Elevated Vitamin B6

[WifeOfJoel]

I have high homocysteine (11.2), low-normal B12, normal serum folate (didn't check RBC folate), high RBC MCH, and a high serum vitamin B6 level (24.5, above the normal range of 2-21). I know the B6 test can be affected by vitamin consumption, but I don't think I took vitamins the day before, and I was fasting the day of the test.

Given that I am homozygous for the C677T MTHFR mutation, I know I have a methylation defect. I don't know what form of B6 the Quest Diagnostics test measures. Perhaps an increase measured vitamin B6 is seen in MTHFR patients, if the test is measuring the unmethylated form (that would build up presumably, as the methylation step is inefficient)?

Since getting my test results, I've started taking methyl folate and methyl B12. Do I need a special form of Vitamin B6, i.e., do I need to take pyridoxal-5-phosphate instead of pyridoxine hydrochloride?

[slacker]

I have high homocysteine (11.2), low-normal B12, normal serum folate (didn't check RBC folate), high RBC MCH, and a high serum vitamin B6 level (24.5, above the normal range of 2-21). I know the B6 test can be affected by vitamin consumption, but I don't think I took vitamins the day before, and I was fasting the day of the test.

Given that I am homozygous for the C677T MTHFR mutation, I know I have a methylation defect. I don't know what form of B6 the Quest Diagnostics test measures. Perhaps an increase measured vitamin B6 is seen in MTHFR patients, if the test is measuring the unmethylated form (that would build up presumably, as the methylation step is inefficient)?

Since getting my test results, I've started taking methyl folate and methyl B12. Do I need a special form of Vitamin B6, i.e., do I need to take pyridoxal-5-phosphate instead of pyridoxine hydrochloride?

I'm linking the Quest Diagnostics information on Vit B6 testing. You can always go directly to the lab's website for more information.

There is a wiki chapter on methylation that you may find helpful, especially with figuring out how to lower your homocysteine within your unique genetic environment.

My guess is that taking a different form of Vit B6 may not change your homocysteine level. Your B6 level is barely outside the Quest normal range. As another member has noted in another topic, Bredesen's recommendations on B6 levels are much different that the standard lab companies. There are other members much more knowledgeable about methylation than me.

[WifeOfJoel]

Thanks, Slacker.

I read the methylation wiki backward and forwards, and I think I will follow the recommendations to start with B12 and methlyfolate, then add 20mg pyridoxal-5-phosphate aka P5P. I don't know if pyridoxal-5-phosphate is necessary instead of pyridoxine, as I don't think MTHFR is involved in its conversion. I didn't see the recommended CBS SNP to check (rs5742905) in my 23andme.

Bredesen's book had made me confused, because in the same section (pages 121-122 in my book), he uses different units (first he says you want a blood concentration of 60-100 nmol/L, then 60-100 mcg/L). One of these must be a typo, because pyridoxine is 169.18 g/mol and pyridoxal-5-phosphate is 247.143 g/mol, so whichever form is checked in the blood, those units are not equivalent. Quest reports in ng/mL, which is equivalent to mcg/L, so assuming this is standard, I am guessing Bredesen is recommending 60-100 mcg/L, meaning I am high according to Quest, and low according to Bredesen.

I suppose as long as I stay under 100ng/L, I shouldn't be at risk for sensory neuropathies. I'm likely overthinking this, as usual

[Its Me]

and a high serum vitamin B6 level?

I find this website very interesting and helpful. FWIW, here is their B6 fact sheet.
https://ods.od.nih.gov/factsheets/Vitam ... fessional/

Also, you can go directly to SNPedia to see info. Here is rs5742950:
https://www.snpedia.com/index.php/Rs5742905

[WifeOfJoel]

and a high serum vitamin B6 level?

Also, you can go directly to SNPedia to see info. Here is rs5742950:
https://www.snpedia.com/index.php/Rs5742905

The problem I'm having is that I don't see that SNP in my raw data from 23andme.