Methylation help?

[nryanh94]

Hi,

I recently had the Genova nutreval, and the Genova gut health tests completed.

The gut health came back almost completely normal, with a slight imbalance of healthy bacteria. But no inflammation, overgrowth, etc.

However the nutreval came back showing I was extremely deficient in B12, b9, b6, and b1.

I’ve been taking 6000 mcg (sublingual jarrow) methyl b12 a day, 800 mcg of methyl folate, and 3mg of p5p (b6) so I’m not sure how I’m deficient in these. My Dr is now wanting to put me on B complex injections. But I thought that the sublingual worked just as well.

Any advice to address this deficiency would be appreciated

 

[nanonug]

I recently had the Genova nutreval, and the Genova gut health tests completed.

Do you have info on your nutreval about lactic acid, pyruvic acid and citric acid? If yes, what are the values?

 

[nryanh94]

Do you have info on your nutreval about lactic acid, pyruvic acid and citric acid? If yes, what are the values?

Forgot to add I’m also deficient in B7

As for
Lactic acid: 2.9, ref range 1.9-19.8
Pyruvic acid: 14, ref range 7-32
Citirc acid: 145, ref range 40-520

I did have an elevated β-OH-Butyric Acid of 11.9. Below 2.8 is normal
And an elevated Formiminoglumatic Acidof 10.3, normal being below 1.5

Let me add that I find it strange that all of these vitamins are severely deficient. But my glutathione levels are well above normal at 1094 , normal being above 669

 

[nanonug]

Lactic acid: 2.9, ref range 1.9-19.8
Pyruvic acid: 14, ref range 7-32
Citirc acid: 145, ref range 40-520

These values are OK and not consistent with the hypometabolic state model of SEID by Naviaux et al. What are your main symptoms?

 

[ljimbo423]

I did have an elevated β-OH-Butyric Acid of 11.9. Below 2.8 is normal

It looks like a low carb diet can cause high β-OH-Butyric Acid also called B-hydroxybutyrate-

β-Hydroxybutyrate is a primary ketone body. It builds up in urine when someone is on a low carbohydrate diet or fasting. It will also build up in someone with impaired insulin functions.

Chromium and vanadium have been shown to help regulate insulin functions and may be helpful. The major function of chromium and vanadium is to help insulin act on your cells to regulate blood sugar.

https://www.gdx.net/core/interpretive-guides/Organix-IG.pdf

The gut health came back almost completely normal, with a slight imbalance of healthy bacteria. But no inflammation, overgrowth, etc.

Stool testing cannot find small intestine bacterial overgrowth (SIBO), which is often a cause of increased intestinal permeability (AKA, leaky gut). A breath test is needed to diagnose SIBO.

Leaky gut can be tested for by a lactulose/mannitol test, also a blood test for zonulin levels. It's also my understanding that the inflammation caused by SIBO is often chronic, low grade and sub-clinical. Which means it won't show up as abnormal on tests sometimes but because it's chronic it does damage to the gut over time.

Increased intestinal permeability or leaky gut can cause many systemic symptoms. Here is a quote from SIBO.com. Allison Siebecker runs it and is an expert in diagnosing and treating SIBO. Here is a list of some symptoms it can cause-

Leaky Gut Symptoms (I prefer to call this Leaky Small Intestine)
Food Sensitivities
Headaches
Joint Pain
Fatigue
Skin symptoms (such as eczema or rashes)
Respiratory symptoms (such as asthma)
Mood symptoms (such as depression)
Brain symptoms (such as Autism)

https://www.siboinfo.com/symptoms.html

Jim

 

[ljimbo423]

However the nutreval came back showing I was extremely deficient in B12, b9, b6, and b1.

I’ve been taking 6000 mcg (sublingual jarrow) methyl b12 a day, 800 mcg of methyl folate, and 3mg of p5p (b6) so I’m not sure how I’m deficient in these. My Dr is now wanting to put me on B complex injections. But I thought that the sublingual worked just as well.

I don't know why you are still deficient in b12 but that does sound like a methylation issue. Off the top of my head I wonder if a higher dose of methylfolate might help. I had a BIG increase in energy at exactly 6.4 mg of methylfolate a day.

It happened literally overnight. It was like somebody flipped a switch, it was that profound and noticeable. I clearly had a big block in my methylation cycle that high dose sublingual methylcobalamin alone could not undue but b12 and the high dose methylfolate did the trick!

Jim

 

[nryanh94]

These values are OK and not consistent with the hypometabolic state model of SEID by Naviaux et al. What are your main symptoms?

Main symptoms are disturbed/unrefreshing sleep
Muscular and mental fatigue worsened by exertion
Muscle spasms/twitches
Lack of mental clarity, ability to concentrate, and decreased memory

 

[nryanh94]

I don't know why you are still deficient in b12 but that does sound like a methylation issue. Off the top of my head I wonder if a higher dose of methylfolate might help. I had a BIG increase in energy at exactly 6.4 mg of methylfolate a day.

