August 3, 2016 at 10:01 am #726
Hi Dr. Woeller,
Thank you again for this tremendous information. I’m confident that my clients are benefiting from my added knowledge already!
I have several questions regarding methylation.
1. When you refer to betaine conversion to DMG, is this the same betaine as Betaine HCL? If so would supporting the production of stomach acid aid in this methylation route?
2. The discussion of high dose b6: I understand that P5P, as the active form, should be dosed lower than B6 as pyrodoxine. Is this correct and if so what is the difference in dosing?
3. Can you advise on how you’d approach a client that is possibly over vs under methylating? Lab work would be most helpful in determining necessary supports but I am familiar with adverse reactions to folinic acid/supporting the folate pathway.
4. Can you share your experience with children taking medications and the heightened response from the medications that may occur when methylation is supported (I’m referring to AED’s as well as other medications).
LynnAugust 3, 2016 at 5:04 pm #727
Thank you for the compliment!
1 – I am not a chemist, so sometimes I need to rely on chemical definitions myself – http://medical-dictionary.thefreedictionary.com/betaine. Betaine HCL is not the same as TMG, but the betaine which can be derived from sugar beets is a based structure of both compounds. There are many different types of betaines. Therefore, using Betaine HCL will not do much for direct methylation support from my understanding.
2 – I get mixed messages on P5P. I know Dr. Shaw feels that is just gets reconverted by to Pyridoxine HCL in the gut. Also, he had some literature, which I cannot find anymore, that P5P may make oxalates worse (not exactly sure). Therefore, I don’t have specific conversion for B6 to P5P or vice versa. I don’t know of any discussion that Rimland had on this topic either.
3 – much of this work comes from Willam Walsh, Ph.D. at http://www.latitudes.org. In Module #9 slides 53 and 54 outline his observations of over versus under-methylators. For example, for undermethylators he lists folic acid as being contraindicated. The problem is Folinic Acid and L-Methyl-Folate are different structures and what may be happening is Folic Acid is known to block the folate receptors which are necessary to uptake active folate into the central nervous system. Therefore, that adverse reaction to folic acid may be a blocking effect of folate overall.
Folinic acids seems to be a form of folate via supplementation that has been around, or at least studied more with regards to its effects on Cerebral Folate Deficiency, compared to L-Methyl-Folate. I believe, although it is hard to confirm, that individuals who react negatively to L-Methyl-Folate may have significant damage within the Methionine Synthase enzyme and therefore have problems with oxidized cobalamin.
With over-methylation types it makes sense that being conservative with methylation supplements is needed. The approach is to the individual though and having exact milligram amounts per age and/or weight isn’t available.
The SNP profiles can help identify potential problem areas, but I have never solely relied on just SNP’s as an all determining factor of whether to or not to give a supplement.
4 – I haven’t experienced kids having adverse reactions to methylation supplements and their medications, or a situation where the medication dose suddenly became too much for them causing problems.
I hope this helps.
Dr. WoellerAugust 4, 2016 at 7:24 pm #728
In my experience, I have had results with transdermal P5P. (Response to #2)
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