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Lowering Homocysteine using Hydroxocobalamin instead of Methylcobalamin

Peyt

Senior Member
Messages
678
Location
Southern California
Hi,
I am trying to bring my Homocysteine levels down naturally. (Lab test showed high)
The usual protocol for lowering Homocysteine is B6(P5P), Folate and B12

So regarding B12, I am trying to decide between Methylcobalamin and Hydroxocobalamin.
I am overmethylated with COMT++ and lower than normal Plasma Histamine (based on blood test)

So My question is: does it matter which type of B12 is used to lower Homocysteine?
If there is no difference, I prefer to use Hydroxocobalamin which is suppose to not be a methyl donor.
Please advise.
Thanks
Peyt
 

PeterPositive

Senior Member
Messages
1,426
Hi,
hydroxy-B12 will lower your homocysteine, no doubt. If methyl-B12 is better I don't know, probably it is since it is already methylated and it doesn't need to take other methyl groups in the system, but how much better is very difficult to say and it depends also on your specific case.

Anyways, doctors routinely prescribe non methylated forms of B12 (cyano-B12, hydroxy-B12) for high homocysteine.

You will certainly see benefits from P5P, folate and B12.

Cheers
 

Peyt

Senior Member
Messages
678
Location
Southern California
Hi,
hydroxy-B12 will lower your homocysteine, no doubt. If methyl-B12 is better I don't know, probably it is since it is already methylated and it doesn't need to take other methyl groups in the system, but how much better is very difficult to say and it depends also on your specific case.

Anyways, doctors routinely prescribe non methylated forms of B12 (cyano-B12, hydroxy-B12) for high homocysteine.

You will certainly see benefits from P5P, folate and B12.

Cheers
Thank you PeterPositive,
How about Adenosylcobalamin? Do they make injectable versions of this type of B12?
 

PeterPositive

Senior Member
Messages
1,426
Thank you PeterPositive,
How about Adenosylcobalamin? Do they make injectable versions of this type of B12?
I was taking a sublingual B complex containing only adenosyl-B12 while trying to lower my high homocysteine and it worked okay, at least to bring it back into an acceptable range (was over 90!). Later I added methyl-B12 and it helped even more.

I am not aware of injectable versions. I mostly take sublinguals.
 

Peyt

Senior Member
Messages
678
Location
Southern California
I was taking a sublingual B complex containing only adenosyl-B12 while trying to lower my high homocysteine and it worked okay, at least to bring it back into an acceptable range (was over 90!). Later I added methyl-B12 and it helped even more.

I am not aware of injectable versions. I mostly take sublinguals.
Over 90?
I thought the range was 0-15, at least for Plasma
Anyways, that's good to know about the sublingual... I read somewhere that some people can't absorb B12 due to
low intrinsic factor in their stomach, so this is why injections are prevalent for that group.
 

PeterPositive

Senior Member
Messages
1,426
Over 90?
I thought the range was 0-15, at least for Plasma
That's the healthy range ;) and I was waaay above that...
Depending on who you ask you will find doctors that say 15 is too high a value and other doctors who will say it's fine. The first time I tested homocysteine the range was 0-20.

Anyways, that's good to know about the sublingual... I read somewhere that some people can't absorb B12 due to low intrinsic factor in their stomach, so this is why injections are prevalent for that group.
Sublinguals bypass the entire digestive system and go directly into the blood stream, so they don't need the intrinsic factor.

Naturally injections can be more effective because nothing goes to waste. Personally I've seen that sublinguals work very well at raising plasma levels.

cheers
 

Santino

Senior Member
Messages
209
@PeterPositive : Wow, 90!! I thought I was already at max levels with my 50!

May I ask whether any symptoms you had improved with lowering your homocysteine?

I only can say that I likely never had been deficient of hydroxo because I injected it from 2010 on or so a few times a year which always lead Doctors to wonder about my high b12 levels. Today I ask myself whether the injections maybe even contributed to the disease state?

2011 when my disease carrier really began with diagnoses my homocysteine was 5,9 (and b12 levels above 3222 which was max the lab could measure).

2 years leater despite taking daily B complex (but no more injections since I saw my high blood level). The b complex contained cyanocobalamine.

So 2 years later my homocysteine showed up as 9.5 which was above normal range of that doctor.

I stopped taking any b vitamins in mid 2014 because of a stupid doctor who told me to stop taking vitamins (I was already getting sicker and sicker).

