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Afternoon crash on Rich's methylation protocol

Messages
25
A few months ago, my doctor tested me for MTHFR. I came back homozygous for 677T, and she started me on a regimen of 1000 mcg methylcobalamin, tapered up to 5000mcg over a month. Then I started taking 400mcg methylfolate and tapered up to 800mcg over a month. During that time I started feeling incredibly toxic. My muscles were sore, I couldn't exercise because I was so tired, and I cried multiple times per week which was extremely unusual for me (having never really cried much in my life).

After two months, I stopped the supplements and felt better the next day. During that time I did some research and got my genes tested by 23andme using the v4 chip. Here are some of my results:

VDR Taq +/-
MAO A R297R +/+
MTHFR 677T +/+
MTRR A66G +/-
MTRR K350A +/-
BHMT-02 +/+
BHMT-08 +/+
ACHY-01 +/-
ACHY-19 +/-

After getting these results I started on Rich's protocol, taking the following supplements early in the morning:

2000mcg hydroxocobalamin
200mcg methylfolate
Yasko's All-in-One (1x)
Yasko's BeCalm spray (6x)
Yasko's Phosphatidyl Serine Complex (1x)
Vitamin D 4000 IU

It has been about two weeks since I started. I feel good in the mornings, but I crash about 8 hours after taking my supplements. For the next 6 hours until bedtime, I become extremely fatigued, sad (often wanting to cry), unable to move around much, and my brain gets foggy and I have difficulty stringing thoughts together. Sometimes I have difficulty speaking properly -- I mispronounce words or combine multiple words together. That never happened to me before starting the protocol.

I would be grateful for any help figuring out what is causing this afternoon crash, and whether or not my current protocol makes sense based on my genetic mutations.
 
Last edited:

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
@Waldemath I'm really sorry you're having such a hard time. Rich's protocol, hydroxyB12, didn't work for me, but Freddd's Protocol returned me to life. There are a couple links to it in my signature. I need MethylB12 rather than other forms. Also the 2 other components of Fred's Deadlock Quartet, AdenoB12 and carnitine, usually L-Carnitine Fumarate (LCF) form.

You might try splitting your doses of B12, folate, to see if that avoids the crash. Caledonia has created an snp guide that is really helpful. And I found that FMN form of B2 has been miraculous, gotten me off many other supps. There are a few of us who've had this excellent result with MAO++
 

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
@ahmo. Thanks for helping

Is the FMN B2 something one could take without other B's?

Since my problems with methylation I stopped everything but the LCF which I have no problems with. I could add MB12 Probabaly since I took that alone before I added metafolin.

I found source naturals sublingual. Are there others?
 

ahmo

Senior Member
Messages
4,805
Location
Northcoast NSW, Australia
Is the FMN B2 something one could take without other B's?
The best I can do is quote you from @ppodhajski, whose comments inspired me to try it. I don't believe he's active on pr now. But from reading the following, it might be that you don't need the others. Although the conventional wisdom is that B vitamins need to be balanced. I haven't looked further than Source Naturals.
http://forums.phoenixrising.me/inde...lation-protocol-srmp.36344/page-2#post-586710 Sustained-release Methylation Protocol (SRMP)

This talk of methylation and MAO is confusing to me. The only methyl that helps break down biogenic amines is SAMe and that helps the COMT enzyme, not the MAO enzyme.

But why take B2 when you can take flavin mononucliotide (FMN) as a sublingual? That is all I take for my MAO, plus magnesium for my COMT. I also stopped taking B12 in any form and my levels are normal after being very high for so long. I think all those sups you have listed are a waste.

Also, a low amine diet helps but I find I can eat more amines as long as I take more FMN. And it also took me, and one of my friends only one day to feel the effects from FMN.

My disabling anxiety and neuropathy (among other things) are all gone.

...But I also take FMN (B2) which helps lower catecholamines by fixing my MAOA and MAOB SNPs. And I am also on a low amine diet

I found the sublingual FMN works much faster, like 15 minutes, when I was having epinephrine provoked anxiety.
 
