Long-term overmethylation--advice requested

[waxleaves]

Hello all,

I am a new user and have been reading many of the threads here, looking for information, as I believe I am quite overmethylated and possibly experiencing methyl trapping. I stumbled upon this thought recently after learning about the various methylation protocols. I was put on 5-MTHF by a doctor a couple of years ago (1mg/day, then 5mg/day, for anxiety--I am bipolar), but stopped seeing her because I objected to her insistence that I become vegetarian. I tried it at her recommendation for a while and became B12 deficient. My new doctor has given me B12 shots.

I am +/- for C677T. I have a LiveWello/23andMe report if you are curious about anything else.

My anxiety has been through the roof lately. I now realize I have many of the symptoms of overmethylation. I have had severe food sensitivities out of nowhere for years, I am anxious and paranoid, etc. I also have many of the symptoms of B12 deficiency. I am taking sublingual B12. I am also taking Niacin every few hours and as much potassium as I can--I am deficient, likely because I am on lithium. I have the other things on hand to start methylation again when it is time.

Okay, my questions:
1. Will it take me a long time to get out of this situation? Do I just keep taking niacin for a while?
2. How do I know when it's time to stop taking niacin?
3. Does the food sensitivity reverse when the overmethylation ends? I am wondering whether I can look to that as a sign, and also whether I'll need to do any gut repair.

Thanks. I'm sorry if these things have been answered before--a lot of the answers I have read seem to apply to shorter-term overmethylation so I would appreciate help in being pointed in the right direction.

 

[caledonia]

Hi @waxleaves
Can you post your Livewello results and exactly what supplements and meds you're taking right now? Brands, amount, type, how often, etc.? When did you discontinue the methylfolate?

 

[waxleaves]

I'm taking, daily, 600mg Lithium, 100mg topamax, 7.5mg lexapro, 100mg Seroquel; 400mg magnesium glycinate; 1 capsule holistic health all-in-one (just started that yesterday--had not been on a multi before); 25mg zinc citrate; 500mg Jarrow NAC; also just started (Weds) 1 tab Perque activated B12.
Yesterday I introduced potassium citrate--took 10 tabs off 99mg over the course of the day--I have some NOW Potassium Gluconate on the way. My psychiatrist tested my serum potassium at my request and I'll know that soon--but she said it was low in 2013.
I have been taking Natural Factors Niacin, 50mg, every few hours but have not kept track.

I last took Thorne 5-MTHF on, I believe, Wednesday.

 

[Victronix]

Any time you are taking B-12 it's important to take the other Bs as well, B1, B2, etc. I take them separately since I cannot take B6 and am avoiding either mfolate or folic acid and it's very difficult to find a b-multi that doesn't have one of those. My anxiety decreased greatly with the addition of a B-multi.

 

[undcvr]

it is the seroquel? Did that coincide with your anxiety? I know the dosage is low but seroquel is nasty stuff. u are on alot of Lithium, long term it will slow down your thyroid and cud make autoimmune issues related to a slower thyroid follow, one of those symptoms is anxiety.

U r over methylated but B12 deficient??? Is that possible?

 

[Victronix]

Yes, I would get thyroid checked -- I can affirm that low thyroid can cause intense anxiety and paranoid feelings.

I have friend who is bipolar and pharmaceutical grade fish oil has done wonders for her.

 

[waxleaves]

Last TSH I had was 0.717 in August 2013, which seems to be low within the normal range but since it's still within that normal range my doctor was fine with it. I brought it to another doctor and she wasn't concerned, either. Does it look low?

I've been on Seroquel for 7 years--it was a godsend for my bipolar disorder for years. The intensification of anxiety has happened much more recently, in the last year. I ask my doctor every time I go in if I can lower or get off the lithium but she tells me I'm already on a very low dose. I would really like to remove it from my cocktail because I worry about my kidneys--my blood urea nitrogen and creatinine were off in 2012 until we lowered the lithium dose.

