1. Patients launch $1.27 million crowdfunding campaign for ME/CFS gut microbiome study.
    Check out the website, Facebook and Twitter. Join in donate and spread the word!
Knitting Equals Pleasure, Despite ME/CFS
Jody Smith loves knitting. Again. She thought her days of knitting and purling were long over but ... she's back ...
Discuss the article on the Forums.

Health Diagnostics Res Inst - Test results-methylation panel,FIGLU,cysteine,nagalase

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by globalpilot, Jun 18, 2011.

  1. globalpilot

    globalpilot Senior Member

    Messages:
    594
    Likes:
    213
    Ontario
    Hi all,
    I have some test results. First I'll post those and then I'll post the treatments I've been doing. These tests were run on 5/23/2011

    plasma cysteine 17 umol/l (15-60)
    plasma glutathione (oxidized) .61 umol/l (.16-.5)
    plasma glutathione (reduced) 3.4 umol/l (3.8-5.5)
    nagalase 2.1 nmol/min/mg (.32-.95)
    RBC s-adenosylmethionine 312 umol/dl (221-256)
    RBC s-adenosylhomocysteine 51.6 umol/dl (38-49)

    5-ch3-thf 12 nmol/l (8.4-72.6)
    10-formyl-thf 2.9 nmol (1.5-8.2)
    5-formyl-thf 3.7 nmol/l (1.2-11.7)
    thf .64 nmol/l (.6-6.8)
    folic acid 15.6 nmol/l (8.9-24.6)
    WBC folinic acid 14 nmol/l (9-35.5)
    RBC folic acid 336 nmol/l (400-1500)

    urine FIGLU 3.7 mg/24 hour (0-3)
    adenosine 24.6 10^.8 M (16.8-21.4)

    Treatments:
    methylb12 2.5 mg sublingual Dec 09 until now
    folinic 800 mcg Dec 09 to Dec 10, then 400mcg thereafter
     
  2. richvank

    richvank Senior Member

    Messages:
    2,717
    Likes:
    758
    Hi, globalpilot.

    Just checking before I comment further: Is your SAMe level really 312 umol/dl, or is there a typo? This is a very high value.

    Rich
     
  3. globalpilot

    globalpilot Senior Member

    Messages:
    594
    Likes:
    213
    Ontario
    Hi Rich,
    I just checked the sheet again. It is definitely reported as 312.
     
  4. richvank

    richvank Senior Member

    Messages:
    2,717
    Likes:
    758

    O.K., globalpilot, then here goes!

    It looks to me as though your methylation cycle is being overdriven, so that the SAMe level is very high, and the ratio of SAMe to SAH is also high, but the glutathione is not being restored to normal.

    There appears to be a pathogen (or, I think less likely in view of your history, a tumor) present that is able to produce nagalase and suppress the response of the immune system.
    This may be a retrovirus. There also appears to be a state of oxidative stress, perhaps also caused by infection with a pathogen. The oxidative stress is indicated by the elevated oxidized glutathione and the low RBC folic acid, the latter suggesting damage to cell membranes by oxidative stress.

    With this high level of SAMe., I would expect that the glycine N-methyltransferase reaction is running at high activity to prevent the ratio of SAMe to SAH from becoming too high, though it is still running at about 6.4, well above the mean normal value of 5.48. This will be lowering glycine and raising sarcosine. (We don't have values for these, but I am inferring them here from your other results, the way the biochemistry works, and what I have seen in other cases.) The (inferred) low glycine may be hindering the synthesis of glutathione. Normally, cysteine is the rate-limiting amino acid for glutathione synthesis, but if glycine goes too low, it can become rate limiting.

    The effect of taking folinic acid as the source of folate can be seen in the relatively high levels of 5-formyl tetrahydrofolate and folinic acid (which are the same substance, just measured in different places), compared to the levels that were achieved in our clinical study. Judging from your fairly high level of 5-CH3-THF, I would say that your cells are capable of using folinic acid well. As you may know, Freddd has argued from his experience and that of others that folinic acid is not used well in some cases. This does not seem to be a problem in your case.

