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Why Does High Dose (Methyl)B12 Cause Diarrhea?

Discussion in 'Detox: Methylation; B12; Glutathione; Chelation' started by aaron_c, Jan 19, 2014.

  1. aaron_c

    aaron_c Senior Member

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    Hi Yall,

    I have been taking high doses of mB12 for almost two weeks, and I have had diarrhea every morning of those two weeks. At this point taking either methylcobalamin or adenosylcobalamin triggers gut motility almost instantly (rumbling, a downbearing sensation).

    A few more details: I have actually been doing something like Freddd's protocol. Over maybe two weeks I ramped up to taking

    30 mg methylcobalamin
    6 mg adenosylcobalamin
    30 mg methylfolate
    1-2 g ALCAR
    something like 2000 mg more potassium than I might otherwise eat. (supplements plus many bananas)

    WiseGeek seems to think that diarrhea is one of the most common side effects of high amounts of mB12. So I figure I'm not the only one out there with this issue. Has anyone figured out why this might be, and what can be done to help?
  2. aaron_c

    aaron_c Senior Member

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    My Theories So Far:

    (1) Potassium Deficiency. It seems like a long-shot, since potassium causes both diarrhea and constipation. But I should get a blood test back some time this week.

    (2) Folinic Acid Issues: I have been eating a raw smoothie for both breakfast and dinner. Prominent in these smoothies are blueberries and lettuce, both big providers of folinic acid (I think). But my diet hasn't changed all that much since starting the high mB12, and although raw food might initiate gut motility, I know that B12 initiates it indipendant of food....and anyhow, it seems like I need some food in order for my gut to try to move it.

    (3) "Donut Hole" Folate Deficiency: Maybe I just didn't take enough methylfolate? This could tie in with the folinic acid issue, and potentially explain why B12 caused diarrhea--depletes methylfolate.

    (4) [Pelvic?] Nerve Remyelination: Diarrhea is a symptom of diabetic neuropathy resulting from poor blood flow to nerves. Maybe we could get the same symptom coming and going? But it doesn't seem clear that other symptoms resulting from diabetic neuropathy's effects on nerves are also common.
  3. ahmo

    ahmo Senior Member

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    @calebtrask, these seem like v high doses of Mb12 and Mfolate. That's really all I can say. cheers, ahmo
    Star-Anise likes this.
  4. aaron_c

    aaron_c Senior Member

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    Ya, I had a hard time finding concrete numbers for Freddd's thing, but I read 30 mg mB12 per day somewhere and went with it. But now even 1 mg of methylB12 or adenosylB12 seem to trigger gut rumbling.
  5. knackers323

    knackers323 Senior Member

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    Are you seeing any benefit from the supplements?
  6. ahmo

    ahmo Senior Member

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  7. Red04

    Red04 Senior Member

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    I would hold everything and ramp up potassium and see if that stopped it. Those do seem like high doses though.
  8. PeterPositive

    PeterPositive Senior Member

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    I would second that.
    30 + 6mg, that sounds like a hell of a lot of B12 for one dose. Can the body really use all that much in one shot?
    Star-Anise likes this.
  9. Star-Anise

    Star-Anise Senior Member

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    @calebtrask Hi there! Yes, I noticed the loose stools/diarrhea @ small doses from the beginning. I would not increase my dose until these symptoms subsided. Every time I increased my dose of methylfolate, and methylB12 the loose stools would happen again. I think that maybe this side-effect is more prevalent in those that have underlying IBS issues (I do - but not formally diagnosed). Interestingly, I noticed that everything started to go a bit better when I put the sublingual up by my gums to be absorbed versus under my tongue. Maybe slower absorption over an hour+ helps mitigate some of the loose stool symptoms? Or perhaps its just a coincidence.
    I agree, however, that is a HUGE dose. When I started, I used about 250 mcg. If my math is correct you are taking 120x my startup dose.
    I have no loose stools now by the way. I have read numerous places that methyl agents if introduced too quickly can exacerbate inflammation. I have always regarded my IBS symptoms as inflammatory in nature, so I was quite careful about increasing my doses of methyl donors. Also, I had read that when one starts up methylation they can increase detox processes, and I related to the phenomena of "copper dumping." I have always struggled with estrogen dominance, and there appears to be this relationship with high estrogen & high copper. Interestingly, my loose stools have decreased in conjunction with me being able to tolerate more high copper foods. This recent progress has came about within the last month after working on methylation protocol since spring-ish 2013.
    Hope that helps :)
    S
    whodathunkit and helios like this.
  10. aaron_c

    aaron_c Senior Member

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    @ahmo

    Thanks for the links! The one in the middle actually has some decent info on basic dosage ranges.

    @PeterPositive

    For what it's worth, I was taking it divided over six doses a day. Still, it was a lot.

    @Star-Anise

    That is very helpful. I have thought that diarrhea might be the main symptom of B12 for those of us with some IBS in our CFS, but you are the first confirmation of that I've seen. I think I might do what you say: Titrate the B12 and wait for the diarrhea to stop, then titrate up some more.

