The 12th Invest in ME Research Conference June, 2017, Part 2
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Lots of test results. Uncertain how to proceed

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by drew, Oct 27, 2015.

  1. drew

    drew

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    Lab results attached. Code to open NutrEval is is 30339.

    Thanks in advance for your insight

    Do I detox first? Does that mean getting rid of my three amalgams first or dealing with missing methylation short cuts? Are detox markers so poor because I'm missing methylation short cuts? Are a lot of the less than optimal results due to trickle down effects of not having methylation short cuts?

    I would appreciate insight into which of Dr. Amy’s suggestions I should follow. She puts a lot of supplements down without indicating a priority. Won't some of the less than optimal results balance out without taking every supplement considering my diet is pretty good? I'm definitely not taking the saw palmetto / prostate supp written at the top of the HMT results as there is no indication for that and I don't want to over supplement.

    Any alternative supplement recommendations or brands to what she recommends would be appreciated.

    How do I account for some discrepancies between tests? (Taurine: NutrEval serum = low, DD urine = high). It would seem that I am a taurine 'waster' and not 'overproducer'. Is this part of a larger picture and if so, how do I fix it? B6 is low according to NutrEval even though I was taking 50mg P5P / day and Dr. Amy says to stop taking it due to high urine Taurine and C699T ++.

    Ammonia: What about the difference where the two blood tests show mid level and urine shows in upper range?

    Lithium: She wants me to continue it to support methylation even though it’s at the top of the range. Should I be concerned about lithium overdose?

    Creatine: Dr. Amy circled creatine levels but I'm thinking it's elevated (even though it's within the normal range) due to the fact that I tend to be on the dehydrated side as of late which was indicated on previous blood tests. (24 hr urine cretine was 17.1 range 8.6-18.4)

    CoQ10: Dr. Amy indicates that MitoQ supplementaion is not working as cobalt levels are reamining low, yet NutrEval indicates good CoQ10 levels

    Probiotics: Dr. Amy indicates to only supplement with lactobacillus bifidobacterium? Why should I not include fermented food sources, as well?

    Currently using the Circadian T3 Method to increase low cortisol and address hypothyroidism

    Symptoms:
    Lack of energy
    Fatigue
    Lack of libido
    Poor digestion
    Bloating
    Trouble losing weight
    Tired even after light exercise
    when hungry and no food around - anxious, irritable, and then tired
    dry skin

    Additional symptoms since childhood:
    Mood instability
    Depressed mood
    Inability to motivate self for activities – can’t focus
    tired but wired at night
    Difficulty thinking
    Difficulty concentrating
    100 yard stare
    Impaired memory
    Severer Insomnia – trouble falling asleep mostly trouble staying asleep (+/+ ADORA2A, +/- PERIOD2)
    Restlessness - impatient
    take things too seriously, and are easily defensive

    Lab results attached:
    NutraEval
    GI Effects
    Urine Amino Acids
    Hair Mineral Test
    Urine Toxic Metals
    Dr. Amy’s emailed comments

    Test highlights:
    Oxidative Stress (Jan 2014):

    Glutathione: 1,224..range >669 micromol/L
    Total Antioxidant Capacity (TAC): 0.78…range: >0.54 nmol/L
    Cysteine: 0.42..range 0.46-1.20mg/dL
    Sulphate: 4.5..range 3.0-5.9 mg/dL
    Cysteine/Sulphate: 0.99..range 0.12-0.32
    Cystine: 2.77…range 1.60-3.20 mg/dL
    Cysteine/Cystine Ratio: 0.15…range 0.17-0.50

    Glutathione Peroxidase: 26..range 20-38 U/g Hb
    Superoxide Dismutase: 21,325…range 5,275-16,662 U/g Hb
    Lipid Peroxides: 10.5 range<10 micromol/L

    GI Effects (July 2015): According to that test, I don't have candida and very little yeast

    NutrEval (Sep/Oct 2015)
    Serum:
    Glutathione: 534 range: >669 LOW
    Malic Acid: 1.1..range is <3
    Molybdenum: normal (even though not supplementing with it)
    Taurine: 5.06 range 5.25-9 LOW
    Methionine: 2.7 range 2.5-4.9
    Cysteine: 6.6 range 4.9-8
    Ammonia: 2.5 range <6.5
    Ammonia: 16…range:9-33 umol/L (independent lab)