Messages
25
@Valentijn Yes. I shouldn't have abbreviated that. The supplement is called "Phosphatidyl Serine Complex" and it contains:

Phosphorus 10 mg
Potassium 3 mg
Phosphatidyl serine complex: 500 mg
~Phosphatidylserine 100 mg
~Phosphatidylcholine 55 mg
~Phosphatidylinositol 10 mg
~Phosphatidylethanolamine 20 mg
~Linolenic acid 10 mg
~Linoleic acid 85 mg
~Oleic Acid 15 mg
~Palmitic Acid 27 mg
~Stearic acid 6 mg
~Capric acid 51 mg
~Caprylic acid 120 mg
 

caledonia

Senior Member
That's not Rich's protocol. Yasko's All In One multi is not comparable to the old General Neurological Health formula.

The All in One contains everything that Rich spec'd out, except I would also suggest adding sublingual B12 to that (even though there's B12 in the All In One - it's oral, so basically the same as nothing).

So basically you're doubling up on nutrients.

Check out my documents, the "SNPs Interpretation Guide", "Start Low and Go Slow" and "Roadblocks to Successful Methylation" for more help (click on my signature link)
 
Messages
25
@caledonia Thanks. I was looking at an updated version of Rich's protocol posted by someone else:
Simplified Methylation Protocol Revised as of Today

Now I am looking at the version posted by Rich in 2012:
Revised Simplified Methylation Protocol (August 25, 2012 Revision)

One pill of the All in One multivitamin contains:
Folic Acid, calcium folinate, and Methyltetrahydrofolic Acid, Glucosamine Salt as Quadrefolate) 26.4mcg
~Phosphoserine (as Sunflower Sharp PS 60P-SF) less than 216.8mg

Rich's protocol calls for 200mcg Methylfolate, 200mcg Folinic Acid, and 1200mg Lecithin (which I guess could be substituted for PS)

Based on the ingredient list, the All in One doesn't contain adequate amounts of Folinic Acid, Methylfolate, or Lecithin to match Rich's protocol. Does this make sense?
 

caledonia

Senior Member
@caledonia Thanks. I was looking at an updated version of Rich's protocol posted by someone else:
Simplified Methylation Protocol Revised as of Today

Now I am looking at the version posted by Rich in 2012:
Revised Simplified Methylation Protocol (August 25, 2012 Revision)

One pill of the All in One multivitamin contains:
Folic Acid, calcium folinate, and Methyltetrahydrofolic Acid, Glucosamine Salt as Quadrefolate) 26.4mcg
~Phosphoserine (as Sunflower Sharp PS 60P-SF) less than 216.8mg

Rich's protocol calls for 200mcg Methylfolate, 200mcg Folinic Acid, and 1200mg Lecithin (which I guess could be substituted for PS)

Based on the ingredient list, the All in One doesn't contain adequate amounts of Folinic Acid, Methylfolate, or Lecithin to match Rich's protocol. Does this make sense?

Let me take a really good look at this and I'll get back with you. It might be a day or two.
 

caledonia

Senior Member
Hi Waldemuth,

I took a really detailed look at Rich's Protocol. I found the ingredients for the old Neurological Health Formula (NHF) so I could see what was intended. I compared the NHF to the All In One.

In general, 2 tablets of NHF = 1 tablet of the All In One except for one very important exception (which I will get to in a minute).

Minor exceptions:
  • The All in One is missing choline bitartrate, turmeric and TMG (probably a good thing as people can get overmethylated with this)
  • The All in One has the extra ingredients DHA, Phosphoserine (Sunflower Sharp PS 60P-SF), SAMe, astralagus membranus, and the trace minerals strontium, vanadium and lithium.
  • I believe the Phosphoserine would substitute for the TMG/choline and that would also be equivalent to sunflower lecithin and NT Factor.
  • As the extra ingredients are in the Proprietary Blend section, the individual amounts aren't spec'd out, just an overall amount. However the Proprietary amounts in the All in One are half the amount of the similar ingredients in the NHF so that would make think the amounts would be about half of what is spec'd out in the NHF.

The important exception:

The folate has been changed from folic acid (not converting well for most of us) to a blend of folic acid, then the active folates, folinic acid and methylfolate. For people sensitive to methylfolate (like me), even 1 capsule could be too much to start with.

The B12 has been changed from cyanocobalamin to the active form hydroxycobalamin. However, as both forms are oral and not sublingual, they barely absorb, so I don't even bother to count them.