    The elevated level of FIGLU results from the low-normal level of THF. I suspect that what is happening is that sarcosine is being produced at a high rate, and it is reacting with THF at a high rate to give it a methyl group, producing 5,10-methylene tetrahydrofolate, which in turn is being converted to 5-CH3-THF pretty well. This is holding THF down, so that FIGLU stays elevated.

    This glycine-sarcosine reaction normally serves the double purpose of limiting the SAME to SAH ratio, which controls the rate of numerous methyltransferase reactions in the body, and also conserving and recycling methyl groups when they are abundant, so that they can be provided when they are scarce. However, when methylcobalamin is continuously supplied sublingually or by injection, there is an abundance of methyl groups on a continuous basis, and if the flow into the transsulfuration pathway is not fast enough, the system sort of gets swamped with methyl groups.

    I think that the elevated adenosine is indicating that the SAHH reaction is proceeding faster than normal, which I think agrees with the high SAMe level and the inferred high rate of reaction of glycine N-methyltransferase, converting SAMe to SAH at a higher than normal rate.

    So what can be done? Well, I think that it would be good to make sure that there is enough B6 and magnesium available to support the enzymes of the transsulfuration pathway, so that the flow of homocysteine in that direction can be increased, hopefully draining more of the metabolites from the methylation cycle and lowering SAMe to a normal level.

    Also, it may be necessary to switch from methylcobalamin to hydroxocobalamin so that the cells can control how much methylcobalamin is made, also (I realize that this is heresy to Freddd, but thats what your lab results appear to be saying. I think this varies between cases, depending on genetics.).

    In addition, I suspect that you will have to try to figure out what is making nagalase and go after it, because it is probably contributing to oxidative stress and hindering the normalization of the glutathione levels. As you probably know, Drs. de Meirleir and Cheney believe that the retroviruses are the cause of the elevated nagalase in ME/CFS, and they are currently treating it with GcMAF and other additional things.

    As you may also know, some of the CFS/ME old-timers on the methylation treatment are now reporting that it has not done the whole job for them, though it does seem to help, and they are having to treat other issues in addition, including exposure to mold toxins, Lyme disease and its coinfections, and high body burdens of heavy metals. I suspect that these are preventing the recovery of glutathione in various PWCs, and they may have been what brought it down in the first place. So, while this methylation--glutathione issue may be the central core of the pathogenesis and pathophysiology (and I still think it is), it may not be possible to fix it in many cases unless whatever is holding down glutathione is also addressed specifically. I think this agrees with what we saw in the clinical study, in which the women had previously been treated for a number of other issues, and some received subsequent treatment for other issues and were found to benefit. I think it also agrees with anecdotal reports from those who have experienced recovery or near-recovery on the methylation treatment. They reported that they had also done other prior treatments.

    I hope this helps.

    Best regards,

    Rich
     
  5. learner2life

    learner2life David Pain

    Messages:
    71
    Likes:
    11
    Tijuana-San Jose, Ca
    Hello.
    Rich, I was hoping to get an idea of which tests would be useful to include with the methylation test from Health Diagnostics. I have an appointment to see a doctor at an indian health clinic and am going to try and get the prescription for the methylation test there. Should I try and include any other tests that you feel may help. My last major blood draw was in february and the test results were relatively normal. I do have a b12 deficiency that a spectracell test revealed coupled with periphial neuropathy. I have treated it with hydroxy, adenosyl and methyl forms of b12.

    The tests that I would like to include (if feasible) are: sarcosine, mma, homocysteine, possibly tsh w/ t2, t3 and t4 again, magnesium and vit D.

    Should I bother with the serum levels of b12 and folate?

    Do you know of any oxidative stress and inflammatory markers to include?

    Shall I try to test for things related to the transulfuration pathway such as vit b6, taurine, glutathione (on the spectracell test it was within normal limits), and possibly sulfate?

    I take similiar supplements to others within the forum.

