Ron Hoffman, M.D., of New York City, who has a general holistic practice, has tested hundreds of patients for homocysteine levels and has lowered their levels with vitamin supplements. “l use a shotgun approach,” he says. “Not just the B complex for homocysteine, but also fish liver oil, garlic and CoQ10, among other things. For individuals with a serious level of homocysteine that resists coming down into the normal zone, I find trimethylglycine (TMG) helpful.

TMG is a vitamin-like substance that has been found to help normalize defective amino acid metabolism, particularly in patients who have high homocysteine unresponsive to vitamin B-6 therapy. It enhances the reconversion of homocysteine to methionine for use in the body.

In an Australian study reported in a 1996 issue of the Journal of Nutrition, researchers found that long-term supplementation with TMG generated a substantial lowering of homocysteine among patients with high levels who were resistant to regular vitamin treatment. The report said that patients had been successfully using TMG for this purpose for up to 13 years.

Hoffman recalls the case of a 24-year-old stroke patient who was paralyzed and in a wheelchair. Several months before, the young man had been diagnosed with blood clots and a pulmonary embolus, a clot that moves from the legs and lodges itself in the lungs. This condition causes extreme breathlessness and is life-threatening. In order to prevent more blood clots and the possibility of a lethal blockage in the lungs, the patient was taking blood thinners.

Recalling that elevated homocysteine promotes the formation of blood clots, Hoffman ran a blood test for the patient’s homocysteine level.

“To my amazement, it was ‘off the chart’— an astronomical 300!” says Hoffman. Normal levels are considered to be below 16, but the optimal goal is in the 8 to 10 range.

“I immediately started the patient on high doses of vitamins B-6, B-12 and folic acid, and monitored the response. The homocysteine plunged rapidly. First to 150, then 100, then 80. Around 60 or 70, we got stuck. And it took a lot of extra trimethylglycine (TMG) to reinforce the homocysteine breakdown process and get him down to around the 20 range.” This was an example of a serious genetic case.

“TMG actually works pharmaceutically for this,” says Hoffman. “But only rarely do you have to get into TMG to drop your homocysteine, because it is so easily done with the B vitamins. But for people with very serious problems, TMG may be the only thing that will do it.”