Betaine (trimethylglycine) (6 grams per day) and choline (2 grams per day) have each been shown to lower homocysteine levels.^4,5 Choline in the amount of 2.6 grams per day (provided as 34 grams per day of soy lecithin) has also been shown to lower homocysteine levels in a double-blind trial.⁶ More recently, 1.5 grams of betaine per day, an amount similar to that in a typical diet, also has been found to lower homocysteine levels.⁷ Doctors usually consider supplementation with these nutrients only when supplementation with folic acid, vitamin B6, and vitamin B12 do not reduce homocysteine levels sufficiently. The results of this study, however, point to the potential benefit of increasing one’s intake of foods rich in betaine (such as whole wheat, spinach, beets, and other plant foods).

Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research,^8,9 though uncertainty remains about whether elevated homocysteine actually causes heart disease.^10,11 Although some reports have found associations between homocysteine levels and dietary factors, such as coffee and protein intakes,¹² evidence linking specific foods to homocysteine remains preliminary. Higher blood levels of vitamin B6, vitamin B12, and folic acid are associated with low levels of homocysteine¹³ and supplementing with these vitamins lowers homocysteine levels.^14,15

For the few cases in which vitamin B6, vitamin B12, and folic acid fail to normalize homocysteine, adding 6 grams per day of betaine (trimethylglycine) may be effective.¹⁶ Of these four supplements, folic acid appears to be the most important.¹⁴ Attempts to lower homocysteine by simply changing the diet rather than by using vitamin supplements have not been successful.¹⁸