1) Get fasting insulin and a repeat fasting lipid profile after a strict 12-hour fast to confirm the triglyceride level. 2) Serum B12, folate, TSH and creatinine, plus repeat vitamin D, before starting any supplement - B12/folate/D correction under supervision is what brings homocysteine down. 3) Lifestyle is the main treatment at your age: cut sugar, refined carbs, alcohol and fried food, add 40-45 minutes of brisk walking or gym 5 days a week, and aim to reduce waist size - triglycerides respond fastest to this. 4) No cholesterol medicine is needed on these numbers alone; recheck lipids in 3 months. You can book an online consult with me on Practo to review your reports and plan supplement doses, or visit me at Synergy Multispeciality Hospital, Miraj if you prefer an in-person check with BP and waist measurement.

Please do not start high-dose B12 or vitamin D on your own. If you ever develop chest pain or tightness on exertion, breathlessness, or numbness/tingling in the hands and feet, get evaluated in person without delay.

feel free to consult me on practo for further evaluation and management

Adjust Your Diet eat leafy greens: Fill your plate with spinach, kale, broccoli, and asparagus for natural folates. Include legumes: Add lentils, chickpeas, and black beans to your meals. Eat B6 and B12 sources: Incorporate fish, poultry, eggs, and moderate amounts of organic dairy or lean meat. Add betaine-rich foods: Eat beets, quinoa, and spinach to further support the breakdown of homocysteine. Modify Lifestyle Habits Limit alcohol: Reduce or eliminate alcohol, which blocks your body's ability to process B vitamins.Quit smoking: Avoid all tobacco products to protect your blood vessels. Exercise regularly: Stay active with at least 150 minutes of moderate movement each week.