MTHFR and hyperhomocysteinemia: The hyperhomocysteinemia resulting from poor folate metabolism related to MTHFR/COMT or poor folate intake directly damages endothelial cells and impairs nitrous oxide release, reducing endothelial functioning.38,39 Thus, supplementing the folic acid cycle with 5 mg of folate for 3 months may work to overcome endothelial damage and may help to improve overall endothelial functioning, potentially through an anti-inflammatory process given our reduction in measured cytokines, and relative lack of change in metabolic measures.