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Therapeutic Uses
There is no doubt that TMG greatly reduces homocysteine levels and improves health among people with the rare disease cystathionine beta-synthase deficiency (as well as related conditions). 1 TMG also appears to reduce relatively mild homocysteine elevations in people without genetic defects. 2 However, as noted above, TMG also seems to worsen cholesterol profile , and this may counteract any possible benefits. 3 For this reason, if you have elevated levels of homocysteine, it may make more sense to reduce it by taking supplemental folate , vitamin B 6 , and vitamin B 12 ; these supplements are known to reduce homocysteine levels , and, unlike TMG, they provide nutritional benefit as well.
TMG may help protect the liver against the effects of alcohol, perhaps by stimulating the formation of SAMe . 4 In addition, it may be helpful for non-alcoholic forms of fatty liver (non-alcoholic steatosis) as well. 5 TMG has also been suggested as a less expensive substitute for SAMe in other condition for which SAMe is used (such as osteoarthritis and depression ). However, there is no evidence to show that it is effective.
A substance labeled pangamic acid or vitamin B 15 has been extensively used as a performance enhancer by Russian athletes and has also become popular among American athletes. However, it is not clear there really is any such substance; or, to state it another way, various substances have at various times been given that name. Most recently, the term has been associated with a mixture of calcium gluconate and DMG; one small study failed to find this form of pangamic acid effective for enhancing sports performance . 6
References
- Wilcken DEL, Dudman NPB, Tyrrell PA. Homocystinuria due to cystathionine beta-synthase deficiency—the effects of betaine treatment in pyridoxine-responsive patients. Metabolism. 1985;34:1115-1121.
- Schwab U, Törrönen A, Meririnne E, Saarinen M, Alfthan G, Aro A, Uusitupa M. Orally administered betaine has an acute and dose-dependent effect on serum betaine and plasma homocysteine concentrations in healthy humans. J Nutr. 136(1):34-8.
- Olthof MR, Vliet TV, Verhoef P et al. Effect of homocysteine-lowering nutrients on blood lipids: results from four randomised, placebo-controlled studies in healthy humans. PLoS Med. 2005;2:e135.
- Barak AJ, Beckenhauer HC, Tuma DJ. Betaine, ethanol and the liver: a review. Alcohol. 1996;13:395-398.
- Abdelmalek MF, Angulo P, Jorgensen RA, Sylvestre PB, Lindor KD. Betaine, a promising new agent for patients with nonalcoholic steatohepatitis: results of a pilot study. Am J Gastroenterol. 96(9):2711-7.
- Gray ME, Titlow LW. The effect of pangamic acid on maximal treadmill performance. Med Sci Sports Exerc. 14(6):424-7.