Then Januari 2015 it was 13.5, slightly out of range of that doctor. Due to a healthy crash in Februari where I suddenly got intolerant to all vegetables that contain beta carotene I had to switch to white basmati rice, chicken, and flax seed oil and could drink one green tea a day.

I also remember trying a detox protocol of Dr. Mercola using high amounts of niacine and did that for 2 months between March 2015 and May 2015.

After being on that diet for 9 months my homocysteine was measured 50!

I am not sure how far this contributes to my symptoms. Most symptoms did I already have in mid 2014.


How did working on your homocysteine change your symptoms?

I have difficulties working on that because of intolerances.

Best regards
 

PeterPositive

Senior Member
Messages
1,426
@PeterPositive : Wow, 90!! I thought I was already at max levels with my 50!

May I ask whether any symptoms you had improved with lowering your homocysteine?
Yes many symptoms have improved.
I was in bed all day, after fixing the problem I was at least able to keep care of myself in the house, do stuff and work at the computer.

I only can say that I likely never had been deficient of hydroxo because I injected it from 2010 on or so a few times a year which always lead Doctors to wonder about my high b12 levels. Today I ask myself whether the injections maybe even contributed to the disease state?
If you still have high homocysteine after injecting B12 it means your methylation cycle is stuck probably because of the lack of the other main factors such as folate, Vit B6 and B2.

So 2 years later my homocysteine showed up as 9.5 which was above normal range of that doctor.
9.5 is almost perfect. I would not worry about it.

I also remember trying a detox protocol of Dr. Mercola using high amounts of niacine and did that for 2 months between March 2015 and May 2015. After being on that diet for 9 months my homocysteine was measured 50!
This is probably the culprit! High dose niacin is an effective way to slow down methylation, if you already have problems in that area this has very likely contributed to the problem.

How did working on your homocysteine change your symptoms?
It has helped removing some symptoms (especially neurological) but I still struggle with ME/CFS, so it's not that easy. Homocysteine is just one of the many problems.

I have difficulties working on that because of intolerances.
Yeah, me too.
Rebalancing methylation seem to have improved intolerances quite a lot. Back in 2011 I couldn't touch most food, almost any supplement would give me horrible reactions unless I cut the dose to a 1/10th or less, not to mention drugs ... a true disaster. These days things are less horrible.

Good luck :)
 

Santino

Senior Member
Messages
209
Hey @PeterPositive :

Does that mean, that if my hydroxocobalamine levels are high, I could only take B6 and folic acid and could lower homocysteine without having to take b12 daily?

Do you think it matters whether the folic acid is taken daily orally or injected once a week?

I ask because a Dr. in Germany told me that some people react with paradoxical increase in homocysteine when they only take folic acid.

And also one important question:
Did you get detox symptoms when you started to take all that? I injected hydroxocoablamine (150-250mcg--> I think daily recommended dose is 1-2mcg), 2,5mg folic acid took 100mg b6 orally once and had no immediate side effects. However during the last weeks I noticed more sweating, better cognitive functioning but since 2 days I feel awful an my shoulder and neck and cheek muscles are super tight.


There are some other variables that could be the reason but I ask myself whether this could be detox?!?!

Sorry for all those questions and thanks for your help!
 

PeterPositive

Senior Member
Messages
1,426
Hey @PeterPositive :

Does that mean, that if my hydroxocobalamine levels are high, I could only take B6 and folic acid and could lower homocysteine without having to take b12 daily?
Yes. Vitamin B12 is not enough to lower homocystein. At least you need folate and B6 and I would also add some B2 and B3 (100% RDA is fine), since they are needed in the folate cycle.

Do you think it matters whether the folic acid is taken daily orally or injected once a week?
Unless you have digestive issues that prevent absorbing folate it won't make a big difference. Surely injections are always more efficient since 100% of the substance goes directly in your system.

My doc prescribed high dose folinic acid and B12 injections in 2011 when my homocysteine came back super high, but I refused because I was too sensitive to even small doses of B vitamins and I chose to start "low and slow" with oral supplementation. It worked just fine, maybe it took longer but I avoided many side effects.

I ask because a Dr. in Germany told me that some people react with paradoxical increase in homocysteine when they only take folic acid.
Never heard of this. Sounds strange... but in any case folate alone is not enough just like B12 alone is not enough.

