Active B12 Protocol: How to start?

[nem201]

Hi,

I have just finished reading through the thread 'B12: The Hidden Story' and I feel I am ready to start on the Active B12 protocol and I am about to get ordering my supplements. I am finding it quite hard to work out which order to do things in and how to work out starting dosages (this could well be due to my brain fog!)

There seems to be a lot of different advice being given as the thread evolves over the years and I am just wondering what the most up to date protocol is? Is the 'Minimized One Month Trial to Detect Active Coblamin Responsiveness - Estimated 80% Detection Trial' which gives a week by week plan of what to do, still valid? http://forums.phoenixrising.me/index.php?threads/b-12-the-hidden-story.142/page-3#post-2619

I would find this straight forward to follow if it is still up to date.

My other questions are:

1) What should I start with first (apart from the basic critical vitamins and minerals?) The enzymatic B12 infusion, the methyl B, the metfolin or the adb12? This is the different advice I have found over the course of the thread:
A) The 'Minimised One Month Trial to Detect Active Cobalamin Responsiveness' recommends starting Methyl B on day 1

B) "If one starts the adb12 a couple of days before the mb12 then it separates to some degree the effects of each. Get going on 1 adb12 daily and work up the mb12 dosage"


C) "Metafolin daily, Jarrow mb12 5mg daily, the Ezymatic Therapy 1mg can wait until you see if you need a little more help"


D) "A single 1mg Enzymatic Therapy per day is quite adequate for most preople to start with. After a week, add dibencozide at least once a week. The Jarrow 5mg comes later as you step up the dose and when you go for maximum effectivness you will need both brands"

2) What is the best way to start the methyl B? The 'Minimized One Month Trial to Detect Active Coblamin Responsiveness' protocol gives the impression of recommending 1 x 5000 mcg methylB lozenge per day (if I have understood it correctly) whereas I have also seen these options posted:

A) "Jarrow methyl B-12, 5mg, working up to 25mg a day (sublingual)


I would suggest starting with 1 x 1000mcg Jarrow sublingual a day for 45-120+ minutes per day, increasing to 5 or 6 per day one at a time and then go to two at a time, then 3 at a time several times a day and then switch to the 5mg and increase by one at a time. Do them serially at first then increase dose size until an additional tablet makes no additional difference."

B) "A 1000mcg tablet is a good place to start. To start out, 1/4 4 times in a day will probably work out better giving a more even serum level than taklng the whole 1mg at once. After a few day if you are not having too much start up responses you might start increasing by another quarter each day, going to half"

C) "Jarrow Formulas Methyl-B12 5000 mcg: most correspondents take 2-4 spaced across the day; however, I'd suggest starting on one per day, and gradually working up"

D) I also saw the 'Active B12 Titration Methods' post at the bottom of this thread: http://forums.bettermedicine.com/showthread.php/62327-active-b12-basics - is this the best advice to follow when titrating doses?

3) When is metfolin added in? The 'Minimized One Month Trial to Detect Active Cobalamin Responsiveness' recommends starting metfolin on day 1, however I have also found this advice:
"When you are up to 3mg (methylB) daily add 1 Metafolin (Solgar methylfolate or other Metafolin brand"
4) How often per day is metfolin taken if one is starting out on 800 mcg? The 'Minimized One Month Trial to Detect Active Cobalamin Responsiveness' recommends taking it once per day, however after reading the advice below, does this mean it is necessary to split the 800 mcg dose in two? "B-complex and methylfolate need to be taken twice a day because of short serum half lifes for best effectiveness"

I also read this post which might be answering some of my questions for me - if anyone thinks THIS is the most up to date way to go, then please let me know!
"If a person is having a lot of startup reaction to mb12 then I would suggest starting with adb12. Either should be started on a base of the basic vitamins and minerals; A, D, C, E, B-complex that includes P-5-P and pantethine and without Cyanob12 (Jarrow B-Right, twice a day), methylfolate, magnesium, calcium, zinc (50mg) and Omega3 oils."

Many, many thanks in advance for any advice anyone can give me!

 

[Freddd]

Hi Nem,

I have a new version under preparation based on much additional information and experience since that one was posted, paying extra attention to those with extreme responses to make it more comfortable by them. It will be a couple of days. In genral this is what I am now suggesting.

