Methylcobalamin causes tachycardia - why?

When I take 5mg methylcobalamin it causes me tachycardia. I then need massive amounts of potassium to calm down my heart rate (about 10 grams). Why?

I also take 3 x 800mg methylfolate. When I take it with hydroxycobalamin, I can control my POTS/tachycardia with a steady dose of about 5 grams potassium daily. When I switch to methylcobalamin, my heart rate gets out of control and I need much more.

I have heard the theory that there is a drop in potassium levels, caused by new cells being created. But come on, 10 grams!? Also, I do have doubts about this theory. What about other people who create lots of new cells, like people who just gave blood, people who had surgery, people who had chemotherapy, or athletes/bodybuilders? I have never heard of anyone needing to take 10 grams of potassium daily.

Thank you for any comments.

Adreno,

I also had this problem. I was taking a larger dose of methylfolate and ended up not being able to take enough potassium to reduce the "low potassium" symptoms. I decided that it was ridiculous and wasn't working for me so I switched over to taking b2 and manganese with tiny, tiny (250mcg total) doses of b12. Taking those two without other vitamins is very different from taking them with other vitamins. Also, I just found out that Christine used to recommend also taking Choline; I now started taking Choline (non gmo soy lecithin) and do not get any "low potassium" symptoms anymore and my healing is much improved over that with the methylation protocol.

If you really want to stay on the methylation protocol then several people have found that taking magnesium (such as magnesium malate) reduces their need for potassium. I think magnesium and b2 activate b6 which regulates your potassium levels. However, if I remember correctly (this may not be true), manganese is needed to increase your magnesium levels (or you end up in the same situation of having to supplement with a high dose as you are now with potassium).

Well, take it for what its worth, but I wonder if the answer relates to the effects that the MB12 has on amino acids, namely the methylation of arginine and possibly the production of taurine. I know nothing about POTS, but I know the MB12 can dramatically effect these AA's, and these are closely tied to the electrolytes and cardiac function. I would be curious if you have urine or plasma amino acid results. (Like high urinary taurine) What about very poor B6? I could see how this could cause problems in someone with abnormal biochemistry like poor GSH and poor magnesium status. Could the oxididation of arginine result in excess NO to further lower GSH. If you get too much NO wouldn't this drop your pressure and then the heart would accelerate as a compensatory mechanism for the hypotension. Many, many processes are affected by that cobalamin, and you probably have lots of pathways that aren't working so well. Those particular AA's just seem to stand out. Certainly a lot more complicated than I could ever understand, but it sure sounds like you should go easy on the MB12. POTS/tachycardia sounds like a nightmare.

I can only stand a crumb (1/10) of methylB12 (5mg) and adenosylB12 (3mg) every two days as well as 400mcg once every two days. If I take 5mg I think I would drop dead LOL.

Adreno, you are going to pee all that potassium right away. In my opinion, extended-release potassium is the way to go. Then, you wouldn't need such high quantities.

Perhaps it has some relationship with not beeing able to stand methyl donors. Maybe someone who has more SNPs knowledge could help... I have none but recall there was some discussion about it.

I had no idea that MB12 affected amino acids this way. Interesting! This might be a plausible explanation.

I haven't done an amino acid test, but I do know that arginine and taurine both worsen my POTS. I'm guessing the mechanism is what you describe; excess NO causing compensatory tachycardia.

WRT B6, I have tried adding up to 100mg P5P without any effect, so I doubt this is a cause.

I should probably clarify; I don't take it in a single dose, but spread the intake over the day. I take between 350-700mg mixed in water (and other electrolytes) every hour I'm awake. So I guess it's my own homemade time released version.

I have looked into that angle. According to the information on the heartfixer site I should be able to tolerate some methyl donors. But I must admit that I have at times felt overstimulated and hypomanic taking large doses.

Another aspect of this is the balance between the B vits. As I understand it, B3 gobbles up excess methyl groups, so maybe there could be an imbalance there. Indeed, taking NAD (coenzyme B3) helps to lower my heart rate significantly.

It's simply a nightmare figuring out how to balance B vits.

You're absolutely right!

Amen!

I have been thinking about this situation.... Did the 10 gram take care of it?

Also, last night I woke up around 1:30 with negative thoughts/anxiety and could not go back to sleep. Took more potassium and it went away. Something is up with potassium!

