So...I'm going out on a limb here and saying that the "really didn't notice a difference" is probably your biggest indicator. There has been some misinformation going around about CBS being a huge deal. Someone read a report (the research was valid) and mistook the findings for something artificially created in the laboratory (a CBS enzyme with a big chunk cut off) for what happens with the CBS C699T mutation (a single nucleotide swapped out). It appears that one person misread the report and a lot of people repeated it. I stopped reading Dr. Ben when I found I had the MTHFR A1298C SNP and his site only addressed the 677T mutation; I think he has made updates to his site. I don't know what is there now, or if he has made what I feel is too big a deal out of CBS or not.
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OK about the Vitamin D. Do you get enough green leafies? Without enough Vitamin K, Vitamin D can end up placing the calcium in the blood instead of the bones. Not a good thing, particularly with high homocysteine.
B12 in serum, if I understand correctly, measures both active and inactive. Your MTRR A66G +/- means that half your enzyme for methylating (activating) B12 don't work so well. So normal serum levels mean that your intake is enough, but not necessarily that your functionality is enough. If you increase the available B12 using hydroxy form, you'll still have less than efficient conversion, but as more is available, more will be converted. If you use methylB12, you skip the inefficient enzyme.
High homocysteine...actually that's not a surprise. There are three ways that homocysteine gets used up. One uses methylfolate (which you have less of through the MTHFR C667T +/-) and methylB12 (which you have less of through the MTRR A66G +/-). The second way is through the BHMT pathway (and yours is significantly slowed with the BHMT 08 being +/+. At first I wrote 'blocked' but that's probably too strong. I don't know what % efficiency it actually works at). Supplementing Betaine (Trimethyl Glycine, TMG) helps accelerate that pathway. The third way - get this - is through the CBS pathway - which in you is ACCELERATED by your C669T +/- SNP. Is your CBS giving you problems? Apparently not enough to lower your homocysteine!
Some of the things that can slow down the accelerated CBS pathway are lack of active B6 (the pyridoxine-5-phosphate) and lack of magnesium. There are also toxic blockers, like perhaps mercury or arsenic, but I don't know much about them. Let's concentrate on the factors you can add if you need to. The link to what your doctor wants you to take has the B6, albeit in a form that needs activation. Did they test your magnesium (Mg) level?
So, in the end, the product you linked to has methylfolate, methylB12, B6, and TMG. All good puts, as far as I can see. It has riboflavin, too, that I haven't identified a need for in your SNPs. But we didn't identify the need in mine, either, and when I did the NutraEval, riboflavin was my biggest need. So I'm not going to say it's bad for you. Two questions to consider: (1) Cost of the recommended product vs. cost of the individual products, and (2) What does it do to your relationship with this healthcare practitioner if you use what he recommended vs. buying the products independently?
Your practitioner seems to have made a good recommendation (said like I know what I'm talking about!
). I would recommend additionally that you check your magnesium on your lab results and ask him whether or not to supplement with that, too. I like him and am glad you're working with him. There's another forum on doctors here. I don't have CFS/ME so I don't read it. But if he turns out to be a good guy, think of making a post there so others can find him
Critterina
P.S. I think I'm the only person I know who knows they can't activate pyridoxine hydrochloride. It may be fairly rare, and I don't know what gene is responsible or whether I have SNPs in it.
