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In cells, homocysteine is metabolized in three ways :[ref] It can be remethylated to form methionine (requires folate, MTHFR, and vitamin B12, MTR gene or needs betaine, interacting with BHMT and PEMT genes) Can be converted to cysteine (CBS gene, serine and B6 as a cofactor), which is used in the synthesis of glutathione It can be converted to homocysteine thiolactone, which can be a problem at higher levels Lets dig into each of these pathways further: Methylation Cycle: Homocysteine, Methionine, SAMe, and SAH Homocysteine is maintained at a relatively constant level by several mechanisms in the methionine cycle
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That gap matters because GLP-1 medications work best when combined with intentional dietary changes
The fix is usually consistent timing, taking levothyroxine at least 30 to 60 minutes before retatrutide, and monitoring TSH more frequently during dose escalation
