Betrinac is a combined B-vitamin and anti-oxidant supplement marketed by COBALZ Limited and manufactured in the USA by Red River Pharma. Betrinac contains Vitamin B6 (20 mg), Vitamin B12 (1000mcg), Folic Acid (800mcg), and N-acetyl-L-cysteine (NAC) (600 mg). This unique combination works to reduce blood levels of the amino acid homocysteine. Elevated blood levels of homocysteine are associated with an increased risk of vascular disease, stroke, cognitive decline, brain atrophy and dementia, including Alzheimer's Disease. Lowering homocysteine with high dose B vitamins has been shown to slow brain atrophy  and improve cognitive and clinical outcomes in patients with mild cognitive impairment.Case studies have shown improved clinical outcomes from the addition of NAC to B vitamins, and NAC alone can additionally lower blood homocysteine levels. However, randomized clinical trials are still being conducted to determine whether or not lowering homocysteine can prevent or delay the conversion from mild cognitive impairment to clinical dementia.