This is our Naturopathic Doctor’s email response (in blue) to several questions I had regarding Brian’s genetic mutations and treatment plan. My questions are in bold.
1) Will the supplements also help with the MTHFR?
So MTHFR is just one of the enzymes that regulates or provides the ability to break down things. B vitamins help with this as does magnesium and also glutathione (in some cases). The MTHFR is just the tip of the iceburg. The secondary enzymes that are key include COMT, CBS, BHMT, MAO. Think of the MTHFR as the main highway like I-95 and then the other enzymes as Rt. 1/301 as the back-up routes. If the main one is compromised and processing is deficient it puts a load on the other roads (detours). The goal is to get all the roads flowing again to decrease the traffic. The traffic in this case are his skin symptoms. Magnesium helps at nearly all the side roads as do the B complex vitamins. It is all about balance.
2)He’s taking molybdenum to help get rid of sulfites (?) and I think you said to decrease sulphur-containing foods, but glutathione comes from sulfur-containing foods and you have him on glutathione? Sulphur or not to sulphur…
Great assessment on the sulfur and molybdenum connection. Glutathione is needed for at least 4 major or different pathways. One of which is the sulfuration reactions. Because he is struggling with other snips including the COMT, CBS and BHMT the secondary roads needs help. CBS needs the molybdenum and other sulfunation reactions. The glutathione helps at so many places specifically at the mitochondria. Right now Brian has a fair amount of damage at the mitochondrial level. Glutathione helps with recovery at the cells but provides more oxygen at the cells as well. Glutathione is one of the most potent antioxidants and can decrease histamine reactions. It is also needed for CBS and MTHFR to work properly. CBS is one of the key sulfuration enzymes and since his is compromised this is the key enzyme besides the MTHFR that we are addressing. Glutathione also helps at GIF.
3)What does the magnesium do?
Magnesium helps at MTHFR, DAO, MAO, CBS, COMT, GIF- nearly all of them. It is a histamine stabilizer in general. It helps to open up the vessels to allow proper oxygen and repair.
4)Please explain the gut-brain link again.
Okay on the gut to brain connection- many people for years have thought the gut and brain were separate. They are not separate at all. There are so many nerve endings to the gut that then of course go straight to the brain. The BHMT snip is the enzyme that is more vulnerable to this then impacting the brain with catecholamines but also then histamine responses. In many disciplines, the gut is seen as its own brain due to the amount of nerve endings. Additionally, what we have learned over the last years is that most of the production of serotonin is made in the gut not the brain. Furthermore, we also see that the majority of the immune system is in the gut and thus when foods are eaten that the body cannot process then it causes more aggravation to the catecholamines, histamines and then impacts the skin. What occurs in the gut then dictates what occurs throughout the entire system. This is why certain foods are so damaging to the rest of the body. For Brian, the gut will dictate what occurs on the skin. In most ice creams or dairy, there is often egg, fruit with sugar or potato added which then further downregulates BHMT, MAO, SHMT, and increases the catecholamines which then dictates mood and skin reactions. I hope this makes sense.
5)Please list in order of importance exactly what the supplements are supposed to be “fixing.”
The enzymes that are most important for him right now are BHMT, CBS, COMT, MAO, MTHFR, GIF. We have chosen the therapies that have key enzymatic reactions or support (inducers) to the rest of the system.
6)Do you need to check the levels of B-12, homocysteine, Vitamin D, etc. to have an objective measure of whether or not the treatment is working?
We an always check these. Often times families are not interested due to cost but I am completely open to this. In order to get accurate information, we would want to test MMA vs B12. B12 is only the serum level and not at the tissues. Thus MMA is the best. Vitamin D can also be important to look at 2x/yr for most people esp since he doesn’t have major issues with VDR snip. The one suggestion that I have in reference to the methylation is that it is often related to how the individual feels more frequently than testing since it can change from one moment to the next. Vitamin D is a fat soluble vitamin and has more consistent reading but the B’s can change very quickly within the same day or week. If we do homocysteine, we can do a number of different tests for this pre and post. Objectivity is very important and can help in some cases but the symptoms of the person we find are the most useful as a consistent pattern.
7)The active forms of B vitamin: methylfolate, methylcobalamin, pyridoxal -5-phosphate are not listed in the B-Complex vitamin but their other forms are: folate, B12, and B6. Is Brian’s body is efficiently breaking them (folate, B12, B6) down to these active forms?
On the B vitamins- we use this one because it has the best outcomes that we have seen clinically. They are food based versus synthetic and thus much easier to break down. Many of the active form are synthetic or have other additives added that can cause more damage. Sometimes depending on things, I will add one of the additional forms. If you add them immediately, then the person can have more symptoms in some cases if the other enzymes are off. Due to his severe past symptoms, I don’t want anything getting worse. So slow and steady is the best option at this time. I do add P-5-P and sometimes the adenosyl-cobalamin or methylcobalamin depending on things esp to break down catecholamines and assist with sleep or aggression. We are starting him slow with a baseline vs adding more things first. I want to see how he does with the basics before we add more sophisticated or complex products. We have started him with the building blocks first.
I know this is a lot of information. I would continue keeping a log. The diet is huge and cannot be stressed enough. I know the dairy is not helping him specifically with the MAO, SHMT, CBS, BHMT and COMT. I know it is a balance with trying to give him what he wants vs the emotional suffering he has been going through but the BHMT, COMT and CBS and MAO makes him more vulnerable for the food to cause nothing but further histamine and catecholamine reactions.