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methylcobalamin vs hydroxocobalamin

Hi Lotus,

B12 will create a stronger reaction and possibly cause overmethylation so be prepared to lower your dose of B12 if necessary

It just doesn't work that way. Healing can turn on at about 100mcg absorbed per day for most layers. Below that it's "iffy", not proportional. The curve shows that at about 10mcg there is a minute effectiveness that never really gets going the absorbed dose increases the effectiveness increases at an increasing rate, goes over the knee on the way up at a bit bellow 100mcg (estimated) and goes up very slowly after that. I would predict that in a well controled study that virtually nobody could distinguish between 250 mcg absorbed and 5000mcg absorbed on the basis of reactions.

As for adenosylcobalamin, I would wait until you get the methyl b12, folinic acid, and methylfolate in place before adding it. If you take

And I'm finding it most effective in a lot of people to microtitrate both AdoCbl and MeCbl with methylfolate for predictable results. Then, as soon as healing turns on, cease titration of those and bring everything else into balance before continuing. That way one doesn't bounce all over the place alternating back and fort on and off methyltrap and partial ATP block.

Low potassium is a common and potentially lifethreatening effect of overmethylation and overdriving the methylation cycle so you might want to consider supplementing with potassium even if you are taking hydroxocobalamin.

The percentage of hypokalemia with HyCbl is lower but is NOT a result of over methylation. It is the result of turming methylation on enough to start making a backlog of cells from years of delayed healing. With AdoCbl, MeCbl and l-methylfolate hypokalemia is a dependable and predictable occurance and ois the first sign of gneralized healing. Excessive potassium need as Dbkita pointed out can happen and is something else entirely different which does need to be identified.

Capsules and tablets are not recommended for potassium supplementation because those can damage the stomach and GI tract.

This warning applies to prescription time release forms of a non-disperable type that has 500mg in a single capsule/pill that can sit in a dissolving mass against the stomach causing tissue necrosis. It is not a hazzard of OTC capsules or fast dissolving low dose pills. But it is well worth warning. Also, don't take too much at a time. More smaller doses with a full gass of water are more effective and safer.
It's hard to say. Most of the supplements aren't going to cause problems, but some people here (including myself) are very sensitive to certain things so I'll try to list a few. The most likely to cause problems would be the methylfolate so I'd save that for last (Rich suggests an order to do things so I'll post that below).

Maybe the B12 would also cause problems, but I'd start that before folinic acid like Rich recommends. The Perque is tricky to cut in half or quarter, but I use an exacto knife to cut mine up. I'm not taking 2000 mcg yet, but when I do get up to that dose I'm still going to divide up my doses so I can spread it out during the day. If 1/4 tablet of B12 is too much I suppose you could try taking a whole tablet orally (swallowing it instead of taking sublingually), but B12 taken orally has a very low absorption rate compared to taking it sublingually so only do that if 1/4 is too much. Even 2 or 3 tablets taken orally probably wouldn't be equivalent to 1/4 tablet taken sublingually. I've seen some estimates suggesting an even bigger difference between oral and sublingual than what I mentioned, but I'm not sure if anyone knows for sure what the difference is. There are a lot factors that affect absorption rate so any estimates are going to be iffy at best.

A certain amount of folinic acid will be converted to methylfolate so that's another reason to start with that before adding methylfolate. If you buy the brands Rich recommends, make sure to take 1/4 tablet (200 mcg each of folinic acid and methylfolate). I misread his protocol initially and was taking 800 mcg of folinic acid a day. Luckily I didn't make the same mistake with methylfolate.

Lecithin is usually made from soy, so if you have a soy sensitivity you should get the sunflower lecithin instead. Also, one tablespoon of lecithin has around 225 mg of choline. Since choline is a methyl donor it could contribute to overmethylation. It also stimulates the BHMT pathway which can convert dopamine to norepinephrine. I'm not sure that amount of choline is enough to affect most people, but it's worth mentioning. If you're also taking TMG, betaine hcl, SAMe, and/or phosphatidylserine (especially Seriphos which is similar to PS, but more potent) which have the same effect as choline on the BHMT pathway and as methyl donors then possibly the combination those could affect some people. Especially once you add B12 and folate. The amount of TMG in the multiple isn't enough to do much of anything though so don't worry about that.

As far as the other ingredients in the multiple. Most of the ingredients are relatively low doses so they aren't likely to cause problems for that many people. My biggest complaint about the multi is that the doses of many of the ingredients seem too low to be effective, but I wonder if that's part of the reason Rich picked it was because he was afraid adding too many things to the protocol would be more likely to cause problems. 12.5 mg of P5P is relatively low, but some people are sensitive to it so that's partially why I recommend dividing up the dose of the multi. Another reason why it's good to divide the dose is because certain B vitamins only stay in your body a certain amount of time so it's good to spread it out. Pine bark extract and curcumin are listed as Th2 stimulants and some people here are Th2 dominant, but again, the dosages are low and I'm not even sure they'd cause problems for people who are Th2 dominant. Milk thistle extract is an iron chelator, but as I said with the other ingredients it's a relatively low dose. I noticed that the multi has 400 iu of vitamin E in the form of alpha tocopherol. If finances allow, I'd recommend taking a gamma tocopherol supplement in addition because alpha tocopherol depletes your body of gamma tocopherol (as well as tocotrienols). While alpha tocopherol is a good supplement to take, gamma tocopherol has additional benefits such as being anti-inflammatory, protects against LDL oxidation, and has a positive effect on nitric oxide and peroxynitrite. If you do decide to take gamma tocopherol, Jarrow's Gamma E would be the best since it has mostly gamma tocopherol and it's also a good price.

Methylfolate is the most likely to cause problems and maybe the B12 after that. It would still be better to start the B12 before the folinic acid like Rich recommends. This is what Rich says as far as the order goes
I have been diagnosed with compound heterozygous in MTHFR. I have read with interest the case of Potassium depletion while supplementing with methylcobalamin and Methylfolate.
Actually I am supplementing with 1000mcg of Methylcobalamin (solgar's) and 800 mcg of methyfolate 4 days a week and 3 days off, for over 4 months now. I have measured my Potassium level and it was within normal range. Any further clues?