    The one thing I did like about the high mB12 is that I could take more methyl groups (including choline, which helps my gut.) Plus I could tolerate more glutamine.

    Do you know the mechanism of methyl to inflammation?

    Thanks everyone, I feel on much more solid ground, and will update as I get more info.
  11. Star-Anise

    Star-Anise Senior Member

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    @calebtrask
    Unfortunately no. But it is referenced frequently in my readings especially Dr. Lynch's stuff:
    from: http://www.seekinghealth.com/media/Improving-Patient-Outcomes-short-ver.pdf
    I have not had success with curcumin, as I understand it is high sulphur (which increases fatigue for me).
    I used lactoferrin for awhile, which my naturopath says helps decrease inflammation, as part of the Yasko protocol for those with ACAT snps. I have stopped this recently when I started Fredd's quartet & actually feel much better on this simpler routine. I have found that the most success is to follow a Weston Price approach & eat simple, simple grain free diet with an emphasis on saturated fats from grass fed animals. That foundation with the introduction of the quartet seems to be golden for me, yay! :)

    this is really interesting. I have also ready that glutamate sensitivity is related to an undermethylated brain. I am ++sensitive to glutamate, & have trouble supplementing with glutamine. My hunch is that you likely need larger doses of methylB12, but there is a fine line with the dosage, which is definitely the case with me. Take enough to help, but not so much to aggravate the inflammation. Eventually you will be ahead of the game, and the overall net result will be decreased inflammation...
    I know some people experience the best results with a steady dosage. But I have found that I have had to alter my dose at different stages through the last 10 months. Note I also noticed that I was able to make quite a bit more progress with stabilizing my dose following the removal of my amalgam fillings :)
    Hope that helps,
    S
  12. aaron_c

    aaron_c Senior Member

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    I didn't know that about curcumin. Very good to know. Thanks!

    Very interesting indeed.... So there is some hope that this will get better with time. Do you know who was saying this, or where?

    I think that the short-term reason that my glutamate sensitivity went down, however, is probably different. Here's my guess:

    High methylB12 and methyltetrahydrofolate (MTHF) would create rather more tetrahydrofolate (THF) than my cells would be used to. FPGS is an enzyme that adds a glutamate or two to folates. It likes THF and Folinic Acid (I'm not sure what else) but doesn't like MTHF. The glutamates that it adds allow the folates to stay in the cell much longer, and also allows them to function better in the various enzymes, including Tetrahydrofolate Synthase, which adds even more glutamate groups. Thus, increasing THF should allow my body to soak up a few more glutamates.

    I believe FPGS mechanism is also why Rich Van K suggested folinic acid to counter excitotoxicity.

    Thanks again, @Star-Anise
  13. Star-Anise

    Star-Anise Senior Member

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    @calebtrask
    Ya, it's made from tumeric, which is on the avoid list for those with sulfur sensitivity. I'm not sure of how much of active sulfur remains in supplement though.
    Sorry I don't have a specific source handy. But it made sense to me at the time, and explained to me why my sensitivity to glutamate did decrease a bit since I have been on methylation protocol. I believe it likely was in some of Yasko's writings...

    Wowzas, I *did not* know that. I admire your brain that you can follow that too! :) That is super cool all around!
    All the best,
    S
  14. aaron_c

    aaron_c Senior Member

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    @Star-Anise (or anyone else who wants to chime in)

    I forgot to ask: Have you noticed a decreased methyl sensitivity as you increased mB12? Like you can take more methyl donors?
  15. Star-Anise

    Star-Anise Senior Member

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    @calebtrask
    My decreased methyl sensitivity most markedly came about as a result of having my amalgam fillings removed. It was amazing. I haven't noticed anything specific to mB12. S
  16. Freddd

    Freddd Senior Member

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    Hi Calebtrask,

    Have you tried L-carnitine fumarate 30 minutes before food? About 90% of us have a strong response to fumarate and very little or no response to ALCAR. 10% are the other way around The only way to know is a short trial. I knew in a few days.

    Are you taking more than 30-40mg a day of B1 and/or B2 and/or more than 100mg of B3? These all appear to cause increased need of methylfolate and/or potassium? They sure do for me. My need for methylfolate decreased from 30+mg to 8mg. My potassium need went from insatiable at tolerance point (3000mg) to 1500mg typically.

    Those amounts of b12 don't wouldn't normally cause that problems in my experience. And I have taken far more in trials. Most b-complex these days have more b1, b2 and b3 than works well with active b12 and folate.
  17. Star-Anise

    Star-Anise Senior Member

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    @Freddd
    Wow me too! My potassium needs have decreased by about 1/3 too!
    And + Freddd from another thread, the increased methyfolate totally helped with the edema :) xoxo S
  18. ahmo

    ahmo Senior Member

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    And I've had no recurrences of blood blisters in my mouth since increasing Mfolate. :)
    Star-Anise likes this.
  19. vortex

    vortex

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    30 mg methylfolate ! ? That's a very high dose

    That is what is causing the diarrhea.

    Did you google methylfolate and diarrhea ?

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