Active B12 Protocol Basics

[Jigsaw]

@keenly,

Hi,

What's the connection between methylation, B12, and iodine?

 

[Creachur]

I find B12 useful but a lot of the B12 theory makes my head spin!

I have been using methyl-B12 but recently found that adeno-B12 gave me an extra boost. I take about 1000mcg of each sublingually. Is it okay to take the two at the same time?

Thank you for any information.

(PS: I take Swanson's adeno-B12 plus hydroxo-B12 but I am ignoring the hydroxo-B12. I also take 800mcg of Solgar's metafolin at the same time.)

 

[garyfritz]

Yes, I use a mixed adenosyl/methyl product from the Aussie oil company. That combo works best for me.

 

[grapes]

I find B12 useful but a lot of the B12 theory makes my head spin!

I have been using methyl-B12 but recently found that adeno-B12 gave me an extra boost. I take about 1000mcg of each sublingually. Is it okay to take the two at the same time?

Thank you for any information.

(PS: I take Swanson's adeno-B12 plus hydroxo-B12 but I am ignoring the hydroxo-B12. I also take 800mcg of Solgar's metafolin at the same time.)

Freddd definitely feels they should be taken separately as I understand it. Yet I see garyfritz does well with both. This is my string, by the way: http://forums.phoenixrising.me/inde...ng-off-hydroxy-b12-starting-methyl-b12.50562/

 

[grapes]

With 30 pages in this string, I haven't yet gotten all through it, but can someone explain to me what it takes to get my high B12 into my cells?? It's went to 1500 while taking Methyl B12 and then over 2000 while taking the Adenosyl/Hydroxy...and with symptoms of low B12 to match---numbness in little fingers, limbs easily going numb.

I then switched to Hydroxy-only which got rid of those symptoms.

But after over a month, read what Freddd stated, moved back over to Methyl B12 more than 3 weeks ago and started to raise my Folate. Today I'm on 2000 mcg Methyl and 1600 folate...and my symptoms of B12 deficiency are coming back royally--numbness. Is this about raising the folate a lot more?? Or am I going to need to add some Hydroxy back into the mix for awhile??

 

[garyfritz]

I haven't seen any coherent explanation of who needs which flavor and why. I think we're stuck with "try them all and see what works for you." Sounds to me like your body functions well with hydroxy, so if it was me I'd stick with that. (Want some hydroxy/methyl oil?? )

 

[grapes]

I haven't seen any coherent explanation of who needs which flavor and why. I think we're stuck with "try them all and see what works for you." Sounds to me like your body functions well with hydroxy, so if it was me I'd stick with that. (Want some hydroxy/methyl oil?? )

Hi Gary. I've read what Freddd has been stating all over this forum and it seems very logical to me. That though I felt better on hydroxy as far as getting rid of low B12 symptoms, it's not the best way to go for my body. Hydroxy will convert to the Methyl and Adenosyl versions of B12 (the needed active forms), yes, but it also USES methyl and Adenosyl to do the conversion. And we end up with not enough of either as a result. And he explains that methyl B12 is needed for at least 600 functions in the body, thus it's important to have enough. That's impressive.

So....since I've got high levels of B12 in the blood and symptoms of a functional deficiency, I think at the moment I'm going to focus more on raising my folate even higher and see if that will start breaking down that high serum B12. I had already done a spectracell test which showed I was borderline deficient with folate anyway. I've seen one gal on here in the 4000 mcg/4mg area, and Freddd has stated some go as high as 30,000 mcg/30 mg.

And I saw where Freddd answered to someone with a similar issue like this:

I suspect that you do have a partial block of methionine synthase because of lack of enough methylfolate. That is probably preserving glutathione depletion, which results in a functional B12 deficiency. The latter would account for the buildup of B12 in your blood. http://forums.phoenixrising.me/inde...lation-protocol-poll.3579/page-11#post-296554​

 

[Creachur]

Freddd definitely feels they should be taken separately as I understand it. Yet I see garyfritz does well with both. This is my string, by the way: http://forums.phoenixrising.me/inde...ng-off-hydroxy-b12-starting-methyl-b12.50562/

Grapes, that's a great thread and you provided direct text of some very useful info. Thank you. Trouble is that each bit I read from your initial posts makes great sense but I can't put it all together because there are so many parts. In fact, I can't even work out what to start taking experimentally.

