question about donut hole insufficiency

[Aerose91]

If one suspects folate insufficiency how are you supposed to jump up to 4-8x the dose of mfolate without throwing yourself right into methyl trapping? Wouldn't you have to largely increase your dose of mb12 along side it? I don't think this is possible for me considering how much mb12 revvs me up.
I'm currently at 6 mg mfolate and 10 mg mb12 and recently started feeling awful but yet very revv'd uo any any dosage of mb12 over this. If this is potentially donut holing what's the best way to go about it?

 

[minkeygirl]

I think the ratio if mb12 to methylfolate is 2:1.
Beyond that I'm clueless.

Maybe @PeterPositive can help.

 

[Aerose91]

Thanks, minkey. Freddds protocol is so all over the map I don't ever feel comfortable trying to progress it

 

[ahmo]

If one suspects folate insufficiency how are you supposed to jump up to 4-8x the dose of mfolate without throwing yourself right into methyl trapping? Wouldn't you have to largely increase your dose of mb12 along side it? I don't think this is possible for me considering how much mb12 revvs me up.
I'm currently at 6 mg mfolate and 10 mg mb12 and recently started feeling awful but yet very revv'd uo any any dosage of mb12 over this. If this is potentially donut holing what's the best way to go about it?

You won't necessarily need to increase the B12. What are your low folate symptoms?

Here are some comments from Fred, from page11-13 A Guide to Freddd's Protocol
http://forums.phoenixrising.me/index.php?threads/should-i-reduce-my-b12.29096/

Question: methyl folate can range from 400, to roughly 1600mg a day.. Do you think that low dose of folate would even trigger paradox deficiency? It seems most people that had that were using much higher doses...

This one you have 100% backwards. A low dose like this almost always triggers donut hole paradoxical folate deficiency. Higher doses relieve it. Low dose methylfolate PFD can cause massive inflammation.

Daily doses of B1 and B2 above 30-50mg a day and B3 above 100mg a day can cause an insatiable need for methylfolate and potassium, so make sure that is ok. Remind me that you are not taking NAC, glutathione or Whey.

If you want to get rid of low folate symptoms and inflammation try 4mg of l-methylfolate or so each 4-6 hours Typically it will start turning around within a few hours and after a day or 3 you should know for sure. Now it is possible you are one of those who needs 30mg a day to make any headway but that is rare without folic acid or folinic acid or large amounts of vegetable folate.

Try 8mg before you go to bed tonight. Metafolin has no side effects different from sugar pills. That is what the Deplin study says at doses up to 30mg/day. Best results are at 15 and 30mg daily. That is what all my experience says. The people who take tiny doses have terrible reactions and think it is because of so much folate instead of so little. They have even worse responses with 200 mcg of folinic and 200mcg of mfolate. Wow do they get hit. That is because of a double whammy paradoxical folate deficiency. Without the folate you are wasting your money and wasting 90% of the b12. You could get equally bad results from 500mcg of b12.

Try it cautiously, 4 mg and then 4rmg in couple of more hours to avoid possible stomach distress or take 8mg and some food and go for it. You could be a new man in 2 days.

After you get rid of all the folate deficiency symptoms, then is the time to adjust other things. Doing it otherwise is bass akwards.

11

Now this is my opinion and experience. Everybody who takes the small doses has terrible results and a rough time. The people who use the larger doses get healing going. You can always go back but I would bet you won’t want to. Do as you wish. It is your game of you bet your life. I would bet on the bigger ”go for it“ doses.

Simplified Understanding of Folate

http://forums.phoenixrising.me/index.php?threads/problems-beginning-methylation- needing-some-direction.28302/#post-432943

@whodathunkit: You might want to read up on “Paradoxical Folate Insufficiency”, too. Search it in the forum. I’m new here but have been reading A LOT, and it sounds like you were exhibiting symptoms of that. It’s Freddd’s theory and seems to hold true for many people (but not all).

Briefly, the theory is that in order to get well there are multiple levels of healing we must go through to reach wellness. Your first doses of folate start you on that healing. But if the dose is too low to affect *all* the necessary levels of healing, eventually the folate gets spread to thin and can’t keep the healing going. So you need progressively larger doses for a while, until you feel normal again. The progressively larger doses keep the healing going.

