Hi GreenMachineX,,
The way you are going about it is going to maximize severity and duration of your suffering. With each of these things there are TWO sets of symptoms. First is a healing response and brightening of the the neurological. You may find it very intense because you appear to be very deficient. Then the second set of symptoms are the refeeding syndrome induced deficiency symptoms telling you what you need to titrate up. Also you are assuming that MeCbl increases strength of response in a linear form. At 125 mcg absorbed MeCbl can give a very powerful positive response for the first 3 days and then the refeeding deficiency symptoms occur and are usually many times worse and unpleasant than the beneficial responses. They are telling you what is next most deficient. All of these symptoms are each a flag that healing has started and you have no idea what to do with it.
Are you taking any folic acid? folinic acid? extracted from vegetable b-vitamins? NAC, glutathione? high dose b-complex with the wrong mix like b-50 or b-100, cyanocobalamin, hydroxycobalamin, or too much of some other b-vits cause too much response too fast with MeCbl. Titrating MeCbl is a lousy way to control it. Because all the body effects are mostly started in the first 125mcg absorbed, say from a 1000 mcg sublingual tablet held for 45-120 minutes. Doubling or tripling the dose will increase the intensity of healing only a little. If your goal is to have healing, there are things to learn. So I have found one brand, and there are others, that have nothing disagreeable in them and small enough doses of the other b-complex that it doesn't overdrive some channels. NatureMade B-complex with Vitamin C. "List no. 1338", . They are abou US$7.00/100. I take 1/2 tablet twice a day.
Then you also need A, D, E, C, Magnesium and Calcium, 25 mg or so of zinc, and a trace mineral multimineral tablet. Some lecithin is a good idea. These are your basic cell making ingredients. Then start with just MeCbl. Use a know effective for you brand, something that blows your socks off is great. The catch is you want to turn on healing. When you do that you will have lots of refeeding symptoms and you want to minimize those. Hypokalemia can put someone in the hospital or 6 feet down. So can other undetected symptoms of some minerals.
On the third day usually, refeeding symptoms start. With MeCbl those will be potassium and l-methylfolate. One needs to get those first two balanced before you add the other part of the deadlock quartet (MeCbl, AdoCbl, L-methylfolate and l-carnitine) Each one of these will cause refeeding syndrome symptoms. Day 1-3 healing, days 4 and 5 titrating the nutrient(s) for the one or two items that come up, then often as not mfolate and potassium each increases the healing the other does so they need more of each. So, first you titrate the MeCbl to get healing started and going all day. If you use the sublingual, put it under your lip. When you feel "brightening" chew the tablet and swallow. The brightening won't increase past the next 5 minutes or so. Then when it fades, do it again. You might need to do that 4-6 times a day. Then when the refeeding symptoms start, and itching is hardly ever the first one except for some people and that can be from both folate deficiency and potassium deficiency. The potassium feels deeper and scratching doesn't work at all. If it is histamine driven, allergies are increased severely when there is methyltrap (MeCbl partial deficiency) or paradoxical folate deficiency (refeeding deficiency symptoms). A dose of about 4 mg or more per day will start bringing down the intensity and number of folate deficiency symptoms. With healing started, more cells get started then can be supported by low doses of methylfolate as you take. Discomfort and intensity will go down as you increase the methylfolate. I need 45mg/day to get to zero folate deficiencies as you see a post above this. Many people need to start with 1200+ mg of potassium spread across the day and may go as high as 3000mg or more. When I restored 50 pound of atrophied muscle it was difficult to keep up with the potassium I needed. For starters the typical RFS symptoms are groups 1, 2a, 2b and 3. You may have immediate refeeding syndrome as you are not starting from the beginning. Then when the methylfolate deficiency symptoms and potassium stabilize with the those symptoms gone or rapidly reducing, or healing stops, its time to start AdoCbl. A 10mg sublingual for 45-120 minutes might have a response or your body will have already converted enough MeCbl to AdoCbl that there is no more startup. If there is noticeable startup you could go through another round of potassium and methylfolate deficiency symptoms Then 10mg once a week sublingual will top it off for most people. Then it's start titrating with l-carnitine of an appropriate form. This is the main accelerator. If a person has anxiety as a "usual" symptom, carnitine can be microtitrated with Jarrow Liquid freebase carnitine starting at 100mcg (and adding 2 x 33mcg during the day to keep it more even, on empty stomach. Then increase by one or two 33 mcg doses each day. When it gives a brightening, level off until it fades, and then increase by small increments. If you decide to do this I will tell you how it is done. I've spent 35,000 hours working out the methods and so on. I'm a group health systems analyst, not a doctor. No doctor could diagnose me or treat me with any success. I went to more than 100 with no effect except for the chiropractor helped my back.