And also one important question:
Did you get detox symptoms when you started to take all that? I injected hydroxocoablamine (150-250mcg--> I think daily recommended dose is 1-2mcg), 2,5mg folic acid took 100mg b6 orally once and had no immediate side effects. However during the last weeks I noticed more sweating, better cognitive functioning but since 2 days I feel awful an my shoulder and neck and cheek muscles are super tight.
I did have many side effects from using B vitamins at the time, even before my big 2011 crash... I don't know if those were "detox" symptoms or "intolerance" to B vitamins or whatever... B vitamins made me super nervous, lots of anxiety, and killed my stomach. (I eventually found sublingual B supplements and started very low to avoid any of those issues)

Starting with milligram doses of folate and hundreds of mgs of B6 is always risky, when you're sensitive. Plus B6 at 100mg can start causing neurological side effects (i.e. neuropathy)... I never take more than 50mg/day of B6, and I got there starting at 1mg/day. In general 10-15mg is already more than enough, unless there's a specific reason for megadosing.

Cheers
 

Santino

Senior Member
Messages
209
Thanks @PeterPositive
I remember that last summer I had levels of b12 and folic acid both lower end normal range. I then injected a whole vial Hydroxo (1000mcg) and a whole vial folic acid (5mg) and injected a vial B6 (which was "only" 25mg.

The interesting thing is that I did ot react immediately but a reaction built up slowly starting one day after injection.
It started with sweating, then a day later I started having flu like symptoms, rapid cycling mood swings with lots of agitation, depression, anxiety for about 1 week until my mood slowly balanced in again. However all that was before I measured my homocysteine at 50. So either the injections made my homocysteine even worse or my homocysteine was even higher than 50??

Have to say, that live on a very resctricted diet and take no supplements for b2 or zinc. I tried pure powders of b5 (horrible joint pain).

Ok, so if I understood it right you started extreme low with everything and that way you could avoid any side effects from the b vitamins...

I have a b complex here with:
50mg b1
25mg b6
25mgb2
25mg b3
25mgb5
250 mcb12
250 folic acid


Maybe I could try starting with 1/8 of a capsule which would be:

12.5mg b1
2.5mg b6
3.125mg b2
3.125mg b3
3.125mg b5
31.25mg mcb12
31.25mg folic acid


But that could be too low for b2 or already to high for the folic acid and methyl b12?!
Also in a capsule you never can guarantee where which of the b vitamins are. maybe all the mbc12 is in lower end of the capsule and the other things on the upper end?!

I got those capsule from a compounding pharmacy because I dont tolerate most fillers used by the regular products...
 
Last edited:

PeterPositive

Senior Member
Messages
1,426
Thanks @PeterPositive
I remember that last summer I had levels of b12 and folic acid both lower end normal range. I then injected a whole vial Hydroxo (1000mcg) and a whole vial folic acid (5mg) and injected a vial B6 (which was "only" 25mg.

The interesting thing is that I did ot react immediately but a reaction built up slowly starting one day after injection.
It started with sweating, then a day later I started having flu like symptoms, rapid cycling mood swings with lots of agitation, depression, anxiety for about 1 week until my mood slowly balanced in again. However all that was before I measured my homocysteine at 50. So either the injections made my homocysteine even worse or my homocysteine was even higher than 50??
I don't see how vitamins that help reduce homocysteine could have raised it :)
Also, one injection of each is not likely sufficient to make a dent in the high homocysteine, it takes months to take it down from a high value such as 50.

Have to say, that live on a very resctricted diet and take no supplements for b2 or zinc. I tried pure powders of b5 (horrible joint pain).
Diet is very important, if you can take vitamins from food it is much better, in general.

Maybe I could try starting with 1/8 of a capsule which would be:

12.5mg b1
2.5mg b6
3.125mg b2
3.125mg b3
3.125mg b5
31.25mg mcb12
31.25mg folic acid
Yes, that's the idea, low and slow.

But that could be too low for b2 or already to high for the folic acid and methyl b12?!
They seem pretty balanced. I would give it a shot.

Also in a capsule you never can guarantee where which of the b vitamins are. maybe all the mbc12 is in lower end of the capsule and the other things on the upper end?!
I wouldn't get that paranoid ;)

good luck
 

Santino

Senior Member
Messages
209
it may seem paranoid but that was exactly what the pharmacist told me who made the capsules when I asked if I split capsules. She said that it would be ok if I mix the capsule in water and then drink half.