It’s like cars using gasoline (with the cars being the levels of healing and gas being the folate). One car can get pretty far on one gallon of gas...in the same way that if you only need to heal a little bit, a single 800mcg tab of folate will do you pretty well.

But if you have four cars and need to split that gallon of gas four ways...none of those cars are going to go very far. You need more gas (folate) or you just won’t go.

Adding more folate can keep the healing going so the healing keeps going.

Low potassium is also a sign of the paradoxical folate insufficiency. My understanding is that when sludgy cells that haven’t been using potassium in a while get kick-started by the folate/methylation supps, they suddenly start intaking potassium again, sucking all available potassium from your bloodstream (or wherever it comes from, like I said I’m new so still sorting it all out, LOL). So you need to add more potassium so your awakened cells can keep on using it, or eventually your cells will run out, making you feel crappy and causing other symptoms. It’s basically like a sponge needing more water to become saturated.

I’m no expert, just, like I said, a noob with a lot of what she’s read still fresh in her mind. And trying to explain what I’ve read to other people helps me sort things out in my own head.

Paradoxical insufficiency is when you’re taking a form of folic acid or folinic acid that your 12

body can’t use, it blocks whatever methylfolate you’re intaking that your body *can* use, and thus causes deficiency. It’s a paradox because it seems like you’re getting the nutrients your body needs by the amount you’re taking. But you’re having weird and disturbing symptoms of poor health.

Freddd says donut hole only occurs with insufficient methylfolate. Some levels of healing/symptoms are slipping through the hole, I guess.

Read this thread, it gave me a better understanding of things

http://forums.phoenixrising.me/inde...rong-reaction-from-taking-methylfolate.21896 /

http://forums.phoenixrising.me/index.php?threads/need-large-amounts-of-mfolate- throughout-day-and-potassium-but-potassium-opposes-mf-help.25857/

Considering that B1, B2 and B3 can cause changes in how much potassium and Metafolin might be used daily, it might pay to check the labels and find out how much you are getting. I found that a B-50 type supplement was too much in the b1 b2 b3 combo. Taking 100mg extras was too much. I found a b-complex with only 20mg of b1 and similar on the others and take it twice a day. It has slowed down the rate of potassium and folate need.

However, keep in mind that that amount of potassium and folate being used is in the range of that of people having effective healing. Stopping the potassium need stops the healing. HyCbl can affect about up to 30% of the symptoms for up to 70% of people. Nobody actually heals on it as the majority of b12 deficiency symptoms will keep worsening even while a few symptoms may improve. HyCbl is great for having the illusion of doing something and will keep most people safe from the discomforts of healing. Unfortunately they will generally continue to have worsening symptoms more narrowly defined. Good health to you. Follow the clues. If you keep it up for a year most of the symptoms being affected now will be largely gone and a different set will be healing.

....Have you identified your early onset folate insufficiency symptoms? I don’t use or suggest any specific fixed ratios. For instance I suggest l-Methylfolate be increased until one doesn’t have periodic bouts or continuous folate insufficiency symptoms. For me these a certain type of muscle pain, angular cheilitis, acne on my face, IBS and so on.

100mcg absorbed AdoCbl/MeCbl is all that is needed to start the need for even 30mg of Metafolin. These items are not tied together in any ratio. It is more the B1, B2 and B3 and maybe other things that drive the relative needs for methylfolate and potassium. Also, the amount of l-methylfolate a person needs also depends on how well their body handles folic acid, folinic acid and veggie folates.

 

[Aerose91]

Thanks for sending these, @ahmo and thanks for the continued help. One thing I question though, it says on the last paragraph there that only 100 mcg of mb12 absorbed may cause a need for up to 30 mg mfolate. Pretty much every source I've ever heard says that mb12 should outweigh mfolate at least 1.2:1, otherwise you are risking methyl blocking. Unfortunately methyl blocking has almost the same symptoms of donut hole insufficiency (if I remember correctly) so how can you tell if you have solved one and not moved on to the other?

My symptoms as of late are emotions all over the place (depression to solemness to anger etc..), i have more "nothingness" in my brain, confusion sometimes to the level of psychosis, auditory halleucinations, muscle achiness and pain, acne.