One important message I got from your threads was the link you gave to a definition of methyl trap where the web page went on to explain that "The unassuming consumer who takes supplements with methylating B vitamins may experience varying degrees of neurotoxic symptoms". It's nice to have that clearly explained because some of the explanations I have come across may as well been written in Chinese.

I am probably hoping for too much to ask for a nice short and simple set of supplements to try and some might consider me lazy for not putting in the necessary work. The discussions here of methylation seem like tuning a car engine with a lot of variables. My car engine (in other words my brain) seems to have stalled and only occasionally can I focus well enough to post at all; at other times I am going into stroke-like delirum with shifting levels of consciousness and confusion.

I currently need some emergency get-me-home tuning, not red-hot race tuning which seems to be what some people are undertaking. Now I think maybe some of the enormous number of supplements I am taking may be worsening my problem rather than helping it. Where to start? I can't stop everything and start with a clean sheet because I know I will go into such confusion that I wouldn't be able to work out at all how to dress or wash. Really. For day or weeks on end. I have just emerged from a YEAR of this in which my life seemed over.

How do I start?

 

[grapes]

Grapes, that's a great thread and you provided direct text of some very useful info. Thank you. Trouble is that each bit I read from your initial posts makes great sense but I can't put it all together because there are so many parts. In fact, I can't even work out what to start taking experimentally.

One important message I got from your threads was the link you gave to a definition of methyl trap where the web page went on to explain that "The unassuming consumer who takes supplements with methylating B vitamins may experience varying degrees of neurotoxic symptoms". It's nice to have that clearly explained because some of the explanations I have come across may as well been written in Chinese.

I am probably hoping for too much to ask for a nice short and simple set of supplements to try and some might consider me lazy for not putting in the necessary work. The discussions here of methylation seem like tuning a car engine with a lot of variables. My car engine (in other words my brain) seems to have stalled and only occasionally can I focus well enough to post at all; at other times I am going into stroke-like delirum with shifting levels of consciousness and confusion.

I currently need some emergency get-me-home tuning, not red-hot race tuning which seems to be what some people are undertaking. Now I think maybe some of the enormous number of supplements I am taking may be worsening my problem rather than helping it. Where to start? I can't stop everything and start with a clean sheet because I know I will go into such confusion that I wouldn't be able to work out at all how to dress or wash. Really. For day or weeks on end. I have just emerged from a YEAR of this in which my life seemed over.

How do I start?

OK, I don't know your situation, but if it's about noticing that your methylation isn't working properly, then I do have some answers based on all the reading and research I've done.

For ME, it's very recent issue, in that it was only last Fall of 2016 that I was seeing rising B12 at 1500 (while on methyl B12) and rising iron (while on NO iron supplementation). By January of 2017, my B12 was "over 2000" (while on a combo of hydroxy B12/adenosyl B12) and my iron was in the upper 160s, which is WAY too high for a woman. I was also manifesting symptoms of a functional deficiency of B12---numbness in my legs and little fingers. I then moved to Hydroxy B12, which got rid of the deficiency symptoms...BUT...I was quickly to find out from Freddd that it was NOT the way to go using Hydroxy B12, even if it helped me lose those deficiency symptoms.

First, his brilliant info taught me that we NEED methyl B12--he said start at 1000 mcg a day. It affects over 600 functions in our body, and it should be the main B12 in our cells. He said to make one's way up to 15,000-20,000 mcg over many weeks or months I don't know yet if that will be true for me. I've only gone up to 2000 mcg and am work in progress on all this. (I also stopped the B12 today since my blood B12 is still quite high i.e. over 2000, and am instead raising folate. More on that later) And by the way, I have six ++ FUT2 which can affect absorption of B12. hmmmm

We also need some adenosyl B12--he said to take twice a week instead of methyl those two days, but I've also noticed him saying once a week in another place. He also said to wait a week before starting. That's the B12 that resides in our mitochondria. (That really struck me as I have a mito issue, too, probably from mold damage, and later high copper. So I could see how important that was for me.) I've seen to start on 500 mcg and work one's way up to 30,000-40,000 mcg (I also saw up to 50,000 in another comment)...but again, don't know if I would need that much yet. Still work in progress.

