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Lessons from ME/CFS: Finding Meaning in the Suffering
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BACK TO BASICS - 70 YEAR OLD MYSTERY SOLVED

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by Freddd, Oct 31, 2012.

  1. Freddd

    Freddd Senior Member

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    LIVER EXTRACT - PROTEIN MYSTERY FACTOR EFFECTIVENESS DUPLICATED

    In 1932 a Nobel Prize was awarded for recognizing that liver could amazingly cure pernicious anemia very well. Studies were done with extracts and more and more concentrated extracts over time trying to find the "protein mystery factor" as some of the authors termed it at them. They found same amazing responses. Post partum Depression was cured overnight. Hallucinating schizophrenics were able to be released from psychiatric hospitals in 3 days, a miracle in the days before Thorazine was invented. However, it wasn't suppressed as with a drug, it had gone rapidly into remission. Against pernicious anemia it was a tremendous success, not just reducing MCV but healing most all symptoms the person has, like severe fatigue, epithelial lesions, mood issues, personality issues, poor healing and all sorts of symptoms. The liver concentrate was miraculous.


    In 1942 the Nobel Prize was for folic acid. The 1948 Nobel Prize was for B12 (Cyanocobalamin). By 1960 it was clear that this cyanocbl was NOT contained in beef liver extract as the two active cobalamins, adenosylcbl and methylcbl were properly identified. It was also very clear that cyanocbl and folic acid did not give except most reduced and slowly, the results of protein mystery factor. Cyanocbl and folic acid, alone or in combination, relieved a few symptoms like large MCV over a multi month period. A few people started to have a noticeable response to injections of cyanocbl before leaving the doctor’s office. The official stance of the AMA was that these people were having placebo effect, rather than Protein Mystery Factor response and that they should not be given more. Basically it established that anything like cyanob12 shouldn’t produce noticeable effects and those that have them should be prevented from doing so. Talk about bringing everybody down to the lowest common denominator.


    Based on the circa 1960 data, if the project had been given to me to figure out, I would have abandoned cyanocbl and gone back to liver extract and worked to duplicate the liver extract effect with methylcbl and adenosylcbl as identified in 1959. It probably would have taken some years to figure out how to have those two. They are actually easier than cyanocbl because during the 50s the researchers found that if they spiked the liver extract with cyanide they could get “good” yields of the preferred “b12” instead of all those pesky analogs like adenosylcbl and methylcbl. All those pesky bacteria wanted to brew up methylcbl so they had to be spiked with cyanide to produce B12. Here they were 12 years down road from the Nobel Prize and it is now known that the Cyanocbl was an unintended lab mistake and is NOT B12 but rather an almost inactive cobalamin, one of many such, and is a “disappointment” (compared to liver extract). Instead of saying “We should try the combinations of nutrients in liver extract” they doubled down on a “disappointment”.


    So let’s do the Vince Lombardi thing; “Gentlemen, this is a football” as he held one up. The metaphorical football in this case is Protein Mystery Factor. Whether Rich VK knew that he was looking for Protein Mystery Factor or not, I don’t know. He was about my age and was likely exposed to many similar things growing up. Whether he knew he was looking for that or whatever would fix a “partial methylation block” he was asking a lot of the questions that need to be asked. After a year of dialog with Rich it was clear that a genetic basis that affected b12 conversion directly likely wasn’t the answer, at least not for very many people. So now, looking at liver extract we can be pretty sure that it contained methylcbl, adenosylcbl and a relatively large amount of l-methylfolate, plus lots of other vitamins and other factors, depending upon the refinement level. Let us toast the generations of Jewish and Catholic and other mothers who insisted “Eat your liver”. They kept generations healthy that might have succumbed to FMS and CFS back in the 30s and 40s and 50s. It might very well have kept me healthy except my mother hated liver and never served it. Rich’s questioning led to my re-examination of my ideas. The answer jumped out and stomped on me in the form of glutathione precursors. The trial (will be presented in a different post) induced the most overwhelmingly severe folate deficiency I had ever experienced and specifically identified folate deficiency symptoms and the realization that many are actually folate insufficiency symptoms as well as they are extremely dose responsive. The glutathione trial led to the understanding of the role that the “methyl trap” plays in all this, again independently identified and explained by Rich confirming what I was considering a possibility.

