The causes of hyperhomocysteinemia can be primarily genetic, such as MTHFR 677C > T polymorphism, or acquired due to underlying diseases, medication, or lifestyle.31,36,37 Next to folate and vitamin B12 deficiency, renal dysfunction, unfavorable lipid profiles, increasing age and male sex are associated with hyperhomocysteinemia.31,36 Furthermore, smoking, increased coffee consumption, and probably increased alcohol consumption influences serum homocysteine levels.31,32. This evidence concerns the gene MTHFR and hyperhomocysteinemia.