Homocysteine may not be a household word, but at Food for the Brain, we want it to become one!
It is arguably one of the most important blood biomarkers for your brain and overall health, predicting the risk of over 100 diseases, from cardiovascular issues to cognitive decline, depression, and developmental disorders in children (1,2,3). For many years it was difficult to obtain accurate testing privately or at home – which is why we developed a new, accurate at-home pin-prick test that is one of our most popular options.
The reason we think this is such a good biomarker to track and research is that whilst high homocysteine is linked to increased risk of over 100 diseases – it can be quick and easy to lower!
Learn more about homocysteine and why it matters in the video below:
What level should you be aiming for?
Based on Patrick Holford’s research in his book Upgrade Your Brain, the recommended homocysteine levels are:
- Ideal/Optimal Level: Below 7.5 µmol/L – This is especially important for women preparing for pregnancy, as higher levels are linked to increased risk of chromosomal damage and developmental problems in children.
- Treatment Threshold: Above 10 µmol/L – Anyone with a homocysteine level above this should be treated with B vitamins to reduce brain shrinkage and risk of dementia.
- Warning Level: Above 11 µmol/L – Associated with increased brain shrinkage and elevated risk for Alzheimer’s and cardiovascular disease.
Ideally, with regular testing, you should maintain homocysteine levels well below 10 µmol/L to support optimal brain health and reduce the risk of neurodegenerative conditions.
Here are eight proven ways to bring your homocysteine levels into the optimal range and keep your brain firing on all cylinders:
1. Supplement Smart: The B Vitamin Trio (and Friends)
The fastest way to reduce homocysteine is through targeted supplementation. The ‘magic trio’ is vitamin B6 (20mg), B12 (500µg as methylcobalamin), and methylfolate (400µg). A major paper has shown that supplementing these B vitamins not only lowers homocysteine, but also slows brain shrinkage and cognitive decline in people with mild cognitive impairment. Add trimethylglycine (TMG), zinc, and N-acetyl cysteine (NAC) for additional support, particularly in older adults with memory concerns. These nutrients work synergistically to support methylation and brain function. (1) Get our supplement guidelines here.
2. Eat for B12: Fish, Eggs, Dairy and Meat
Vitamin B12 is primarily found in animal-derived foods. Aim to eat oily fish three times a week, eggs most days, and small amounts of organic meat or dairy (if tolerated). Pescatarians thrive here. For vegans, the focus should be on fortified foods and sources such as shiitake mushrooms. However, supplementation and regular testing are strongly recommended to ensure optimal levels. Poor B12 absorption – particularly in older adults or those taking proton pump inhibitors – is a common risk factor for elevated homocysteine and brain shrinkage (1,2).
3. Load Your Plate with Greens and Beans
Folate is critical for methylation. Aim for seven servings of fruit and vegetables a day. Prioritise leafy greens, broccoli, lentils, chickpeas, and asparagus. These naturally support homocysteine metabolism and keep your methylation processes running smoothly (1).
4. Move Your Body
Regular physical activity helps lower homocysteine. Studies show that consistent aerobic or resistance exercise can reduce levels, improve circulation, and support metabolic health. Aim for at least 30 minutes of brisk walking, cycling, or swimming five times a week to complement your nutritional strategy (3).
5. Cut Back on Coffee – Especially Excessive Intake
Drinking more than two cups of coffee a day can raise homocysteine levels. While low to moderate coffee intake may offer some antioxidant benefits, high intake (six or more cups a day) has been linked to elevated homocysteine levels and an increased risk of dementia (4).
6. Mind Your Alcohol
Keep it light. Up to seven small glasses (125ml) of red wine or two pints of beer per week is the maximum. Excess alcohol increases homocysteine levels and impairs nutrient absorption – particularly of B vitamins (1).
7. Manage Stress and Prioritise Quality Sleep
Chronic stress may indirectly raise homocysteine by increasing inflammation and depleting vitamin B6 – both linked to higher mortality and accelerated cellular ageing (5).Make stress reduction a priority. Meditation, yoga, deep breathing, regular exercise, and talking therapies are all effective. Equally important is prioritising restorative sleep. The brain clears toxins and resets during deep sleep – both are vital for healthy methylation. Learn more about sleep and your brain here.
8. Test, Don’t Guess – Know Your Level
You can’t manage what you don’t measure. Have your homocysteine levels tested.. We now offer at-home pinprick tests, which also contribute to our ongoing research. Don’t be surprised if your levels are higher than expected. Forty per cent of people over 60 have homocysteine levels above 11 µmol/L. As we age, our ability to absorb vitamin B12 declines (3).
Homocysteine is a key indicator for cognitive and overall health. As we can see, with a few dietary tweaks, lifestyle upgrades, and targeted nutrients, you can lower your homocysteine, support methylation, and quite literally upgrade your brain!
- Join our research and test your homocysteine level today. Purchase a single homocysteine test here or get it as part of the DRIfT 5 in 1 test, which also measures your antioxidant status (another world first in accurate home testing), omega-3, vitamin D and HbA1c.
- Read more in the Upgrade Your Brain book – This fully referenced guide offers practical strategies to improve your brain health – including how to lower homocysteine through diet, lifestyle, and supplementation.
- Support our charitable work by becoming a FRIEND. From just £5 a month, you can help fund vital research and public education. Become a FRIEND today
Food for the Brain is a not-for-profit educational and research charity that offers a free Cognitive Function Test and assesses your Dementia Risk Index to be able to advise you on how to dementia-proof your diet and lifestyle.
By completing the Cognitive Function Test you are joining our grassroots research initiative to find out what really works for preventing cognitive decline. We share our ongoing research results with you to help you make brain-friendly choices.
Please support our research by becoming a Friend of Food for the Brain.
References:
1 Smith AD, Refsum H. Homocysteine – from disease biomarker to disease prevention. J Intern Med. 2021 Oct;290(4):826-854.
2 Vogiatzoglou A, Refsum H, Johnston C, et al. Vitamin B12 status and rate of brain volume loss. Neurology. 2008 Sep 9;71(11):826-32.
3 Vincze G, et al. Physical activity and plasma homocysteine in the elderly: the Rotterdam Study. Am J Clin Nutr. 2011;93(5):1025–31.
4 Grubben MJAL, et al. Unfiltered coffee increases plasma homocysteine concentrations in healthy volunteers: a randomized trial. Am J Clin Nutr. 2000;71(2):480–4.
5 Pusceddu I, et al. Subclinical inflammation, telomere shortening, homocysteine, vitamin B6, and mortality: the Ludwigshafen Risk and Cardiovascular Health Study. Eur J Nutr. 2020;59:1399–411.
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