Well, after I took 25mg NAD I could go back on my regular dosing of 350mg potassium per hour. So I believe the problem is somewhere in the balance of B3 and methyl groups. But at this point I am not sure how much of each is needed.

Has anyone else experimented with choline? I get low potassium symptoms from various supplements that interact with manganese, but never keyed on the choline relationship. And ever since I started taking molybdenum for high copper, I have not been able to tolerate folic acid/folinic/methylfolate, and because mb12 seems to cause a deficiency in folate, I have had to avoid mb12 since then. Choline is something I will experiment with.

I did take about 1g/day of choline bitartrate because of Christine's posts, at least until recently when I ran out. I noticed that the lecithin softgels I have contain 57mg of choline (420mg PC). Seems a drop in the bucket in comparison. I wish I could figure out how well my body was converting choline to PC.

Just to add to the uncertainty, its a long established position that half of us have low total body potassium. Something is also wrong with potassium regulation for maybe half of us. Nitric oxide is likely to be a problem for many of us, but so is peroxynitrite. Methylation protocols probably work better in combination with some kind of antioxidant protocol.

Having said that the amount of potassium being taken is beyond that needed for a simple deficiency state. In my current opinion, either potassium is misregulated or the amount used has a drug like action, not a deficiency correcting action.

For most of this we are talking hypotheses and models. We are trying to treat ourselves, in the absence of a good medical understanding, but a lot of it is not established and validated research. This is an ongoing process and it will be years before the science is fully worked out, if not decades. When someone attributes something as a possible cause, its important to remember its only a possible cause - and that includes my own suggestions. We want certainty, but we don't have it yet.

Bye, Alex

Hi, Adreno.

As you know, I have suggested a somewhat different approach to treating the methylation cycle partial block than Freddd has suggested.

When high dosages of methylfolate and methyl B12 are taken together, the cells are no longer able to control the rate of the methylation cycle, and it becomes overdriven.

One result of this is a rapid buildup of folates in the cells, because of the rapid production of tetrahydrofolate by the methionine synthase reaction.

Tetrahydrofolate is readily converted to the forms of folate needed to support DNA and RNA synthesis, and this releases cells from a block at the S phase of the cell cycle.

They rapidly start dividing, and this produces a strong demand for potassium.

As Alex has noted, it has been shown that the intracellular potassium levels are low in CFS (likely because of an ATP deficit at the membrane ion pumps, due to mito dysfunction, in turn due to primarily to glutathione depletion), so there is no reserve there.

The result is that the plasma level of potassium drops, and that accounts for the tachycardia.

It is notable that hydroxo B12 does not have as severe an effect in your case as does methyl B12. That's because the cells have control of the rate of conversion of hydroxo to methyl B12, and thus have more control of the rate of the methylation cycle.

Note that another effect of overdriving the methylation cycle is a further drop in glutathione, as less homocysteine is available to go toward cysteine synthesis.

There seem to be more and more people who are exhibiting effects of overdriving the methylation cycle from taking high dosages of methylfolate and methyl B12 together. I do not recommend this approach.

My suggestion would be to lower the dosage of methylfolate to something nearer the folate RDA (400 to 800 micrograms) and try hydroxo B12 instead of methyl B12, perhaps starting at 2 milligrams sublingually and working up from there if needed.

As always, I recommend working with a physician while on this type of protocol.

Best regards,

Rich

Thanks Rich. I now only take a B complex (Thorne) twice daily, which gives me a little methylcobalamin/adenosylcobalamin, and 400mcg folinic acid/methylfolate each. I take this with 2mg hydroxycobalamin. This seems to work much better for me, and I can get by with a more reasonable dose of 1600-2400mg potassium. I also take a long list of other supplements. Mostly my POTS has been under control lately, which is fantastic.

@adreno - Any update on your POTS? Do you still require potassium support?

What did you mean by nitric oxide is a problem for us? Do you mean too much NO or not enough? I've mostly heard of increasing NO as good (and peroxynitrite as bad).

Hi Adreno,

I'm don't knbow if you have an answer yet to your situation, but I will say that potassium appears to need increases alone, without the other electrolytes or the other electrolytes may drive q need for potassium as the potassium is used rapidly and doesn't stay in serum.