The H Factor
Patrick Holford, BSc, DipION, FBANT, NTCRP, is a leading spokesman on nutrition and mental health andfounder of both the Food for the Brain Foundation and the Institute for Optimum Nutrition, initiallytrained in psychology. He was one of the first promoters of the importance of zinc, essential fats, low-GL
diets, and homocysteine-lowering B vitamins and their importance in mental health and Alzheimer’sprevention. He is the author of 47 books, translated into over 30 languages, including Upgrade Your Brain.
He is a retired visiting professor at the University of Teesside and is in the Orthomolecular Medicine Hallof Fame.
“HOMOCYSTEINE-LOWERING TREATMENT [WITH B VITAMINS] SEEMS THE MOST PROMISINGINTERVENTION FOR ALZHEIMER’S DISEASE PREVENTION". THESE ARE NOT MY WORDS BUT THECONCLUSION OF THE LARGEST-EVER REVIEW OF 396 STUDIES ON ALZHEIMER'S PREVENTION [1]THE US NATIONAL INSTITUTES OF HEALTH (NIH) RESEARCH ATTRIBUTES 22% OF THE RISK FOR
ALZHEIMER'S TO RAISED HOMOCYSTEINE, LOWERED BY B VITAMINS – SPECIFICALLY B6, B12, AND FOLATE,WHICH IS RICH IN GREENS (THINK FOLIAGE).

Homocysteine, which is a simple and inexpensive blood test, available fromfoodforthebrain.org/tests. If your level is above 11 mcmol/l, this is consistent withaccelerated rate of brain shrinkage. 40% of over 60-year-olds in the US have raised
homocysteine [2]] This is. This is often a function of poor absorption of B12, which is only
found in animal-origin foods – fish, meat, dairy, and eggs. But if your homocysteine is above
10, the recommendation is to supplement not the basic RDA of B12, which is 2mcg, but
500mcg, together with 20mg of B6 and at least 400mcg of folate. There are manyhomocysteine-lowering supplements that provide these in combination. It might cost you 10cents a day.
Watch this film to understand how homocysteine accumulates and why B vitamins are vital for aprocess called methylation.
Homocysteine is not just a risk factor – it is considered causal because lowering it with B
vitamins has produced more than a 50% reduction in the rate of brain shrinkage and virtually
no further memory decline in those with pre-dementia [3].] The B vitamin treatment actuallyreduced shrinkage of the Alzheimer's related areas of the brain by almost 9 times in a year,compared to placebo.[4]This reduction in the rate of brain shrinkage goes up to 73% in thosewith sufficient omega-3 DHA [5], another prevention essential. Why? Because making brain
cells requires omega-3 to be bound into the cell membrane, a process dependent on these B
vitamins.
Homocysteine isn’t just an indicator of insufficient B vitamins. It is also toxic to the brain andthe arteries, thus very strongly linked to vascular dementia. Having a raisedhomocysteine has been shown to increase the risk of blood vessel damage in the brain by 17times. [6]If you give a builder a hammer, do you get a house? No. If you give them a bag of nails, doyou get a house? No. However, if you give them both you get a house. B vitamins are thehammer, and omega-3 is the nail. That's why testing your homocysteine level, andsupplementing B vitamins if your level is above 10, is one of the most effective andinexpensive prevention steps you can take. A home test homocysteine kit is available in theUK, US and EU from foodforthebrain.org/tests. If you would like to take part in theHomocysteine project, visit foodforthebrain.org/Hproject.
Homocysteine is actually a biomarker for 100 diseases, mainly of the brain. You can readmore about homocysteine, not just for Alzheimer’s, and other ways to protect your brain in
my book Upgrade Your Brain .
References:
1. Yu JT, Xu W, Tan CC, Andrieu S, Suckling J, Evangelou E, Pan A, Zhang C, Jia J, Feng L, Kua
EH, Wang YJ, Wang HF, Tan MS, Li JQ, Hou XH, Wan Y, Tan L, Mok V, Tan L, Dong Q,Touchon J, Gauthier S, Aisen PS, Vellas B. Evidence-based prevention of Alzheimer’s
disease: systematic review and meta-analysis of 243 observational prospective studies
and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry. 2020
Nov;91(11):1201-1209. doi: 10.1136/ jnnp-2019-321913. Epub 2020 Jul 20. PMID:
32690803; PMCID: PMC7569385.
2. Pfeiffer CM, Osterloh JD, Kennedy-Stephenson J, Picciano MF, Yetley EA, Rader JI, Johnson CL.
Trends in circulaGng concentraGons of total homocysteine among US
3. Smith, A.D. et al., ‘Homocysteine-lowering by B vitamins slows the rate of accelerated brain
atrophy in mild cognitive impairment: a randomized controlled trial’, Public Library of Science
ONE, 5(9) (2010)
4. Douaud G et al., ‘Disease-modification in MCI with homocysteine-lowering B vitamins slows
atrophy of particular brain regions: the Vitacog trial.’ The Journal of Nutrition, Health & Aging,
Volume 15, Supplement 1, 2011
5. Jernerén F, Elshorbagy AK, Oulhaj A, Smith SM, Refsum H, Smith AD (2015). Brain atrophy incognitively impaired elderly: the importance of long-chain ω-3 fatty acids and B vitamin status in arandomized controlled trial. Am J Clin Nutr. 2015 Jul;102(1):215-21
6. Teng Z, Feng J, Liu R, Ji Y, Xu J, Jiang X, Chen H, Dong Y, Meng N, Xiao Y, Xie X, and Lv P
(2022). Cerebral small vessel disease mediates the association between homocysteine and cognitivefunction. Front. Aging Neurosci. 14:868777. doi: 10.3389/fnagi.2022.868777