Start with 1/4 of an ET mb12 and 1/4 of a metafolin. If it is too much cut in half the next day and try again. Once you find a comfortable amount titrate my small steps to 1 tablet of each. If 1/4 is comfy, try 1/2 the next day etc. Then try a crumb of the 10mg dibencozide or a tiny pinch from the Dibol capsule between the lower lip and gum. Increase each day. Somewhere around the 3rd or later day of mb12 or maybe adb12 (dibencozide) you might feel quite sick.. Check the symptoms on the potassium and folate induced deficiency decision tree and do what matches the symptoms and conditions as specified. If it hasn't started up by the time you are up to 1/4 of the dibencozide, it requires another factor, usually l-carnitine fumarate. If you have anxiety then a micro titeration is needed and at this point I doubt I'll get that up until tomorrow. Otherwise start with a single drop of the liquid carnitine. Each day it has no effect you can double the dose until you get up to a teaspoon. In any case be watchful for the startup of brightness with the mb12 as the healing usually starts about that time and potassium need usually follows shortly thereafter. Then more metafolin is needed, titatrating by effect until the folate insufficiency symptoms are done. If you exceed 4000mcg consider paradoxical folate deficiency and look for ways to eliminate folic and folinic acid from your program or minimize folate containing food until you know what it feels like to have adequate folate and can titrate to that despite folate containing veggies. I think it is important to get that balance going before increasing doses or adding other items. Some adjustments are typically needed when adb12 is added if it starts with the mb12/metafolin. Then it often increases a bit more with carnitine added and often other potential critical cofactors. More explicit description will be available in a few days. Once you know what being in a state of healing is like, that is a clue and you will want to follow the clues of healing. Also be sure to start the basics first so you are not playing guessing games as to what is missing ovr and over again.




DISCLAIMER
I am a self taught systems analyst and consultant. I am not credentialed, certified or licensed to do anything besides drive a car. I have been disabled by the disease processes being discussed and affecting neurology in a multitude of ways for 10 years and impaired in a variety of ways and levels for 54 years before that. Everything I say is my opinion, synthesis, understanding or otherwise of my own creation except direct attributed quotes. Approximate paraphrases are also my interpretation of what I have read. All of this is at best my data analysis, understanding, synthesis and hypotheses and not to be construed as medical advice. I am not responsible for anything you do with any information provided in any way. Anything you do is your own responsibility and at your own risk. There are no published peer reviewed studies backing up my opinions or statements, except the incidental ones quoted or implicit in my synthesis or understanding, and then only in so far any reading of such papers may confer. Your interpretations, actions and variations of what I say are strictly at your own risk.

 

[nem201]

Dear Fred,

Thank you so much for your response.

Does the metfolin need to be taken at the same time as the ET?

Am I right in thinking that the metfolin isn't taken sublingually but the ET & adb12 are?

 

[Freddd]

Hi Nem,

I have found that the metafolin is most effective taken as several doses spread across the day as the serum halflife is about 3 hours. The mb12 and adb12 works best under the tongue (rare because of vast saliva generation it doesn't last) or between the lips/cheeks and gum, upper or lower. The trials I ran comparing that absorbtion to injections indicates that there is a typical absorbtion of 15-25% in 45-120 minutes, extremes being 10%-33% between 45-180 minutes retention. Oral b12 swallowed, chewed and swallowed, slurped down in 5 minutes like candy results in 1-2% absorbtion. Folate ansorbtion oraly is considered excellent. They don't need to be timed together. I find that the Metadfolin is best taken so that it is absorbed slightly before the mb12/adb12 and then aids the retention of the mb12/adb12.



DISCLAIMER

I am a self taught systems analyst and consultant. I am not credentialed, certified or licensed to do anything besides drive a car. I have been disabled by the disease processes being discussed and affecting neurology in a multitude of ways for 10 years and impaired in a variety of ways and levels for 54 years before that. Everything I say is my opinion, synthesis, understanding or otherwise of my own creation except direct attributed quotes. Approximate paraphrases are also my interpretation of what I have read. All of this is at best my data analysis, understanding, synthesis and hypotheses and not to be construed as medical advice. I am not responsible for anything you do with any information provided in any way. Anything you do is your own responsibility and at your own risk. There are no published peer reviewed studies backing up my opinions or statements, except the incidental ones quoted or implicit in my synthesis or understanding, and then only in so far any reading of such papers may confer. Your interpretations, actions and variations of what I say are strictly at your own risk.

