Horrible methylation panel results, any ideas?

[hixxy]

I've just had a methylation panel done with a local Australia pathology lab (NutriPath). The results aren't overly promising. Click here for the report.

I'm currently on:

1. 3 mg of Solgar Metafolin
2. 1 pump of B12oils methylcobalamin
3. 1 mg of AOR Sublingual Methylcobalamin
4. 1/2 cap of Metabolics B Complex twice daily
5. Other less important supplements (too lazy to list )

There appears to be a block causing SAH to accumulate in the methylation cycle and a block in the folate cycle causing THF and folinic acid to accumulate.

Before starting on methylation treatment my normal homocysteine was 6.5 umol/L (0.0-15.0), it has now risen to 9.5 umol/L. It should have been high to start with, so there was obviously a block in conversion from SAH to homocysteine which has been relieved somehow with methylfolate and methylcobalamin. I've been undergoing treatment this time for about 2 1/2 months.

I was suggested TMG, but this causes immediate improvement for an hour or two then the worst imaginable crash even at tiny doses.

Any ideas? Thanks.

 

[Dufresne]

Haven't seen you around in a while. How are the sensitivities?

 

[hixxy]

Horrible

Although methylation shows hints of helping but it's been really rough going and as you can see by my post methylation is still really really screwed.

 

[Crux]

Hi @hixxy ;

Here's a guess. Maybe it's a type of Choline deficiency.

It may not just be that simple, even though it can occur from restrictive diets, say without eggs or liver, etc.

There are gut microbes that utilize choline for growth. There are also microbes that utilize many of our nutrients. I think that's how we can become deficient even with a nutritious diet.

Some microbes that utilize choline can produce potentially toxic compounds. So, even with a deficiency, we can become intolerant of it.

Choline is also involved with methylation and folate metabolism. With sufficiency, less folate may be needed.


http://www.hindawi.com/journals/aurt/2013/578429/

http://ajcn.nutrition.org/content/85/3/702.full

 

[hixxy]

I'm beginning to wonder if the folate cycle is blocked up by SHMT because of B6 deficiency (I have no SHMT mutations, so can't be genetics). I do get B6 in my b complex, but possibly not enough as I have pyroluria. In the past I haven't tolerated B6 supplementation at all well. Would this explain only the elevated THF?

Seems the elevated folinic acid can also inhibit SHMT. I have a heterozygous mutation in MTHFS, but I'm skeptical that could cause such high levels of folinic acid.

 

[Lynn_M]

hixxy,

Riboflavin plays an important role in metabolizing B12 and folate. See this excerpt.
Also see the B2 I Love You thread. It appears that a full Metabolics B Complex only supplies 7 mg of riboflavin, so 1/2 of one might be leaving you short, depending on your diet and other unspecified supplements.

 

[hixxy]

I actually take 1/2 twice a day (corrected the post). I considered this, but I feel worse supplementing more b2/p5p.

 

[Sea]

The mainstream approach for high SAH is to supplement B12. Maybe you need more B12 or maybe you're not absorbing what you're taking and need injections. Maybe your folate and B12 supplementation are not in the right balance.

I'm beginning to wonder if the folate cycle is blocked up by SHMT because of B6 deficiency (I have no SHMT mutations, so can't be genetics)

I don't know anything about SHMT but I hope you're not assuming you have no mutations based on 23andme or someone's interpretation of 23andme. The human genome has about 3 billion base pairs, 23andme test around 900 000. Also, some of the interpreters miss a lot of the info that is there in your raw data.

 

[hixxy]

Does anyone have any idea if those elevated THF and folinic acid would have significant consequences? Maybe similar to unmetabolised folate blocking folate receptors?

 

[vortex]

so what are your health problems, do you have Lyme ? any infections ?

 

[hixxy]

ME/CFS, very severe food and chemical sensitivity, eosinophilic esophagitis, dystonia and a really screwed gut.

 

[caledonia]

Couple of ideas -

Too much methylfolate relative to methylcobalamin (assuming the pump is 1000mcg).
You're getting 3220mcg folate to 2000mcg methylcobalamin. (The B12 in the B complex is oral, so it barely absorbs - I don't bother to count it.) This ratio is backwards and can cause methyl trapping over time.

Your gut is screwed up. You may not be absorbing oral vitamins well. That would be the folate, B vitamins and possibly miscellaneous. The sublingual and skin routes should be fine.

The B12 may not be absorbing well because you lack enough lithium to get it into the cells (no matter what route in gets in your body).

 

[hixxy]

Couple of ideas -

Too much methylfolate relative to methylcobalamin (assuming the pump is 1000mcg).
You're getting 3220mcg folate to 2000mcg methylcobalamin. (The B12 in the B complex is oral, so it barely absorbs - I don't bother to count it.) This ratio is backwards and can cause methyl trapping over time.

I usually feel worse increasing b12 dosage and cannot take b12 at all without methylfolate. Also, my methylation usually doesn't "click" until I up methyfolate?

Your gut is screwed up. You may not be absorbing oral vitamins well. That would be the folate, B vitamins and possibly miscellaneous. The sublingual and skin routes should be fine.

My gut is screwed, but I don't tolerate sublinguals well due to hypersensitivity and I'm also yet to find a transdermal cream other than b12oils of anything I tolerate. Also, the folate must be absorbing. Why? The elevated THF and folinic acid are coming from somewhere. I have very little folate in my diet at all so they must be coming from methylfolate after it's donated it's methylgroup.

The B12 may not be absorbing well because you lack enough lithium to get it into the cells (no matter what route in gets in your body).

I've been on lithium for a few months. I probably should have mentioned it. I also feel the affect of methylb12 quite strongly.

 

[vortex]

ME/CFS, very severe food and chemical sensitivity, eosinophilic esophagitis, dystonia and a really screwed gut.

Have you been tested for infections, viruses, lyme disease etc ?

I just spent 2 years fiddling around with my methylation pathways just like you are, but only to find out I have a bunch of infections like lyme, bart, bab, viruses etc. wreaking havoc on my system and making my methylation labs all screwed up.

I thought all my problems were from my mthfr defect and if I just corrected that, I would be fine.

But I was wrong, it was a red herring, it wasnt the problem, and I was spending endless time trying to fix something that wasnt causing my problem and wasnt going to cure my problem because obviously you cant cure your infection by taking methylation supplements.

I am not saying this is the case for everyone and your problems might be strictly from methylation defects. But dont assume it is until you get tested for infections, mold etc. to rule those out.