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While we need methionine and protein in the diet, one way to increase homocysteine is to significantly increase dietary methionine without a concomitant increase in choline, B12, or folate.[ref] Timing of testing: Homocysteine levels are lowest in the first hour after a meal, so if you test your homocysteine level after eating, it will likely be different than what a fasting blood test will show.[ref] Down syndrome, CBS, and low homocysteine: People with Down syndrome usually have very low homocysteine levels due to the extra copy of chromosome 21, which causes an extra copy of the CBS gene

doi: 10.18565/urology.2020.5.67-72 60 PennaGMondainiNAmuchasteguiSDegli InnocentiSCariniMGiubileiGet al

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doi: 10.1038/s41582-019-0155-7 27 ErlichJ

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However, when emodin, rhein and to a lesser extent cis -stilbene, were used in combination with each topoisomerase II inhibitor, there was an antagonistic increase in ATP, an inhibition of apoptosis and no cell-cycle arrest