Now WHY would I want to get back on methyl B12 and adenosyl B12 when I know for a fact that my serum B12 was rising on both, and I was having deficiency symptoms?? This where l-folate comes in...and you want to be sure and use an active one, like Metafolin, of any of these: L-5-MTHF or L-5-Methyltetrahydrofolate or 6(S)-L-MTHF or 6(S)-L-Methyltetrahydrofolate or (6S)-5-methyltetrahydrofolic acid. Interestingly in early March 2017, I did a Spectracell test, and guess what was "borderline deficient"? Folate (and other B's) !!! And guess what else?? I also am ++ and+- for MTRR, which is a folate SNP, resulting in poor methylation of B12. I just clearly need way more folate than I've been taking all this time...and perhaps THAT is one reason my methylation started working poorly. So I'm now up to 2000 mcg and will keep going up to see if that will help my B12 break down for use!! I retested my B12 and on 1600 mg folate, it's STILL "over 2000".

Also important is L-carnitine fumerate--the fumerate is an important version apparently. Carnitine works with the adenosyl and the two are important combinations for energy and mood. It's recommended to start low, such as 250 mg and make your way up to approx 1000 mg a day. I was already on it.

Finally, since using all the above will help methylation to kick in, your potassium requirements will go up, up for your cell division!! Without extra potassium, they say you will notice this by day 3. For me, it was day 5, and I noticed increasing fatigue. So I got on 4 cups of V8 juice a day to equal 2000 mg of potassium (500 mg a cup). Really helped. I have stayed on it for over two weeks now. I've also read that increasing folate will increase the need for potassium, too.

It's also mentioned to be on on SAM-e because it makes the methylcobalamin more effective. I'm on 400 mcg and was before I even started all the above. And to use TMG, which enhances the effects of SAM-e, Methyl B12 and L-Carnitine. I'm taking SO MANY supps right now due to various issues that I'm not on TMG.

I am also bringing up other B's which Spectracell said were borderline deficient, including biotin and b6 and other nutrients. I highly recommend Spectracell testing, but be prepared it's expensive.

Anyway, the above is a start and I hope it helps. I'm going to add it to my own string, which is basically a diary of what I'm doing and what is working...plus I paste in any excellent info I find researching these forums: http://forums.phoenixrising.me/inde...ng-off-hydroxy-b12-starting-methyl-b12.50562/

 

[AlwaysTired]

I have a question that I hope someone can answer. My naturopath have me a multi that has Naturefolate blend (5-FTHF + 5-MTHF from natural sources). Is the 5-FTHF form ok to take? The supplement is called metabolic synergy and because it also contains all other B vitamins (including B12 as methyl cobalamin) plus all the essential vitamins and minerals mentioned in the protocol, I would really like to be able to continue taking it.

I am planning to buy the enzymatic therapy active B12 too but supplementing all these other things in addition is overwhelming and expensive!

 

[LynnJ]

Are all the other "essential" supplements (zinc, vitamin E, fish oil, etc) TRULY, 100% essential? I confess I'm not taking them right now... Eek.

I'm taking B12, folinic acid, B2, calcium, vitamin C (in a much lower dose than what's recommended here - I don't like C megadoses), and magnesium on a daily basis. Also some potassium as needed. I was thinking of adding in a kelp supplement, too.

 

[Eastman]

Are all the other "essential" supplements (zinc, vitamin E, fish oil, etc) TRULY, 100% essential?

Freddd actually said that they "usually needs supplementing". I'm quite sure not everyone needs to supplement them.

 

[AlwaysTired]

Are all the other "essential" supplements (zinc, vitamin E, fish oil, etc) TRULY, 100% essential? I confess I'm not taking them right now... Eek.

