Which comes first - the Methyl folate or the Methyl cobalamin (and other questions)? Discuss :)

[Katy131]

Hello everyone – my first post on this forum

Before I get to my first question, a quick background as it’s my first post– I’m in the UK and I follow Dr Sarah Myhill’s protocol for CFS/ME. Although I’m not on the PK diet I do follow a lower carb, Mediterranean diet and cook from scratch every day.

I was diagnosed with CFS/ME in 2008, MCS in 2010, have been having EPD (Enzyme Potentiated Desensitisation) shots since 2016 and I’ve recovered to about 70% on the ability scale. Last year I was working to get my chronic low magnesium up to a reasonable place in Red Blood Cell tests via nebulising magnesium sulphate daily and it worked well but started to fail, giving me odd stinging and nausea symptoms, which my functional medicine doctor and I now think is because my system was in a good enough place to start to methylate properly, which resulted in symptoms. I was also B2 and B6 deficient which he said also pointed to a methylation problem. So this year I have started on Dr Myhill’s Methylation protocol.

https://www.drmyhill.co.uk/wiki/CFS_-_The_Methylation_Cycle

In February, after a break of a few months, I restarted taking Dr M’s recommended BioCare multivit which contains methylated versions of B2, B6, B12 and Folate but in small amounts. I was already taking 1 x 250 mg Maximised Reduced Glutathione and have done for years.

https://www.bodykind.com/supplement...adult-multivitamins-minerals-30-vegicaps-p298

After 3 weeks I added in 1 x BioCare P-5-P complex which has methylated B2, B6 and magnesium. A week later I added a second one, as per the protocol. After three days I had a burst of energy for two days (luckily over the Easter weekend when I needed it!) but then a kind of adrenal crash and I’ve been struggling with symptoms of nausea, stinging all over, aching, headaches and so on. These symptoms have been coming on slowly since early February when I started the multivit, but were very bad this week.

https://www.salesatdrmyhill.co.uk/p...h-co-factors-by-biocare-60-capsules-177-p.asp

Having read around this forum in the last few days looking for clues, I have added in some Potassium in the last day or two. I’m still titrating, but yesterday I took 4 x Solgar Potassium Gluconate (99mg Potassium each) and also having glasses of Coconut water as snacks in between and, yes, today the symptoms have dialled down quite a bit. Thank you @Mary for pointing me in that direction and also someone else (whose thread I can’t find now) who talked about Coconut water.

So to my first question:

I’ve seen @Pyrrhus give a clear indication that after the B vitamins are well tolerated, the next step should be to add in small amounts of Methyl folate before adding in B12, yet in another place (sorry brain fog I can’t find the thread!) I’ve seen people recommend starting B12 before Methyl folate. What is the consensus? And given I’m already taking small amounts of these in my multivit, does that make any difference to what I should do next?

Secondly I’m wondering about Phosphatidyl Serine which is in Dr Myhill’s protocol. I’m not sure why that’s in there because I don’t see it mentioned much in the forum here – could it be to help deal with the symptoms? Perhaps I should consider taking some of that sooner rather than later (although it is very expensive)?

Thirdly, re the Potassium – I’m leaning towards adding in more tomorrow (possibly double what I'm now taking, so that would be 8 x 99 mg) hoping to dial down the symptoms even more. Is it really OK to increase so quickly? Later on, after adding in further methyl elements, do you continue to increase Potassium to cover further symptoms?

Thanks everyone for your time and support here on the forum, and in advance for your help with my questions!

 

[linusbert]

which contains methylated versions of B2, B6,

B2 and B6 can be methylated? you probably mean the active forms R5P and P5P. usually in B vitamins only B12 and Folat can be methylated - according to what i've read so far, but i could be wrong.

i'd recommend to take some sodium.
people tend to go crazy with potassium ignoring all other electrolytes. too much potassium can sure be stressing on the adrenals. in that case add some sodium.

also for adrenals, take some vitamin C, you can combine it with sodium, so take Sodium Ascorbate. that has 11% sodium, so 1000mg = 110 sodium , 990 vitaminc.

also checkout pantethine (its a b5).

 

[Katy131]

B2 and B6 can be methylated? you probably mean the active forms R5P and P5P. usually in B vitamins only B12 and Folat can be methylated - according to what i've read so far, but i could be wrong

Yes, my mistake, I do mean R5P and P5P, the active forms. If you check the link I gave for the Biocare Multivitamin, it details that in the ingredients section. Thanks also for your other comments; amongst many other supplements, I'm taking plenty of sodium, Vitamin C and Pantothenic Acid.

 

[TinaT]

and Folate but in small amounts. I was already taking 1 x 250 mg Maximised Reduced Glutathione and have done for years

Thanks for sharing your protocol and the links to the explanation for the recommendations.

Big difference between your protocol and the one from this thread is that, in this one, glutathione strongly discouraged, much higher folate amounts, plus different cofactors.

It's really hard to know what's doing what.

 

[cheeseater]

When starting methylfolate along with the methyl B12 be sure and start slow with the methylfolate. 250 or 500mcg twice a day. Then after a week you can increase it. Someone else here on the forum noted extreme tiredness associated with methylfolate.

When I started methylfolate a few days ago I took a 1000mcg tab and was wiped out. Next day I went to 500mcg 2x a day along with 2500mcg methyl B12 (also 2x/day) and all is well. I also take my regular 99mg potassium twice a day and have not increased it. I have long ago found some potassium keeps my blood pressure from creeping up. Soon I will go to 1000mcg methylfolate and 5000mcg methyl B12 twice a day.

This is my response to the Tulane Univ advice for methylfolate for people with EDS hypermobility syndrome.

 

[Katy131]

Big difference between your protocol and the one from this thread is that, in this one, glutathione strongly discouraged, much higher folate amounts, plus different cofactors.

I've been lurking on the forums here and reading around methylation a lot over the past few months. I knew that the folate recommendations are different (Dr Myhill recommends 800 mcg and Rich only 400 mcg if memory serves?) but I didn't realise glutathione is strongly discouraged. Why is that?

 

[Katy131]

When starting methylfolate along with the methyl B12 be sure and start slow with the methylfolate. 250 or 500mcg twice a day.

Thanks for the pointers. Would this dose of 250 mcg or 500 mcg be when you aren't taking any other folate at all? There is 100 mcg Methylfolate in my Multivitamin. So when I get to starting on additional Methylfolate, I'm not sure whether I need to take what's in my Multi into account when adding in more later.