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The homocysteine pathway encompasses the biochemical reactions whereby the amino acid homocysteine is generated from methionine and then either converted back to methionine by remethylation or irreversibly catabolized to cysteine by transsulfuration. Key enzymes include methionine synthase (remethylation) and cystathionine β-synthase (transsulfuration), which rely on cofactors such as folate, vitamin B12, and vitamin B6. Disruptions in these pathways, resulting in elevated homocysteine (hyperhomocysteinemia), have been strongly associated with an increased risk of cardiovascular disease, neurodegenerative disorders, pregnancy complications, and other systemic conditions.

Other names

Homocysteine metabolismMethionine cycleRemethylation pathwayTranssulfuration pathway

Lower homocysteine level via enzyme cofactor supplementation (B vitamins)\nEnhance remethylation (folate/B12)\nEnhance transsulfuration (B6)\nMethyl donor supplementation (betaine)