I'm taking B12, folinic acid, B2, calcium, vitamin C (in a much lower dose than what's recommended here - I don't like C megadoses), and magnesium on a daily basis. Also some potassium as needed. I was thinking of adding in a kelp supplement, too.

I've only been taking mb12 and adenosyl b12 for the most part (some days I take a multi that has c, zinc, and a few other things he recommends) and have had some pretty amazing results.

Everyone is different though. If it doesn't work for you leaving some stuff out maybe consider adding, or get your blood levels tested to see what's low?

 

[LynnJ]

Okay, one more question, because I confess I'm STILL confused about this.

I have - had - a folate deficiency. I am on a drug that depletes folate levels. I currently take more folate than B12. I take 2400mcg of folate, and 1000mcg of B12.

I've seen mixed info on ideal ratios of B12/folate. But I feel like taking more folate than B12 makes sense for my situation. Can anyone help shed any light on whether these dosages are most likely okay, or if I'm making a mistake here?

I feel good. I used to take 800mcg of folate with 1000mcg of B12, and I was experiencing more air hunger/shortness of breath and a racing heart. Since upping my folate to 2400mcg, I'm definitely improving.

 

[Eastman]

I've seen mixed info on ideal ratios of B12/folate. But I feel like taking more folate than B12 makes sense for my situation. Can anyone help shed any light on whether these dosages are most likely okay, or if I'm making a mistake here?

I made this post earlier in the thread.

The recommendation to keep mB12 no lower than methylfolate was by richvank. Freddd did not agree with it. You can read their debate here.

I myself take more methylfolate than mB12, as do, I believe, some other members here. I am mainly guided by symptoms.

...

Incidentally, some people find that taking vitamin B2 reduces their need for methylfolate.

I thought I'd take this opportunity to link this article here.

Clinical Experience with Use of Nutrition in Hospitals

The introduction includes the case of a wheelchair-bound neurological patient given B12 while a second case involved a patient who woke up from surgery completely incoherent who was subsequently given a nutrition-oriented treatment.

 

[LynnJ]

I made this post earlier in the thread..

Thank you - that's helpful! I'm having a hard time keeping track of all this. Ugh. But I seem to be doing better taking around 2500mcg of folinic acid (the form my body seems to prefer by far), and 1000mcg of methyl B12. Still not doing GREAT, but better.

 

[Tizzi]

Hi. I hope you don't mind me jumping on this thread. I was wondering how you were doing Grapes? Are things still improving for you?

I've recently started the active protocol and it's been interesting to say the least. I am probably going faster than recommended but I'm a bit impatient and I seem to be tolerating it reasonably well. Prior to starting I had been taking a multivit with active Bs so I guess that helped as well. My most interesting response so far has been to adenosylcobalamin. It's like a light bulb went on after years and years of being in the dark and believe me I will do anything to keep it going. I'm currently on the following supplements:

5000mcg MeB12,
3000mcg AdB12,
2000mcg Methylfolate,
1100mg Potassium
5000 IU Vit D
5mg Lithium Orotate
2 daily Life Extension 2 per day multivits
100mcg Vit K2 as MK-7
300mg Magnesium Malate
2000mg Omega 3s

I'm at a stage where I'm increasing methylfolate and potassium. Once those are stable I'll be introducing L-carnitine. That should be interesting!

Regards
Tizzi

 

[garyfritz]

Congrats on your good results so far, @Tizzi! 5mg methylB12 and 3mg adenosylB12, holy cow that's a big dose. Bigger even than I was taking, and that's sayin' something!!

What form of B12 are you taking? Pills are very poorly absorbed, sublinguals are usually only about 3-5% (and that only if you dissolve them very slowly), so you may not be getting nearly that much usable B12. Injections are basically 100% absorbed. The Australian oil product that's mentioned here is said to be 80% absorbed, and I was taking 5-7mg (combined methyl/adenosyl) of that per day.

