NutrEval Test - any recommendations or caveats?

[ebethc]

@caledonia - yes, I'm doing the CBS protocol (details below). I have +/+ for 3 CBS snp's and 2 BHMT snp's. My doc says that (based on my symptoms) ammonia is the biggest culprit for me, vs sulfur, so I am not on the super-strict low thiol diet. I just avoid the biggies, like cruciferous veggies & eggs, and I limit protein to 60 grams a day.

Brain fog is my #1 complaint, because it interferes w work; joint pain/general aches and fatigue are a close 2nd. I take Tramadol for pain. I get sick ALL the time, I believe because i don't have enough glutathione, and possibly not enough SOD. So how do I get more glutathione?? Can I do anything besides the methylation protocol? thanks!


CLEAR AMMONIA:
· l-arginine 500mg in the AM (this esp helps the liver clear ammonia)
· l-ornithine 500mg in the PM
· l-citrulline 500mg in the PM
All three of these amino acids are components of the urea cycle and can help in clearing ammonia toxicity by increasing urea formation (thus the need for also supporting the kidney in its ability to excrete urea). L-Ornithine is especially important to the brain, as the brain does not have an ornithine related enzyme found in the rest of the body, that is needed to detoxify ammonia by metabolizing it to urea.

CLEAR HEAVY METALS:
· Zeolite: ACZ 2 sprays twice daily the first two weeks of each month-clear heavy metals, which compromise the other paths to breakdown ammonia


SUPPORT LIVER & KIDNEY:
· Silymarin Forte one daily (has sulfur, but as I said, my prob is more ammonia so I'm not as strict on avoiding sulfur right now..)
· Artichoke Extract one daily with food,
· Celery (food) daily, possibly even celery juice

ENERGY:
- Acetyl L-Carnitine - 500mg one daily in the AM, may help prevent ammonia related neurotoxic damage to the brain; brain antioxidant - better for mental energy than L-Carnitine Fumarate, which is better for physical / muscle energy.
- Ribose
- NADH
- Ubiquinol / CoQ10

RAISE S.O.D.
- Manganese - co-factor; M-W-F

OTHER SUPPLEMENTS:
· Yucca - 2 capsules 2x day (gut support, also may clear the ammonia directly)
- Molybdenum Glycinate 1 mg - breaks down toxic sulfites to sulfates and supports liver detoxification
- Also brain needs C, E, Magnesium and Zinc to prevent excitotoxin (glutamate) damage. So stay on Magnesium, add Unique E one daily three times per week and Unique Tocotrienols one daily three times per week, and use C a couple of times daily- Probiotics


B12

DIET
- Remove major SULFITES: alliums (garlic, onions, leeks); eggs; cruciferous veggies (broccoli, cauliflower, bok choy, cabbage, brussels sprouts, kale, arugula, radish, horseradish, mustard, canola, turnip, kohlrabi, mizuna); dairy & peas.
- http://en.wikipedia.org/wiki/Cruciferous_vegetables
- http://www.livingnetwork.co.za/chelationnetwork/food/high-sulfur-sulphur-food-list/
- AMMONIA IS KEY THING FOR ME TO AVOID OVER SULFITES
- Magnesium chloride salts for bath - avoid magnesium sulfate.
- Re brain fog, ammonia in brain is different than ammonia in the body... very hard to test.
- Ammonia & Leaky Gut can lead to joint pain & inflammation
- Should see significant improvement in 4 - 6 weeks. (we'll see..)

GAPS diet with small meals daily, no sugar, low carb. Mostly because this type of diet helps stabilize blood sugar, and balanced blood sugar, is essential for healthy brain function and protects against damage from excitotoxins.
Limit Protein to 60 grams per day. Do have meats, fish, poultry in small but consistent amounts, but do not have too much protein because it creates ammonia. (Note: vegetarian protein causes ammonia, too). Broths are okay.
·http://lowcarbdiets.about.com/od/whattoeat/a/highproteinfood.htm

 

[caledonia]

@caledonia - yes, I'm doing the CBS protocol (details below). I have +/+ for 3 CBS snp's and 2 BHMT snp's. My doc says that (based on my symptoms) ammonia is the biggest culprit for me, vs sulfur, so I am not on the super-strict low thiol diet. I just avoid the biggies, like cruciferous veggies & eggs, and I limit protein to 60 grams a day.

Brain fog is my #1 complaint, because it interferes w work; joint pain/general aches and fatigue are a close 2nd. I take Tramadol for pain. I get sick ALL the time, I believe because i don't have enough glutathione, and possibly not enough SOD. So how do I get more glutathione?? Can I do anything besides the methylation protocol? thanks!

