High Homocysteine Possible Deficiencies

[Stefan]

Thanks, I will try!

[slacker]

On my most recent (as well as past) DUTCH (dry urine test for comprehensive hormones), my methylation activity based on estrogen phase 1 metabolism indicates low activity. The recent Methylmalonate (MMA) result on DUTCH was slightly above range, indicating Vitamin B12 deficiency. Vitamin B6 markers, xanthurenate and kynurenate, were within range, low normal. Folate is not checked by DUTCH.

My MTHFR is C/C. Other than ApoE4, no other genetic status know. (Other than assumed XX!) I’ve been taking the same multivitamin for years, and follow a mostly vegetarian diet, with less than daily cheese or eggs, and either salmon or shrimp most days. Many days are vegan plus seafood or egg.

My Functional Medicine/Bredesen trained MD recommended adding the normal suspects to support methylation, including 5 mg of folate daily. I checked the amount of B vitamins in my multi; folate 400 mcg, with B12 and B6 amounts lower than suggested in our website’s homocysteine wiki entry. Given my diet, I opted to increase B12 and B6 by purchasing individual supplements for both. I’ve been taking 400 mg magnesium daily for months. My supplement stack is onerous, so trying to choose additions wisely.

I also requested lab testing for MMA and homocysteine from my FM MD for serum baseline, so that we could compare in 3 months after starting new supplements. (DUTCH covers much more ground, and is expensive) I ordered supplements before the blood work was ordered and drawn.

Here are the results:

MMA 153 nmol/L (normal range 0-378 per labcorp, not sure what Bredesen recommends)
Homocysteine 7.0 umol/L (Bredesen recommends under 6? or up to 7 OK?)

I plan to continue my plan, but wonder about whether it is needed at all or if I have selected the wrong supplements for my initial experiment.

Comments and feedback welcome!

[Julie G]

Hi slacker! <7 is the goal announced in the upcoming book. Congrats! Something else to keep in mind, Optimized omega-3 and choline (as co-factors) have emerged as other nutrients to consider when managing homocysteine. You likely have these covered with your seafood and egg intake.

[roxanne]

Any ideas?

You might experiment with adding choline (or phosphatidylcholine) and/or creatine. See Chris Masterjohn's take on treating MTHFR.

I used both PC and creatine on top of things in your list (but smaller amounts of methyl-folate at 400 mcg/day) to drop mine from 10.4 to 6.9.

I tried the PC and from 8.3 I jumped to 10.4 homocysteine. I can't bring it down. It now occurred
to me that the culprit might be Niacin 500mg that I take daily as recommended by my FM MD for cholesterol. So I'm stopping that and taking B12 1mg, folate 400mcg, 5mg B6, all these every other day as when I wasn't supplementing my homocysteine was 7. I do eat 4 to 6 eggs a week plus fish and shellfish, 3 times a week. Jafa recommended Jarrow Vitamin B complex one a day as she brought hers down to 6 but because of COVID I haven't received it yet.

Does this protocol sound sensible, or does anyone recommend something else? Is there something I can do to continue Niacin that can override its effect on methylation? I was taking
Methyl Guard Plus. It has 1.8 g of Trimethylglycine but it didn't work either. It just reduced homocysteine to 9.1 with 3 pills a day, but with the same protocol it went to 10.4 the next time I tested. Tricky.

I'm ready to just go without supplements , but I did before I switched to a ketoflex and it jumped to 12.1

Thank you very much for your response.

Roxanne

[SusanJ]

I'm ready to just go without supplements , but I did before I switched to a ketoflex and it jumped to 12.1

At your original reading of 7, were you taking the niacin? Because your homocysteine rise is likely related to the niacin.

Your body gets rid of excess niacin by using up methyl groups. So those B vitamins you are taking are diverted to getting rid of excess niacin from the 500 mg you are taking, and are not being used in the methylation cycle to recycle homocysteine. That is why it jumped to 12. You are taking more niacin than your body can use normally.

Does the niacin reduce your cholesterol? You probably need to talk to your doctor about the rise in homocysteine (there is plenty of research that shows high homocysteine is bad), and discuss other things than niacin to lower your cholesterol.

[roxanne]

Thank you Susan:

Originally, I wasn't taking Niacin. I was doing a zero carb diet and my cholesterol went thru the roof, that's why she recommended Niacin. Now, I don't know if the Niacin did the trick with the cholesterol or it was the change in diet. I'm going to message her and maybe she can give me something different for it. By the way even though the numbers were high when looking at total cholesterol, trigs were 36, hdl was 120, so not too shabby.

I will keep you posted.

Thanks again.

Roxanne

[roxanne]

I'm ready to just go without supplements , but I did before I switched to a ketoflex and it jumped to 12.1

Your body gets rid of excess niacin by using up methyl groups. So those B vitamins you are taking are diverted to getting rid of excess niacin from the 500 mg you are taking, and are not being used in the methylation cycle to recycle homocysteine. That is why it jumped to 12. You are taking more niacin than your body can use normally.

.

Hi Susan:

I'm sorry, I didn't quote you before, so you probably didn't see my previous message. Just to thank you and let you know I will keep you posted with my homocysteine saga, lol.

Renee