    α-Aminoadipic Acid: 1.05 range <0.8 HIGH
    Dihomo-γ-linolenic Acid: 0.51 range >1.19 LOW
    Phosphoethanolamine: 0.05 range 0.15-0.45 LOW
    Ethanolamine: 0.7 range 0.5-1.2
    Pyroglutamic Acid: 19 range 16-34
    3-Hydroxypropionic Acid: 4 range 5-22 LOW

    Mercury: 6 times the upper limit
    α-Ketophenylacetic Acid: 0.45 range <0.46 LOW
    α-Hydroxyisobutyric Acid: 4.2 range <6.7 LOW

    I suspect high mercury and detox markers is from eating a lot of wild salmon, sea bass, and hiamchi. Will donate blood and stop eating sea food. I also suspect high α-Ketophenylacetic Acid and α-Hydroxyisobutyric Acid is from the plastic and gas that the fish consume

    Other tests:
    Homocysteine: 5.5 5-15 umol/L Oct 2015
    Homocysteine: 6 5-15 umol/L June 2015

    ####
    Supplements
    Before the NutraEval test I was using the following (stopped 7 days before):

    -50mg of P-5-P daily (yet NutraEval revealed that I am low). Was taking 800mcg methylfolate /day so that could be the reason?

    -60g of Hi Maize resistant starch twice a day (GI effects test indicated that Butyrate was still low) – Why would I still have low butyrate despite large amount of hi maize? Otherwise, wouldn’t high butyrate lower ammonia?

    NAC: 600mg 2x/ day (stopped taking)
    NAG: 1500mg 2x/ day (stopped taking)

    methylfolate (stopped as I am MTHFS rs6495446 C CC +/+)

    NAD+: 2-4 pills (Does this support NADH?)
    MioQ: 10mg
    Methylcobalamin infusion: 5mg
    Dibencomplex 10,000 iu / week
    vit C 1g + 1tspoon camu
    mag malate: 150mg x 3
    mag ancient minerals: 0.1ml x 3
    selenium: 200mcg
    PQQ: 40mg
    probiotics + food sources (kimchi, Bubbies pickles, sourkraut)
    lithium orate: 5mg
    CoQ10: 400mg
    B complex x 2 (Garden of Life)
    D3: 10K IU/week
    K2: 1.5mg
    Zinc: 30mg
    potassium citrate 750mg x 2 (I am +/+ ACE DEL16 + low saliva cortisol)
    C60 2.5ml
    uridine: 250mg before bed
    Modified Citrus Pectin: 2.5ml
    Redmond’s Clay: 2.5ml

    I added Coenymated B2 9mg - 18mg a few days before the Doctor’s Data test.

    Current supplements:
    AM: empty stomach
    NAD+: 4 pills
    MioQ: 10mg
    PQQ: 40mg
    probiotics
    Dibencomplex 10,000 iu / week
    ALCAR 588mg

    mid morning:
    Modified Citrus Pectin: 2.5ml
    Redmond’s Clay: 2.5ml
    CoQ10: 400mg
    B complex (Thorne)
    P-5-P 50mg
    vit C 1g + 1tspoon camu
    lithium orate: 5mg
    D3: 10K IU/week
    K2: 1.5mg
    Zinc: 15mg
    potassium citrate 750mg (I am +/+ ACE DEL16 + low saliva cortisol)
    selenium: 200mcg or one brazil nut
    C60 2.5ml

    Early afternoon
    mag malate: 150mg x 3
    mag ancient minerals: 0.1ml x 3
    Methylcobalamin infusion: 5mg
    B2 18mg

    early evening
    potassium citrate 750mg
    vit C: 1tspoon camu
    mag malate: 150mg x 3
    mag ancient minerals: 0.1ml x 3
    ox bile 100mg before dinner

    Before Bed
    uridine: 250mg
    mag malate: 150mg x 3
    mag ancient minerals: 0.1ml x 3

    Diet (up till testing)
    Breakfast
    Lemon with ½ tspoon sea salt
    Bone broth (sometimes with a little kale)
    Kelp noodles
    Hi Maize (60mg)
    Tasmanian Honey
    brazil nut
    Probiotic food sources (kimchi, Bubbies pickles, sourkraut)
    6 raw egg yolks
    2oz liver (3-4 times a week)

    Lunch 15 live oysters (4-6 / week)

    Dinner
    One of the following: cold smoked wild salmon, sea bass, himatchi, grass finished beef
    Hi Maize (60mg)
    Tasmanian Honey
    Probiotic food sources (kimchi, Bubbies pickles, sourkraut)
    Leafy greens (usually steamed broccoli or kale)
    Green onion
    Olive oil
    Avocado (sometimes)
    Garlic clove (raw)

