Homocysteine doesn't budge :(

[PeterPositive]

Just got my lab test and as usual my Hcy levels haven't moved a bit.
I oscillate between 12.5 and 13.5

What is "interesting" is that when I started handling the problem of high Hcy ( very high at the time ) I didn't know I was MTHFR C677T+/+ and I was taking an active B complex with P5P (10mg), folic acid (400mcg) and Adeno-B12 (800mcg) prescribed by the doc.

That helped bring the Hcy from 50+ down to --> 12.5

These days I take all the active Bs, no folic acid, 2000mcg Metafolin, 3mg Adeno-B12, 5mg Methyl-B12, 50mg P5P ... and Hcy levels are exactly the same.

At least I would have expected even a minor improvement, especially after several months of therapy

I am also dealing with major GI issues probably due to Blastocystis H. and very low bowel secretory IgA.
I say "probably" because that's what emerged from a Great Plain Lab's test last year... they didn't find major dysbiotic flora, no yeasts, no malabsorption and inflammation markers are very low.

If I didn't know those test results were mine I would have thought they belonged to someone who is relatively healthy, besides the blastocystis problem... I really don't match that kind of healthy profile, unfortunately.

Many methylation experts state that bacterial/parasite infections can heavily tax the methylation cycle, so I suppose I fall in that category too. Problem is so far none of the cures to address the GI issues have produced any effect and I almost back to square one...

Thoughts?

 

[liverock]

Assuming your gut is not preventing absorbption of the nutrients.

Sometimes high dosages of TMG added to the folate/B12/ P5P protocol can lower stubborn homocysteine levels. Dosages can vary from 500mg to 6,000mg to get lower levels.

CBS mutations can also cause elevated Hcy and need higher P5P levels.

http://www.lifeextensionvitamins.com/homred.html

An adequate kidney function is also necessary. Cases of people taking drugs (such as ibuprofin) have found difficulty in lowering Hcy due to drugs increasing creatinine kidney levels.

 

[PeterPositive]

Assuming your gut is not preventing absorbption of the nutrients.

Good point. Most of the Bs are sublingual and coenzymated so they bypass the whole issue.
I know for sure that oral folic acid was well absorbed because it kept raising in blood tests when I was taking it. I still have high values (~14.5) even after 1 year stopping it. I don't eat any food containing additional folic acid.

Sometimes high dosages of TMG added to the folate/B12/ P5P protocol can lower stubborn homocysteine levels. Dosages can vary from 500mg to 6,000mg to get lower levels.

I wish I could take TMG but it rips my stomach apart even at 250mg.

CBS mutations can also cause elevated Hcy and need higher P5P levels.

I only have 1 heterozygous CBS mutation --> C699T and I don't eat high sulfur foods nor I am sensitive to sulfur containing foods.

An adequate kidney function is also necessary. Cases of people taking drugs (such as ibuprofin) have found difficulty in lowering Hcy due to drugs increasing creatinine kidney levels.

Creatinine levels are fine, I don't have any history of kidney issues nor I am taking any drugs.

cheers

 

[Lynn_M]

I know for sure that oral folic acid was well absorbed because it kept raising in blood tests when I was taking it.

You are not correct in the assumption that a raise in blood tests means the folic acid was well absorbed. With your C677+/+, it more probably means that it is not being metabolized and is instead pooling in your blood. Continuing high folic acid levels might be preventing metafolin from being absorbed.

I wonder if your body is absorbing the methyl B-12. Oral forms are worthless. Are you taking mB12 sublingually using Freddd's parking-it-under-the-lip technique? You might try subcutaneous shots of mB12 or topical applications of transderm oil B12 (B12oils.com) and see if that helps lower your homocysteine.

 

[adreno]

I would suggest TMG as well, or perhaps SAM-e.

 

[PeterPositive]

You are not correct in the assumption that a raise in blood tests means the folic acid was well absorbed. With your C677+/+, it more probably means that it is not being metabolized and is instead pooling in your blood. Continuing high folic acid levels might be preventing metafolin from being absorbed.

