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Open Access 01-10-2020 | Folic Acid | Review

Folic Acid Supplementation in Patients with Elevated Homocysteine Levels

Authors: Alan D. Kaye, George M. Jeha, Alex D. Pham, Mitchell C. Fuller, Zachary I. Lerner, Gerald T. Sibley, Elyse M. Cornett, Ivan Urits, Omar Viswanath, Christopher G. Kevil

Published in: Advances in Therapy | Issue 10/2020

Abstract

Introduction

Folic acid is the most important dietary determinant of homocysteine (Hcy). Hcy serves as a critical intermediate in methylation reactions. It is created from methionine and either converted back to methionine or transformed into cysteine. This process is aided through several enzymes and three vitamins, folic acid, B12, and B6. Daily supplementation with 0.5–5.0 mg of folic acid typically lowers plasma Hcy levels by approximately 25%. Hyperhomocysteinemia is a known risk factor for coronary artery disease. In this regard, elevated levels of Hcy have been found in a majority of patients with vascular disease.

Methods

A literature review of folic acid supplementation for various disease states including cardiovascular disease was conducted. This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Results

In this review, we discuss the biochemistry of folic acid, Hcy biosynthesis, Hcy and hydrogen sulfide bioavailability, pathogenesis of hyperhomocysteinemia and its role as a risk factor for disease, and treatment studies with folic acid supplementation in disease states.

Conclusion

Folic acid supplementation should be recommended to any patient who has an elevated Hcy level, and this level should be measured and treated at an early age, since folic acid is easily obtained and may likely reduce vascular disease and other deleterious pathologic processes in high-risk populations.

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Title: Folic Acid Supplementation in Patients with Elevated Homocysteine Levels
Authors: Alan D. Kaye
George M. Jeha
Alex D. Pham
Mitchell C. Fuller
Zachary I. Lerner
Gerald T. Sibley
Elyse M. Cornett
Ivan Urits
Omar Viswanath
Christopher G. Kevil
Publication date: 01-10-2020
Publisher: Springer Healthcare
Keywords: Folic Acid
Arterial Diseases
Published in: Advances in Therapy / Issue 10/2020
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI: https://doi.org/10.1007/s12325-020-01474-z

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