Hi Rich,
That is a most interesting hypothesis on how this whole vicious cycle fits together and clearly shows the multiple places at which it is vulnerable to interuption..
It also makes sense then in terms of plenty of methylb12, adb12, methylfolate, l-carnitine fumarate breaking that cycle way open in multiple places by reestablishing the ATP production with the adb12 and l-carnitine fumarate, ample methylb12 to perform all it's functions including detoxification of many toxins and destruction and inactivation of some of the methylb12 thereby but having ample left to perform all required tasks including cofactors such as methylfolate and p-5-p in the homocystein-methionine conversion and DNA replication, functional neurology, healing the neurology and neuropathies including the autonomic neuropathies up to those of the subacute combined degeneration level in the worst of cases which present more of a problem.
From what you say there then using the active b12s and methylfolate gets around the many problems locking folks into the loop in the first place by directly counteracting it in every way. Since it is present in large quantities it doesn't need protection by glutathione and instead detoxifies the toxins and they are excreted removing the problem.
And indeed, attacking the problem on multiple fronts does cause a return to normal funtioning in many ways or reveals more clearly the comorbidities causing continuing problems. As many are finding out, severe abnormal fatigue, brainfog and and many other symptoms can be reduced or eliminated relatively quickly. Damage takes a while to heal however, some forms of damage much longer than other forms to heal. Fortunately most of it heals. Recovery from years of inactivity and reconditioning takes longer however and requires exercise. CNS damage takes longest to heal and appears least likely to heal completely. However, many things don't heal until the last critical cofactor is in place and I don't believe that we have found all of those yet. Thankyou again for a most interesting highly detailed hypothesis.
Hi, freddd.
I'm glad you liked reading my hypothesis. I think we are in substantial agreement about how this type of protocol works. The basic essence of our two treatments is essentially the same, in terms of including B12 and 5-methyl tetrahydrofolate, with some cofactors.
I understand what your views are about the need to use methyl and adenosyl B12 rather than hydroxo B12, and also your views about the need to use higher dosages of the active B12s. These make particular sense to me for people whose cells are genomically not able to do the conversions, but I agree that this approach will also work for those whose cells can make the conversions, so in that sense, your protocol is a more general treatment than the "simplified treatment approach" that I have suggested for CFS.
As I think I've mentioned before, Amy Yasko bases the choice of whether to use hydroxocobalamin or methylcobalamin on the person's individual genomics. In particular, she looks at polymorphisms in the COMT enzyme and the Vitamin D receptor. For people who have a greater need for methyl groups, based on whether these polymorphisms are present or not, she recommends methylcobalamin. In choosing the supplements from her overall treatment program for the "simplified treatment approach," I chose hydroxocobalamin because of my concern about moving mercury into the brain, as I've mentioned. I think that inorganic mercury is more of an issue in CFS than in autistic children, with whom she primarily works.
I still haven't gotten to studying your mathematical model involving mercury. Sorry about that. It may be true that with high enough dosages of methylcobalamin, mercury can actually be removed from the brain, as we have discussed earlier, but I don't have clinical or experimental evidence to support this mechanism, so for now I feel that I have to remain cautious about the possibility that such an approach could move mercury into the brain from elsewhere in the body.
As you know, my other concern has been that it has seemed to me that many people cannot initially tolerate dosages as large as you have suggested. I think that some people have also been reporting here that they need to take the treatment more slowly, in order to be able to tolerate what appear to be dieoff and/or detox symptoms. That is what I have found with the "simplified treatment approach," also.
I agree that we still have more to learn about everything that is needed to bring full recovery to everyone with CFS. I hope to live long enough to see that happen!
Best regards,
Rich