5-Formyl-THF and Folinic acid (same substance but measured in different places) are low so I've added folinic acid to my daily regiment.
THF and Active Folate are low despite supplementing with high doses of MTHF. Rich Vank suggests it might have to do with high sarcosine, which I do have. Sarcosine can methylate THF:
Sarcosine can be generated by GNMT enzyme activity, whose purpose is to normalize Methionine levels (mine are high):
Which would explain low SAMe and high SAH. Rich Vank thinks this means there's too many methyl groups in the system, and that supplementing with hydroxocobalamin would help pace this better. I do better on hydroxy, definitely. I supplement with Glycine because it's come up low in previous amino acid tests. I find it calming but I would cut it out if needed, my only reservation is that would affect GSH levels. Genova doesn't provide much insight on high sarcosine:
My problems started when I began taking Accutane. Vitamin A and its derivatives (accutane) upregulate GNMT activity.
I hope this is not a permanent epigenetic issue. Thoughts?
Any advice is welcome. I couldn't find a viable way to downregulate GNMT besides avoiding Glycine, but this seems bad because it will lower GSH levels and keep Methionine high. I found some studies that suggest 5 methyltetrahydrofolate monoglutamate and 5 methyltetrahydrofolate pentaglutamate are strong inhibitors but they are deconjugated in the gut and there are no sublingual supplements available.