Betaine, or betaine anhydrous, is a nutrient known as a methyl donor [other such nutrients are S-adenosylmethionine (SAMe), folic acid, and vitamins B6 and B12]. This means that betaine carries and donates methyl molecules in the body to help make chemical processes work. Donation of methyl molecules is involved in proper liver function and cellular reproduction. Betaine also helps the body make carnitine.

Heart Disease

Studies have suggested that betaine, along with the other nutrients listed above, helps to reduce potentially toxic levels of homocysteine, a naturally occurring amino acid that, at high levels, is a risk factor for heart disease and stroke. However, scientists don't yet know if homocysteine has a directly harmful effect on arteries or is just a risk factor. Although showing positive results, studies have so far been small and limited. If you are at risk for heart disease, your doctor may test levels of homocysteine in your blood and suggest taking supplements of betaine and the other nutrients listed above.

Homocystinuria

Some people have a genetic condition called homocystinuria, in which homocysteine levels accumulate in the body. They are at much higher risk of developing cardiovascular disease as early as their 20s. Betaine supplements are used to lower levels of homocysteine in people with this inherited health condition.

Liver Disease

Studies with rats have suggested that betaine may help protect against fatty deposits in the liver, which can occur from chronic alcohol use, protein malnutrition, obesity, diabetes, and other causes. A few studies on people have also shown positive results, but the studies have been of varying quality. More research is needed to determine whether betaine is beneficial to people with liver disease.

Dietary sources of betaine include beets, broccoli, grains, shellfish, and spinach.

Betaine supplements are manufactured as a byproduct of sugar beet processing. They are available in powder, tablet, and capsule forms.

Pediatric

Betaine is not recommended for children unless it is prescribed by your doctor to treat homocystinuria, a genetic condition.

Adult

Recommended doses of betaine vary depending on the condition being treated.

• Cardiovascular disease: 1,500 - 3,000 mg per day
• Homocystinuria: 6 g per day

It is generally recommended that betaine be taken in conjunction with folic acid, vitamin B6, and vitamin B12.

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Most side effects from betaine are mild and include diarrhea, stomach upset, and nausea.

People with kidney disease should not take betaine, because it can increase total cholesterol levels when taken with folic acid and vitamin B6.

People who are overweight or obese should not take betaine without talking to their doctor, because it can raise total cholesterol levels.

In people with kidney disease, betaine may interfere with drugs taken to lower cholesterol levels in the blood.

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. 2001;96(9):2711-2717.

Angulo P, Lindor KD. Treatment of nonalcoholic fatty liver: present and emerging therapies. Semin Liver Dis. 2001;21(1):81-88.

Barak AJ, Beckenhauer HC, Badkhsh S, Tuma DJ. The effect of betaine in reversing alcoholic steatosis. Alcohol Clin Exp Res. 1997;21(6):1100-1102.

Barak AJ, Beckenhauer HC, Tuma DJ. Betaine, ethanol, and the liver: a review. Alcohol. 1996; 13(4): 395-398.

Boushey CJ, et al. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes. JAMA. Oct 4, 1995; 274(13): 1049-1057.

Eikelboom JW, Lonn E, Genest J, Hankey G, Yusuf S. Homocyst(e)ine and cardiovascular disease: a critical review of the epidemiologic evidence. Ann Intern Med. 1999;131:363-375.

Hanje AJ, Fortune B, Song M, Hill D, McClain C. The use of selected nutrition supplements and complementary and alternative medicine in liver disease. Nutr Clin Pract. 2006 Jun;21(3):255-72. Review.

Kendler BS. Supplemental conditionally essential nutrients in cardiovascular disease therapy. Cardiovasc Nurs. 2006 Jan-Feb;21(1):9-16. Review.

Kishi T, et al. Effect of betaine on S-adenosylmethionine levels in the cerebrospinal fluid in a patient with methylenetetrahydrofolate reductase deficiency and peripheral neuropathy. J Inherit Metab Dis. 1994; 17(5): 560-565.

Malinow MR, Bostom AG, Krauss RM. Homocyst(e)ine, diet, and cardiovascular disease. A statement for healthcare professionals from the nutrition committee, American Heart Association. Circulation. 1999;99:178-182.

Miglio F, Rovati LC, Santoro A, Senikar I. Efficacy and safety of oral betaine glucuronate in non-alcoholic steatohepatitis. A double-blind, randomized, parallel group, placebo-controlled prospective clinical study. Arzneimittelforschung. 2000;50(8):722-727.

Olthof MR, Bots ML, Katan MB, Verhoef P. Effect of folic acid and betaine supplementation on flow-mediated dilation: a randomized, controlled study in healthy volunteers. PLoS Clin Trials. 2006 Jun;1(2):e10.

Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. Vol 1. 2nd ed. Churchill Livingstone; 1999:462-466.

Robinson K, Arheart K, Refsum H, et al. Low circulating folate and vitamin B6 concentrations. Risk factors for stroke, peripheral vascular disease, and coronary artery disease. Circulation. 1998;97:437-443.

Sarkar PK, Lambert LA. Aetiology and treatment of hyperhomocysteinaemia causing ischaemic stroke. Int J Clin Pract. 2001;55(4):262-268.

Shils M, Olson J, Shike M, eds. Modern Nutrition in Health and Disease Vol 1. 9th ed. Media: Williams & Wilkins; 1999: 452.

Stampfer MJ, Malinow MR. Can lowering homocysteine levels reduce cardiovascular disease? N Engl J Med.1995; 332: 328-329.

van Guldener C, Stehouwer CD. Homocysteine-lowering treatment: an overview. Expert Opin Pharmacother. 2001;2(9):1449-1460.

Wilcken DE, et al. Homocystinuria due to cystathione beta-synthase deficiency--the effects of betaine treatment in pyridoxine-responsive patients. Metabolism. 1985; 34(12): 1115-1121.

Zeisel SH. Betaine supplementation and blood lipids: fact or artifact? Nutr Rev. 2006 Feb;64(2 Pt 1):77-9. Review.