However I will try it out with the 1/8 as soon as I have the possibility. Right now I am in a bad flare since 3 days and I need to wait, otherwise I can´t tell if I make it worse with initiating methylation...
 

Santino

Senior Member
Messages
209
@PeterPositive :

I took 1/5 of a capsule first Wednesday last week. Did not notice anything, then took 1/3 the next day, again no side effects.
Since last Friday I took a half capsule, which is:

500mcg methylcobalamine
500mcg folic acid
50mg B6

I have no adverse effects. At least the last 3 days I feel a little better (calmer and little more positive).

Should I stick with a half capsule a day or should I increase further to lower my homocysteine faster? I am super happy the I can tolerate the three b vitamins at all, because normally I react to everything.

I could try to take a whole capsule a day but that would be 100mg b6 and 1g of each folic acid and methylcobalamine. Especially the b6 seems high.


Would it help to split the intake to morning and middy then to prevent b6 side effects?

maybe I won't even get b6 side effects. I did take b6 isolated before and always felt like I had more joint pain with even 25 -50mg. Now I can take 50mg without problems in the complex.

But I know this is all very soon, maybe too soon to be happy about tolerating the b's as I did not even take it a whole week...However if the tolerance remains, then I can eventually lower my super high homocysteine.




So in short: I ask myself whether I should to increase to 1 capsule/day or alternatively 1/2 capsule 2 times a day to prevent b6 side effects?


Best regards
 

PeterPositive

Senior Member
Messages
1,426
@Santino
to stay on the safe side I'd go with 1/2 capsule/day for a couple of weeks and then see how it goes.

I don't think taking more than 50mg of B6 is necessary, especially for long periods of time, unless there's a specific reason.

If you want to add more folate or B12 you should probably buy them separately so you can fine tune your dosage without megadosing the other Bs.

cheers
 

Santino

Senior Member
Messages
209
Thanks @PeterPositive :

Do you think I could lower the homocysteine effectively when I stay "only" in the normal dose?

Did you reach a normal homocysteine with that low dose? I know you began with folic acid 400mg and it dropped from 98 to 58. Then you wrote that u added the other b's and increased. But with which dose did you achieve a normal homocysteine?

I will stick to a half capsule a day for a few weeks now. Maybe I try to add the other B's such as B2, B5 and B3 in normal doses as well. I always had joint pain from them.

So far I eat a soup made out of chicken (with skin etc.) and hope to get nutrients from that...

Best regards
 

PeterPositive

Senior Member
Messages
1,426
Thanks @PeterPositive :
Do you think I could lower the homocysteine effectively when I stay "only" in the normal dose?
Difficult to say. Normally yes but we're all very different, for some people a little B12 can do a lot for others it takes megadoses. You should give it at least 2 months and then re-check your values.

Did you reach a normal homocysteine with that low dose? I know you began with folic acid 400mg and it dropped from 98 to 58. Then you wrote that u added the other b's and increased. But with which dose did you achieve a normal homocysteine?
800mcg of B12 and 400mcg of folate (+ low dose B complex) was enough to bring it down to around 14-15
Then I added extra methycobalamin (2-3 mg) and methy-folate (800mcg) and it stabilized at 11.

These days I take 10-15mg methyl-B12 and 4-5mg methylfolate + B complex as this is probably the best dosage for me to combat brain fog, low mood etc... in terms of homocysteine however it makes no difference.

cheers
 

Santino

Senior Member
Messages
209
@PeterPositive :

Hello Peter,

I would like to hear you opinion about what happened:

You need to know that my main problem is that I am extremely sensitive to foods and a lot of vitamins. For example can I have 100-200mg of Vitamin C, but when I take higher doses or take moderate doses daily, then I start to get symptoms as sweating, cold, flu like symptoms with mucus in lungs and/or nose. To some things this is an immediate and acute reaction (those things I need to avoid by 100%) for other things it is something that slowly builds up and those things I can only take every now and then like for example vitamin C (however I could tolerate 50-150mg daily without problems).

But there were also things like for example Creatine-Monohydrate that I supplemented with when I was 16. I had no problem taking it for 2-3 months. Then I paused and wanted to try it again a few months later (same product) but then I had this flu like symptoms and from that point on a small dose could cause it. The same happened with lots of medications as well. So as if I had developed an allergy.