I am almost certainly B12 deficient--my new doctor who I feel very good about is working on this with me. I'm guessing it's from high-calorie malnutrition (partly caused by the Seroquel/Topamax combo--strong carb cravings but pickiness and low appetite depending on time of day, refusal to eat meat and vegetables, until I lowered the Seroquel dose--it's better now) plus high-dose 5-MTHF. I've been incredibly pale, my hair is going prematurely gray and falling out, my skin around my fingernails is cracking and bleeding (is that b12 or something else?), and then I have a lot of the other symptoms that could be due to so many different things--mental fogginess, fatigue, crankiness, paranoia, social anxiety, etc.

I got a B-multi today. I have some fish oil I take a little bit of--will step it up.

 

[Victronix]

A TSH of 0.7 is normal. If it were a TSH of 7.0, not 0.7, that would be different.

I recently was very surprised by how the strong the peri-menopause symptoms have been for me, and those can also manifest as hair going prematurely gray and falling out, skin around fingernails cracking / bleeding,mental fogginess, fatigue, crankiness, paranoia, social anxiety, etc. But it's different for everyone. Just took me by surprise.

If you are B-12 deficient that can play a role in everything in your body, so until that is dealt with it's hard to know what's causing what, and you need to rule it out first. But if you are having B-12 shots now, that will make it unclear. I presume those are cyanocolbalamin shots, which is what shots usually are. It's best to take methyl-B-12, at least as a sublingual along with the shots. There is a lot of info on this forum about types of B-12 and the relevance, etc.

What did you notice when you had your first shot?

My other first thought is always to try to deal with the prescription meds since they can have the strongest side effects and sometimes the body response can change over time to them. I know someone who was on lithium and developed anxiety over time, had to come off it, but she was not bipolar, but was taking it for depression. Of course, depression and bipolar are extremely serious and you can't just stop and start things.

I would go ahead and take the full dosage or more of the B-multi for a couple of days and see if there is any change. I've occasionally doubled the dosage of that and it helped even more.

 

[waxleaves]

Definitely 0.7.

I'm not currently having B12 shots--my last one was on 9/9/14. I really liked them, but haven't been able to get in because of travel and work. When I had my first shot, my color came back a bit (as it does when I've been eating properly, like now) and I felt like I had a bit more energy. It wasn't dramatic. I'm not sure what kind of shots but I think they're cyanocolbalamin.

I definitely do want to deal with the psych meds--maybe this is a good sign that I need to do what I've been wanting to do for a while and look around for a new psychiatrist because I have a bad feeling about what's going on now. Perhaps my doctor who I get along with can help with a recommendation.

 

[Victronix]

It sounds like the B-12 shots are not that time-critical, given that you did not have a dramatic response -- the response is usually proportional to the need. You said you're taking sublingual B-12 -- when did you start that? A good thread on that whole situation is here if you haven't been through that yet - http://forums.phoenixrising.me/index.php?threads/active-b12-protocol-basics.10138/

If it is overmethylation, the potassium gluconate powder -- the amt it recommends on the bottle -- should make a dent it that. I notice the difference within about 45 minutes if I have too much methylation. That would be an important clue. Starting mfolate, for me, made me totally paranoid and anxious, through-the-roof.

Have you decreased the amt of m-folate?

 

[caledonia]

600mg Lithium
100mg topamax
7.5mg lexapro
100mg Seroquel
400mg magnesium glycinate
1 capsule holistic health all-in-one (just started that yesterday--had not been on a multi before)
25mg zinc citrate
500mg Jarrow NAC - also just started (Weds)
1 tab Perque activated B12
potassium citrate--took 10 tabs off 99mg over the course of the day (started yesterday)
Natural Factors Niacin, 50mg, every few hours but have not kept track

Thorne 5-MTHF last taken Wednesday - put on 5-MTHF by a doctor a couple of years ago (1mg/day, then 5mg/day)
B12 shots (cyanocobalamin?) last taken 9-9-14

severe food sensitivities for years,
I am anxious and paranoid, etc. over the last year

I got a B-multi today.
I have some fish oil I take a little bit of--will step it up.

