Hi, I've been reading quite a lot on these forums the past several months but have never posted before. I have really appreciated all the group help and discussion that has been going on here. @Freddd I have found significant benefit from your protocol after trying other approaches to supplement with methyl Bs. I can't tell you how much I appreciate your perseverance and effort to educate others on what you have learned. Thank you. Right now I am perplexed at why I seem to have a questionably high tolerance/need for methylfolate and B12. Per 23 and me I am homozygous COM-T and hetero MTHFR C6772 but I have been taking 40 to 50 mg of methylfolate (Thorne) and even more B12 (One third methyl, two-third adeno Country life/source naturals). I also have homozygous MAO and SOD 2 mutations and long history of inflammation type headaches, complicated migraine, and neck stiffness. I have needed and supplemented 2000 mg of potassium to keep up with the demand from starting activated B vitamins. When starting, I titrated up the B12s and then folate just fine with good results. Then I tried 1/2 capsule of Doctors Best l-carnitine. I had severe fatigue like others have mentioned but no anxiety (anxiety/mood is not usually an issue for me). I switched to and had amazing results with Jarrow liquid carnitine starting with 4-7 drops undiluted per day divided in two doses. This seemed to increase my folate need and greatly increase my potassium need, but I had fantastic energy and great mood for a few days and still no anxiety whatsoever. Prior to this I had worked my potassium up from 3.4 to 4.3 over the previous few months (K had dropped to 3.4 due to very high dose b1 a naturopath had put me on). Unfortunately, with carnitine my potassium decreased from 4.3 to 3.7 despite being on 2000mg K per day. I took a break from the carnitine for a couple of days and had very low mood and increased fatigue which I understand is to be expected. I restarted with 1 drop per day with good results the first day, but ongoing do not seem to be fully coming out of the fatigue/low mood. I suspect fatigue is related to lower potassium so I have increased my K to about 2400 mg. I did feel like there was some healing going on with the carnitine and the energy was really great. I was wondering if like other components of the DQ, once you start at a low level, you must increase progressively to meet the demand your body begins having from having started that supplement/healing. Meaning, should I titrate up on carnitine slowly? I'm feeling a bit fearful one because of the demand on potassium and two because I also saw that my ALT liver enzymes went from 16 to 37 (with 32 being top of nml for females) it's never been out of range before--always 12–16). @Johnmac I saw that you mentioned in a post that you had crashed recently. Was carnitine the reason do you think? I saw that you are no longer taking it and now doing B-2 per Greg. (incidentally, I have also ordered the B-12 oil. Thank you @garyfritz for your discussion about this. I found it helpful given my voracious need for B 12 especially adeno.) I have read that carnitine is a major component of healing, and with the positive results I had initially, would love to have guidance as to whether to continue it or not. I also purchased Coenzymated B – 2 (FMN) with the theory that high folate needs may be due to b-2 deficiency. I have been taking 13mg per day (Source Naturals) the last two days with no immediate effects negative or positive. (EDIT: actually, possible decrease in folate need noted with FMN) I started with plain riboflavin prior, but got an inflammatory type headache that only went away with even more folate. No headache with FMN. Thanks very much for any guidance or info anyone can provide. ***My main symptoms now overall are severely tight and painful musculoskeletal system with some nerve symptoms, difficulty building strength, inconsistent fatigue, and fluctuating very dry eyes, though I had other symptoms before starting Freddd's protocol).