Susan,
I really have no medical training for looking at your lab tests. The fact that your homocysteine isn't elevated probably means that the two MTHFR mutations are probably on different strands, which is a great relief.
Do you "need" to supplement B12? Well, you can do what you want. But you do have two of the MTRR mutations (the lesser one is +/+, the more important one is +/-). It probably wouldn't hurt. You're sensitive to sulfurs and have low glutathione, and have CFS/Fibro/Migraines (all associated with biopterin cycle). So here are some connections to think about:
- If you keep the homocysteine in the methyl cycle (with methylfolate and B12), it doesn't go into the sulfur cycle, so that might help the sulfur issues, but probably not solve them. Even though you don't have CBS C677T, it's still possibly something that might help some.
- Methylfolate supplements will encourage the biopterin cycle to produce BH4, the active form of biopterin, and low levels of it are associated with CFS/Fibro/Migraines. I'm not saying these will go away if you use methylfolate, but you might get some relief.
- Glutathione production depends on BH4 and active B6, so in a round-about way, the methylfolate might help raise glutathione. But you might also consider supplementing B6 (pyridoxine hydrochloride) or the active form of B6, called P5P (pyridoxyl-5-phosphate) to boost glutathione production.
I would suggest, though, since you don't have glaring SNPs associated with most of this, that very small quantities may be enough. You probably want the B12 to be sublingual (and avoid cyanocobalamin). The others, methylfolate and B6, are swallowed. It could be that the amounts in an active B multi (complex) would be enough for you. That doesn't let you vary things independently, but it's up to you how much experimenting you want to do.
I'm starting to be a believer in addressing leaky gut, maybe first (I didn't, but I had to learn my way didn't work first). I'm just starting that myself, in a more organized fashion. With leaky gut and intolerance for fermented foods, I have to suspect histamine intolerance, which I think should change the way you go about fixing leaky gut. Do you do OK with tomatoes and spinach?
Crit