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Pernicious Anaemia Society
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Homocysteine Reduction via B12 and Folate results?

My Homocysteine levels were measured at 20 (forgot the standard unit) and supposedly it explains why I get brain fog and fatigue (I get really tired in the afternoon and have to take a nap for a couple hours or else I can't function).

Now I'm getting treated with hydroxocobalamine injections and methylfolate, and it's been about two weeks. I feel a little bit better on the days I take my b12 shot (I think), but the rest of the days it's the same.

How long does it usually take to reduce the homocysteine levels? Is there anyone that has successfully treated homocysteine levels and had the same symptoms -- brain fog and fatigue?

Also, I have not been diagnosed with anaemia, but would any neuroligical damange i have be permanent? im talking about the brain fog, lack of concentration and short term memory.

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B12 and folate deficiencies can cause the symptoms you describe in a number of ways- not just raised homocysteine levels- which will usually reduce quite quickly.

permanent neurological damage is a possibility but it isn't the norm.

It can take a while for symptoms to go - some people find it takes months - for others its quite quick - and it can vary depending on the symptoms. Some people also find that things can get a bit worse -eg aches and pains get worse or you notice colds and infections more - before things even out.

Suggest you make a full list of symptoms - and include things that may have been around for years - and monitor how each of those is doing



thanks for the reply. out of those symptoms i only have brain fog and fatigue, but the brain fog was really bad a couple months ago.

question is, if my full panel blood work didn't indicate anything wrong asides from elevated homocysteine, does that mean my red blood cells still need repairing? i always assumed it would come up on the hemoglobin test?

my hemoglobin value is 15.6 and my red blood cell count is 5.13.


unfortunately different units get used - and ranges can vary from test to test and iron anaemia isn't an area I'm really that familiar with.

homocysteine tends to be high in relation to folate and B12 deficiencies because both are used in the process that recycles it into a useful building block - as far a I am aware this isn't directly related to anaemia at all - but is another marker in relation to B12 and folate deficiencies.

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I see so I could not have anaemia at all and still have to go through the normal effects of the treatment process where my symptoms can get worse before better, right?


basically yes - B12 deficiency affects people in different ways - it's used in a lot of processes at the cell level and not all of them may go wrong - and they may heal at different processes. Some processes start running properly very quickly - others can take a very long time to rectify damage


Hi Jakcson9090, I recently wondered the same thing about how long it takes to reduce homocysteine levels when B12 and folate are no longer deficient. I did not find a clear answer but it appears to be a week or two.

Though homocysteine does cause problems, it does not directly cause the symptoms of brainfog and fatigue (as far as I know). Brain fog tends to get better pretty quickly, in my case. Fatigue can take a few weeks to get better as any malformed red blood cells needs to be replaced. Though fatigue may result from the MUT(Methylmalonyl-CoA mutase) and MTR(Methionine synthase) pathways not working too well when B12 deficient. They should start working pretty quickly once you have enough B12.

Peripheral neuropathy symptoms like burning feet/hands, numbness, dizziness and poor vision can take many months to fix. Generally the longer the nerve the longer it takes.

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Interesting, well now I'm about -2 weeks into the treatment and yesterday when I took the injection I had clear mind (could read and understand everything) and didnt crash in the afternoon after a big carb junk food meal.

Today I, didnt have the shot, had trouble reading, and crashed for a little over an hour in the afternoon, which is less than usual, but still crashed nonetheless.

I guess my brain fog didn't instantly go away like yours. So now I'm assuming that everytime I take the injections which is every 3 days, I will feel good, and will crash in between, until I start getting better on the 1st day without injections, and then slowly feeling better on all days.

Is this how you progressed as well?


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