 

[cureminded]

Hi Nem,

The trials I ran comparing that absorbtion to injections indicates that there is a typical absorbtion of 15-25% in 45-120 minutes, extremes being 10%-33% between 45-180 minutes retention.

Hi Fred,

I've seen you mention this before. Could you please tell more about that or direct me to a thread where more info is given on this? I have tried to discuss this with a doctor and he was very sceptic, so I would appreciate something to back this up if possible.

Thanks

 

[Freddd]

Hi Fred,

I've seen you mention this before. Could you please tell more about that or direct me to a thread where more info is given on this? I have tried to discuss this with a doctor and he was very sceptic, so I would appreciate something to back this up if possible.

Thanks

Hi Cureminded,

I know it is on here somewhere. It will be easier and faster to write it again and keep a copy than to find it.

I have tried to discuss this with a doctor and he was very sceptic

Sceptical of what aspect? That the effects of injection can be matched with sublingual? That a 5mg sublingual equals a 1mg injection? That it can be determined without $10,000,000 worth of hardware? That there is a CNS threshold of effectivness?

For those wanting to duplicate the results I used 20mg/ml concentration if mb12 in sterile saline. It required 4 hours of magnetic stirring at 100 deg F in a water bath to fully dissolve the mb12 crystals leaving no residue of microcrystals in the 0.2 micron filter. The largest single SC injection was 20mg (1ml) so 100mg required 5 injections at a time. I also did a daily series of 180mg (3x60mg) to see if there was a higher dose effect. Did I ever feel like a pincushion after that series. There wasn't, at least not with the 3-4 star mb12 I had available to use for this.
MB12, ADB12 AND URINE COLORIMETRY of SUBLINGUAL TABLETS COMPARED TO SC INJECTION

If we were to fire up our way-back machine and go back to the old days before digital photography, I had a photographic darkroom. I had a set of enlarger gel filters for color printing. They come in gradations of 05 of cyan, magenta and yellow. Now picture one of those hot tub or swimming pool test kits with a spectrum of colors which show the concentration of various things.

I have been injecting mb12 for 7+ years. When I first injected I was surprised to see how much it colored my urine. In fact I found that the color of the urine for the first 3 hours following injection was indicative of how much I injected. So first I calibrated the colors based on injection size. A filter pack, the collection of various colors and strengths needed to correct the color in a color print can tell you all about the light conditions. A pack can be put together that turns any color to gray (neutral) and I still have my neutral gray cards for comparison. By seeing what turns the urine to neutral gray I can define how much yellow, how much cyan and how much magenta is present. Pure b12 is almost exactly magenta in coloration. Therefore I can take the urine to neutral and see how much “anti-magenta” filters it took or I can eliminate the yellow and then compare how magenta it is compared directly to the magenta filters, just like the swimming pool test kit. It is really quick and easy and takes longer to write than to do. I never spent the money for color meters which were very expensive back then.

I found the difference glutathione made (a 10mg injection ended up with urine the color of a 100mg injection so much was excreted so fast). I saw the difference quite blatantly the first time I took Metafolin. Before Metafolin, the first visible color was at 2.5mg injected. With the first dose of Metafolin the first visible color was at 4.4mg injected and it stayed there. I standardized on the Metafolin present condition for all testing. Then I did several injection series from 1mg to 100mg, totaling around a thousand injections in all.

Intermixed with the injection series I did series’ of mb12 and adb12 under the lip and tongue series of 1mg to 100mg in all, over several years. As I intermixed the injections I could make sure the responses were not changing. From there it was easy to calculate absorption percentages. I found that 50mg under lip mb12 of Jarrow mb12 at various timings, produced the same colorations as 7.5 to 12.5mg injections. I duplicated the results with Country life adb12 and had to take extra Metafolin to counteract the folic acid in it and Enzymatic Therapy 30mg (whole bottle). I found that the percentage was strongly linked to duration in contact with tissues. No liquid b12 drops were able to be held in place to get absorption long enough to have any visibility regardless of amount. It was the same with “instant dissolving microdots”.

