Rich - Methylation Results.

[Ema]

Hi Rich - Finally, here are my methylation panel results...Could you please take a look?

I was taking approx 8-10 mg of mB12, 1600 mcg of the metafolin, and two of the B complex vitamins from Douglas with metafolin per day when these were drawn.

Thanks, Ema

GLutathione (oxidized) 0.50 (0.16-0.50)
Glutathione (reduced) 4.0 (3.8-5.5)
S-Adenosylmethionine (RBC) 235 (221-256)
S-Adenosylhomocysteine (RBC) 48.6 (38-49)
5-CH3-THF 15.0 (8.4-72.6)
10-Formyl-THF 2.3 (1.5-8.2
5-Formyl-THF 1.2 (1.2-11.7)
THF 0.88 (.6-6.8)
Folic Acid 11.5 (8.9-24.6
Foilinic Acid (WB) 12.7 (9-35.5)

 

[richvank]

Hi Rich - Finally, here are my methylation panel results...Could you please take a look?

I was taking approx 8-10 mg of mB12, 1600 mcg of the metafolin, and two of the B complex vitamins from Douglas with metafolin per day when these were drawn.

Thanks, Ema

GLutathione (oxidized) 0.50 (0.16-0.50)
Glutathione (reduced) 4.0 (3.8-5.5)
S-Adenosylmethionine (RBC) 235 (221-256)
S-Adenosylhomocysteine (RBC) 48.6 (38-49)
5-CH3-THF 15.0 (8.4-72.6)
10-Formyl-THF 2.3 (1.5-8.2
5-Formyl-THF 1.2 (1.2-11.7)
THF 0.88 (.6-6.8)
Folic Acid 11.5 (8.9-24.6
Foilinic Acid (WB) 12.7 (9-35.5)

Hi, Ema.

Thank you for posting these results.

Your total glutathione looks pretty good, though still somewhat low. Your reduced glutathione is within its reference range, but still low-normal. Your oxidized glutathione is at the high end of its reference range.

Your SAMe is almost on its mean normal value, and that's good.
Your SAH is at the high end of its normal range.

Your folates aren't too bad.

I would say that your methylation cycle and folate metabolism (with the possible exception of folinic acid, aka 5-formyl THF) have been well supported. You probably have a good level of methionine, which feeds the methylation cycle. Your methionine synthase reaction appears to be running pretty well, given the relatively good level of THF, which is a product of this reaction. I usually see this one below its reference range, or barely within it.

There seems to be not quite enough flow of homocysteine from the methylation cycle into the transsulfuration pathway. This could be due to overdriving the methylation cycle somewhat. In general, another possible cause of this can be low B2 or B6, but since you were taking a B-complex, and you were taking fairly hefty dosages of methylfolate and methylB12, I think the first explanation is the more likely one in your case. As we've discussed before, I have different views from Freddd about the best dosages. Taking high dosages of methylfolate and methylB12 together removes control of the rate of the methylation cycle from the cells, overdriving the methylation cycle.

You might benefit by lowering these dosages somewhat.

Your high-normal oxidized glutathione means that your body is under oxidative stress. This could be due to inflammation produced by the immune system in response to one or more infections. You would probably benefit by trying to determine what is producing the oxidative stress, and treating it if possible.

As I've been posting lately, I believe that the methylation protocols address the core of the pathophysiology in ME/CFS, and I think that you have done this fairly well. However, the methylation treatments do not directly address the etiologies that are placing demands on glutathione. I think that infections and toxins are the main categories that are doing this, and infections seem to be the major one. Once infections become entrenched, even a restored immune system does not seem to be able to knock them all out, because they have ways of foiling the immune system or hiding from it. In my view, this is where the remaining challenges lie in conquering ME/CFS. I am heartened by the considerable number of good researchers who are now addressing this aspect, and I hope that we will see good progress there soon.

Best regards,

Rich

 

[Ema]

Thank you, Rich, for taking the time to look at my results and comment on them. I really appreciate it!

I thought that my results fit the profile for a methylation cycle block pretty well based on the interpretation you posted in earlier threads. But it sounds like you are thinking that the methylation cycle is working pretty well for me overall based on these results and that there isn't a block currently?

I can't decide if I am encouraged by my results or not! It's always discouraging to have poor results but at least that provides some explanation for feeling less than optimal. Things are much better now after addressing methylation, infections and hormone imbalances for the past year but there is still a lot of room for improvement in my opinion. I guess I feel a little lost and discouraged because I'm not ready for this much improved but still not vital state to be the best I can hope to achieve for myself.