    They include: magnesium, vitamins k, b6, e and d3, essentially all the b's , taurine, glucosamine sulfate, soy lecitin, tmg, small amounts of metafolin and folinic acid, vit a, krill oil, acetyl l carnitine, coq10 amongst others.

    I have taken the 23andme test and am waiting for the results. I think it will get to me in another 4 weeks.

    Are there any tests available for cytokines to include?

    My troubles started when I got mononucleosis over 3 years ago when I was 30. I haven't been able to come out of it. While in the last 6 months I have made alot of improvements, I am really tired of the guessing game and just need more guidance. I read on another support forum that Dr. Yasko's Protocol was around $2300 in testing. One member posted something in the order of $1500 dollars per month there after. I am not opposed to selling off things and getting into that type of program if it can provide the guidance to make me better. It's a difficult decision to make. I do have free healthcare in oklahoma as I am part indian. Would doctors who specialize in autism be adequately trained in your opinion to help due to the similiar treatment regimes. I am really ready for all of this to be over.

    Also on a side note, I felt adenosyl b12 helped me the most with treating the neuropathy in my arms and legs. I have been taking it for about 3-4 months now. Upon larger dosages, this has the capacity to overramp the methylation cycle as well and possibly steal homocysteine from the transulfuration pathway? I would say I would take 10-15 mgs/day for the last month. I started on lower doses at the beginning and it really helped with my neuropathy it just always kept on coming back. So, I would generally lower the dose and keep take it more frequently. Ironically today is the first day where my symptoms feel almost nonexistant however I have some really droning headaches for about the last 20 hours. So, another symptom has started up. I can forward my test results if you think that would be helpful. Thank You for the time!!
    David
     
  6. dannybex

    dannybex Senior Member

    Messages:
    2,279
    Likes:
    579
    Seattle
  7. learner2life

    learner2life David Pain

    Messages:
    71
    Likes:
    11
    Tijuana-San Jose, Ca
    Great!!
    It's a small world within cfs. I know you from another support group just never met in person. Thanks for the link. This brings up another question.... which one is a more comprehensive test? The one from health diagnostics or the nutrigenomics?? I guess they both will answer the same questions... Thanks Danny.
    David
     
  8. harrycat

    harrycat

    Messages:
    66
    Likes:
    0
    testing value

    Echoing learner2life's questions really, I wondered if Rich or someone else can explain whether the Yasko test does add value to the Health Diagnostics methylation panel and in what way? If it only measure tendencies, how helpful can this really be for someone with FMS/CFS?

    I have ordered the Health Diagnostics panel (from the Netherlands) but am wondering about adding the Yasko test too (if it turns out I have the methylation block as I suspect).

    My funds are not going to stretch to buying all the supplements Dr Yasko suggests on the pdf about the mutations.... would it still have its value - could I pick and choose some more important supplements for example? Or would I likely need a load of other tests afterwards to get enough information to make that type of decision? Any input from people with experience with this protocol would be gratefully received. Many thanks.
     
  9. anniekim

    anniekim Senior Member

    Messages:
    594
    Likes:
    199
    U.K
    Rich, I read your reply to globalpilot's test results with great interest. In your reply you say that people's experiences are showing that some pwc's are needing also to address things such as Lyme disease, heAvy metals and retrovirus before completely lifting the methylation block and making complete or very good recoveries.

    In looking at globalpilot's nagalase results, you suggest this could suggest he has a retrovirus. When you go on to explain that virus', Lyme disease, other coinfections and heavy metals may need to be addressed, are you saying that globalpilot's test results could indicate he may have as well as a possible retrovirus the other things you mention, or that from his test results his other problem could be a retrovirus? Many thanks
     
  10. dannybex

    dannybex Senior Member

    Messages:
    2,279
    Likes:
    579
    Seattle
    Hi David -- I think the nutrigenomics tests for many (hundreds, thousands?) more genetic polymorphisms, but health diagnostics tests for those they believe are more involved, and provides guidance/recommendations on their results.

