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Recurring angular cheilitis

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4
I started Doxycycline, Metronidazole, Azithromycin, Valtrex about 6 weeks ago, and added Clindamycin 2 weeks ago, recently added Rifampin. However from the beginning, I seem to be struggling with a recurring case of angular cheilitis. I tend to take a fluconazole tablet every 5-7 days to keep any candida at bay due to antibiotics, but somehow that seems to also help wipe it.
All these B vitamins are out of range high as I have been taking Folgard and then switched to MetanX since it has Folate instead of Folic Acid.
my B12 was >2000 , B6 is 82.1 , Folate (folic acid serum) is >20

what could be the reason for this happening. It happens every 10 or so days. Starts as a slight redness and dryness on corners of my mouth, increase moisture, and then one day when I go open my mouth and I feel it split.
 
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4
Actually I just read this under the guide for MetanX.
Does this mean this pill could be artificially increasing my B12. Ugh.

PRECAUTIONS
GENERAL
Folic acid, when administered in daily doses above
0.1mg, may obscure the detection of B12 deficiency
(specifically, the administration of folic acid may reverse
the hematological manifestations of B12 deficiency,
including pernicious anemia, while not addressing the
neurological manifestations). L-methylfolate Calcium
may be less likely than folic acid to mask vitamin B12 deficiency. Folate therapy alone is inadequate for the treatment of B12 deficiency.

Each METANX® capsule contains 3 mg of L-methylfolate Calcium (as Metafolin®)*, 90.314 mg of Algae-S Powder (Schizochytrium), 35 mg of Pyridoxal-5 ́-Phosphate and 2.0 mg of Methylcobalamin *CAS#151533-22-1

INGREDIENTS
Silicified Microcrystalline Cellulose, Algae-S Powder [Schizochytrium Algal Oil (Vegetable Source), Glucose Syrup Solids, Mannitol, Sodium Caseinate (Milk), Soy Protein, High Oleic Sunflower Oil, 2% or less Sodium Ascorbate, Tricalcium Phosphate, Tetrasodium Diphosphate, Natural Flavors, Soy Lecithin, and Mixed Natural Tocopherols and Ascorbyl Palmitate (as antioxidants)], Pullulan, Pyridoxal 5’- Phosphate, L- methylfolate Calcium, Methylcobalamin, Titanium Dioxide (color), Magnesium Stearate (Vegetable Source), Caramel (color), Riboflavin USP, Shellac, Propylene Glycol USP. Contains Milk and Soy
METANX® capsules do not contain lactose, yeast or gluten.
 

Learner1

Senior Member
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6,286
Location
Pacific Northwest
Serum B12 if a useless test. It will be high if you're ingesting it. The "gold standard" test fir B12 is methylmalonic acid which any doctor can order. I've seen people have serum B12 over 2000 and be deficient in B12.

I agree with @junkcrap about the B2.

You might find a Genova Diagnostics NutrEval or a Great Plains OAT test to be useful in sitting these issues out. Individuals have very different needs for B vitamins. You may very well need different ratios and maybe even some minerals to get things to work better.
 

junkcrap50

Senior Member
Messages
1,246
You might find a Genova Diagnostics NutrEval or a Great Plains OAT test to be useful in sitting these issues out. Individuals have very different needs for B vitamins. You may very well need different ratios and maybe even some minerals to get things to work better.
Which test out there is best for evaluate nutritional deficiencies? I know only of Genova's NutrEval really. Haven't done one in nearly a decade and haven't looked into it much yet. Is that the most comprehensive test, most reliable, etc.
 
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dannybex

Senior Member
Messages
3,537
Location
Seattle
IMHO, Fred is wrong when he states that other deficiencies cause angular chelitis. As others have mentioned here, it is one of the key symptoms of a B2/Riboflavin deficiency, if not the classic one. You might just try taking some for a few days or so and see what happens.
 

Learner1

Senior Member
Messages
6,286
Location
Pacific Northwest
Which test out there is best for evaluate nutritional deficiencies? I know only of Genova's NutrEval really. Haven't done one in nearly a decade and haven't looked into it much yet. Is that the most comprehensive test, most reliable, etc.
The NutrEval is far and away the best. It's comprehensive enough that one can see what's going on with various pathways. It does lipids, aminos, Bs, antioxidants, Krebs cycle, neurotransmitters, high level gut, need for enzymes, lipid peroxides, DNA damage, some toxins, and minerals. I've correlated it with other tests and it is accurate. It's weakest on minerals. It has vitamin D as an add on. I usually run a pmadms amino osbrl in addition to their urine aminos, which has picked up some interesting problems.

Spectracell is odd and disjointed. I've found it can lead one astray. It has carnitine, which you have to extrapolate on other tests.

OAT has some overlap with the NutrEval. It's the best for identifying an oxalate problem, but it does not do lipids, it's lousy at antioxidants, does not do minerals, but is decent at B vitamins. It's harder to see pathways. It's helpful for some neurotransmitters but not others and it's missing most aminos. It does BAC and find gut markers.

HDRI has some unique tests no one else does like nitrotyrosine or oxidized vs reduced glutathione.