It happened literally overnight. It was like somebody flipped a switch, it was that profound and noticeable. I clearly had a big block in my methylation cycle that high dose sublingual methylcobalamin alone could not undue but b12 and the high dose methylfolate did the trick!

Jim

Interesting, I’ll definitley give more methylfolate a shot.

Thanks,

 

[nryanh94]

It looks like a low carb diet can cause high β-OH-Butyric Acid also called B-hydroxybutyrate-

https://www.gdx.net/core/interpretive-guides/Organix-IG.pdf



Stool testing cannot find small intestine bacterial overgrowth (SIBO), which is often a cause of increased intestinal permeability (AKA, leaky gut). A breath test is needed to diagnose SIBO.

Leaky gut can be tested for by a lactulose/mannitol test, also a blood test for zonulin levels. It's also my understanding that the inflammation caused by SIBO is often chronic, low grade and sub-clinical. Which means it won't show up as abnormal on tests sometimes but because it's chronic it does damage to the gut over time.

Increased intestinal permeability or leaky gut can cause many systemic symptoms. Here is a quote from SIBO.com. Allison Siebecker runs it and is an expert in diagnosing and treating SIBO. Here is a list of some symptoms it can cause-


https://www.siboinfo.com/symptoms.html

Jim

Interesting, I’ll speak with my dr about the breath test. I believe he ordered Zonulin and it came back within normal

 

[nanonug]

Main symptoms are disturbed/unrefreshing sleep
Muscular and mental fatigue worsened by exertion
Muscle spasms/twitches
Lack of mental clarity, ability to concentrate, and decreased memory

Well, these symptoms are consistent with SEID. If I were in your place, I'd probably start by addressing sleep. Have you considered over-the-counter sleep aids such as melatonin? A small dosage of extended release melatonin (0.75mg at night) is something that I take and helps in my case.

 

[caledonia]

Main symptoms are disturbed/unrefreshing sleep
Muscular and mental fatigue worsened by exertion
Muscle spasms/twitches
Lack of mental clarity, ability to concentrate, and decreased memory

The sleep issue can cause the cognitive issues. The muscle spasms and twitches can cause the sleep issues.

So three out of the four could relate to magnesium deficiency and some supplementation could be helpful. You might need some of the other electrolytes too, like potassium and/or sodium.

They might not necessarily show up on a test. What matters is what gets into the cells, and if your symptoms get better.

If you have electrolyte deficiency issues, those can be cause by adrenal fatigue or insufficiency or whatever you want to call it. So some adrenal support could be helpful if you tolerate it.

The adrenal fatigue could be causing the general muscle/mental fatigue, as could sleep deprivation.

High glutathione - there are two types - oxidized and reduced. The Nutreval shows overall glutathione, but not which kind you have the most of. A normal person would have more reduced glutathione than oxidized. Someone with ME would likely have the opposite because the glutathione is being used up dealing with various toxins and other things that glutathione is used for.

If you go to my signature link, I have a document on interpreting the Nutreval which can help you pull more out of it than the interpretation that comes with it, and also documents on methylation.

 

[Mary]

However the nutreval came back showing I was extremely deficient in B12, b9, b6, and b1.

I’ve been taking 6000 mcg (sublingual jarrow) methyl b12 a day, 800 mcg of methyl folate, and 3mg of p5p (b6) so I’m not sure how I’m deficient in these. My Dr is now wanting to put me on B complex injections. But I thought that the sublingual worked just as well.

Re B12: It can be difficult to get it into the cells. I did injections for a few years with no apparent benefit (didn't feel any different). Then I switched to sublingual and still felt no different. And then tried liquid sublingual methylB12, and took two 5000 mcg doses a day, and finally felt a boost in energy. For me, the liquid works the best. I did the shots self-injecting 3 times and it just wasn't enough.

Re methylfolate - yes, you very well could need more. The 6.4 mg that @ljimbo423 takes is quite a high dose - you should work up gradually and see how you do. I had a noticeable boost in energy with 1600 mcg. But we're all different.

Re B6 - 3 mg. of P5P is not very much at all. Nutreval testing showed a severe B6 deficiency for me as well and I ended up needing 150 mg. P5P a day (divided into 2 doses).

Re B1 - it can make a big difference in how you feel. When I started taking thiamine, I had an almost immediate boost in energy - it was amazing. I'm now taking 100 mg thiamine and 150mg benfotiamine a day, but am going to switch to just benfotiamine when I finish my regular thiamine.

A word of caution: with both the methylfolate and the B1, I experienced very pronounced symptoms of refeeding syndrome. With the folate (and it often happens when people take B12 as well), after the initial energy boost, within 2 or 3 days I was hit with severe fatigue - my potassium levels had dropped quite a bit very quickly. Fortunately I had read about this possibility on Freddd's posts about methylation and started taking potassium in divided doses, titrating up to 1000 mg a day over a couple of days, and the severe fatigue went away. I subsequently learned I had to keep taking potassium (it's been 8 years now) but it works.