The highest rate of absorption I was able to get was 33% at 3+ hours. The lowest was 10% at 45 minutes. There was of course variation at each time and dose, so when I say 15% at 45 minutes that represented an average of many doses of various sizes but all at 45 minutes with the remaining parts of tablets chewed and swallowed. The typical results were 15% at 45 minutes and 25% at 120 minutes, across the range of doses that produced visibility. The only brands of mb12 sublingual tablets that produced the threshold effect were Jarrow and Enzymatic Therapy. Only some batches of mb12 were of suitable variety of crystals to produce the threshold effect. However, all batches produced the same color urine.

Further, I found the CNS effect threshold at greater than 6mg injected SC and less than or equal to 7.5mg injected SC. I was able to duplicate that threshold effect with 25mg of sublingual held 3 hours and 50mg held 45 minutes and of course with more and longer. So I say that 50mg sublingual held between 45 minutes to 120 minutes produces the same effectiveness in the CNS as SC injections of 7.5 to 12.5mg. There is no difference in effect between 7.5mg and 12.5mg except duration of action. There is no difference in effectiveness between 7.5mg and 100mg injected SC except duration. So I find 4x7.5mg SC daily to be the same as 3x10mg SC. Another person finds 2x15mg equally effective. The same person duplicated these series but didn’t repeat them as often, but with the same results.


DISCLAIMER

I am a self taught systems analyst and consultant. I am not credentialed, certified or licensed to do anything besides drive a car. I have been disabled by the disease processes being discussed and affecting neurology in a multitude of ways for 10 years and impaired in a variety of ways and levels for 54 years before that. Everything I say is my opinion, synthesis, understanding or otherwise of my own creation except direct attributed quotes. Approximate paraphrases are also my interpretation of what I have read. All of this is at best my data analysis, understanding, synthesis and hypotheses and not to be construed as medical advice. I am not responsible for anything you do with any information provided in any way. Anything you do is your own responsibility and at your own risk. There are no published peer reviewed studies backing up my opinions or statements, except the incidental ones quoted or implicit in my synthesis or understanding, and then only in so far any reading of such papers may confer. Your interpretations, actions and variations of what I say are strictly at your own risk.

 

[cureminded]

Hi Fred,

Thanks again for the very extensive answer. I read it a cople of times now and I am only beginning to understand how you did it. The thing my doctor was sceptic about was that I was trying to hold (quarters and halves of) the tablet in my mouth for as long as possible because it was the contact with tissue that mattered. He was convinced that if I swallowed it, I would still get most of it through the small intestine. But hey not everybody is meant to think out of the box.

 

[bertiedog]

Hi Fred

I am wondering why some of us only seem to need about 1/4 of Jarrow 5000 mcg MB12 and 400 mcg of active folates? I have found that if I go any higher on both of these I develop a hyper response, ie brain way over stimulated so much so I cannot switch off, difficulty staying asleep, all in all almost slightly manic with a tendance to anger and aggression. Obviously they are upsetting my neurotransmitters.

I have everything else in place as regarding the other supplements. One important thing I should add is that this has only really happened since I started having to breathe in oxygen for an average of 3 hours a day (not in one go) because my tissue saturation for oxygen was so low. It has made a massive difference to how I feel right from the first dose. It would seem so much damage has taken place since I first got sick in 1979.

Also I should add that for the past 2 weeks I have been taking 500 methionine with extra zinc and selenium followed by 250 mg liposomal glutathione to get rid of a high level of nickel I have had for over 10 years. I am tolerating this well, without the oxygen I could never tolerate it. This protocol is for a period of a maximum of 3 months when hopefully the nickel will be down to more normal levels in my cells. It is causing many problems in the oxygenation of my cells and it is also possible there is still some mercury around too although a lymphocyte test 4 years ago showed I had gone back down to a normal level.

One exciting thing I have found since using an oxygen concentrator is that my temperature is normal around 36.7-36.9. This is unheard of for me despite thyroid and adrenal meds, I never got higher than 36.3.

I am also taking Immunovir as an antiviral on a rotation basis and do well with it. I would be glad of an explanation regarding my intolerance of anything but a small amount of MB12 and methylfolate.

Thanks Pam

 

[nem201]

Hi Fred,

Thanks for all the detailed info above. Is there any harm in stating off with potassium straight away when beginning the protocol? How much is a good dose to start with? I have read somewhere that 300 mg per day is ok to start off with but then I have also seen 2000-3000 mg being recommended. I understand that it all becomes very individual when trying to keep low potassium symptoms at bay but I am just trying to get a rough idea of a good starting dose when first beginning the protocol.

Many thanks!