So in layman's terms - some people don't process folic acid well? This can undermine their B12 therapy, is this correct? Because the folic acid can't be utilized for some people, and builds up in their system?
Is there a way to determine that this is going on with an individual person, or only by trial/error? The nutritionist/pharmacist who is helping my friend & I with his B12 therapy, is having him test his PH (which has been running right in the middle), and wants to review his CBC & B12 to see where it is at to see if we need to adjust the folate type, which I have been asking her about.
However, does it HURT to add the metafolin or methylfolate or folinic acid?
I hate to wait for the labs which I realize may not paint a true picture anyway, since while he is having some improvements especially in the morning - he's not so slurry or hoarse, feels really good, and is very conversant. In the afternoon he starts to fade to where by the evening he is confused & irritable, and his voice becomes more slurry & hoarse. While I appreciate the nutritionist's caution in getting the B12 going first then see where we're at before throwing more supplements into the mix, I don't want more damage to occur as we trial this out and also he is getting frustrated & worried at his perceived lack of improvement. He also has a lot of anxiety in the evening - this could be worry about his condition or chemical imbalances or both ?
Does this going downhill toward evening point to anything to anybody?
A clue ? - earlier this week he had some tingling on the one side of his chin, and it was red and a bit swollen. Turns out he took 2 multi's in the morning and one at evening, instead of the 1-am, 2-pm. This went away the next day.
Hi Pea,
So in layman's terms - some people don't process folic acid well? This can undermine their B12 therapy, is this correct? Because the folic acid can't be utilized for some people, and builds up in their system?
Yes, that is correct. It also appears dose related. 400mcg a day might not be a problem whereas 1000mcg could be enough to entirely block the methylfolate. SOme people can procees folic acid a little. It isn't an all or nothing thing.
However, does it HURT to add the folinic acid?
I split out these two questions becasue they have different answers. Some people can't use folinic acid either. This has a worse result than folic acid. The folinic acid lasts longer in the blood and it is renewed from vegetables. This is the "natural" paradoxical folate deficiency and can be triggered by vegetable food source folate and by folinic acid. It is unknown what percentage of people are so affected.
However, does it HURT to add the metafolin or methylfolate?
The is the only form of folate, methylfolate of which Metafolin is the pharmaceutical grade brand and was allowed a patent for making a stable form of methylfolate. It has been through full pharmaceutical testing. It appears to work for everybody if they have the needed cofactors.
and wants to review his CBC & B12 to see where it is at to see if we need to adjust the folate type, which I have been asking her about.
That likely isn't going to do any good.
he is having some improvements especially in the morning - he's not so slurry or hoarse, feels really good, and is very conversant. In the afternoon he starts to fade to where by the evening he is confused & irritable, and his voice becomes more slurry & hoarse.
Metafolin, adb12, l-carnitine fumarate,
POTASSIUM , b-complex, magnesium, A, C, D, E, zinc calcium, will all help. Mb12 by itself does very little. It HAS to have the other thongs to work. Also, the brand of mb12 makes all the difference in the world. ON the BASICS page
http://forums.phoenixrising.me/showthread.php?11522-Active-B12-Protocol-Basics is a list of reasons why b12 therapies fail. You can use it as a checklist.
REASONS WHY B12 AND FOLATE THERAPIES DON'T WORK FOR MANY PEOPLE
Version 2.0 - 03/10/11
Version 2.1 - 05/08/11
1. They take an inactive b12, either cyanob12 or hydroxyb12. The research validating their use was primarily for reducing blood cell size in Pernicious Anemia, keeping the serum b12 level over 300pg/ml at the end of the period between injections. They make a statistically significant effect that can be seen in lab tests in a significant percentage of people compared to placebo. They do not heal most damage done by active b12 deficiencies and have little or no effect on the vast majority of symptoms. They may even block active b12 from receptor sites hindering the effects of real b12. They both cause a keyhole effect of having only a very limited amount (estimated at 10mcg/day) that can actually be bound and converted to active forms. They in no way increase the level of unbound active cobalamins which appear required for most healing. They do nothing beneficial in a substantial percentage of people (20-40%) while giving the illusion that the problem is being treated and if it doesnt work, oh well, thats the accepted therapy. There is no dose proportionate healing with these inactive b12s because it all has to go through this keyhole. Some people are totally incapable of converting these to active forms because they lack the enzyme
2. They take active b12 as an oral tablet reducing absorbtion to below 1%. A 1000mcg active b12 oral tablet might bind as much as 10mcg of b12.
Again the b12 has to be squeezed through a keyhole that limits the amount and is subject to binding problems in the person whether genetic or acquired.
3. They take a sublingual tablet of active b12 and chew it or slurp it down quickly reducing absorbtion back to that same 1% and limited to binding capacity. With sublingual tablets absorbtion is proportionate to time in contact with tissues. I performed a series of absorbtion tests comparing sublingual absorbtion to injection via hypersensitive response and urine colorimetry.
4. Of the many brands of sublingual methylb12 only some are very effective. Some are completely ineffective and some have a little effect.
5. For injectable methylb12, if it is exposed to too much light (very little light actually is too much) it breaks down. Broken down methylb12 is hydroxyb12. It doesnt work at healing brain/cord problems of those who have a presumed low CSF cobalamin level. That requires a flood of unbound methylb12 and adenosylb12 (2 separate deficiencies) that can enter by diffusion. Adenosylb12 from sublinguals can ride along with injected methylb12.
6. They dont take BOTH active b12s.
7. They dont take enough active b12s for the purpose.
8. Lack of methylfolate
9. Folic acid is taken which can block at least 4 times as much methylfolate from being active inducing folate deficiency even if methylfolate is also taken. These induced deficiency symptoms are often called "detox" symptoms.
10. Folinic acid is taken which can block at least 5 times as much methylfolate from being active inducing folate deficiency even if methylfolate is also taken. These induced deficiency symptoms are often called "detox" symptoms.
11. Lack of other critical cofactors.
12. Lack of basic cofactors
13. Glutathione, glutathione direct precursors or NAC is taken causing what is often called "detox" while actually being induced folate and b12 deficiencies.
since while he is having some improvements especially in the morning - he's not so slurry or hoarse, feels really good, and is very conversant. In the afternoon he starts to fade to where by the evening he is confused & irritable, and his voice becomes more slurry & hoarse
This sounds like he is getting very marginal CNS penetration of cobalamin. He appears to need larger doses of mb12, some adb12 to the mitochondria working, Metafolin to help it all, and some l-carnitine fumarate and omega3 oils to aid CNS healing and get the body's and brain's energy going, and of course ALL the basics. I had that hoarse voice for years. It cleared up in mid word and never went back, but then I was taking much larger doses of mb12 and all the basics.
Does this going downhill toward evening point to anything to anybody?
Yes, inadequate doses, more frequent doses, missing cofactors. For me as long as the mb12 was in my mouth things worked much better. Hours later it was all worn off. As the dose went up it got closer and closer to lasting all day and evening.