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Causes of High Homocysteine Levels (Hyperhomocysteinemia) Many factors contribute to high homocysteine levels: Insufficient folate, vitamin B 6 , vitamin B 12 , betaine, vitamin B 2 , and magnesium Certain prescription drugs (including cholestyramine, colestipol, fenofibrate, levodopa, metformin, methotrexate, high-dose niacin, nitrous oxide, pemetrexed, phenytoin, sulfasalazine) High-methionine diet (including red meat and dairy products) Smoking High coffee consumption Alcohol consumption Advancing age Obesity Genetic variant that causes an impaired ability to metabolize active folate from folic acid Note: Life Extension believes that the optimal range for homocysteine levels is 11 mol/L) has been associated with a substantial increase in risk of dementia in the elderly