To answer your other question - the CBS diet is only temporary until you get CBS working properly again - probably three months tops. So I don't think that's anything to worry about as far as CYP SNPs.

Getting sick all the time seems more like an immune system thing to me. So #1 that would be the gut, as most of the immune system resides in the gut. The 4R Gut rebuilding program is the standard of care for that (in my signature links).

If you have CBS issues, you're probably not making glutathione, as where that's made is at the bottom of the CBS pathway. CBS issues will cause substances coming down that pathway to go off into making things other than glutathione. So getting CBS working properly will help you make more glutathione, as will supporting the rest of the methylation SNPs (MTHFR, MTR/MTRR) once you get CBS working.

Ben Lynch had also found research showing that certain methylation supplementation will kill viruses (I think that's outside of producing glutathione). Remember, methylation controls over 30 major reactions in the body. I have the exact supplements listed in Roadblocks to Successful Methylation in my signature links.

You can also supplement directly with glutathione, but some people have problems with that. Ben Lynch says to take NAD with glutathione to make sure you're making the good reduced glutathione, and not the bad oxidized glutathione.

Then also avoiding toxins, as those will deplete glutathione.

=-==-=-=
So basically it sounds like you're on the right track, it's just going to take awhile. Like Yasko is fond of saying, "it's a marathon, not a sprint".

 

[Valentijn]

If you have CBS issues, you're probably not making glutathione, as where that's made is at the bottom of the CBS pathway. CBS issues will cause substances coming down that pathway to go off into making things other than glutathione. So getting CBS working properly will help you make more glutathione, as will supporting the rest of the methylation SNPs (MTHFR, MTR/MTRR) once you get CBS working.

Actually "CBS issues" (assuming we're talking about Yasko's hysteria regarding a mild up-regulation) would increase glutathione production. CBS converts homocysteine into cystathionine, lowering homocysteine in the process - everyone else in the medical world considers lower homocysteine to be a good thing, so long as it's not getting ridiculously low.

Cystathionine then can go on to either create glutathione, or various other products, including sulfate. But by slowing down CBS, someone is necessarily slowing down the production of glutathionine and raising their homocysteine. Both of which seem rather stupid in the context of current medical knowledge.

 

[caledonia]

Actually "CBS issues" (assuming we're talking about Yasko's hysteria regarding a mild up-regulation) would increase glutathione production. CBS converts homocysteine into cystathionine, lowering homocysteine in the process - everyone else in the medical world considers lower homocysteine to be a good thing, so long as it's not getting ridiculously low.

Cystathionine then can go on to either create glutathione, or various other products, including sulfate. But by slowing down CBS, someone is necessarily slowing down the production of glutathionine and raising their homocysteine. Both of which seem rather stupid in the context of current medical knowledge.

That's not how it worked for me in practice. I was not making glutathione. I worked on CBS. Now I am.

Perhaps there are some other factors we just don't know about yet.

 

[ebethc]

That's not how it worked for me in practice. I was not making glutathione. I worked on CBS. Now I am.

Perhaps there are some other factors we just don't know about yet.

@caledonia - how did you know that you weren't making glutathione? nutraval? I definitely feel like low glutathione a big part of my problem! I get sick ALL the time, and have no tolerance for pollution/particulate matter. I tried glutathione this summer (IV, then liposomal) and both made me very sick... big mistake. I'm guessing that this is due to sulfur problem.. Although, I think I have much more of an ammonia problem in general..Adding butyrate this week.

Is there any reason NOT to add sunflower lecithin? it makes me feel better (I have at least 2 BHMT mutations). I didn't notice any mention in any of your guides.

thanks.

 

[joe12]

Hi

My doc suggested that I get a NutrEval test. It's super expensive, and I'm wondering if it's worth it. If you've had it and would like to share your feedback - pro & con - I would really appreciate it.

thanks

Hi, I was wondering about the same thing when caledonia said Nutreva could be better than the methylation panel from hdri, but then I looked at some info about Genova and mostly found bad things. Many people not getting pricing quotes at all, insurance not paying, then getting charged quite a price. It seems they where somewhat better when Metamatrix was independent and competing but after being acquired it changed.

To be honest, I would be cautious, thou some people seem to get good info from them. But here is a blog post from a doctor who used to order those tests but from Metamatrix. I myself am looking at an alternative but using a bigger lab, no luck so far thou.
http://chartingdoctorterritory.wordpress.com/2013/10/25/why-genova-diagnostics-is-now-on-my-st-list/

 

[caledonia]

That's not how it worked for me in practice. I was not making glutathione. I worked on CBS. Now I am.

Perhaps there are some other factors we just don't know about yet.

