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In cells, homocysteine is metabolized in three ways :[ref] It can be remethylated to form methionine (requires folate, MTHFR, and vitamin B12, MTR gene or needs betaine, interacting with BHMT and PEMT genes) Can be converted to cysteine (CBS gene, serine and B6 as a cofactor), which is used in the synthesis of glutathione It can be converted to homocysteine thiolactone, which can be a problem at higher levels Lets dig into each of these pathways further: Methylation Cycle: Homocysteine, Methionine, SAMe, and SAH Homocysteine is maintained at a relatively constant level by several mechanisms in the methionine cycle
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If you have an underlying health condition like kidney disease, or if you take medication that interferes with B6 metabolism or absorption (such as oral contraceptives, hypertension drugs like hydralazine, and others), ask your doctor about appropriate supplement dosing