Another interesting experiment was with N-Acetyl-Cysteine in 2014 (at that time I was taking a b complex daily and my homocysteine was normal). I supplemented it 2g two times a day without any problems for 9 days. Then I suddenly got the flu like reaction and as I did not thought was the NAC (because I tolerated it without any problems for 9 days) I went on taking it and I ended up with shivers, lot of sweating and as if I had the worst virus on earth...

My diagnosis is mast cell activation disorder.


With hydroxocobalamine injections I also had a reaction. The higher the dose, the more severe the reaction. But in general it never was worse than moderate sweating, feeling cold and mild pressure on my lungs and joint pain. But that all was moderate, so I always could go on with life.




Wednesday 2 March, I, so 12 days started with 250mg of each methycobalamine and folic acid and 50mg b6 (1/4 of a capsule of the product I got from the compounding pharmacy).
Thursday I doubles the dose so that I took half a capsule.

I did not have any problems and only felt like I am on a good way with the b vitamins. I even asked you if I maybe should increase dose further because I did not notice anything bad. But I stayed on the dose first.

Thursday or Friday I felt like I should increase the dose. So I started to take half a capsule 2x a day.

I did not notice any difference. Saturday I noticed mild pressure on my lung (I mean the feeling that you have to cough) and I had to cough but only very short.

Sunday the same and I noticed yellow mucus coming up. However I felt good.

Today I feel like crap. As if I have the flu. Coughing, sweating, headache, tight muscles around my neck...

As if I developed the same type of allergy/adverse reaction that I also developed against creatine or NAC.

However I still have some hope that it might only be some type of detox because I took too much of it?!


Do you have any idea Peter?

Best regards...
 

PeterPositive

Senior Member
Messages
1,426
@Santino
I have had problems like yours. In my mid 20s I took anti histamine medications during winter time for a number of years, but I eventually quit since they were making me feel very sleepy.

A few years later I tried the same anti histaminic again and had a very bad reaction, with heart palpitations, agitation etc... similar to an allergic reaction. The same thing has happened with a bunch of other medications, so I am familiar with the situation. No idea as to what might be the cause, though. :rolleyes:

The problem with upping the dosage of a certain supplement and when is very subjective. For me it was a very slow process that took me over a year of going slow enough so that I wouldn't cause side effects.

For example, doubling the dose is not necessarily a good idea. For me it wasn't. You may need to use smaller increments of, say, 50% every few weeks or months.

I was very eager, like you probably are, of upping the dosage as soon as possible, but unfortunately the process requires patience and your body will tell you, no doubt it will. As you have noticed.

For some people progress arrives pretty quickly but for others (and I am of those) it takes longer times. It's an exercise in patience.

Also, as a side note, sometimes we get symptoms that are unrelated to what we're taking but we tend to associate them anyways, at least that's what I do. This sort of illness fluctuates, especially during winter and at the change of season... so yeah, that's another big variable that can cause confusion, if all the rest wasn't enough. :rolleyes:

good luck
 

Santino

Senior Member
Messages
209
@PeterPositive

Thank you very much Peter. I share your thoughts on patience and that I often associated fluctuating symptoms to changes that I had made but sometimes is was just a fluctuation of the disease. At the same time there is always a reason for a fluctuation. Sometimes it is obvious, sometimes it is not seeable and we must see it as a fluctuation of the disease. This reaction I have now is a typical acute reaction which always has a reason in the past and was reproduceable once I knew the trigger.

Regarding your intolerance to medication etc.: Did that get better and if so, how did you achieve it? Mostly by using the b vitamins or what else were big game changers for you?

I am much more patient now compared to earlier but every now and then (especially when I am feeling good like I did last week), I tend to think I can have things that I just can´t have.



It might be, that it was something else. I only will be able to report back in a few days:

I am intolerant to beta carotene since one year. I get exactly the type of systemic reaction I have now.

I ate chicken soup since 2 weeks as well. No problem.

However, I changed suppliert of chickens on lat friday and noticed that the fat from these chickens was yellow in color whereas the other chickens I had before had only white fat.


Also the soup had the yellow fat on top later.

I then found on wikipedia that chickens and humans yellow coloring of fat is due to beta carotene storage.

So it could be, if I am "lucky" that it "only" was my already known reaction to beta carotene.


Dont ask me why, but I only tolerate a tiny amount of it each day (like as much as is in one green tea).

If I get too much of it, I get exactly the symptoms I have now.

So I have some hope that it weren´t the b vitamins. It will take 2-3 days to tell.

I will let you know later.

Thank you for your help Peter. It is very helpful.

Best regards