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Significantly elevated homocysteine has been observed in people suffering with cardiovascular disease, stroke, neurodegeneration (Nelson et al, 2016) and frailty in old age (Guaita et al, 2021) and elevated homocysteine is associated with a reduced blood flow to the small vessels in the brain (reduced microcirculation) (Hassan et al, 2004) which is an important connection because a reduced microcirculation may increase the risk of developing Alzheimers disease, amyotrophic lateral sclerosis (ALS) or Parkinsons disease (Erdener and Dalkara, 2019)

Two better-absorbed options are N-acetylcysteine (NAC), which provides the rate-limiting amino acid cysteine so the body can build its own supply, and liposomal glutathione, which uses fat-based capsules to protect the molecule through digestion

She says several companies, including her own, are developing small-molecule TREM2 agonists that can turn up the volume on microglia, but only where amyloid or another misfolded protein or target is found

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