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Homocysteine Resist - lower dose of B6

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 Posted 2/26/2012 10:58:27 AM
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If your MCV is high also you may need more folate, though possibly in Folinic instead of Folic acid form. If you have the known gene defect for 5-MTHFR you may need that form as well.
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 Posted 2/26/2012 11:24:28 AM
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I have MCV of 91 (ref. 80.0-98.0) and been tested negative to the MTHFR gene defect. I just placed a new order for targeted supplementation but will not go for testing the massive doses of folates. I just considered that even if I do that and reduce my hcy count (as I did in the past) I am not ready to supplement for life with ultra super RDA of folate to keep it at that level.

Also, I was expecting 23andme also testing for the CBS (cystathionine b-synthase
) anomalies (which would require extra B6) but this was not included.

So I wonder if I should stay with my hcy cont of 13 which is still in the norm but not quite optimal. Problem is that even if there seems no causation for CVD then what's about Alzheimer and dementia? (e.g. see here)



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 Posted 2/26/2012 11:57:26 AM
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MCV of 91 is pretty good, my wife had over 102 at one point. Since you don't have the MTHFR gene defect Folinic should work for you if you want to try that. Neither of us had the gene defect and taking Folinic seemed to help both us, but it helped me more. My MCV is now around 88-89, and my wife's is down to around 96. I'm not sure if she needs more Folinic or if something else is causing her elevated MCV. Her uric acid is also very low which seems to point towards possibly some kind of folate cycle issue. Low molybdenum can also lead to low uric acid, unfortunately its hard to get a molybdenum blood test.

Another thing that can lead to high homocysteine is too low choline as its the basis for the one carbon (choline oxidation) pathway, which is where homocysteine is converted back to methionine. Its thought that the genes (eg PEMT) involved with endogenous choline production in the body are defective in quite a few people, especially in the US. Almost no foods have substantial amounts of choline either...
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 Posted 2/26/2012 4:45:14 PM
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 Posted 2/22/2013 11:30:21 AM
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Hi DDye, just a thought ... is there any available statistic of homocysteine level in LEF Members, a bit as I recollect LEF has analyzed for Vitamin D. I would expect a lower that average level due to supplementation. Could you forward to LEF?

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 Posted 2/22/2013 12:20:23 PM
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Will do.  In the meantime, this http://www.lef.org/magazine/mag2006/oct2006_cover_homocysteine_01.htm might be of interest.

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 Posted 2/23/2013 2:08:35 AM
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DDye (2/22/2013)
Will do.  In the meantime, this http://www.lef.org/magazine/mag2006/oct2006_cover_homocysteine_01.htm might be of interest.


Thank you DDye. I really need to look (again) to this in more detail when my other concerns settle down. I seem to be in a situation similar to the one Mr Faloon describes in the article with the difference of not having a genetic predisposition (at least as tested by the MTHFR gene mutation, but it might be more complex than that, I recollect).

Interesting is the point, I admit forgotten, of the relation to kidney conditions. I am having a 14 mcmol/l homocysteine level (ref <16) with a creatinine of 0.83 mg/dl (0.7-1.3) and BUN of 17.4 mg/dl (8.4-25.8) giving a BUN/creatinine ratio of 21 which is borderline high (9-20)

Is there anyone commenting on these values? Also, we should look at trend rather that spot values which can be caused by specific conditions, such as protein intake before the test etc...

Problem is I do not have a doctor looking at this seriously and I am juts told everything is OK. I feel this is not the case and I can improve but on the other side I feel uncomfortable taking the huge amounts of B complex as quoted. In the past I could achieve some good result but as soon as I lowered the doses (mainly of folate, I also used
L-methylfolate) the homocysteine values went up again. I did not try SAM though neither asked for Cerefolin.

Now, if maybe a bit controversial looking at homocysteine versus CV disease mortality rates, hence some doctors do not care much, a worsening of the kidney condition makes me more committed to try something. And I also recollect a connection with cancer.

Looking at a LEF statistics might help me understanding what other Members are doing and the success score.