So my prior suggestion still stands - when you're starting out, start with one or less All In One multi and add your favorite form of active sublingual B12. You can increase up to 4 capsules and that will be the equivalent of 6 tablets of the NHF. Increase the B12 commensurately.

Note that per your question, I believe there would be enough Phosphoserine in the All In One to not need additional lecithin/NT Factor unless you want to increase folate and B12 further. There would also be enough methylfolate and folinic to get started.

However, if you're tolerating that, you can do further increases with the other supps suggested by Rich (and/or updated by Sherpa).

Note that 4 caps of the All In One contains approximately 100mg of folic/folinic/methylfolate. So I would suggest possibly only adding another 150mg instead of 200mg of methylfolate and folinic, especially if you're sensitive.

Note that Rich had suggested adding potassium if you're experiencing low potassium symptoms. This often gets dropped out of his protocol because he added it in the next post instead of editing the original post. (He said something about being unable to edit.)

=-==-=-=-=
To sum up, my version of Rich's SMP, updated, would be as follows:

1. All-in-One Multivitamin / Mineral - (1 to 4 capsules per day) - http://www.holisticheal.com/all-in-one-multi-vitamin-mineral-120-capsules.html

2. Taken with your favorite active sublingual B12 (for this protocol that would be hydroxycobalamin).

1 All in One (25mcg folate) + 125mcg hydroxy
2 All In Ones (50mcg folate) + 250mcg hydroxy
3 All in Ones (75mcg folate) + 375mcg hydroxy
4 All in Ones (100mcg folate) + 500mcg hydroxy​

Then if you want to increase further, add #3, #4, and #5 along with additional B12:

3. 150mcg folinic (I realize this is not a simple amount to divide, if you're not sensitive use 200mcg instead)

4. 150mcg methylfolate (I realize this is not a simple amount to divide, if you're not sensitive use 200mcg instead)

Then also increase the hydroxy more or less commensurately in a 5:1 ratio (5 times more hydroxy than folate). The final amount of hydroxy would be 2000mcg.

5. 1200mg of sunflower lecithin (if you're on a budget) or NT Factor EnergyLipids Powder (1/8 to 1/4 teaspoon, once or twice a day) - http://www.pureformulas.com/nt-factors-energy-lipid-powder-150-grams-by-nutricology.html#.

6. Add potassium if you are experiencing low potassium symptoms at any time. Order potassium to have it on hand before you start. NOW Potassium gluconatehttp://www.iherb.com/now-foods-potassium-gluconate-100-pure-powder-1-lb-454-g/13939
http://www.iherb.com/now-foods-potassium-gluconate-100-pure-powder-1-lb-454-g/13939
 

Oci

Senior Member
Messages
261
Many many thanks, Caledonia. This is just what I want/need just now. I have started on the All-in-One and am up to 2 a day now. I seem to be doing well on it.

I also started Yasko's Ultimate B complex not really knowing what to do. Here are the ingredients...
Vitamin B2 (as Riboflavin 5-Phosphate) 50mg
Vitamin B3 (as Niacinamide) 11.25mg
Vitamin B3 (as Niacin) 6.07mg
Vitamin B6 (as Pyridoxine HCI) 7.5mg
Folate (as folic and folinic acid) 57.5mcg
Vitamin B12 (as hydroxo & adenosyl- cobalamin) 715mcg
Biotin 50mcg
Vitamin B5 (as d-calcium Pantothenate) 49.5mg
Proprietary Blend 260.5mg
~Parsley Leaf Extract
~Para-Amino Benzioc Acid
(PABA)
~Benfotiamine
~Inositol Hexaphosphate
~Betaine Anhydrous
~SAMe
(as S-Adenosyl L-Methionine)
~Trehalose
~Inositol
~NADH (stabilized)

I'd really appreciate your thoughts on including this formula. I ordered it to minimize the number of supps I need to take. However, I am in Canada and shipping supplements is expensive.
Also I was wondering about the PS/PE/PC (Phosphatidyl Serine Complex). Would this be a good idea in order to get the shortcut going?