By the way, I just noticed you're taking the LE 2-per-day multi. Do you have mercury amalgam fillings? If so, I strongly recommend you find another multi. After several years of maddening symptoms, I finally realized my voracious B12 need (among other things) was driven by mercury toxicity. One of the clues that convinced me was when I learned about mercury chelation. The Cutler chelation protocol uses ALA (alpha lipoic acid) to grab mercury and usher it out of the body -- but it must be taken every few hours in low doses, and only after ALL amalgams are removed. Otherwise the amalgams provide a huge reservoir of mercury, which the ALA grabs and spreads all over the body, causing problems. I'd had some nasty "B12 symptoms" flare up for a few weeks, and then I realized the 2-per-day multi (which I'd started taking about 5-6 weeks earlier) contains 12.5mg of ALA per pill -- and I still had amalgam fillings then. I stopped taking the multi, and the symptoms vanished within 24 hours.

 

[Freddd]

Hi. I hope you don't mind me jumping on this thread. I was wondering how you were doing Grapes? Are things still improving for you?

I've recently started the active protocol and it's been interesting to say the least. I am probably going faster than recommended but I'm a bit impatient and I seem to be tolerating it reasonably well. Prior to starting I had been taking a multivit with active Bs so I guess that helped as well. My most interesting response so far has been to adenosylcobalamin. It's like a light bulb went on after years and years of being in the dark and believe me I will do anything to keep it going. I'm currently on the following supplements:

5000mcg MeB12,
3000mcg AdB12,
2000mcg Methylfolate,
1100mg Potassium
5000 IU Vit D
5mg Lithium Orotate
2 daily Life Extension 2 per day multivits
100mcg Vit K2 as MK-7
300mg Magnesium Malate
2000mg Omega 3s

I'm at a stage where I'm increasing methylfolate and potassium. Once those are stable I'll be introducing L-carnitine. That should be interesting!

Regards
Tizzi

Hi Tizzi,

I'm going to give you a road map for this stage. This should be able too help you figure out what the RIGHT NOW symptoms are that need correction. Only the things that actually stall cell making are the symptoms that show. Each time you add something that increases healing you may get more potassium deficiency and low folate again. I found that most of my folate symptoms started going away in the range 8mg to 45 mg (last folate symptom went away) daily of l-methylfolate, in multiple doses.

Version 2.4 11/05/2017 A work in process, incomplete, limited testing, people come in many variations, use at your own risk.
INDUCED DEFICIENCY SYMPTOMS FROM REFEEDING SYNDROME. This can follow 5 days of food deprivation, anorexia, or sort of a pinpoint starvation via vitamin or mineral or amino acid deficiencies. Whatever the “most needed” item is will often cause a strong response. The first usual notable symptoms occur on typically the third day of starting a previously insufficient nutrient with normally feeling or seeing the changes within minutes to hours. From MecBL I had over 30 sym[ptoms respond in the first few hours with blow my socks off intensity with neurological startup and potassium deficiency on the 3rd day along with increasing folate deficiencies that took years to figure out. For instance it was noted in the 50s with injections of B12 with potassium deficiency (hypokalemia) as a side effect. It is dangerous and can be unpredictably fatal if not corrected and the cause is continued. When they say people are dying in Syria after they have been starved and given food, they are often sufferring REFEEDING SYNDROME. When previous symptoms return

Group 1 – Hypokalemia onset. Often called “detox”. Symptoms may appear with serum potassium as high as 4.3. May become dangerous if ignored. Considered “rare” with CyCbl (Cyanocobalamin) it is very common with MeCbl (methylcobalamin) and AdoCbl (adenosylcobalamin) and less so with HyCbl (Hydroxycobalamin).

There does not appear to be a clear order of onset. The order of onset varies widely from person to person but many appear consistent for each episode for any given person. There tend to be more and more intense symptoms as it gets worse. Some people have ended up in the ER because of not recognizing the symptoms.

IBS – Steady constipation, Nausea, Vomiting, Paralyzed Ileum,

Hard knots of muscle, Sudden muscle spasms when relaxed, Sudden muscle spasms when stretching , Sudden muscle spasms when kneeling, Sudden muscle spasms when reaching , Sudden muscle spasms when turning upper body to side, Tightening of muscles, spasms and excruciating pain in neck muscles, waking up screaming in pain from muscle spasms in legs. Muscle weakness

Abnormal heart rhythms (dysrhythmias), increased pulse rate, increased blood pressure, intense sudden dizzy spells correctable potentially in minutes with water with potassium gluconate for instance.

