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Table of Contents > Supplements > Betaine
Also Known As:  Trimethylglycine
Dietary Sources
Available Forms
How to Take It
Possible Interactions
Supporting Research


Betaine is a nutrient that plays an important role in the health of the cardiovascular system. Studies have suggested that betaine, along with other nutrients, helps to reduce potentially toxic levels of homocysteine (Hcy), a naturally occurring amino acid that can be harmful to blood vessels thereby contributing to the development of heart disease, stroke, and peripheral vascular disease (reduced blood flow to the legs and feet).

Betaine functions closely with other nutrients -- namely, S-adenosylmethionine (SAMe), folic acid, and vitamins B6 and B12 -- to break down Hcy and reduce toxic levels of this substance in the bloodstream. When betaine, or any of these related nutrients, becomes low in the body, Hcy levels may rise. Some people have a genetic condition called "homocystinuria," in which Hcy levels accumulate in the body. Betaine supplements are used to lower levels of Hcy in people with this inherited health condition.


Heart Disease and Stroke

Betaine may contribute to the lowering of Hcy, a substance recognized as a significant risk factor for atherosclerosis and blood clots in the walls of blood vessels, which can lead to a heart attack or stroke. The American Heart Association does not currently recommend population-wide Hcy screening, and suggests that obtaining appropriate amounts of betaine, as well as folic acid and vitamins B6 and B12, be met through diet alone. Individuals at high risk for developing heart disease, however, may be screened for blood levels of homocysteine. If elevated levels are detected, a healthcare practitioner may recommend supplementation in addition to dietary changes.

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, poorly controlled diabetes, and other causes. A few studies on people have also been conducted. In one preliminary study, 10 people with fatty liver disease from causes other than alcohol received betaine for up to one year. All of the participants had improvement in liver function tests and a reduced amount of fat and other changes in the liver itself. In another larger, better-designed study that took place in Italy, nearly 200 patients received either betaine, in combination with two other substances, or a placebo. Those who received the betaine combination supplement had improved liver function, reduced fat in the liver, and diminished abdominal pain. Further research is needed to confirm these findings and to see whether it is the betaine that is specifically responsible for the benefit to the liver.

Hypochlorhydria (abnormally low levels of stomach acid)

Betaine is also used to increase the concentration of acids in the stomach.

Dietary Sources

Dietary sources of betaine include beets, broccoli, and spinach. Interestingly, many wines contain betaine, particularly less expensive wines that use beet sugar to increase the alcohol content. Some experts suggest that this may be part of the so-called "French paradox," in which wine drinkers from France tend to have low rates of heart disease despite diets high in fat and cholesterol.

Available Forms

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

How to Take It


There are no known scientific reports on the pediatric use of betaine. Therefore, it is not currently recommended for children.


Recommended doses of betaine vary depending on the health condition being treated. The following list provides guidelines for the most common uses:

  • Heart disease and stroke prevention or treatment: 500 to 1,000 mg per day
  • Homocystinuria: 6 g per day
  • Hypochlorhydria: take with each meal according to product label directions

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 healthcare provider.

Possible Interactions

There are no known scientific reports of interactions between betaine and conventional medications.

Supporting Research

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.

Budavari S, O'Neil MJ, Heckelman PE, Kinneary JF, eds. The Merck Index. 12th ed. Whitehouse Station: Merck & Co., Inc.; 1996: 198.

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.

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.

Mar MH, Zeisel SH. Betaine in wine: answer to the French paradox? Med Hypotheses. 1999;53(5):383-385.

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.

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.

Steinmetz CA, et al. Vegetables, fruit, and cancer prevention: A review. J Am Diet Assoc. 1996: 1027-1039.

The Third National Health and Nutrition Examination Survey. Phase 1, 1989-91. The National Center for Health Statistics. Accessed at: on April 2, 2002.

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.

Review Date: April 2002
Reviewed By: Participants in the review process include: Ruth DeBusk, RD, PhD, Editor, Nutrition in Complementary Care, Tallahassee, FL; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH. All interaction sections have also been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

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