    With the glutathione trial I was intending to see if glutathione was the missing piece in my healing and that of others. It turned out to be a revelation. Instead of healing it gave us an experimental model for inducing acute folate deficiency symptoms and all four body and CNS b12 deficiency symptoms sets in order starting in hours as it shuts down methylation and continuing for months until actively reversed. If not discontinued and actively reversed soon enough it can cause (worsen) subacute combined degeneration, pernicious anemia, MCS, asthma, allergies, lesions all over the body. This actually allowed the description of folate deficiency and insufficiency symptoms and the ability to rate the folate insufficiency/ deficiency symptoms of Paradoxical Folate Deficiency/Insufficiency compared to the brutally complete folate deficiency produced by the “methyl trap” caused by the glutathione.


    So taking my own history of when various symptoms worsen as a child and teen, it wasn’t because of the cyanocbl in my diet suddenly as much as it was the folic acid that was always also there. Instead of poor b12 being my “lowest level of cause” it was Paradoxical Folate Deficiency/Insufficiency worsened by folic acid and cyanocbl which will also cause b12 deficiency symptoms because of the many biochemical deadlocks that are in the way. So now, in the 14 years since methyb12 and adneosylb12 have become commercially available at vitamin prices and the past few years the same for l-methylfolate as Metafolin, it is possible to make comparisons never before possible and to define the methylb12, adenosylb12 and l-methylfolate deficiencies specifically and individually, realizing that all 3 with l-carnitine are part of a mutual quadratic deadlock.



    DEADLOCKS – Pragmatically observed and mostly verified in literature



    1. To convert cyanocbl to methylcbl requires an enzyme and ATP (requiring adenosylcbl and carnitine (requiring methylcbl) and a methyl group in addition to what may be needed for ATP production) and methylfolate for lengthened serum-halflife and utilization of active b12s

    2. To convert hydroxycbl to methylcbl requires an enzyme and ATP (requiring adenosylcbl and carnitine (requiring methylcbl) and a methyl group in addition to what may be needed for ATP production) and methylfolate for lengthened serum-halflife and utilization of active b12s

    3. To convert folic acid to folinic acid requires an enzyme and ATP (requiring adenosylcbl and carnitine (requiring methylcbl)) and methylfolate for lengthened serum-halflife and utilization of active b12s

    4. To convert folinic acid to l-methylfolate requires an enzyme and ATP (requiring adenosylcbl and carnitine (requiring methylcbl)) and methylfolate for lengthened serum-halflife and utilization of active b12s

    5. To convert adenosylcbl to methylcbl requires an enzyme and ATP (requiring adenosylcbl and carnitine (requiring methylcbl) and a methyl group in addition to what may be needed for ATP production) and methylfolate for lengthened serum-halflife and utilization of active b12s



    In other words, if a person is down to empty on the adb12, mb12, l-carnitine and l-methylfolate, and the possibility of quite a few other items at a <1% level each, the big 4, the blocked methylation doesn’t unblock and generalized healing does not start unless all needed deadlocking items are present. Single item tests will only work for a limited sample who happens to match that one specific most limiting factor. If it is an inactive limiting factor (hycbl, cyanocbl, folic or folinic acid) that requires the deadlocking active items to be present for inactive item conversion then healing does not turn on. The turn on of methylation and healing signals itself both by healing and an increased need for l-methylfolate and potassium.



    The hypothetical “protein mystery factor” in liver extract might have contained l-carnitine as the liver is a major carnitine synthesizer in the body. Depending upon how “purified” the liver extract is then very likely contains l-carnitine, adenosylcobalamin, methylcobalamin and l-methylfolate. In addition the extract could have contained a lot of vitamin A, C, b-complex and minerals. As the four specified items are given against the background of all usual vitamins and minerals and fatty acids those 4 items will start blocked methylation, and generalized healing, approximately 100% of the time, starting in hours, just as liver extract does.



    An objection of Rich’s was that huge doses of methlyb12 would “force methylation” and other dire warnings and such doses were not obtainable anyway in nature. As has been demonstrated 100mcg absorbed adb12/mb12 with methylfolate and l-carnitine will turn on methylation and start generalized healing. In the increase from 100mcg daily to 10,000 mcg mixed active b12s daily both l-metafolin and potassium may need some additional titration, but usually not much as compared to what has already started. Healing increases somewhat with 100x the dose but maybe by only 50%. The large doses that are needed by me and others with low CSF/CNS levels of b12 and damged CNS and is a separate compartment and is a separate consideration and not to be confused with what heals my body and others. I started feeling the mb12 with the first few mcg entering my body via diffusion. IT IS FAST. Generalized body healing not including muscles (those needed l-carnitine and adb12) turned on in 1 hour for me on a single ENZY mb12 1mg absorbing perhaps 150mcg. This is a NORMAL biologically attainable dose if one eats liver or liver extract. This speed of activity occurred with liver extract after allowing for digestion and absorption time.