I have tested positive for a variety of viral and bacterial infections and take antibiotics and antivirals to treat those. Hopefully this will begin to lower inflammation and help with the oxidative stress.

I also started the TD glutathione after I did this test. I wonder if you think that would be beneficial to continue based on my results? If my total glutathione is OK (where is this shown on the test?), maybe I don't need it? I honestly haven't noticed anything one way or another after using it for a month or so. Of course, I also had the Flagyl trial in that time period which may have thrown a wrench into interpreting any other trial.

I am ready to lower the dosages of the mB12 and the methylfolate as well. I may switch over to the hydroxy form as well when this bottle runs out.

Thanks again, Rich!

 

[richvank]

Hi, Ema.

You're welcome.

Most of the methylation panel results I have seen have been for people who have not yet started methylation treatment.
Compared to them, your results are much better, so I think that the methylation treatment you have done has helped you. In fact, I would say that your results are one of the three best sets I've seen, outside of some from our clinical study at nine months and a year of treatment. But again, not many people have rerun the methylation panel after an extended period of treatment. I think this is consistent with your report of symptomatic improvement.

It's true that your results are still not optimum, but as I mentioned, the methylation treatment does not deal specifically with the etiological factors. I'm hopeful that your treatment of the bacteria and viruses, while maintaining the status of your methylation cycle and related pathways, will prove to be a good combination for improving things more.

Total glutathione is found by adding together the reduced and twice the oxidized glutathione, and comparing that to doing the same with the mean values of the reference ranges for the reduced and oxidized glutathione.

I think it is O.K. to use the TD glutathione, so long as you continue the support for the methylation cycle. I'm not sure that you would need it, if you continue the methylation cycle support (B12 and folate).

Flagyl does produce oxidative stress, so that could have impacted your glutathione, causing more of it to be oxidized.

O.K. on lowering the dosages of the methylB12 and methylfolate, and switching to hydroxoB12 later on.

I hope you will continue to experience improvement. Hang in there.

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

Best regards,
Rich

 

[Ema]

Hi Rich -
I've been thinking more about what my next steps would be in light of these results. I am still considering the RBC Elements test from Doctor's Data that we discussed earlier in light of my low zinc results. I also saw a recommendation for the plasma amino acids profile from Doctor's Data on another thread from several years ago. Would that be one to consider as well to see if amino acid deficits are an issue?

The DD website seems to indicate that the urine amino acids test may be preferred over the plasma.

The 24-hour urine amino acid analysis has the highest probability of detecting abnormalities if renal function is normal. The 24-hour test indicates what is high and low over the course of a day, reflects blood and tissue amino acid pools, and is not affected by circadian rhythm. Healthy kidneys efficiently conserve essential amino acids. Therefore, urine levels of amino acids decrease first and tend to give an earlier indication of inadequacy than do plasma levels.

A first morning void urine amino acid analysis, with results normalized per gram creatinine, provides an alternative when a complete 24-hour collection is not a viable option. The first morning void analysis is excellent for identification of marked abnormalities, particularly with respect to gastrointestinal health, inherited disorders in amino acid metabolism, and renal function, and can be used for protein challenge testing.

Plasma amino acid analysis measures what is being transported at the time of sampling. Abnormalities are deduced by comparison of measured levels with an established reference range. (The specimen should be collected after an overnight fast to reduce the influence of dietary protein). Plasma analysis is an excellent compromise if urine collection is difficult.

Do you have any thoughts about whether urine or plasma would be preferred?
Thanks as always for your thoughts!
Ema

 

[richvank]

Hi, Ema.

As stated in what you quoted from Doctor's Data, the urine test is more sensitive. However, it is dependent on the kidneys operating normally, which they usually do in ME/CFS. Also, for some species, a high urine level does not necessarily mean a high blood level. Taurine is an example, if beta alanine is high, which it often is in ME/CFS, because of intestinal dysbiosis. The blood test is less sensitive, but more easily interpreted unequivocally. I have used them both. Of course, the ideal situation is to have both , and some people who don't have to worry about money have done both of them. It's easier to do the urine test, because you can do it at home and ship the sample to the lab yourself. If the urine test would work better for you, I would suggest doing that.

Best regards,

Rich