What is Trimethylglycine (TMG), also known as Betaine?

From the Guidelines

Trimethylglycine (TMG), also known as betaine, is a valuable supplement for reducing homocysteine levels and potentially lowering cardiovascular risk factors, and its use is supported by recent studies 1. When considering the use of TMG, it is essential to understand its role in the body and its potential benefits. TMG serves as a methyl donor, helping to convert homocysteine into methionine through a process called methylation. This mechanism may reduce homocysteine levels, which is associated with a lower risk of cardiovascular disease. Some key points to consider when using TMG supplements include:

• Typical doses range from 500-3000mg daily, divided into 2-3 doses
• TMG may help improve exercise performance, support liver health during alcohol consumption, or manage certain metabolic conditions
• Side effects are generally mild but may include digestive discomfort
• Individuals taking medications that affect homocysteine metabolism should use TMG cautiously
• Recent studies suggest that using methylcobalamin and 5-methyltetrahydrofolate instead of cyanocobalamin and folic acid may be more efficacious in preventing stroke 1 It is crucial to consult a healthcare provider before starting TMG supplementation, especially for those with existing health conditions. By understanding the benefits and potential risks of TMG, individuals can make informed decisions about its use and optimize their health outcomes.

From the FDA Drug Label

When administered in recommended oral dosage to children or adults, Cystadane acts as a methyl group donor in the remethylation of homocysteine to methionine in patients with homocystinuria. The chemical name of betaine anhydrous powder is trimethylglycine.

Trimethyglycine is another name for betaine, which is used to treat homocystinuria by reducing toxic blood levels of homocysteine.

• It acts as a methyl group donor in the remethylation of homocysteine to methionine.
• The onset of action of betaine is within several days and a steady state in response to dosage is achieved within several weeks 2.
• Trimethyglycine has a molecular weight of 117.15 2.

From the Research

Trimethyglycine Overview

• Trimethyglycine, also known as betaine, is an important human nutrient obtained from various foods and can be synthesized from choline 3
• It plays a crucial role in the kidney as an osmoprotectant and in the liver as a methyl donor in the methionine cycle 3

Health Benefits and Uses

• Betaine has been studied for its potential therapeutic uses, including the treatment of nonalcoholic fatty liver and hyperhomocysteinemia, a risk factor for atherosclerotic disease 3
• Supplementation with betaine has been shown to reduce plasma homocysteine concentrations in healthy humans, with a dose-dependent effect 4
• Betaine may also have a role in reducing homocysteine levels in patients with mild cognitive impairment, with studies suggesting that supplementation with vitamins B6, B12, and/or folic acid can lower homocysteine levels 5

Relationship with Other Nutrients

• Betaine is linked to homocysteine metabolism, and its supplementation can affect plasma homocysteine concentrations 4
• Folic acid, vitamin B12, and vitamin B6 are also important in homocysteine metabolism, and their supplementation can reduce homocysteine levels in certain populations, such as those with chronic kidney disease or mild cognitive impairment 6, 7, 5

Pharmacokinetics and Metabolism

• Orally administered betaine has an immediate and dose-dependent effect on serum betaine concentration, with absorption and elimination being dose-dependent 4
• The urinary excretion of betaine increases with increasing betaine dose, although a small proportion of ingested betaine is excreted via urine 4