Good point. Thanks.
I haven't been taking any folic acid since October 2013, yet my levels of folic acid (the synthetic one, to be clear) are still almost the same. Folinic and THF are below range (suggesting B12 insufficiency) and 5-MTHF is at the very bottom of the range.

I wonder if your body is absorbing the methyl B-12. Oral forms are worthless. Are you taking mB12 sublingually using Freddd's parking-it-under-the-lip technique?

I take only sublingual B12. I don't use the lip technique though. Would it make any difference if there was a B-12 transport problem?

In any case my B12 serum level are through the roof meaning that at least it makes it into the blood stream without problems. So, I guess if it gets there it doesn't make much difference which part of the mouth it gets absorbed from?

thanks

 

[Lynn_M]

Peter,
What you say about the high B12 serum level indicating that the B12 is at least getting into your blood stream makes sense to me. But you don't know if the B12 is getting into your cells. Dr. Ben Lynch and Dr. Bill Walsh like the whole blood histamine test as a measure of B12 sufficiency. MMA will measure your adenosylcobalamin sufficiency.

This article might be worth reading: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667971/ Genome-wide association of Vitamin B6, Vitamin B12, Folate, and Homocysteine Blood Concentrations

There are a number of genes, such as MTRR, MTR, FUT2, TCN1, and TCN2 which affect the transport and metabolism of Vitamin B12. Have you had a 23andMe test? I can give you rs numbers and risk alleles for those SNPs.

Dr. Amy Yasko says low dose lithium orotate (2.5 mg) helps Vitamin B12 get into the cells.

 

[PeterPositive]

Peter,
What you say about the high B12 serum level indicating that the B12 is at least getting into your blood stream makes sense to me. But you don't know if the B12 is getting into your cells. Dr. Ben Lynch and Dr. Bill Walsh like the whole blood histamine test as a measure of B12 sufficiency. MMA will measure your adenosylcobalamin sufficiency.

Thanks. I haven't done those tests because I can't find a lab near here that checks those two values. I can't even find a lab near where I live that tests B6 levels!! I live in Italy but labs here are at the level of the 3rd world countries... I can use foreign labs but they are very expensive.

There are a number of genes, such as MTRR, MTR, FUT2, TCN1, and TCN2 which affect the transport and metabolism of Vitamin B12. Have you had a 23andMe test? I can give you rs numbers and risk alleles for those SNPs.

Yes I did the test. I have the following snps:
TCN2 C766G +/+, FUT2 +/+, MTR A2756G +/-, MTRR A66G +/-

Dr. Amy Yasko says low dose lithium orotate (2.5 mg) helps Vitamin B12 get into the cells

This is probably something I need to try. The only hesitation is about lithium messing with thyroid function.

What I find weird is that I was able to largely reduce my Hcy levels from 90+ to 12-13 with a few month of regular folic acid and less than 1mg of adeno-B12.

Having added larger amounts of reduced folate, methyl-B12 and all the other active Bs has made no difference. Well, no. Actually, it has improved several symptoms, which is good, but it's been pretty much irrelevant to lowering homocysteine. Isn't it a bit bizarre?

 

[whodathunkit]

I wish I could take TMG but it rips my stomach apart even at 250mg.

Possibly belaboring the obvious, so please excuse if so...

Even when taken with food?

Just checking.

 

[PeterPositive]

Possibly belaboring the obvious, so please excuse if so...

Even when taken with food?

Just checking.

No probs Yes unfortunately it does that taken with food. I wouldn't dare taking it on empty stomach at the moment.

There have been other supps such as Zinc that I have struggled with at super low dosages (5mg!) but eventually my stomach got used to it and I was able to take 10x without problems. TMG is not one of those unfortunately.

 

[whodathunkit]

TMG plays havoc with my GI tract, too. Not so much with my stomach, but with bowels. I hate that, because the first week I took it, before the GI sides kicked in, I loved it.

Sorry you can't take it, either. Hope you can figure something out to lower your hcy.

 

[adreno]

Doesn't choline work on the same pathway as TMG, i.e. BHMT?