    Diet (current)
    Breakfast
    Lemon with ½ tspoon sea salt
    Bone broth (sometimes with a little kale)
    Nori sheets (three)
    Hi Maize (60mg)
    Tasmanian Honey
    brazil nut, some walnuts
    Probiotic food sources (kimchi, Bubbies pickles, sourkraut)
    6 raw egg yolks
    2oz liver (6-7 times a week)
    apple cider vinigar ~1oz with ice water sipped during meal

    Lunch Beets or blueberries
    Oysters occasionally


    Dinner One of the following: cold smoked wild salmon (1-2/ wk), lamb chops (colder months), kidney, Heart, grass finished beef
    sweet potato (6oz)
    Hi Maize (60mg)
    Tasmanian Honey
    Probiotic food sources (kimchi, Bubbies pickles, sourkraut)
    Leafy greens (steamed broccoli, kale, some bock choy)
    Green onion
    Olive oil
    Avocado (most days)
    Garlic clove (raw)

    Other genes to note:

    SLC6A9 +/+: Glycine transporter GLYT1 is essential for glycine-mediated protection of human intestinal epithelial cells against oxidative damage
    SOD3 +/+
    NQO1 +/-:
     

    Attached Files:

    Last edited: Oct 27, 2015
  2. Valentijn

    Valentijn Senior Member

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    @drew - Yasko isn't a reliable source of information. She is frequently wrong about her claims regarding SNPs. So unless there's a better source saying the same thing (and not just repeating what Yasko said), her protocols should probably be ignored.

    As for the rest ... no idea.
     
    barbc56 likes this.
  3. caledonia

    caledonia

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    Hi Drew,

    You can interpret the Nutreval using the Nutreval Interpretation Guide linked in my signature. Use the handy tally sheet at the end to keep all your notes in one place and help you design a program for yourself.

    Look at the GI Effects Interpretive Guide for help on that. https://www.gdx.net/core/interpretive-guides/GI-Effects-IG.pdf

    I also have a link to an older guide from them which might be helpful (they changed their guide quite a bit). That goes through the 4R Gut Rebuilding Program and I also have a separate document for that.

    In general it looks like you're low in SCFA and certain probiotics. You may need to kill off the bacteria which are showing high. The Nutreval is showing dysbiosis, although I would rely more on the GI Effects test. The test tells you which substances will be effective against the bad bacteria.

    The UAA interpretation at the bottom has several hits for low B6. I would expect to see the same on the Nutreval.

    The UTEE and Nutreval should give you a good idea of which minerals you're low in and need to supplement.

    Your cobalt is zero on the UTEE (just like mine). This means there is no cobalamin (B12) in the cells. Dibencozide is adenosylcobalamin which doesn't contain methyl groups, and therefore will not affect methylation, however, it will help the mitochondria. Methylcobalamin infusion and liver don't appear to be helping. Absorption is probably the reason.

    I have a list of good absorbing B12 in one of my documents - the Roadblocks to Successful Methylation I think. Note, I'm in the process of a fairly substantial update to that document, especially regarding toxic metals.

    The Nutreval is showing a current exposure to mercury. Fish could be the reason. It would be good to discontinue or at least cut back and find a cleaner source. Wild Alaskan salmon is supposed to be ok. However, you also have amalgams and those are also a source of current exposure. They could be a larger source than the fish.

    DO NOT supplement with Alpha Lipoic Acid and DO NOT get your amalgams out until you have a thorough understanding of Andrew Cutler's Frequent Dose Chelation program. Otherwise you can mobilize mercury which will then recirculate and make you feel much worse.

    Take the HMT and get it interpreted via the Yahoo Frequent Dose Chelation group.

    It sounds like you've also done a SNP test? If so, you can use the SNPs Interpretation Guide to help interpret that.

    In general, if you follow Dr. Amy's protocol you may be going down a rabbit hole of zillions of expensive supplements. I'm following what I would call a "lite" version of that program, which is outlined on the Heartfixer page, then I also add in info from Freddd, Ben Lynch, Cutler or whatever works. I've tried to document what I'm doing.

    There are also more methylation doctors you can consult with. I have links in one of my documents - I think Roadblocks.

    What else - I suggest starting with the gut first, then it looks like CBS is an issue for you. So gut first, then CBS, then methylation, then I think get amalgams out, then metal chelation (methylation first, so that you have the detox capability to handle the metals coming out).

