid and B-group vitamins is superior at lowering homocysteine than omega-3 alone: A meta-analysis. Nutr Res. 2016 Jun;36(6):499-508.

A8. Ji Y, Tan S, et al. Vitamin B supplementation, homocysteine levels, and the risk of cerebrovascular disease: a meta-analysis. Neurology. 2013 Oct 8;81(15):1298-1307.

A9. Huang T, Chen Y, et al. Meta-analysis of B vitamin supplementation on plasma homocysteine, cardiovascular and all-cause mortality. Clin Nutr. 2012 Aug;31(4):448-454.

A10. Huang T, Zheng J, et al. High consumption of Ω-3 polyunsaturated fatty acids decrease plasma homocysteine: a meta-analysis of randomized, placebo-controlled trials. Nutrition. 2011 Sep;27(9):863-867.

A11. Ebbing M, Bønaa KH, et al. Combined analyses and extended follow-up of two randomized controlled homocysteine-lowering B-vitamin trials. J Intern Med. 2010 Oct;268(4):367-382.

A12. Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. Homocysteine Lowering Trialists' Collaboration. BMJ. 1998 Mar 21;316(7135):894-898.

Last reviewed November 2019 by EBSCO NAT Review Board Eric Hurwitz, DC