Important to mention that this whole disease is in my brain anyway so none of these symptoms are atypical, i have many more psychological symptoms just that these have become worse as of late.

 

[ahmo]

Have you tried lithium? It apparently helps B12 transport, also corrects mood imbalances. I felt the difference within hours of my first dose, my emotional lability disappeared. Your symptoms sound very like mine have been. Each step I've taken has relieved my brain and nervous system, until they're more or less *fixed*.

Have you looked into pyroluria? I'm linking a questionnaire. Just adding the correct supplements made a big difference for me. And coffee enemas to clear liver and adrenals. After detoxxing for a year, I had a major clearing of my adrenals, which seemed to bring with it almost a reset to my temperament: irritability, agitation, low tolerance of frustration...things which had plagued me for decades, now only appear under extreme stress or need for detox.

Unfortunately methyl blocking has almost the same symptoms of donut hole insufficiency (if I remember correctly) so how can you tell if you have solved one and not moved on to the other?

I'm afraid I can't answer this. Maybe @whodathunkit can. Here's another thread, maybe your symptoms overlap.

http://www.hputest.nl/evraag.htm Online questionnaire to suspect pyroluria
Pyroluria/Lyme protocol.
http://www.lymeinducedautism.com/images/1_KlinghardtKPU_09_PX.pdf

Here are some notes from Fred. The first one is from whodathunkit.

http://forums.phoenixrising.me/index.php?threads/95-for-l-methylfolate.33089/#post-511772
whodathunkit: The short answer is that there is no answer to your question about the “right amount” of methylfolate. The right answer varies for everyone. Most of us let our symptoms/side effects be the boss.

But even with symptoms there are two schools of thought: one school advocates starting very low and going very slow, then if you get adverse side effects slowing down or stopping and then re-starting according to how you feel.

The other side recommends starting off at whatever you’re comfortable with (typically fairly low), and then if you get certain side effects dramatically increasing the amount until you feel better. This is my side, and what worked for me. YMMV.

It’s all about what you’re comfortable with.

Likewise, the amount of time you spend at a dose varies. Most of us want to take the lowest possible amount we can get away with. But getting to that nice, normal maintenance dose can be tricky with either school of thought. Myself, I was taking 40mg/day at one point. $$$$$!!! (That was when I could have used the high-dose prescription) Now I’m down to between 8mg - 16mg/day, depending upon symptoms. I’d like to be at more like 4mg/day. Working on it.

But there are also lots of variables like nutritional status with other vitamins and minerals, particularly potassium. Getting methylation started can get a potassium deficiency started. Mild potassium deficiency is a PITA engendering symptoms like leg cramps, fatigue, and irritability; severe potassium deficiency can cause heart arrhythmias and be life-threatening

So please read and research, and see which tack you want to take. Also read up on paradoxical methylfolate deficiency (aka “the donut hole”). Before choosing it’s important to understand about that.

But basically, what tack you take all boils down to what you can tolerate as far as side effects. Some people like to go low and slow, which lessens the severity of the sides but can also take longer to get through them; some people like to radically increase dosage and power through the sides, thereby lessening the time spent dealing with them. Some people want to power through but get too sick and are forced to stop. It’s just an individual thing.

The thing that doesn’t seem to be individualized is that if you have the symptoms that drive most people to this discussion board, you will get sick and crash at some point after you start methylfolate and methylation. LOL Getting sick seems to be some byproduct of kickstarting a slow metabolism. Seems like it’s part detox, part induced nutritional deficiencies with stuff like potassium, other B vitamins, etc.. What’s individual is the approach taken to deal with it, the dosages involved in the approach, and how long it takes to get through the crash.

As far as we understand, the methylfolate in OTC supplements is the same thing as prescription Deplin. But regardless of form it’s all fairly costly, and the benefit of Deplin is if you’re doing high-dose, you only have to take a couple pills per day. With the OTC, if you’re doing high-dose, it’s handsfuls of pills per day.