Many thanks again for all the information you've given. I've read a lot of your posts and learned a great deal. Oci.
++: COMT V158M, COMT H62H,VDR Taq, BHMT-02, BHMT-08
+-: MAO-A R297R, ACAT1-02, MTRR A66G, MTRR A664A, CBS A360A

Hi Waldemuth,

I took a really detailed look at Rich's Protocol. I found the ingredients for the old Neurological Health Formula (NHF) so I could see what was intended. I compared the NHF to the All In One.

In general, 2 tablets of NHF = 1 tablet of the All In One except for one very important exception (which I will get to in a minute).

Minor exceptions:
  • The All in One is missing choline bitartrate, turmeric and TMG (probably a good thing as people can get overmethylated with this)
  • The All in One has the extra ingredients DHA, Phosphoserine (Sunflower Sharp PS 60P-SF), SAMe, astralagus membranus, and the trace minerals strontium, vanadium and lithium.
  • I believe the Phosphoserine would substitute for the TMG/choline and that would also be equivalent to sunflower lecithin and NT Factor.
  • As the extra ingredients are in the Proprietary Blend section, the individual amounts aren't spec'd out, just an overall amount. However the Proprietary amounts in the All in One are half the amount of the similar ingredients in the NHF so that would make think the amounts would be about half of what is spec'd out in the NHF.

The important exception:

The folate has been changed from folic acid (not converting well for most of us) to a blend of folic acid, then the active folates, folinic acid and methylfolate. For people sensitive to methylfolate (like me), even 1 capsule could be too much to start with.

The B12 has been changed from cyanocobalamin to the active form hydroxycobalamin. However, as both forms are oral and not sublingual, they barely absorb, so I don't even bother to count them.

So my prior suggestion still stands - when you're starting out, start with one or less All In One multi and add your favorite form of active sublingual B12. You can increase up to 4 capsules and that will be the equivalent of 6 tablets of the NHF. Increase the B12 commensurately.

Note that per your question, I believe there would be enough Phosphoserine in the All In One to not need additional lecithin/NT Factor unless you want to increase folate and B12 further. There would also be enough methylfolate and folinic to get started.

However, if you're tolerating that, you can do further increases with the other supps suggested by Rich (and/or updated by Sherpa).

Note that 4 caps of the All In One contains approximately 100mg of folic/folinic/methylfolate. So I would suggest possibly only adding another 150mg instead of 200mg of methylfolate and folinic, especially if you're sensitive.

Note that Rich had suggested adding potassium if you're experiencing low potassium symptoms. This often gets dropped out of his protocol because he added it in the next post instead of editing the original post. (He said something about being unable to edit.)

=-==-=-=-=
To sum up, my version of Rich's SMP, updated, would be as follows:

1. All-in-One Multivitamin / Mineral - (1 to 4 capsules per day) - http://www.holisticheal.com/all-in-one-multi-vitamin-mineral-120-capsules.html

2. Taken with your favorite active sublingual B12 (for this protocol that would be hydroxycobalamin).

1 All in One (25mcg folate) + 125mcg hydroxy
2 All In Ones (50mcg folate) + 250mcg hydroxy
3 All in Ones (75mcg folate) + 375mcg hydroxy
4 All in Ones (100mcg folate) + 500mcg hydroxy​

Then if you want to increase further, add #3, #4, and #5 along with additional B12:

3. 150mcg folinic (I realize this is not a simple amount to divide, if you're not sensitive use 200mcg instead)

4. 150mcg methylfolate (I realize this is not a simple amount to divide, if you're not sensitive use 200mcg instead)

Then also increase the hydroxy more or less commensurately in a 5:1 ratio (5 times more hydroxy than folate). The final amount of hydroxy would be 2000mcg.

5. 1200mg of sunflower lecithin (if you're on a budget) or NT Factor EnergyLipids Powder (1/8 to 1/4 teaspoon, once or twice a day) - http://www.pureformulas.com/nt-factors-energy-lipid-powder-150-grams-by-nutricology.html#.

6. Add potassium if you are experiencing low potassium symptoms at any time. Order potassium to have it on hand before you start. NOW Potassium gluconate
http://www.iherb.com/now-foods-potassium-gluconate-100-pure-powder-1-lb-454-g/13939
 

caledonia

Senior Member
I tried it for awhile, but can't remember why I discontinued it.