Following are the groups of induced deficiency symptoms when starting with the Deadlock Quartet (AdoCbl, MeCbl, Metafolin, L-carnitine fumarate). I usually have 3-lots of the symptoms in any group for it to be a match. Over time I learned earlier and earlier symptoms for early recognition and tend to have the same sets of symptoms over and over.Thats how I got down to 5 day cycles or so.
It took me more than a year to titrate from 64mg to 500mg of l-carnitine, meanwhile going through cycle after cycle with more folate and more potassium as the amount of healing increased with each increase of carnitine especially and most other things. Copper increased my need for potassium by 400mg for instance. So remember, the symptoms on this list can do damage if not reversed. And ask questions if you need. If you look at the Deplin studies you will see that Deplin (brand name Methylfolate) has no side effect symptoms different from placebo. It takes the MeCbl/Mfolate combination to start cells.
Version 2.41 06/11/2018 A work in process, incomplete, limited testing, people come in many variations, use at your own risk.
Copyright 2018, Frederick D. Davis, aka Fred Davis, aka Freddd, copied from original manuscript.
INDUCED DEFICIENCY SYMPTOMS FROM REFEEDING SYNDROME. This can follow 5 days of food deprivation, anorexia, or sort of a pinpoint starvation via vitamin or mineral or amino acid deficiencies. Whatever the “most needed” item is will often cause a strong response. The first usual notable symptoms occur on typically the third day of starting a previously insufficient nutrient with normally feeling or seeing the changes within minutes to hours. From MecBL I had over 30 symptoms respond in the first few hours with blow my socks off intensity with neurological startup and potassium deficiency on the 3rd day along with increasing folate deficiencies that took years to figure out. For instance it was noted in the 50s with injections of B12 with potassium deficiency (hypokalemia) as a side effect. It is dangerous and can be unpredictably fatal if not corrected and the cause is continued. When they say people are dying in Syria after they have been starved and given food, they are often suffering REFEEDING SYNDROME. When previous symptoms return that can also indicate a developing deficiency that started hindering cell formation.
Group 1 – Hypokalemia onset. Often called “detox”. Symptoms may appear with serum potassium as high as 4.3. May become dangerous if ignored. Considered “rare” with CyCbl (Cyanocobalamin) it is very common with MeCbl (methylcobalamin) and AdoCbl (adenosylcobalamin) and less so with HyCbl (Hydroxycobalamin).
There does not appear to be a clear order of onset. The order of onset varies widely from person to person but many appear consistent for each episode for any given person. There tend to be more and more intense symptoms as it gets worse. Some people have ended up in the ER because of not recognizing the symptoms.
IBS – Steady constipation, Nausea, Vomiting, Paralyzed Ileum,
Hard knots of muscle, Sudden muscle spasms when relaxed, Sudden muscle spasms when stretching , Sudden muscle spasms when kneeling, Sudden muscle spasms when reaching , Sudden muscle spasms when turning upper body to side, Tightening of muscles, spasms and excruciating pain in neck muscles, waking up screaming in pain from muscle spasms in legs. Muscle weakness
Abnormal heart rhythms (dysrhythmias), increased pulse rate, increased blood pressure, intense sudden dizzy spells correctable potentially in minutes with water with potassium gluconate for instance.
Emotional changes and/or instability, dermal or sub-dermal Itching, and if not treated potentially paralysis and death.
Group 2a - Both hypokalemia and l-methylfolate deficiency
IBS – Diarrhea alternating with constipation, IBS – Normal alternating with constipation
Group 2b – Either or both hypokalemia and l-methylfolate deficiency
Headache, Increased malaise, Fatigue
Group 3 - Induced and/or Paradoxical Folate deficiency or insufficiency, partial methylation block to methyltrap on 1 or more internal triage levels. Frequently called “NAC DETOX” or “GLUTATHIONE DETOX”. Can be caused by folic acid, folinic acid and for some people, like me and quite a few others, excess vegetable folates. Further excess B1, B2, B3 and/or inositol can increase methylfolate deficiency symptoms. Methylfolate, MeCbl and just about anything else that starts healing can cause the folate deficiency symptoms.
These symptoms appear in 2 forms generally, the milder symptoms that start with partial methylation block and the more severe symptoms that come on as partial methylation block gets worse or very quickly with methyltrap onset.
Edema - An additional thing I would like to mention. I would never have found it without 5 years of watching the onset of paradoxical folate insufficiency and trying to catch it earlier and earlier and to figure out what was causing it and to reverse it. For me the onset order goes back to the day of onset now with edema and a sudden increase of weight. I noticed that within 2 hours of taking sufficient Metafolin I would have an increase in urine output.
Old symptoms returning in a general sense, a person may have had onset of these hundreds of time if they are on the borderline
Edema
Angular Cheilitis, Canker sores,
Skin rashes, increased acne, Increased itchy acne on scalp and face, Skin peeling around fingernails, Skin cracking and peeling at fingertips, painful cracks in the skin at the corner of fingernails at approximate right angles to nails, can take months to occur and it may be only non mood or neurological symptoms.