    So, 100mcg of absorbed mb12/adb12 or either alone could start healing depending upon lockouts. And so can amounts of l-methylfolate and l-carnitine easily available in healthy beef liver. These four items in combination can replicate the speed and effectiveness of the hypothetical “protein mystery factor” because it was actually a “protein mystery complex”. The name itself suggests the single item mentality which was exhibited by carving the ONE COMMANDMENT in stone: CYANOCOBALAMIN.



    It has taken 80 years (liver corrects pernicious anemia Nobel) to get to an understanding of the tremendous effectiveness of liver extract concentrate and to be able to duplicate it. Folic acid and cyanocobalamin are repeatedly “disappointments” in research. They turn out to be good reasons for not buying a pig in a poke when it comes to nutrition. CYANOCOBALAMIN, HYDROXCOBALAMIN, FOLIC ACID and for some FOLINIC ACID, were marketed as being “folate” and “b12” and it is an ongoing health disaster for millions and millions.



    Adele Davis’s book was titled LET’S GET WELL. Her favorite nutritional item for almost every disorder known to mankind was liver.



    http://en.wikipedia.org/wiki/Pig_in_a_poke



    The idioms pig in a poke and sell a pup (or buy a pup) refer to a confidence trick originating in the Late Middle Ages, when meat was scarce, but cats and dogs (puppies) were not.[1][2][3] The idiom pig in a poke can also simply refer to someone buying a low-quality pig in a bag because he or she did not carefully check what was in the bag.[4]



    It severely damaged my health that the researchers of the time didn’t go back to the basics and work to duplicate the effectiveness in all particulars of the liver extract concentrate but instead focused on “proving” that cyanocbl “worked” at microscopic levels despite being a complete failure at shear fast outright healing because it wasn’t the same as liver extract and that was KNOWN. Instead they take this pig, put a new dress on it, glue some paper wings on, paint it up with lots of lipstick and rouge and throw it out a 50 story window to prove it can fly. That of course changes nothing. It still doesn’t work but now they can prove that it does at a microscopic level so we ought to be convinced of it here on the macro level of bodies needing healing.





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  2. snowathlete

    snowathlete

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    Hi Fredd, nice to see you back here. Interesting read though I struggled to understand some of it.
    So what does this mean in terms of getting methylation working for people? Eat liver?
  3. Nielk

    Nielk

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    Yes,Freddd, I too seem to need an explanation that is easier to understand. I tried to read it, but it is above my understanding.

    Great to have you back.:hug:
  4. Freddd

    Freddd Senior Member

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    Hi Snowathlete,

    I'm in the middle of a reconceptualization of this whole business taking into account what I have learned here over the past few years. I really wanted to run it by Rich. I object to what happened back in the 60s when researchers and medical establishment decided to try to make a pig fly instead of backtracking and going for the match of effect of the concentrated liver extract which nobody can afford to do for their selves. If they had followed the clues we wouldn't even need to be having this conversation. A few mcg of prevention work a lot better than grams of cure.

    Figuring out the primary 4 way mutual interdependencies on which the whole thing works is new as is showing it 2 to 3 levels deep. This whole thing takes into account all the criticisms Rich had made as to rareness of the b12 conversion gene problems and size of the "necessary" b12 doses. What I have posted on the BASICS page is the new zones of b12 cartegorized by how it is carried; ie active distribution only, diffusion into body and active distribution, forced diffusion into the CSF/CNS and dirrect injection into the CSF.

    With these basic ideas established if I am correct it will possibly provide us with guidance as to where to go from here. I'm in the process of rethinking this from an object oriented point of view.

    When the thinking was done on protein mystery factor from liver extract they became committed to the idea that it was a single substance they were looking for, B12. This single item thinking has continued to lead them astray for 70 years. Liver extract protein mystery factor (LEPMF as an object name) is not a single item. Is NOT methylb12. It is NOT adenosylb12. It is NOT l-methylfolate. It is NOT l-carnitine. It is all of them in a balance for about 95+% of people. The remaining folks have other "lockout" items that so far have lined up to be SAM-e, TMG, D-Ribose, vit D, magnesium, vit C, vit A, zinc and no doubt a few others at least.