    Complete each step as much as possible before going on to the next step. For example, you may not be able to get complete resolution of the gut until you get some B12 and also get mercury out, but just take it as far as you can, then go the the next step.

    You are taking so many supplements. I think I might discontinue everything unless you know for sure it's helping you, and start over.

    ps. I don't think you can OD on 5mg of lithium, that's a very low amount. Dr. Amy is suggesting lithium because it helps transport B12 into the cells.
     
  4. drew

    drew

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    @Valentijn - Thanks for the warning about Yasko

    @caledonia - Thanks for the detailed feedback.

    I'm low in SCFA despite the high butyric acid supplementation in the form of hi maize. Seems like high Enterobacter cloacae is the first hurdle.

    Regarding CBS, would I simply supplement with glutathione directly?
     
  5. caledonia

    caledonia

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    No, there are two protocols that help get the transsulfuration pathway working correctly. The long one is at Heartfixer and Ben Lynch has a short one. You have to lower sulfur (and ammonia if you have that as an issue) and support SUOX with molybdenum.

    After you do that and get methylation going, the taurine situation should straighten out, and you should be making glutathione instead of inflammation.

    If you're having trouble tolerating methylfolate, then after that, ironically, you can try certain types of glutathione (liposomal or s acetyl) and Ben Lynch's other suggestions such as SOD, etc.

    Heartfixer protocol - takes about 2 months - http://www.heartfixer.com/AMRI-Nutr...thase) Explanation and Generic Plan of Action

    Ben Lynch (opening up the sulfite pathway section - low sulfur diet, B1 and high dose molybdenum for a few days)
    http://mthfr.net/preventing-methylfolate-side-effects/2014/11/26/

    You can try the short one first, but you may or may not tolerate 500mg of moly.

    ps. I noticed on your GI Effects that natural supplements aren't going to be very effective, but antibiotics would be. I would suggest avoiding Cipro and other floxin antibiotics like the plague. Google "floxies" for more info. MTHFR people are at high risk for floxin syndrome. There may be other natural supplements they don't list that might work.
     
  6. drew

    drew

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    Plasma ammonia is mid range but urine ammonia is towards the high end. Does that mean Ammonia is an issue for me? If it's not, does that mean I still have to remove sulfer foods? If I do still have to remove sulfer foods, is that just temporary?

    Dan from yeastinfectionadvisor.com thinks I should be ok with a biofilm remover and alternating between Berberine, oregano, plant tannis, and Uva Ursi every 4 days for a few rounds to lower Enterobacter cloacae

    Which test do you suggest I do once I think I've addressed CBS before moving on to methylation? After I think I've addressed methylation, should I redo NutrEval and HMT? Any other test?
     
    Last edited: Oct 28, 2015
  7. Oci

    Oci Senior Member

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    Hi Drew, Just fyi...
    I did the Doctor's Data CDA test this past June and had 4+ Enterobacter cloacae and 2+ Candida. Both were shown to be sensitive to grapefruit seed extract and silver. I used both but had to stop the GSE after a couple of weeks as it was very irritating to the bladder.
    I did the Great Plains OAT test a couple of weeks ago and yeast and fungal markers were all below the median except for Arabinose which was 4+. There seems to be some question of the meaning of Arabinose. Bacterial markers were likewise low except for 4-Cresol which is the marker for C difficile. It was just above the median.
    However, I've had a virus (nasty cold and cough) for the past 10 days and now see a white scum on my tongue which I'm assuming is thrush (candida). Raw spots where some has come off...rest won't.
    So, I think these gut bugs can change pretty quickly! I'm increasing probiotics. I'm still on S. Boulardi.
     
  8. Rlman

    Rlman Senior Member

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    Toronto, Canada
    @caledonia since Drew's homocysteine is in a good range doesn't that mean B12 is being absorbed?
     
    Last edited: Dec 21, 2015
  9. drew

    drew

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    I believe homocysteine should be <6
     
  10. drew

    drew

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    @caledonia - Until I reach the methylation phase, should I be taking the minimal amount of supplements as they likely will not be absorbing? That includes not taking any B12 or lithium supplement? After I deal with the CBS mutation, should I redo any of the tests before moving on the methylation phase?
     
  11. Valentijn

    Valentijn Senior Member

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    There is no CBS variant in the Genetic Genie/Yasko report which needs dealing with. Yasko's claims about CBS are completely baseless, and so are the claims of anyone repeating Yasko's garbage.
     
  12. drew

    drew

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    @Valentijn - So Yasko has no citations to back up her claims about the CBS gene? So what is she basing it on?
     
