Question: You recommend 5 mg of folic acid each day for homocysteine levels over nine. I am 74 and my reading is 12, although all other tests are good. The people at the Vitamin Shoppe say this must be a misprint, because the top level is 1 mg per day.

Dr. Brownstein's Answer:

That was no misprint. My experience has clearly shown folic acid up to 1 mg a day is not the correct dose to lower homocysteine levels. In fact, I have used much higher doses — up to 25 mg a day for specific conditions.

To optimally lower homocysteine, I frequently have my patients use 5 mg a day of folic acid. For those with a defect in folic-acid metabolism, the activated form — methyl folic acid — may be necessary.

Appropriate blood tests before and after supplementation should be conducted.