Emotional changes and/or instability, dermal or sub-dermal Itching, and if not treated potentially paralysis and death.


Group 2a - Both hypokalemia and l-methylfolate deficiency
IBS – Diarrhea alternating with constipation, IBS – Normal alternating with constipation

Group 2b – Either or both hypokalemia and l-methylfolate deficiency
Headache, Increased malaise, Fatigue

Group 3 - Induced and/or Paradoxical Folate deficiency or insufficiency, partial methylation block to methyltrap on 1 or more internal triage levels. Frequently called “NAC DETOX” or “GLUTATHIONE DETOX”. Can be caused by folic acid, folinic acid and for some people, like me and quite a few others, excess vegetable folates. Further excess B1, B2, B3 and/or inositol can increase methylfolate deficiency symptoms. Methylfolate, MeCbl and just about anythjing else that starts healing can cause the folate deficiency symptoms.

These symptoms appear in 2 forms generally, the milder symptoms that start with partial methylation block and the more severe symptoms that come on as partial methylation block gets worse or very quickly with methyltrap onset.

Edema - An additional thing I would like to mention. I would never have found it without 5 years of watching the onset of paradoxical folate insufficiency and trying to catch it earlier and earlier and to figure out what was causing it and to reverse it. For me the onset order goes back to the day of onset now with edema and a sudden increase of weight. I noticed that within 2 hours of taking sufficient Metafolin I would have an increase in urine output.
Old symptoms returning in a general sense, a person may have had onset of these hundreds of time if they are on the borderline
Edema
Angular Cheilitis, Canker sores,
Skin rashes, increased acne, Increased itchy acne on scalp and face, Skin peeling around fingernails, Skin cracking and peeling at fingertips, painful cracks in the skin at the corner of fingernails at approximate right angles to nails, can take months to occur and it may be only non mood or neurological symptoms.
IBS – Diarrhea alternating with constipation, IBS – Normal alternating with constipation
Headache, Increased malaise, Fatigue
Increased hypersensitive responses, Runny nose, Increased allergies, Increased Multiple Chemical Sensitivities, Increased asthma, rapidly increasing Generalized inflammation in body, Increased Inflammation pain in muscles, Increased Inflammation pain in joints, Achy muscles, Flu like symptoms
IBS – Steady diarrhea, IBS – Diarrhea alternating with normal, Stomach ache, Uneasy digestive tract,
Coated tongue, Depression, Less sociable, Impaired planning and logic, Brain fog, Low energy, Light headedness, Sluggishness, Increase irritability, Heart palpitations,
Longer term, very serious:
Loss of reflexes, Fevers, Forgetfulness, Confusion, Difficulty walking, Behavioral disorders, Dementia, Reduced sense of taste, bleeding easily.
High MCV, > 93, persistant and resitant to MeCbl and B6 and/P5P. The warning about too much folate causing subacute combined degeneration which kept folic acid to a max of 800 mcg for deades becasue large folate doses can lower MCV without MeCbl. There is a long history to this.

n b

Group 4 - HyCbl onset, degraded MeCbl onset, MeCbl after photolytic breakdown onset.
Itchy bumps generally on scalp or face that develops to acne like lesions in a few days from start.

Group 5 – Copper deficiency after methylation startup has been achieved which often starts refeeding syndrome. 50mg or more of zinc has been indicated as a possible cause. 200-400 mg of zinc has been linked to copper deficiency. Excess supplemental or environmental manganese is linked to copper deficiency. Any or all symptoms can occur at “low normal range” copper tests. Well after all other observable copper deficiency symptoms showed up, a lower value as copper contibued to fall, MCV suddely went over 100 after it had fallen to

Demyelination of nerves similar to Sub Acute Combined Degeneration except that methylation and ATP startup has occurred, and copper deficiency favors damage to the upper motor neurons with perceived muscle weakness. Brittle nails. Sleep disorders. Mood (especially depression perhaps) and personality changes. Connective tissue breakdown. Spider veins. Varicose veins. Shrinking gums. Gum disease not responsive to usual measures. Unstoppable tooth decay on exposed areas without enamel. Low testosterone

Group 6 – Excess P-5-P, an active form of B6 that appears to drive hematocrit.
High hematocrit. The blood thickens and doesn’t pump as easily. Deep vein thrombosis can result. Other suspected circulatory hazards. Sometimes linked to high testosterone when lowering P-5-P might reduce it.

