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Is There a Test for Ability to Metabolize Folic Acid?

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by Little Bluestem, Jul 7, 2013.

  1. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    I was just diagnosed with osteoporosis and my dr. recommend a supplement for it. The supplement contains 800 mcg. folic acid. Getting the other 11 ingredients in the doses recommended could be quite a challenge in my rural area, as well as more expensive. I would like to know if it is safe for me to take this supplement.

    Last fall I had my red blood cell folate tested, hoping to find out if I was metabolizing folic acid properly. Unfortunately, the reference range only gave a minimum value. My result of 592 was over twice the minimum of 280. I thought this might be high for someone who was taking no supplemental folate of any kind and had been avoiding foods with added folic acid for 6 months, but I don’t really know. A better test would clarify the situation.
  2. Valentijn

    Valentijn Activity Level: 3

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    The genetic results from 23andMe should be pretty reliable for determining ability to create folate from folic acid. The two relevant SNPs are on the MTHFR gene.
  3. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    I had been thinking about getting the 23and Me test while the price is reduced. That is more reason to do so.
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  4. Lotus97

    Lotus97 Senior Member

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    What about DHFR mutations? I thought those hadn't been mapped out yet.
    Little Bluestem likes this.
  5. Lotus97

    Lotus97 Senior Member

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    boo85 said they had a high folate level too even thought they weren't supplementing with any form of folate. I'm also curious what that means. I seem to recall a high B12 serum without supplementation indicating deficiency, but I don't know what high folate without supplementation means. Maybe not converting food folates into the reduced forms, but I really don't know.
  6. Valentijn

    Valentijn Activity Level: 3

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    Yeah, the DHFR would be more useful with Little Bluestem having possibly elevated levels of folic acid. But I think there's been a lot less research into that gene, so it's more a case of looking at the SNPs on it to see if anything looks particularly odd.
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  7. Bluebell

    Bluebell More % Neanderthal than Adreno but less hairy :-D

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    L.B., I have not had any folic acid in supplements or foods, nor any supplemental folate/folinic acid/etc. for 8 weeks, and my recent blood test for serum folate showed that I was at 9.7 ng/mL with a reference range that being above 3.0 is normal.

    I do try to eat some veggies every day (I should eat more), and I don't often have the ones that are highest in folate, although I should.

    And - I am compound heterozygous for the 2 MTHFR genes that have been studied the most, which is apparently like a 70% reduction in the ability to process folate ( or something like this -- I'm not clear about that area yet, so don't take my word for it).

    So I was surprised my blood test for folate came back so "normal".

    I have read tonight, before seeing your question, that there are two different types of test for folate, one is serum folate and one is red blood cell folate. There seems to be disagreement about which is best. I'll put the references below.

    I was aware that there were two, and I thought that I was getting the better one when I ordered my recent blood tests, but perhaps I did not get the right one.


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    Wikipedia talks about the 2 tests in several entries, I won't link to them here

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    Somewhere on labtestsonline.org I saw where they said there was disagreement about which test was best, but I can't find that quote now.
    The best I can do is: http://labtestsonline.org/understanding/conditions/vitaminb12/start/3

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    "The measurement of folate in red blood cells (RBCs) is preferred since it reflects long-term folate status in the body compared to plasma/serum folate which may be influenced by recent dietary intake."
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716806/

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    "Evidence from the literature indicates that serum folate measurements provide equivalent information to red cell folate measurements when attempting to determine whether folate deficiency is present. There seems to be no basis for the routine testing of all samples for serum/plasma folate and a red cell folate."
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1770141/

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    "Tests commonly used for the detection of these vitamin deficiencies are serum folate, red cell folate and serum B12 concentrations. Serum folate becomes subnormal in the early stages of negative folate balance, before reduction of folate stores. Red cell folate is a direct measure of tissue folate stores. Measurement of both serum and red cell folate yields the maximum information, but in practice, red cell folate needs to be assayed only when there is macrocytosis and the serum folate is low. Serum B12 is a sensitive index of deficiency, but a low level does not necessarily indicate deficiency."

    "the serum folate level depends on recent dietary intake and is not strictly a diagnostic test for body folate depletion"

    "Measurement of serum folate only will not differentiate between negative folate balance and tissue folate depletion. Measurement of red cell folate only may miss the early stage of negative folate balance. Serum and red cell folate yield complementary data and together the maximum information. However, in practice, it is usual to `screen' with the serum folate assay and to proceed to red cell folate only if the serum folate is subnormal. In a folate deficient patient recently given folic acid, only red cell folate will detect deficiency."

    http://www.australianprescriber.com/magazine/22/1/16/8/
    Valentijn likes this.
  8. Bluebell

    Bluebell More % Neanderthal than Adreno but less hairy :-D

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    Also, I just wanted to say that while I have been avoiding all foods with folic acid in them, in addition to all supplements, I actually think it's helped me to feel a tiny bit better (maybe because I have the genetic difficulty in using artificial folic acid internally).

    Some of my external symptoms indicating that something is amiss in my body, which I've had continuously for several years, have gotten a little better (a constant fingernail deformity, a constant lip inflammation) over this short period. It may or may not be related to stopping the artificial folic acid.

    My opinion, for what it's worth, is that I would do what I could to avoid the daily 800 mcg of artificial folic acid. There are reports that it can be harsh on people even if they don't have the MTHFR genetic defects.

    In terms of needing to substitute for a formula that has many ingredients, and living in an out-of-the-way area -- I couldn't find any B vitamin multiple that has the right ingredients in the right levels for me, so I've had to purchase each one separately (it's a lot of ingredients), but I got them at pretty good prices from swansonvitamins.com and from amazon.com, with free shipping from both, and I was able to find exactly what I wanted, so I could put together my own daily intake.