    But don't quote me on that. :)
     
  11. Sushi

    Sushi Moderator and Senior Member Albuquerque

    Messages:
    7,255
    Likes:
    6,303
    Albuquerque
    Also, my understanding is that the Health Diagnostics Panel gives a picture of where you are right now with methylation, whereas the genetic test shows genetic strengths and weaknesses. So if you want to monitor progress, the Health Diagnostics will show the changes over time.

    I have done two of their panels a year apart and there was considerable improvement.

    Sushi
     
  12. globalpilot

    globalpilot Senior Member

    Messages:
    594
    Likes:
    213
    Ontario
    Hi Rich,
    I have test results for my second methylation panel and nagalase.
    The first test was completed 6/14/2011 and the second on 12/5/2011

    Here are the supplements taken:
    methylB12 2.5 grams 12/09-6/11
    hydroxyB12 1 gram 7/11-present
    folinic acid 12/09-8/10 800 mcg daily, 1/11-8/11 400mcg daily, 9/11-present 800mcg every other day
    Milk thistle started 9/2011, no other changes in antioxidants between the 2 test dates



    glutathione oxidized 0.5 .16-.5 umol/l 0.61
    glutathione reduced 3.9 3.8-5.5 umol/l 3.4
    nagalase 1 .32-.95 nmol/min/mg 2.1
    SAM 238 221-256 umol/dl 312
    SAH 48.9 38-49 umol/dl 51.6
    5-ch3-thf 15.4 .4-72.6 nmol/l 12
    10-formyl-thf 1.3 1.5-8.2 nmol/l 2
    5-formyl-thf 1.8 1.2-11.7 nmol/l 3.7
    thf .88 .6-6.8 nmol/l 0.64
    folic acid 19.4 8.9-24.6 nmol/l 15.6
    folinic acid wbc 15.2 9-35.5 nmol/l 14
    folic acid rbc 384 400-1500 Nmoll 336
    adenosine 20.7 16.8-21.4 24.6


    Which polymorphism did the patient in your study test positive for ? I am heterogenous for both tested in Yaskos panel.

    A couple of interesting notes:
    My RBC folic acid has always been high in the past (1200-1500 range). The last high result was March 2011. The next test was June 2011 and it was low. There was no change in supplements during that time. I cant think of any reason for this change.

    Most of my folic acid metabolites remain very low except folinic (I take) and folic acid (from food). In the study by Rich 5-ch3-thf also remained low even as glutathione rose.

    Id be interested in any comments you may have.

    Regards,
    GlobalPilot
     
  13. rydra_wong

    rydra_wong Guest

    Messages:
    514
    Likes:
    31
    This Health Diagnostics Res Inst panel looks good. How much does it cost?
    Can you get it w/o going through a doctor? Thanks.

    Rydra
     
  14. Skyline

    Skyline Senior Member

    Messages:
    132
    Likes:
    72
    Bangkok, Thailand
    globalpilot in the test results above which are the first and which are the second results (ie. 8 months later)

    for example, in this line:
    glutathione reduced 3.9 3.8-5.5 umol/l 3.4

    Is 3.9 the second result and 3.4 the first result?
     
  15. globalpilot

    globalpilot Senior Member

    Messages:
    594
    Likes:
    213
    Ontario
    3.9 is the 2nd result
     
  16. Skyline

    Skyline Senior Member

    Messages:
    132
    Likes:
    72
    Bangkok, Thailand
    Congrats - that looks like good progress!
     
  17. BFG

    BFG

    Messages:
    83
    Likes:
    20
    Sacramento, CA
    globalpilot did the switch from methylb12 to hydroxyb12 give you much better progress? How are you feeling now?

    How did you manage to reduce your nagalase levels?
     
  18. globalpilot

    globalpilot Senior Member

    Messages:
    594
    Likes:
    213
    Ontario
    I don't think the methylation protocol did anything for me at all.
    But i really am more of a "gut case" than most I think and my symptoms stem from that.
    My nagalase - I didn't do anything special - maybe that was just normal variation.
     

See more popular forum discussions.

Share This Page