=-==-=-=-
Hi Waxleaves, you have a complex case because of the pysch meds involved. It is possible to gradually taper off psych meds, but it can be a very long process (possibly years). There is danger of severe withdrawal symptoms, but if done correctly you can minimize that. You can also at the same time take methylation supplements, again if you're very careful. I know this because I'm doing it myself.

It may be possible to get totally off all meds and just take methylation supplements, or be on minimal amounts of pysch meds along with methylation supplements.

=-==-=-=-=

First let's analyze what you're taking now and see if that's causing overmethylation or methyl trapping. You have several COMT mutations, which is likely why you're bipolar in the first place. COMT will also make you sensitive to too many methyl groups. You were taking a lot of methylfolate, but the reason that didn't cause problems was because there was no B12 in place to create methyl groups. That was a methyl trapping situation. Vegetarianism would worsen that situation as you would be getting less B12 in your diet (assuming your doc didn't have you take effective B12 supplements to replace the B12 from meat).

The new doc gave you B12 shots, which you think were cyanocobalamin. That would be ok for someone with COMT. Also the amount in shots is quite high for a starting dose, usually 1000mcg. That could cause anxiety for someone with COMT.

Now you have added a Perque tab. That's 2000mcg of hydroxycobalamin. That's a good form for COMT, but again, quite high for a starting dose, possibly causing anxiety.

Then you have added a capsule of the All In One multi - that has more methylcobalamin. The B12 is oral, so that absorbs so poorly I don't even bother to count that.

Technically though, you would still be in a methyltrapping situation because you were still taking 5mg methylfolate until quite recently - 5mg being quite a bit more than the amount of B12 your taking.

Does the niacin seem to be helping? You should feel relief within 15-20 minutes of a dose.

 

[waxleaves]

I would love to get off the lithium but I know that the other psych meds are going to be in place for a long time--and that's okay with me. They have dramatically improved my life. But I honestly don't notice any difference in mental symptoms when the lithium dose changes and it is so hard on my body, which is why I continually ask my doctor if I can get off it.

The doctor didn't have me on B12--and I should also mention that she had me switch to vegetarianism from a high-meat diet. I have switched back very recently to getting a lot of meat into the diet and am using FitDay to try to track my eating and micronutrients because the Seroquel/Topamax combo makes appetite strange.

The niacin does help--and actually, I feel that overall, throughout the day, the anxiety and paranoia have been lifting since yesterday. I'm still very tired, but this is a huge improvement.

One thing I forgot to mention: what I have been thinking of as "food sensitivity" for years has actually been cystic acne, which I thought was happening in response to certain foods. I just remembered that I asked my 1st doctor a while ago if this could be due to the 5-MTHF and she said probably not. The acne had been clearing up--slowly, not completely--over this last week without 5-MTHF, but after taking a b-complex including 400 mcg folic acid, my face broke out intensely again. Granted, it could be because I was on the road and eating strange things, but I think I might get individual B vitamins as suggested above.

Thank you to all of you for taking the time to offer your suggestions and knowledge. This is such a big help for me.

 

[Victronix]

the anxiety and paranoia have been lifting since yesterday

That's great. With those feelings, any small relief is so important.

I've also had to minimize my diet to cope with things -- gluten free, no fried foods ever, minimal dairy, only edame for soy (no tofu or soy milk), almost no sugary things like ice cream, almost no alcohol, etc. Gluten free is hard but was extremely helpful over a period of months -- the difference was not obvious right away and I've never tested positive for it, so, apparently just gluten sensitive. Gut issues affect everything, including sleep, which is important.

I have been reading the book the Mood Cure and that author recommends a lot of protein at every meal to keep moods in order, and that's been helpful for me. Thyroid issues will make absorption of nutrients difficult and so you need to get all the aminos somehow for neurotransmitters, etc, so loading up on protein helps that.