@Valentijn I had a brain flash about this last night. I think we're both actually right in our own ways, but sort of talking apples and oranges and that's why we disagree.

To clarify - there are two types of glutathione - oxidized and reduced. The reduced kind is the good kind that helps detoxify toxins. This is what I'm referring to when I say "I'm making glutathione". I can tell when I'm making reduced glutathione because my MCS gets better i.e. I'm detoxifying better.

However, there is also oxidized glutathione, which is the bad kind. Most tests will just show an overall glutathione measure, not differentiating between the two. The Nutreval test is like this. My whole blood glutathione is slightly below the normal green range, showing that I am making an almost normal amount of glutathione (and this is prior to CBS treatment.) Score a point for Valentijn here...

However on my HDRI methylation panel you can see that I have a horrible imbalance - I'm making like 99% oxidized glutathione and only 1% reduced glutathione. Score a point for Caledonia here....

So I propose that while CBS doesn't make any difference as to whether you make glutathione or not, it does make a difference as to what kind of glutathione you make. And that furthermore, possibly, as you crank up methylation and CBS is not working properly, you just end up making more oxidized glutathione and that's why you feel the stress/anxiety reaction. (Instead of the alpha keto glutarate/butyrate thing that Yasko proposed.)

What do you think?

 

[Valentijn]

@caledonia - CBS (and cysteine in general) leads to the production of the reduced form of glutathione (GSH). Glutathione becomes oxidized (GSSG) in the process of doing it's job, and GSSG can then be recycled back into GSH.

 

[joe12]

@Valentijn I had a brain flash about this last night. I think we're both actually right in our own ways, but sort of talking apples and oranges and that's why we disagree.

To clarify - there are two types of glutathione - oxidized and reduced. The reduced kind is the good kind that helps detoxify toxins. This is what I'm referring to when I say "I'm making glutathione". I can tell when I'm making reduced glutathione because my MCS gets better i.e. I'm detoxifying better.

However, there is also oxidized glutathione, which is the bad kind. Most tests will just show an overall glutathione measure, not differentiating between the two. The Nutreval test is like this. My whole blood glutathione is slightly below the normal green range, showing that I am making an almost normal amount of glutathione (and this is prior to CBS treatment.) Score a point for Valentijn here...

However on my HDRI methylation panel you can see that I have a horrible imbalance - I'm making like 99% oxidized glutathione and only 1% reduced glutathione. Score a point for Caledonia here....

So I propose that while CBS doesn't make any difference as to whether you make glutathione or not, it does make a difference as to what kind of glutathione you make. And that furthermore, possibly, as you crank up methylation and CBS is not working properly, you just end up making more oxidized glutathione and that's why you feel the stress/anxiety reaction. (Instead of the alpha keto glutarate/butyrate thing that Yasko proposed.)

What do you think?

Isn't there yet another dimension to this which is if the isozyme's needed to use the reduced glutathione are being produced or absorbed, which makes the reduced useful by producing glutathione conjugations from glutathione-s-transferases? Since s-transferases are actually enzimes, then their function can be hindered by toxicity. http://en.wikipedia.org/wiki/Glutathione_S-transferase

 

[liverock]

There is some good info on this thread at MTHFR.net - http://mthfr.net/forums/topic/bh4-supplement-for-a1298c/
Be sure to read Heartfixer for dosing and timing (like don't supplement with BH4 until you have all the other supplements in place). There are also some caveats and helpful hints on the MTHFR.net thread.

Using a sauna is a good way to get ammonia levels down and increase BH4 levels it also helps with MCS. Sweating ammonia out also spares B4 in the urea cycle.
I bought one of those infra red portable ones for about $150 a few years ago which is quite useful once you get used to it.
Doctors are now using sauna therapy to treat heart disease and heart failure. The increase in BH4 raises nitric oxide levels which heals damaged endothelial function in the arteries.