  13. Valentijn

    Valentijn Senior Member

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    She seems to have based her claims on very bizarre interpretations of CBS research completely unrelated to the CBS SNPs she tests.

    The 10x-15x upregulation of CBS C699T seems to be based on her reading a paper where half of the entire gene was lopped off in a lab yeast. Whereas actual research of CBS C699T shows it's an extremely mild upregulation which has only shown beneficial health effects.

    For the other two Yasko CBS SNPs (A360A and N212N), there wasn't any research into them at all, the last time I checked. So I guess she's just making those up at random.
     
  14. caledonia

    caledonia

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    Yasko, Ben Lynch and Andrew Cutler have all independently come up with CBS expression and protocols for that. All are based on research. Yasko claims a 10X upregulation, Lynch, I think, claims a 2-3X upregulation. Cutler claims mercury as the cause of CBS expression.

    At this point, I'm leaning towards Cutler's explanation as to why CBS becomes expressed (or at least if a person has a CBS issue, they should also suspect that they have a mercury issue), but his protocol doesn't fix the problem (until you get mercury chelated).

    I've been successful fixing the issue, while still having mercury, using the Heartfixer protocol.
     
  15. caledonia

    caledonia

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    You may or may not be able to tolerate B12. I was having issues until I addressed CBS. If you tolerate it, it is one of the supplements that help the gut.

    I don't see where lithium would hurt. Keep the dose very small, like 5mg or so. Not 100mg or more.

    I don't think it's necessary to retest after dealing with CBS.
     
  16. Valentijn

    Valentijn Senior Member

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    That research does not exist. If you think it does, please cite to it.
     
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  17. drew

    drew

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    @caledonia - Although I am homozygous for BHMT-02, BHMT-08, and CBS C699T, what about my lab results makes you think that my transsulfuration pathway is blocked? Does my sulfate and ammonia seem high?

    Oxidative Stress (Jan 2014): Sulphate: 4.5..range 3.0-5.9 mg/dL
    NutrEval (Sep/Oct 2015): Ammonia: 2.5 range <6.5
    independent lab: Ammonia: 16…range:9-33 umol/L
    UAA: Ammonia 29,900 range: 9,000 - 39,000
    UAA: glutamate 12 range: 5-45

    I don't see sulfite levels tested anywhere. Any test you recommend for that?

    Apparently SUOX activity, which converts sulfite to Sulphate, requires molybdenum, which is thus depleted in CBS + individuals.

    NutrEval: not deficient
    MHT: 0.035 range 0.025 - 0.060
    UTEE: 0.009 range 0.01 - 0.13 >>>LOW

    Why would MHT show sufficient levels yet UTEE indicate low levels.

    BTW, I experience no excitation as a result of taking 5mg of Methylcobalamin infusion daily.
     
  18. drew

    drew

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    I attempted Fred's protocol having the following supplements already in place: A,C,D, E, B-complex twice a day (with low enough B1, B2 and B3), calcium, magnesium, zinc, trace minerals, selenium (to neutralize any mercury that is running loose), chromium GTF, Omega3 via walk Alaskan salmon. Then I started MeCbl. After a few days I added in Metafolin 200 mcg 4 times a day. That made me significantly potassium deficient and I was already taking 1/4 teaspoon of cream of tartar (equivalent to 125mg of potassium gluconate) twice daily.

    It makes me nervous to have to be taking 1200mg - 2400mg of potassium gluconate daily as that is a lot of potassium.
     
  19. caledonia

    caledonia

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    I think I would go ahead and take a bit of moly based on the UTEE, like 25mcg. It looks like you're borderline low, so different testing methods may vary a bit.
     
  20. caledonia

    caledonia

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    The urine sulfate strips are supposed to be the best way to check for sulfur. I have a link in my Roadblocks document to what and where to buy.

    You have both the SNPs and mercury present suggesting CBS could be an issue for you.

    If your overall methylation is low, there won't be that many metabolites going down the CBS pathway - until you start to supplement with methyl supps. This is when some people find out they have a CBS issue. This is what happened to me.

    Usually people have issues with methylfolate. For me, it was methylcobalamin. For some it might be a combination of the two.

    Some people are fine despite everything I mentioned - but you should have some niacin on hand, just in case.

    If you need X thousands of mg of potassium to stop low potassium symptoms, that's what you need. If it scares you, you can always back down on the amount of methyl supps you're taking, or even discontinue.

    I'm taking way way less methyl supps than you and actually a lot more potassium (close to 4000mg).
     

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