    You need to understand that this is revolution. How much real active folate do people actually need? NOBODY KNOWS. The best GUESS I can make now is 1600mcg to 30,000mcg (based on Deplin and other Metafolin research and tintensive titrations from a multitude of people right here and elsewhere) depending upon how awful folic and folinic acid are for the people involved. That dependency couldn't have been stated 2 years ago. Every vitamin works better wirth these essential items. Every vitamin affects the balance of all the others. Our research system can't begin to cope with that. If they could I wouldn't be the one needing to state the obvious.

    Also, they thought that perncious anemia was rare (it is) and the total of b12 problems. It isn't . It is perjhaps 1% of the problem. Half the fight has been to include the full responsive symptoms description instead of defining in terms of just a couple of symptoms and signs.
  5. Idie

    Idie

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    Hi Fredd,

    First welcome back. I didn't think pernicious anemia was that rare from what I've read. My parents (in their late 80's) talk about how common it was and now say---boy you just don't hear about it anymore. Appears to be a disconnect.
  6. alex3619

    alex3619 Senior Member

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    A similar issue happens with antioxidant research. These things are networks. Reductionist isolate and test science gives on a snapshot under specific conditions, and this is a huge part of why we understand so little about body chemistry. These things are dynamic and interact with multiple factors.

    Should we be talking about the Methylation Quartet (after the Antioxidant Pentet)?

    Thanks for posting this Freddd.

    Bye, Alex
  7. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Freddd

    I can't follow the whole post but could this be related to why Nevavir helps many of us--porcine liver extract?

    Sushi
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  8. Sasha

    Sasha Fine, thank you

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    Hi Freddd - good to see you back.

    I'm sorry I couldn't follow the whole post either but in practical terms, does it come down to a suggestion that we eat liver? Or liver extract?

    I just looked up 'liver extract' and found that it's supposed to be capable of stimulating the production of red blood cells. A lot of us have orthostatic intolerance and it's possible that for at least some of us, that's related to low blood volume. so something that helps us produce RBCs might be expected to help. I read somewhere that erythropoietin is a drug used to stimulate the production of RBCs but it's expensive and I don't know how many PWME have tried it.
  9. Tammy

    Tammy Senior Member

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    Great thread Fredd.................I had the same question as sushi and wonder if you have a suggestion for any particular liver extract supplement?
  10. Tammy

    Tammy Senior Member

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    Approx 8 years ago........when I was still unsure whether or not I had MS..........I gave myself injections of B-1 and liver extract because of an article i had read about the combination helping with MS. I did get some improvements but I was also using a number of other supplements so I don't know what was helping and what wasn't. I hated giving myself the injections...............don't remember how long i tried it either. Kutapressin seemed to really help a number of people..................I always wonder why when something is helping...........it gets discontinued.
  11. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    Kutapressin was discontinued but has been reborn as the more expensive Nexavir, 4ME, and another product from New Zealand (forget the name).

    Sushi
  12. Freddd

    Freddd Senior Member

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    Hi Idie,

    Pernicious anemia as such isn't the actual macrocytic anemia. Perncious anemia is related to cause, lack of intrinsic factor. For a long time it was believed as an article of faith that only pernicious anemia produced real b12 deficiency. The problem is that macrocytic anemia can be produced by lack of methylfolate as well. So paradoxical folate deficiency from vegetables can cause high MCV as well like it did for me.
  13. Freddd

    Freddd Senior Member

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    Hi Sasha,

    Not at all. I tried 100 tablets of dessicated liver daily for a few years, 35 grams. That comes out to about half a pound of fresh liver minus connective tissue etc. In 6 months the lights came on as happened with the very first 1mg mb12 in 1 hour. I burped liver all day every day for years, and I HATE LIVER. Then to top it off I didn't heal fast enough and got sick again, a 4 month strep and bronchitis and again. Over the next 4 years I had the lights come on 3 times, the first 3 times in my life but it was just too fragile. Then got several shipments of 1000 tablet jars that were moldy and quit. Out of 4 years of dessicated liver I had the lights come on 3 times for a matter of days to a couple of months each time Each time on the third day of illness I went back to hell. It was hard to take. I had the lights come on in one hour of mb12 and they haven't been off in 9.5 years except for glutathione and they sure dimmed a little the past 6 months