Group 7 – Excess B-vitamins affecting methylation
When taking the active B12/folate deadlock quartet (AdoCbl, MeCbl, Metafolin, L-methylfolate) Excess B1 - Thiamin, Excess B2 – Riboflavin, Excess B3 – Niacin and/or Excess Inositol can all produce an excess need for potassium to deal with Groups 1, 2a and 2b symptoms and/or produce an excess need for l-methylfolate to reduce groups 2a, 2b and 3 symptoms. A person might not be able to correct by taking potassium or folate and may need to reduce B1 <= 15mg/day, B2<= 10.2mg/day, B3 <=50mg, and inositol below an unknown quantity.

Group 8 – Boron insufficiency.
Arthritis swelling and pain, can be reduced by Boron
Contribution to fatigue, neurological effects.
Runaway tooth decay
Loss of calcium in bones and teeth

https://www.organicfacts.net/health-benefits/minerals/boron.html

Although all of the deficiency symptoms of boron are not fully understood, it is known that boron deficiency might result in the abnormal metabolism of calcium and magnesium. Some of the other symptoms include hyperthyroidism, sex hormone imbalance, osteoporosis, arthritis and neural malfunction.

Group 9 - Vanadium insufficiency
Deficiency of vanadium is poorly known or recognized. It affects tissue permeabilty like insulin.

Group 10 - Lithium insufficiency Non ionizing forms, small micronutrient doses
Lithium allows better permiability of B12 in nervous system memberanes. Many people appear to have trouble affecting some B12 deficiency symptoms with B12 even

Group 11 - Iodine insufficiency, especially needed for those who don't eat iodized table salt and/or seafood.

Group 12 - L-carnitine XXXXX, That can be L-carnitine tartrate, L-C Fumarate, L-C freebase, ALCAR and others but usually works only one kind at a time.
neuromuscular pain, feeling of growing inflammation, fatigue, mood changes, sleep problems. These are quick occuring symptoms and they can sprwead to the complete 4 way deadlock over time.
It appears that for most people in this refeeding situation many may respond to only one form of l-carnitine, initially fumarate or ALCAR and sometimes also including a freebase form. However, as the deficienciencies change, the pathways appear to change and the carinitne that worked so well no longer does and the form is some entirely different one, like tartrate or some other variation. A person may need to trial half a dozen forms. A response is usually clear the first day or occasionally several days with micro doses and titration. And it can change based on what else is corrected.

I found, through thousands of comparative trials of sublingual tablets and injections. I found that 45-120 minutes under a lip or tongue can absorb 10 to 33%, typically about 15-25%. I also found that only about 1 in 10 brands-batch of MeCbl is really good, and the rest range from poor to fair. I wish I could tell you there is a way other than trying a bunch of different ones but I haven't. At least you gt that kind of benefit from AdoCbl,. A good MeCbl will be just like that or more and a little different. Then the right Carnitine can up the energy level , so titrating is best. Again, only one of maybe 6 or 7 types usually works art a time and it can change apparently based on which other deficiencies one has.

 

[PinkPanda]

@Tizzi Great that adenosylB12 helps you. I had some improvements on hydroxoB12, too, which can be converted to adenosylB12.

I would still be careful with high doses of supplements, especially methylation supplements. A number of people don't tolerate methylfolate and methylB12 well. Even in my short time on this forum, I have seen a couple of threads of people ending up in the ER because they tolerated methylation supplements badly.
The daily requirment for methylfolate is around 400µg, I don't think there is a need to go several times higher than that dose.

In case you are interested, I wrote my thoughts on methylation here.