http://www.ncbi.nlm.nih.gov/pubmed/19581054

Abstract
Sauna therapy has been used to treat a number of different diseases known or thought to have a tetrahydrobiopterin (BH4) deficiency. It has been interpreted to act in multiple chemical sensitivity by increasing chemical detoxification and excretion but there is no evidence that this is its main mode of action. Sauna therapy may act to increase BH4 availability via two distinct pathways. Increased blood flow in heated surface tissues leads to increased vascular shear stress, inducing increased activity of GTP cyclohydrolase I (GTPCH-I) in those vascular tissues which will lead to increasing BH4 synthesis. A second mechanism involves the heat shock protein Hsp90, which is induced by even modest heating of mammalian tissues. Sauna heating of these surface tissues may act via Hsp90, which interacts with the GTPCH-I complex and is reported to produce increased GTPCH-I activity by lowering its degradation. The increased consequent availability of BH4 may lead to lowered nitric oxide synthase uncoupling, such as has been reported for the eNOS enzyme. Increased BH4 synthesis in surface tissues of the body will produce increased circulating BH4 which will feed BH4 to other body tissues that may have been BH4 deficient. Similar mechanisms may act in vigorous exercise due to the increased blood shear stresses and possibly also heating of the exercising tissues and heart. There is a large and rapidly increasing number of diseases that are associated with BH4 depletion and these may be candidates for sauna therapy. Such diseases as hypertension, vascular endothelial dysfunction, multiple chemical sensitivity and heart failure are thought to be helped by sauna therapy and chronic fatigue syndrome and fibromyalgia may also be helped and there are others that may be good candidates for sauna therapy.
PMID:
19581054
[PubMed - indexed for MEDLINE]

 

[ebethc]

@caledonia - ... GSSG can then be recycled back into GSH.

@Valentijn - do you think part of the problem w ME/CFS patients is that we can't "recycle" GSSG back into GSH? How do you make this more efficient / optimal? thanks

@caledonia - thanks.

 

[caledonia]

@caledonia - CBS (and cysteine in general) leads to the production of the reduced form of glutathione (GSH). Glutathione becomes oxidized (GSSG) in the process of doing it's job, and GSSG can then be recycled back into GSH.

Ok, so not then. Still a mystery...

 

[caledonia]

@Valentijn - do you think part of the problem w ME/CFS patients is that we can't "recycle" GSSG back into GSH? How do you make this more efficient / optimal? thanks

@caledonia - thanks.

Ben Lynch says NAD is an important co-factor in making GSH from GSSG. I think I'm probably getting at least a little NAD in my Holistic Health multi.

 

[ebethc]

Ben Lynch says NAD is an important co-factor in making GSH from GSSG. I think I'm probably getting at least a little NAD in my Holistic Health multi.

@caledonia - is NADH the same as NAD? What do GSH & GSSG stand for?

thanks

 

[joe12]

Ben Lynch says NAD is an important co-factor in making GSH from GSSG. I think I'm probably getting at least a little NAD in my Holistic Health multi.

What is NAD, CBS, and GSSG? And could you tell me if you think I am wrong on my last post?

 

[Valentijn]

@Valentijn - do you think part of the problem w ME/CFS patients is that we can't "recycle" GSSG back into GSH? How do you make this more efficient / optimal? thanks

It might be part of the problem. But my own results indicated that my antioxidant capacity is elevated - basically that it's working far harder than it should have to. So in my case the problem might be that my glutathione and other antioxidants are having to work overtime to cope with the effects of the illness.

But there could be any or all of at least 4 problems I can think of involving glutathione: not producing enough glutathione, not recycling enough glutathione, elevated need for glutathione, and problems with the genes which allow glutathione to hook up with and deal with certain toxins. It's not uncommon to completely lack the entire GSTT1 and/or GSTM1 genes.

Anyhow, restricting glutathione production is not on the list of things I want to try

 

[Valentijn]

@caledonia - is NADH the same as NAD? What do GSH & GSSG stand for?

NADH and NAD are different forms of a co-enzyme (which helps with other reactions) derived from niacin (B3). NAD is the oxidized form, and NADH is the reduced form. Both forms perform a lot of functions, mostly due to moving electrons around as they change forms.

GSH is reduced glutathione (ready to work) and GSSG is oxidized glutathione (used up and needs to be recycled). It's considered problematic if someone has too little GSH and/or too much GSSG, since that means they may have too many free radicals to deal with, and/or aren't producing or recycling enough glutathione back into the GSH form.

 

[ebethc]

NADH and NAD are different forms of a co-enzyme (which helps with other reactions) derived from niacin (B3). NAD is the oxidized form, and NADH is the reduced form. Both forms perform a lot of functions, mostly due to moving electrons around as they change forms.

@Valentijn - Niacin (in all it's forms..) is a little confusing to me.. It makes me feel so much better, and is a big help w brain fog sometimes (either Niacinamide, or NADH) but I've read that it "stops" methylation and is recommended for "overmethylators" or anyone who's too methylated from a protocol... Since I have a methylation problem, shouldn't niacin make me feel WORSE? so confusing.. if you can shed any light on this, I would love to hear what you have to say. thanks.

 

[Valentijn]

@ebethc - No idea ... I don't really know much about methylation.

 

[renski]

If you have low SAMe niacin can be helpful because it mops up excess methyl groups that you can't use (until your SAMe levels are restored). So it isn't always just for overmethylators.