    The point is that the liver extract concentrate used in research was concentrating the b12s and probably methylfolate hundreds of times to try to amplify the effectivess of whatever it contained. They didn't know what they were looking for so they kept testing by effect as they removed various fractions via various procedures. They had it down to mostly b12s when they ran it through the charcoal filter and then crystalized cyanocbl. When they tested that, it had lost the like magic effects of the earlier concentrates but they identified it before they tested it as they were so sure they had it. They didn't know for 10 years though there was lots of suspicion.

    The beef know have cyanocbl and folic acid added to feed. In one test I saw liver has lost 95% of its b12 content that it had in earlier times.

    Since you would need to extract and concentrate many pounds of liver every day it works more reliably to take methylb12, adenosylb12, methylfolate and l-carnitine (cautiously if having anxiety as 100mcg might be limit of tolerable dose). The titrate to effect of the first 3, get healing started and if it doesn't start, find the missing factor or the blocking factor(s). All of this on a background of the basic vitamin and minerals, with additional things added by trial for effectiveness. Oft times order and timing can be important.

    Liver doesn't have a high enough nutrient density for these things for supporting the healing. Liver pointed the way and then they struggled to identify what was in liver that was different. The ignored folate becasue they thought they knew all about that and they mis-identifid BOTH active b12s. So what we are doing her is bypassing 60 years of misguided research and now have the vitamins as they should have been by the 1960s.
  14. Freddd

    Freddd Senior Member

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    Hi Alex,

    You are quite right. The body is not static. Everything serves multiple purposes. It is full of negative feedback mechanisms to keep things in control.

    Calling it the "Methylation" quartet is just as reductionist. The adb12 and carnitine are invloved in ATP production and lipid processing, are required for mitochondria formation lack of which can limit muscle formation (demonstrated) and perhaps even neuron formation (hypothetical) and affects neurological functioning and body funtioning at all levels. Every enzyme reaction in the body requiring ATP to power it is at risk, and it shifts around in some sort of triage fashion. Then there is the methylation and cell formation/DNA transaction and neurological functioning. Also lots of neutralization of toxis with the active b12 destroyed by such. I honestly have no idea what to call it. I've enjoyed singing 4 part harmony.

    Also "Methylation Quartet" sounds like a musical group, like Chad Mitchel Trio. Maybe we can make a good play on words and get the meaning across in a memorable manner.

    I'll add a some nominations.

    The Methylation-ATP Deadlock Quartet maybe? Descriptive but not very snazzy though.
    Most Limiting Factors Deadlock Quartet? I don't know. definitely not snazzy
    Metabolic Harmony Deadlock Quartet? snazzier? less descriptive? or more?
    The Hanging Chad Deadlock Quartet ? snazzier maybe, but cryptic unless they are weird enough to get the joke

    I think you are quite right and we need a name for it
  15. Freddd

    Freddd Senior Member

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    For the past few years It has become increasing clear that the first titration of mb12, adb12 and metafolin need to be done together but because one group of people, basically with an inherent anxiety, the carnitine needs to be done very cautiously , separately after certain other balances have been reached and to certain criteria. It isn't a plunge in with masssive amounts as the effective for most body healing is about 100mcg daily of mixed active b12s witn more healing deeper faster. But first, as healing turns on at about 100mcg absorbed sublingual of BOTH kinds with even 200mcg of methylfolate, there needs to be a pause to titrate the l-methylfoate to effectiveness without insufficiency and potassium at the same time. They each have an maximum effectivness which is when the last responsive insufficiency symptoms stops decreasing by dose. When healing turns on so does body awareness, much more so. With the enhanced abilty of feeling all the things wrong in exqusite detail we can also feel within hours if a particular nutrient is going to be of benefit

    After the basic titration and l-carnitine is being increased at a rate appropriate for the person, one needs to find what other limiting factors they have, what prevents some set of symptoms from healing.

    It's just that in the groups that gather here we share in common lots of symptoms from a common pool of maybe 600. There might be 8 or 10 very specific groupings and each of these groupings needs to build upon the basics and the Deadlock Quartet (until a bettter name comes along). Balance in the deadlock quartet itself is of some matter and can vary considerably.