 

[waxleaves]

I have been diagnosed with celiac disease so have been gluten-free for about three years--it makes a huge difference with digestion, mood, and so much else. I try to eat real foods as much as possible--vegetables, meat, minimal dairy, no soy. Minimizing sugar is terribly difficult because of Seroquel but I do what I can. A paleo-type diet has helped for the last several years but I'm bad at sticking to it. I'm trying to increase protein so it's good to hear that that is helpful for mood.

The difficulty has come in the last 2 years--I was doing really well with eating meat, vegetables, and some fruits, but then it seemed as though I had food sensitivites to so many random things that were not problems before: all fruits except for pears and bananas; coconut; etc. Maybe a salicylate sensitivity--I really don't know. I try my best to avoid but it's not realistic.

 

[JalapenoLuv]

Vitronix have you heard of NT factor? It's useful for repairing damaged mitochrondria.
I use this one.
Nutricology, NT Factor, Advanced Physicians Formula, 150 Tablets

 

[Gondwanaland]

@waxleaves

Lithium increases the intracellular magnesium concentration by competing with magnesium for some intracellular binding sites

Since you take high dose Lithium, perhaps you need to up your magnesium dose - transdermal is an option if you don't tolerate more orally.

I had food sensitivites to so many random things that were not problems before: all fruits except for pears and bananas; coconut; etc. Maybe a salicylate sensitivity--I really don't know. I try my best to avoid but it's not realistic.

Magnesium helped me to overcome salicylate sensitivity. The biggest problem for me was coconut though. Haven't tried coconut water again, but I am currently tolerating coconut oil again.

izzy

 

[waxleaves]

Wow, good to know on both counts. I have no trouble with 400mg mag glycinate so I just tried adding another 200mg. The pharmacy down the street has transdermal, too.

 

[Gondwanaland]

Like everything in life, too much magnesium also has negative side effects. Pay attention to how you react.

I did fine with 600mg daily for about a month and then I got loose stools, sleepiness and low blood pressure. I am currently taking 200-300mg daily, depending on how much of Mg antagonists and synergists I take.

You can read [almost] everything about magnesium here: http://george-eby-research.com/html/depression-anxiety.html (pick up a topic from the menu on the left)

izzy

 

[caledonia]

I would love to get off the lithium but I know that the other psych meds are going to be in place for a long time--and that's okay with me. They have dramatically improved my life. But I honestly don't notice any difference in mental symptoms when the lithium dose changes and it is so hard on my body, which is why I continually ask my doctor if I can get off it.

If you have methylation working correctly, it could be possible to very gradually reduce or even discontinue lithium. So your first job would be to get methylation working correctly, and then convince your doc to let you do a trial of a 10% reduction in dose and then hold for 8 weeks and see what happens. This should be pretty safe.

If you wanted to continue, then the next reduction would be 10% of the reduced dose, and so on. Note that this is not the same as 10% of the original dose. This is the taper developed by the Paxil Progress forum - you can go there for more info, but don't mention supplements or methylation, as they only focus on getting people off meds safely.

This is the taper that I'm using to get off Zoloft - I'm two years into probably a 4 year taper. So far, so good. I had a horrible withdrawal syndrome when I tried to get off it before.

The niacin does help--and actually, I feel that overall, throughout the day, the anxiety and paranoia have been lifting since yesterday. I'm still very tired, but this is a huge improvement.

This is awesome! My suggestion then would be to discontinue all methylation supplements temporarily to assist the process of calming things down. What you're doing right now is like having one foot on the gas and the other foot on the brake.

When you're calmed down and feel able to resume methylation supplements, read/watch the first four links in my signature, especially Start Low and Go Slow, so you don't get overmethylated again.

One thing I forgot to mention: what I have been thinking of as "food sensitivity" for years has actually been cystic acne, which I thought was happening in response to certain foods.

This is different than saying you have gut issues like diarrhea, constipation, reflux and so on. It could be from foods, but it could be other things too.

Have you done stool testing? This would be the best way to see what's going on with your gut. You also have ACAT which can affect the gut, cause kidney stones, etc.