IBS – Diarrhea alternating with constipation, IBS – Normal alternating with constipation
Headache, Increased malaise, Fatigue
Increased hypersensitive responses, Runny nose, Increased allergies, Increased Multiple Chemical Sensitivities, Increased asthma, rapidly increasing Generalized inflammation in body, Increased Inflammation pain in muscles, Increased Inflammation pain in joints, Achy muscles, Flu like symptoms
IBS – Steady diarrhea, IBS – Diarrhea alternating with normal, Stomach ache, Uneasy digestive tract,
Coated tongue, Depression, Less sociable, Impaired planning and logic, Brain fog, Low energy, Light headedness, Sluggishness, Increase irritability, Heart palpitations,
Longer term, very serious:
Loss of reflexes, Fevers, Forgetfulness, Confusion, Difficulty walking, Behavioral disorders, Dementia, Reduced sense of taste, bleeding easily.
High MCV, > 93, persistent and resistant to MeCbl and B6 and/P5P. The warning about too much folate causing subacute combined degeneration which kept folic acid to a max of 800 mcg for decades becasue large folate doses can lower MCV without MeCbl. There is a long history to this.
Group 4 - HyCbl onset, degraded MeCbl onset, MeCbl after photolytic breakdown onset.
Itchy bumps generally on scalp or face that develops to acne like lesions in a few days from start.
Group 5 – Copper deficiency after methylation startup has been achieved which often starts refeeding syndrome. 50mg or more of zinc has been indicated as a possible cause. 200-400 mg of zinc has been linked to copper deficiency. Excess supplemental or environmental manganese is linked to copper deficiency. Any or all symptoms can occur at “low normal range” copper tests. Well after all other observable copper deficiency symptoms showed up, a lower value as copper contibued to fall, MCV suddely went over 100 after it had fallen to
Demyelination of nerves similar to Sub Acute Combined Degeneration except that methylation and ATP startup has occurred, and copper deficiency favors damage to the upper motor neurons with perceived muscle weakness. Brittle nails. Sleep disorders. Mood (especially depression perhaps) and personality changes. Connective tissue breakdown. Spider veins. Varicose veins. Shrinking gums. Gum disease not responsive to usual measures. Unstoppable tooth decay on exposed areas without enamel. Low testosterone
Group 6 – Excess P-5-P, an active form of B6 that appears to drive hematocrit.
High hematocrit. The blood thickens and doesn’t pump as easily. Deep vein thrombosis can result. Other suspected circulatory hazards. Sometimes linked to high testosterone when lowering P-5-P might reduce it.
Group 7 – Excess B-vitamins affecting methylation
When taking the active B12/folate deadlock quartet (AdoCbl, MeCbl, Metafolin, L-methylfolate) Excess B1 - Thiamin, Excess B2 – Riboflavin, Excess B3 – Niacin and/or Excess Inositol can all produce an excess need for potassium to deal with Groups 1, 2a and 2b symptoms and/or produce an excess need for l-methylfolate to reduce groups 2a, 2b and 3 symptoms. A person might not be able to correct by taking potassium or folate and may need to reduce B1 <= 15mg/day, B2<= 10.2mg/day, B3 <=50mg, and inositol below an unknown quantity.
Group 8 – Boron insufficiency.
Arthritis swelling and pain, can be reduced by Boron
Contribution to fatigue, neurological effects.
Runaway tooth decay
Loss of calcium in bones and teeth
15 Surprising Benefits of Boron
Although all of the deficiency symptoms of boron are not fully understood, it is known that boron deficiency might result in the abnormal metabolism of calcium and magnesium. Some of the other symptoms include hyperthyroidism, sex hormone imbalance, osteoporosis, arthritis and neural malfunction.
Group 9 - Vanadium insufficiency
Deficiency of vanadium is poorly known or recognized. It affects tissue permeabilty like insulin.
Group 10 - Lithium insufficiency Non ionizing forms, small micronutrient doses
Lithium allows better permeability of B12 in nervous system membranes. Many people appear to have trouble affecting some B12 deficiency symptoms with B12 even
Group 11 - Iodine insufficiency, especially needed for those who don't eat iodized table salt and/or seafood.
Group 12 - L-carnitine XXXXX, That can be L-carnitine tartrate, L-C Fumarate, L-C freebase, ALCAR and others but usually works only one kind at a time.
neuromuscular pain, feeling of growing inflammation, fatigue, mood changes, sleep problems. These are quick occuring symptoms and they can sprwead to the complete 4 way deadlock over time.
It appears that for most people in this refeeding situation many may respond to only one form of l-carnitine, initially fumarate or ALCAR and sometimes also including a freebase form. However, as the deficienciencies change, the pathways appear to change and the carinitne that worked so well no longer does and the form is some entirely different one, like tartrate or some other variation. A person may need to trial half a dozen forms. A response is usually clear the first day or occasionally several days with micro doses and titration. And it can change based on what else is corrected.
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