You're basically replicating the B vitamin complex portion of the All In One. It has some more folic acid in it which I'm not real thrilled about. You don't seem to have any MTHFR SNPs so it's probably ok.

The All In One has low doses of everything including B complex vitamins and Phosphoserine. A full day's dose is four capsules, so you're only halfway there.

Unless you've tested low for B complex vitamins or something, I would actually suggest skipping that and continuing to increase the All in One as tolerated up to 4 caps per day.

I also suggest taking some sublingual B12 with it, which in your case, looks like it should be hydroxy and adenosylcobalamin. This because the oral B12 included in both the B complex and the All In One will only barely absorb.


Many many thanks, Caledonia. This is just what I want/need just now. I have started on the All-in-One and am up to 2 a day now. I seem to be doing well on it.

I also started Yasko's Ultimate B complex not really knowing what to do. Here are the ingredients...
Vitamin B2 (as Riboflavin 5-Phosphate) 50mg
Vitamin B3 (as Niacinamide) 11.25mg
Vitamin B3 (as Niacin) 6.07mg
Vitamin B6 (as Pyridoxine HCI) 7.5mg
Folate (as folic and folinic acid) 57.5mcg
Vitamin B12 (as hydroxo & adenosyl- cobalamin) 715mcg
Biotin 50mcg
Vitamin B5 (as d-calcium Pantothenate) 49.5mg
Proprietary Blend 260.5mg
~Parsley Leaf Extract
~Para-Amino Benzioc Acid
(PABA)
~Benfotiamine
~Inositol Hexaphosphate
~Betaine Anhydrous
~SAMe
(as S-Adenosyl L-Methionine)
~Trehalose
~Inositol
~NADH (stabilized)

I'd really appreciate your thoughts on including this formula. I ordered it to minimize the number of supps I need to take. However, I am in Canada and shipping supplements is expensive.
Also I was wondering about the PS/PE/PC (Phosphatidyl Serine Complex). Would this be a good idea in order to get the shortcut going?

Many thanks again for all the information you've given. I've read a lot of your posts and learned a great deal. Oci.
++: COMT V158M, COMT H62H,VDR Taq, BHMT-02, BHMT-08
+-: MAO-A R297R, ACAT1-02, MTRR A66G, MTRR A664A, CBS A360A
 

Oci

Senior Member
Messages
261
I tried it for awhile, but can't remember why I discontinued it.

You're basically replicating the B vitamin complex portion of the All In One. It has some more folic acid in it which I'm not real thrilled about. You don't seem to have any MTHFR SNPs so it's probably ok.

The All In One has low doses of everything including B complex vitamins and Phosphoserine. A full day's dose is four capsules, so you're only halfway there.

Unless you've tested low for B complex vitamins or something, I would actually suggest skipping that and continuing to increase the All in One as tolerated up to 4 caps per day.

I also suggest taking some sublingual B12 with it, which in your case, looks like it should be hydroxy and adenosylcobalamin. This because the oral B12 included in both the B complex and the All In One will only barely absorb.
 

Oci

Senior Member
Messages
261
That's very helpful, Caledonia. I see that I made a mistake and left out MTHFR C677T +/-. Does this change your recommendations for me?

I have ordered some sublingual B12 but unfortunately it is hydoxy only. Will see what I can order with both in it.

Many thanks for your help. Oci
 

Oci

Senior Member
Messages
261
With the C677T +/- I think it would be best to avoid it.
I'm sorry, Caledonia. Now, I am confused! When you say it would be best to avoid "it" are you referring the HydroxyB12 or the B Complex or ? Thanks, Oci
 

NilaJones

Senior Member
Messages
647
Hi Oci :).

I am just reading this thread now. Are you no longer having the afternoon crashes, with the new supp regimen?

In case it's helpful to you or anyone else: I find that type and spacing of supps helps even out my energy.

Transdermal B12 is, for me, a more gradual absorption than sublingual, and spreads out the energy over a couple of hours. Same with folinic acid instead of methylfolate (but not everyone's body likes folinic).

The rest of my B vitamins I take throughout the morning and early afternoon, if taking them all at once causes an afternoon slowdown. I put them in a little box in the morning and take one pill whenever I think of it.

HTH :).