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Specifically, high homocysteine inhibits complex I-III, directly impacting the ability of mitochondria to produce ATP.[ref] High homocysteine and chronic diseases: High homocysteine can cause chronic health conditions by: Increasing oxidative stress Causing endoplasmic reticulum (ER) stress Incorporation into proteins in the place of methionine Mendelian randomization studies can be used to show a cause-and-effect relationship between a marker, such as homocysteine, and a disease

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10.20471/acc.2018.57.03.08 Kang Q, Yang C: Oxidative stress and diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications

However, results differ, and larger studies are still needed