Peter Attia· MD
if you came to me and you're on your third bypass or forced then I think it's pretty safe assumption you have screwed up into the allele function so I don't question is what do we do about it so one thing is look if they have impaired renal function hypertension you know those are things that you go after the homocysteine especially in the MTHFR mutation patients you give methylated B vitamins which is still controversial in sort of mainstream circles because even though it lowers homocysteine some will point to that and say well you have no outcome data on lowering homelesses that you have plenty of data that in people with hyper homocystinuria lowering homocysteine drastically improves their vascular outcome so it's plausible at a certain threshold that homocysteine that there's probably makes sense