    In fact, your doctor may not want you to take everything in that formula, but it might be the best one he can find where the things he *does* want you to take are all included in one pill (to make it more convenient for the patient), so you might ask him what the essential ingredients of it are.

    I'd also recommend getting the 23andme test done - it's now permanently priced at $99 (at least for the foreseeable future) and really interesting and useful, even if you don't go gung-ho on all the Yasko diagnostic stuff.
    Valentijn likes this.
  9. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    My guess is that my doctor does want me to take everything in the supplement. She may even want me to take the particular forms of the things that are in the supplement. She said that she helped name it, so she may have helped formulate it as well. I suppose I should ask her, but I kind of hate to tell her that I am not going to take it because I have a poor track record for doing what she recommends. I do not want to take anything that might have side effects that would make me unable to help care for my parents. It is sort of a sore point between us.

    I think part of the confusion over which folate test is because part of the time they are talking about testing for deficiency and part of the time about testing for an accumulation of folate due to the inability to metabolize folic acid. I am fairly sure the red blood cell test is the best for the latter.

    In reviewing my notes, I see that four out of five post menopausal women (that‘s me!) do not metabolize folic acid and that genetic bias is only part of the risk. Now I am not sure I would want to take folic acid even if my genes for it were OK. Why can’t anything be simple!

    Oh, gee, there are all sorts of interesting things in my notes. Too bad I don’t remember them. I just found the ranges for the red blood cell folate tests and my result is high for either test (I don’t know which one was actually used).
  10. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    If a person cannot metabolize folic acid, it will accumulate in the red blood cells (and other tissue? I think it also accumulates in the liver, at least). In the U.S., some foods, including flour, have added folic acid, so a person may be consuming it without realizing it. The folic acid can compete with other folates leading to low methyfolate.
  11. BFG

    BFG

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    I had a serum folate test which came out to be high but still within normal limits. I just got my NutrEval results back and it seems like I have major folate deficiency. I eat alot of veggies and chicken livers(which is very high in folate) and I don't have any MTHFR mutations. So I don't know whats going on but according to the Genova amino acids guide:

    Suspect increased need for folic acid if:
    • Elevated HOMOCYSTINE, SARCOSINE, glycine, serine,
    1-methylhistidine, 3-methylhistidine, methionine,
    cystathionine or histidine
  12. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    It says "suspect increased need for folic acid", so maybe there are other things that can cause these things to be elevated?
  13. Tulip52

    Tulip52

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    Hello To All!

    My serum tetrhydrofolate is normal and B12 along with methylmalonic acid. Should I get a physician to still check for MTHFR gene defect with metamatrix. I found a site that lets you order a salvia kit at .23andme. Has anyone tried these test to determine defect?

    Thanks
  14. Tulip52

    Tulip52

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    Oh my B6 is very elvated and I don't take vitamins daily, my doc and I have researched it extensively, but have not found much. I even stopped all supplements for five weeks; my health went down hill :(

    I wonder if overmethylated could cause a defect in metabolizing B6. I have elevated histamine though and fit in undermethylated category, but actually have symtoms of both. Something just not right,ugh!

    Any other testing. Suggestions?

    Linda
  15. Valentijn

    Valentijn Activity Level: 3

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    23andMe does test for the useful MTHFR mutations. A lot of us have ordered it, and my experience is that it was pretty fast and easy. They 6-8 weeks for results, but mine were available in about 4.
  16. Tulip52

    Tulip52

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    So are you taking methylfolate supplement like one from metagenics. I heard that 70% of population has defect, so why just take the right methylfolate instead if paying 300-400 for a test?
  17. Bluebell

    Bluebell More % Neanderthal than Adreno but less hairy :-D

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    My health results took 8 weeks and my ancestry results took more than 10 weeks.

    (I guess they were just double-checking, since I am apparently related to so many famous people, so full of Neanderthal, and yet so humble and refined. :p )
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  18. Bluebell

    Bluebell More % Neanderthal than Adreno but less hairy :-D

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    Tulip52, the 23andMe test is only $99.

    You can start taking the methylation protocol supplements without having any test, if you suspect that it could help you.

    You may want to have your health practitioner/doctor look into the supplement protocol of Dr. Rich van Konynenburg and Dr. Neil Nathan, in order to get you set up with the right array of supplements and dosages.

    Here is an overview of their protocol, from Dr. Nathan who is a practicing doctor in California:

    Dr. Neil Nathan
    Q&A on the Simplified Methylation Protocol - article
    http://www.prohealth.com/library/showarticle.cfm?libid=16338

    Dr. Neil Nathan
    What is the Methylation Protocol - article
    http://www.gordonmedical.com/unrave...ess/what-is-themethylation-protocol/#more-323

    Dr. Neil Nathan
    Supplements in his methylation protocol - article
    http://www.gordonmedical.com/unrave...update-on-the-methylation-protocol/#more-1958

    I got my Solgar brand Metafolin methylfolate from Swansonvitamins.com for something like $8 or $9. There is no need to pay a lot of money for it or get the prescription strength version.
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  19. Valentijn

    Valentijn Activity Level: 3

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    :eek:

    :rofl:

    Obviously my results got rushed, 'cause I'm so damned awesome :cool:
  20. Tulip52

    Tulip52

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    That's funny, if you believe in that type of interbreeding, however it is still being debated, then they will find another and another.I personally don't want any part of the old menial Neanderthal DNA.

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