    History is important. If history isn't remembered, such as WHAT was being looked for in the first place, sometimes it is difficult to see how we got off onto a side road.

    On the subject of liver as a food item for low cobalamin diseases.

    In January of 1942 my grandfather by adoption went in for a WWII physical. He was rejected for having Lou Gehrig disease (ALS). That was a short term death sentence. He died of ALS in 1972. ALS has a CSF deficiency of cobalamin and elevated CSF MMA and HCY. My grandmothers old family cook from Germany cooked up her "nerve tonic stew". She started a new batch every day with 5 pounds of liver simmered, pureed, strained and simmered and pressure strained over and over until nothing is left but basically light colored cell structure like sawdust. The intense broth is simmered to a very thick consistancy of maybe a quart and has potatoes and veggies and meat added. That is what he ate for the last 29 years of his life. There were always two pots on the stove, the new batch and todays eating batch. My grandmother had lung cancer and he had to be put in a nursing home and no longer had his special diet. The disease that had been advancing at 1% of normal approximately for 29 years sped up and he was dead in months.
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  16. Sasha

    Sasha Fine, thank you

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    Thanks, Freddd - I get it now!
  17. snowathlete

    snowathlete

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    It's a complicated problem isn't it. Glad you have a good grasp on things. I know there is something to the methylation because when I first started it switched something in my immune system and I'd say I got a little better. Then it plateaued and I lost patience and gained frustration.
    I stopped for the last four months until last week.
    The corners of my mouth started getting sore and splitting. I remember reading something on here about that being related to b12 or folate. I'd never had it before.
    So I dug out my pills and started just taking methyl folate and b12 plus potassium and vit c. All low doses.
    Had a headache for two days which again is unusual for me. Then I remembered that I had the exact same headache the first time I started methylation. Not decided where I'm going from here yet but my lips are mostly better already. What puts me off giving it another go is the complexity and when ill it's hard for me to get my head around and keep working at it.
  18. Freddd

    Freddd Senior Member

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    Hi Snowathelete,

    Angular cheilitis is a regular early warning usually on low folate. It takes 3 dasy of low folate and several months of low b12. Often more potassium can relieve the headache. When a plateau is reached one needs to find the next thing that makes a positive difference. Sometimes I would do 3 day trials of 10 or more things before finding the one or two items that added an increment of healing. So far until now with the fuller understanding of methylfoalte for the past 9.5 years, I have always found "the next thing". For me at this point I'm not sure anymore that there is a next thing. Everything but physical damage is taken care of.
  19. snowathlete

    snowathlete

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    is there a reason why i didnt used to get angular cheilitis, but now do. Is that related in some way to having taken the methylation stuff early this year, and then stopping it? What i mean is, before i was on methylation i didnt have this problem, and things now are the same (i.e. not taken anything for months) but now i have angular cheilitis, so did being on the methylation and then stopping actually make my position worse?

    Im guessing that when taking the supplements, i got methylation cycle working which although i was taking folate and b12, burnt through that, and whatever reserves i had before, leaving me more depleted now. ?
  20. Freddd

    Freddd Senior Member

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    Hi Snowathelete,

    so did being on the methylation and then stopping actually make my position worse?

    I would be inclined to say probably. People who did stops and starts forund the oscillations and symptoms and startup got worse each time around. Things get part way healed and then suddenly cut off and all sorts of different stuff can happen. I haven't seen any pattern except for intensity /severity increases. A careful and balanced titration would probably work without being too overwhelming in my opinion. Hoever, if you have the anxiety- carnitine link, that would be the toughest. Things "break" at different points. However, once a pattern of breaks gets established, it often repeats. You may find that you have found a paradoxical folate deficiency indicator when it is all said and done. Other problems will show up over time, usually with the least healed showing up quicker and harder. The thing with epithelial tissues is that they are constantly replacing themselves and can break on any given day depending on the body's triage for short supply situations.

    I'm thinking much more towards the 100mcg absorbed b12 combo with methylfolate on top of the basics, titrate potassium and get rid of the headaches and other symptoms, titrate the methylfoalte until the burn goes out of the cheilitis and starts healing. It may take several times around on the metafolin and potassium until they both are in balance, then bring the b12s up to equilibrium, making adjustments in potassium and metafolin as needed. There are no guarantees of course, but having worked once it is a reasoanbly sure bet it will work again, but maybe not as well.
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