I'm not surprised you have celiac - you're +/+ for HLA which affects how well (or not) you can process gluten.

Also just the TSH test is not good enough to diagnose thyroid problems - you need a complete thyroid panel - TSH, free T3, free T4, reverse T3 and thyroid antibodies.

 

[caledonia]

Now let's look at the four meds you're on. Many medicines deplete various vitamins and minerals. It can be a good idea to supplement with the substances which are being depleted. This is just a quick internet search. A functional medicine doctor or naturopath can be helpful for this kind of stuff.

Lithium - Drug Muggers http://www.amazon.com/gp/product/B004MYG4E6?btkr=1
- may cause an overload of magnesium if you're supplementing with that.

Nutritional Solutions- Jeanne Wallace - DEPLETES sodium, especially during initial therapy until stable blood levels of lithium are reached.
Lithium ALSO DEPLETES brain stores of inositol, a vitamin in the B-complex family; replacement inositol is
typically provided at 500mg 3x/day. Depletion of inositol can trigger or worsen psoriasis, which improves with
inositol supplementation in those taking lithium. Some studies have shown that folic acid (200mcg/day)
improves response to lithium (a multiple vitamin/mineral can supply this amount of folic acid for you). Of note,
essential fatty acids may help reduce the side effects (such as tremor and ataxia) associated with lithium
therapy. Take fiber supplements at least 1-2 hours away from your lithium, as fiber can bind to the drug and
reduce its absorption. The supplement 5-HTP (a tryptophan precursor) has shown efficacy in improving bipolar
disorder, however, it is contraindicated with patients with brain tumors (please avoid 5-HTP supplements)!
Coffee appears to speed the clearance of lithium from the body: if you abruptly alter your coffee consumption,
have your doctor monitor your lithium dosage.

http://nutritionreview.org/2013/04/practical-guide-avoiding-drug-induced-nutrient-depletion/
In addition, be aware that lithium carbonate, used for treating bipolar illness, depletes folic acid (take 800 mcg) and inositol (take 500 mg bid).

Another page says don't replace the inositol as it may affect how well the drug works. http://www.chiro.org/nutrition/ABSTRACTS/Nutrient_Depletion_Checklist_Psychotherapeutic.shtml

topamax (anticonvulsant)- Drug Muggers http://www.amazon.com/gp/product/B004MYG4E6?btkr=1
- depletes "folic acid". The folic acid also weakens the action of the topamax. Take "folic acid" and topamax four hours apart.

Depletes biotin (a B vitamin) and potassium - couple different sources, not sure how reliable they are.

lexapro (SSRI) - http://nutritionreview.org/2013/04/practical-guide-avoiding-drug-induced-nutrient-depletion/
For antidepressants to work optimally, an ongoing supply of the B vitamins must be available as co-factors to help manufacture the needed neurotransmitters, such as serotonin and dopamine. (18,19) So, while these drugs may not directly deplete B vitamins, patients on these medications should ensure they get enough of these vitamins.

http://glutenfreeworks.com/blog/201...-each-year-on-8-drugs-that-deplete-nutrients/

Seroquel, Abilify, Cymbalta, Effexor, Lexapro. Anti-Psychotics/ Anti-Depressants/ Anti-Anxiety drugs deplete Coenzyme Q10 and Vitamin B12.

Seroquel - http://www.network54.com/Forum/2818...PSYCHOTICS+AND+ANTIDEPRESSANTS++deplete+CoQ10
Seroquel depletes:
Vitamin A, vitamin B1, vitamin B12, biotin, folic acid, carnitine, inositol, vitamin C, vitamin D, vitamin K, and calcium.

http://glutenfreeworks.com/blog/201...-each-year-on-8-drugs-that-deplete-nutrients/

• Seroquel, Abilify, Cymbalta, Effexor, Lexapro. Anti-Psychotics/ Anti-Depressants/ Anti-Anxiety drugs deplete Coenzyme Q10 and Vitamin B12.