Jan 2015 http://forums.phoenixrising.me/inde...-that-have-ramped-up.34764/page-4#post-549221

Perhaps my wording wasn’t the best. Let me try again. It’s that amount from a 1000mcg 5 star MeCbl sublingual tablet with somewhere between 10% and 33% of the nominal dose absorbed and at least that much AdoCbl at a different time, that when the needed cofactors are present, is sufficient to start about 80% of maximum healing with some amount of l-methylfolate (Metafolin) that amount of MeCbl/AdoCbl is sufficient to start most all “internal triage layers” except neurological in many people. Increasing to 10mg of MeCbl, might only increase healing the last 20% or so and still not be enough for neurological healing. It normally doesn’t appear to make any noticeable difference in folate need and usually only a little potassium. However, if enough folate wasn’t taken in the first place just continuing the B12s is enough to go into a folate donut hole. That is pretty much irrespective of the B12 amounts.

I hope I said it better. Reading it myself it doesn’t make sense. I would have included a few more words. Who knows. Now I know where that comes from.

sregan: Freddd, thank you.. If I’ve got it right then you’re saying that not as much MB12 is needed as some of us are thinking. (However, in those without MTRR and MTR problems that the B12 is recycling at the proper rate.)

Also that if taking MB12 AND AB12 (possibly LCF?) one might need to up the folate or possibly deal with the Donut Hole. I believe people have taken large doses of just MB12 (injection or otherwise) and not dealt with such issues. So maybe it’s due to the AB12/LCF?


Feb 2012 http://forums.phoenixrising.me/inde...-that-have-ramped-up.34764/page-5#post-553678 Thirst for Mfolate for Those That Have Ramped Up

TMG is a major source of methyl groups and is measured in mgs. SAM-e, like folate and MeCbl is a transferor of methyl groups and is measured in micrograms. Ultimately SAM-e increases methionine. It is part of the Hcy-methionine cycle Sam-e can feel like it is stepping up methylation, but it isn’t a doesn’t drive methylation but is often a limiter of it. It is called the universal methylator because it donates the methyl group to all sorts of reactions. It doesn’t supply the methyl group, except the original one it enters the body with. Instead it is methionine and then homocysteine and everything in-between in both directions.

TMG doesn’t drive it either, just supplies the methyl groups for a lot of things, being changed itself to DMG which can then donate another methyl group in some circumstances. TMG is choline minus one methyl group. So each of these items supplies a methyl group for different energy reactions. Be careful what you believe about these things because if your beliefs don’t match with what occurs you won’t be able to make sense of the responses because they won’t be explained in a way that works. Many of these methylation diagrams are done with folic acid and CyCbl assumed, so watch out for unsuspected “gotchas” in there. One of the things that may be a surprise is that TMG often affects the ATP balance in some way when that might otherwise be “too hot”. The rest of methylation business is at least as tricky as realizing that too little methylfolate produces lots of histamine and inflammation and that it can take a sizable dose to fill the need and get rid of folate deficiency symptoms.

Biotin has an effect on ATP end of things IF there isn’t already enough for the amount of reaction occurring. Biotin doesn’t drive the cycle, it allows the cycle. It limits but doesn’t drive it,

Something I would like to say that is 100% personal to each of us. For all these things based on genes, like the folate usage genes, have affected each of us all our lives. I’ve had folate deficiency symptoms all my life. What I have felt as the effect of an afflicted folate system is not the normal biochemical state of the human body. The partially crippled folate metabolism is “normal”. I don’t know what I would be like or feel like with a fully normal folate and B12 body so I can’t tell you what it is supposed to be but I can tell you it was awful 12 years ago with all 4 of the deadlock quartet in deficiency.

There are far more theories about what the interrelationships between the real MeCbl, AdoCbl and L-methylfolate and everything else than there are biochemical actualities. When talking about 3 things the relationships are pretty straightforward. When there are 15 items involved it gets terribly complicated. This whole business is about finding the combinations and which and how the various things fit together. It was a shocker to find that too much B1, B2 and B3 could cause folate and potassium deficiencies. There are plenty of other things that may have an inverted U shape effectiveness curve too. We have been mislead by 70 years of research studies based on folic acid and CyCbl/HyCbl because 100% of everything else was limited by low levels of active B12 and folate because of folic acid and CyCbl/HyCbl. EVERYTHING is different with these items replaced with body adequate levels of the active forms.