I might also take up this point in a new consultation at LEF with one of their MDs during a next visit I might be organizing (I was very satisfied with the last one and ... Florida is great :-))



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 Posted 2/23/2013 7:53:34 AM
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There is also a concern about folic acid and the immune system. It appears from preliminary research that folic acid had been found unmetabolized in healthy study participants who were not exposed to folic acid supplementation.1

B vitamin fortification of packaged and/or processed food is common nowadays. One’s exposure to folic acid can be many times higher than values via monitoring and analysis of supplementation intake alone.

Unmetabolized folic acid lowered the immune systems ‘natural killer cell cytotoxicity ability’ (NKCA).1 It is common knowledge that lower NKCA may increase the likelihood and complication of disease such as pneumonia2 which in the elderly can be fatal.  Additionally and particularly lower NKCA presents a higher risk of development and growth of cancer.3

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References:

  1. J Nutr. 2006 Jan;136(1):189-94. Unmetabolized folic acid in plasma is associated with reduced natural killer cell cytotoxicity among postmenopausal women
  2.  Am J RespirCrit Care Med. Natural killer T cells are critical for dendritic cells to induce immunity in Chlamydial pneumonia.
  3. TrendsImmunol. 2013 Feb 12. Activating natural cytotoxicity receptors of natural killer cells in cancer and infection.


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 Posted 2/23/2013 1:08:52 PM
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Thank you Tom.

Not only high folic acid supplementation might be cause of concern but might be useless if you try and address only one part of the homocysteine metabolism cycle (e.g. the folate dependent re-methylation vs the transsulfuration path, see: http://jn.nutrition.org/content/137/2/311.full)

To better understand this I researched on possible genetic predisposition to high homocysteine and the possible nutritional interventions.

Provided you did your SNP profile with 23andMe, you can get a Methylation Analysis (at no charge) at Genetic Genie. I did it and it is very easy. You also get some explication of what the analysis means and the actions you can take.

I found amazing the complexity of the homocysteine issue and what you can make wrong with the wrong supplementation. Herewith is an example of the analysis report (see: http://geneticgenie....alysis-example/) (red is mine)

"....MTHFR Mutations. First we’ll look at a few of your MTHFR mutations. According to research, these mutations are important and can be implicated in various disease states. You have 1 heterozygous (yellow) mutation(s). These are generally not as bad as red homozygous mutation, but they may still worth paying attention to. They include MTHFR C677T ... One function of MTHFR (Methylenetetrahydrofolate reductase) is to help convert homocysteine to methionine. A MTHFR C677T mutation means that the MTHFR enzyme may have trouble performing its task leading to high levels of homocysteine.....

.... CBS Mutations. CBS (cystathionine beta synthase) catalyzes the first step of the transsulfuration pathway, from homocysteine to cystathionine.....CBS defects are actually upregulations ....When one tries to take nutrients to support their methylation cycle before addressing the CBS upregulation, all the nutrients basically lead to nowhere. Instead of generating glutathione, the supplements may deplete the rest of the cycle.... There are many things one may need to avoid with a CBS upregulation. Some of the items include garlic, broccoli, eggs, onions, legumes, meat, Epsom salt baths, alpha lipoic acid, glutathione, chelating agents such as DMPS, NAC, Milk Thistle, various other supplements, and much more. Please look to other sources for foods and supplements that are high in sulfur....."

Incidentally, I also found interesting the following article clarifying the different forms of folate we often encounter:

L-Methylfolate, Methylfolate, 5-MTHF,L-5-MTHF.
What is the Difference!?
http://mthfr.net/l-methylfolate-methylfolate-5-mthf/2012/04/05/


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 Posted 4/1/2013 2:15:33 AM
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albedo (2/26/2012)
...
Also, I was expecting 23andme also testing for the CBS (cystathionine b-synthase
) anomalies (which would require extra B6) but this was not included....

Included now in the 23andme methylation report:
CBS C699T rs23470

CBS A360A rs1801181

CBS N212N rs2298758

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