With the B1, I also developed severe fatigue after an initial boost, but it was different than the fatigue from low potassium. Because I'd done reading on refeeding syndrome, I theorized it might be low phosphorous from refeeding syndrome and drank several glasses of kefir, and that fatigue finally went away too and I was able to keep taking the thiamine. Otherwise I would have had to stop it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440847/

Your muscle spasms and twitches could be due to low magnesium, as Caledonia suggested, or low potassium. You could try drinking several glasses of low-sodium V8 or vegetable juice which is high in potassium and see if it helps. You would know relatively quickly I think, likely within a few hours. A few bananas probably would not be enough. I like the low-sodium V8 because it's low in sugar.

People with ME/CFS can have low intracellular potassium despite normal levels in blood work. See http://forums.phoenixrising.me/inde...ded-in-methylation-treatmt.18670/#post-291422

 

[nryanh94]

Interesting, I’ll speak with my dr about the breath test. I believe he ordered Zonulin and it came back within normal

Went back and looked my Zonulin was tested and came back at 63.5 with normal rangers being 22.3-161.1 ml

 

[nryanh94]

Re B12: It can be difficult to get it into the cells. I did injections for a few years with no apparent benefit (didn't feel any different). Then I switched to sublingual and still felt no different. And then tried liquid sublingual methylB12, and took two 5000 mcg doses a day, and finally felt a boost in energy. For me, the liquid works the best. I did the shots self-injecting 3 times and it just wasn't enough.

Re methylfolate - yes, you very well could need more. The 6.4 mg that @ljimbo423 takes is quite a high dose - you should work up gradually and see how you do. I had a noticeable boost in energy with 1600 mcg. But we're all different.

Re B6 - 3 mg. of P5P is not very much at all. Nutreval testing showed a severe B6 deficiency for me as well and I ended up needing 150 mg. P5P a day (divided into 2 doses).

Re B1 - it can make a big difference in how you feel. When I started taking thiamine, I had an almost immediate boost in energy - it was amazing. I'm now taking 100 mg thiamine and 150mg benfotiamine a day, but am going to switch to just benfotiamine when I finish my regular thiamine.

A word of caution: with both the methylfolate and the B1, I experienced very pronounced symptoms of refeeding syndrome. With the folate (and it often happens when people take B12 as well), after the initial energy boost, within 2 or 3 days I was hit with severe fatigue - my potassium levels had dropped quite a bit very quickly. Fortunately I had read about this possibility on Freddd's posts about methylation and started taking potassium in divided doses, titrating up to 1000 mg a day over a couple of days, and the severe fatigue went away. I subsequently learned I had to keep taking potassium (it's been 8 years now) but it works.

With the B1, I also developed severe fatigue after an initial boost, but it was different than the fatigue from low potassium. Because I'd done reading on refeeding syndrome, I theorized it might be low phosphorous from refeeding syndrome and drank several glasses of kefir, and that fatigue finally went away too and I was able to keep taking the thiamine. Otherwise I would have had to stop it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440847/

Your muscle spasms and twitches could be due to low magnesium, as Caledonia suggested, or low potassium. You could try drinking several glasses of low-sodium V8 or vegetable juice which is high in potassium and see if it helps. You would know relatively quickly I think, likely within a few hours. A few bananas probably would not be enough. I like the low-sodium V8 because it's low in sugar.

People with ME/CFS can have low intracellular potassium despite normal levels in blood work. See http://forums.phoenixrising.me/inde...ded-in-methylation-treatmt.18670/#post-291422

Thank you for all of the great information!
Do you have a recommendation as to how to keep potassium up?

 

[Mary]

Do you have a recommendation as to how to keep potassium up?

I can only tell you what I do - I take 800 - 1000 mg potassium gluconate a day in divided doses - generally 200 mg with each meal (breakfast, lunch, dinner) and 200 mg more before bed. And even sometimes more in the middle of the night. It used to be very common for me to get low potassium symptoms (muscle twitches) in the middle of the night. I also periodically drink low-sodium V8 or vegetable juice. The low-sodium kind has more potassium than regular V8.

Also, when I was hit with low potassium after starting the methylfolate, I was surprised to find that I had had these same symptoms off and on before, only I never knew what caused them. It was just another godawful fatigue I associated with ME/CFS, though different than PEM. My blood tests for potassium were always normal so there was no outward indication of problems with potassium.

Many people on the board take a potassium supplement, and the amounts vary because we're all different - some take more than me, some less. It is important not to take a huge amount all at once - your body can have trouble processing a large amount. So I titrated up gradually, in divided doses, over a couple of days to find the dose that eased my low potassium symptoms. And then found that I just need to keep taking it, and I do fine with it. But it would not have been good to start with taking 1000 mg all at once.