Xu J, Xu Z, Ge N, et al. - Possible independent risk factors for erectile dysfunction (ED) are low folic acid (FA) levels and high homocysteine (HCY) levels. Findings indicate that low serum FA and vitamin B12 (B12) concentrations might co-induce high HCY levels and result in ED.

• A total of 134 ED patients and 50 healthy controls were analyzed.

• IIEF-5 scores were applied to evaluate ED.

• Lower median FA (6.08 vs 10.21), B12 (256.0 vs 337.5), and higher median HCY (11.4 vs 7.95) levels were present in the ED group, and these differences appeared to be more pronounced in the younger participants (age < 35 yr).

• Reduction in FA whereas increase in HCY was seen with the severity of ED.

• Lower FA levels were detected in relation to smoking and shift work.

• Best cut-off values for ED diagnosis were: FA ≤ 8.84 and HCY ≥ 10.35.

• There was a negative correlation of both FA (r = −0.703, p < .001) and B12 (r = −0.576, p < .001) with HCY.