Peter Attia· MD
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 and if you really understood the pathway of catabolism imma firin and you'd understand is better and remember in that pathway is gonna be the production of a lot of neurotransmitters - so there's a lot going on if you have the genotype that's gonna screw up methylation or the enzyme is involved with that that's another story