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Purpose of running this test:

While I prefer noninvasive testing, the Plasma Methylation Profile is the one test I recommend that does require a blood draw ordered by your doctor. This test measures the levels of intermediates in your methylation cycle that can be integrated with data from a UAA and a MAP test, as well as with the cobalt levels from a UEE and HMT, to give you a sense of the overall function of the methylation pathway in your body.

This test may be particularly useful for those who are AHCY +, as that mutation can impact the SAM-e (S-adenosyl methionine) levels in your body. It may help determine the need for supplemental SAM-e, not only for those who are AHCY +, but also for those who are COMT ++, who would not ordinarily add SAM-e because of their COMT status. In addition, based on studies by Rich Van Konynenburg and Dr. Neil Nathan, those with CFS and FM may benefit from running this test, as SAM-e may need supplementation in this population as well.

Result This table contains the rationale behind my suggestions. These suggestions are for your consideration. Defer your choices to your own health care practitioner, as always.
Methionine MTR and MS are both accepted abbreviations for the enzyme “methionine synthase”. The indication for where methionine synthase acts in the above test diagram is denoted by “MS”. Elsewhere in this book, methionine synthase is referred to as “MTR”, reflecting the standard three letter nomenclature that is used for this gene. Methionine levels are a reflection of the conversion of homocysteine back into methionine by both MTR/MTRR and BHMT enzyme function. High levels of homocysteine and low levels of methionine suggest a need for support of the function of these enzymes.Check that lithium is in balance before adding extra B12, Methylmate A, and Methylmate B to support MS/MTR/MTRR function. If you are adding methionine, be sure you have support for these enzymes and for overall methylation cycle function in place to process the methionine and homocysteine that is generated.To support BHMT enzyme function and methionine levels, consider AminoAssist and/or Egg Protein Powder, Phosphatidyl Serine Complex (PS/PE/PC), DHA, All in One, and Methylation Support nucleotide blend. Once lithium is in balance, then add extra B12 and Methylmate A and Methylmate B. If methionine is still low, you can use sprinkles of Methionine.

Check lithium on a HMT prior to adding extra B12 or higher levels of Black Bear Spray or Black Bear Drink as a source of B12 and Molybdenum.

Alternately, high methionine is sometimes seen in those who are ACAT +. The use of ACAT/BHMT capsules may be a help to restore methionine to healthy, balanced levels. This is an important consideration because high levels of methionine have been reported to have toxic effects in animal models.

Cysteine & Cystathionine If cysteine and cystathionine are high, be sure there is sufficient transsulfuration pathway support for processing sulfur groups, such as B12 and Molybdenum. Check that lithium is in balance on a HMT before using high dose B12. Cysteine processing can ultimately produce pyruvate that feeds into the Krebs cycle. Be sure that sufficient B complex, such as Ultimate B, is in place to enable pyruvate to enter the Krebs cycle. This can be seen on a MAP test.High levels of either or both cysteine or cystathionine may be due to levels of B6 that are too high, or to a need to address increased CBS activity. Increased CBS activity may be due to certain CBS SNPs, for example CBS C699T, CBS A360A, or CBS 212. High levels of TNF alpha secondary to infection in your system, can also increase CBS activity and lead to elevated levels of cysteine and/or cystathionine. Excessive CBS activity that leads to increased cysteine and/or cystathionine may also be reflected in elevated taurine levels, which can be seen on a UAA test. Consider GSH support when both taurine and cysteine levels are elevated. If cysteine or cystathionine are too low, then consider increased methylation cycle support, as well as support with a B complex that includes low dose B6 or low dose P5P, such as Ultimate B.Basic methylation support includes All in One, Phosphatidyl Serine Complex (PS/PE/PC), DHA and Methylation Support nucleotide blend. Once lithium is shown to be in balance on a HMT, then use low dose Methylmate A, Methylmate B, and extra B12.
SAM-e ( S adenosyl methionine) SAM-e is the single most important methyl donor in your body. If levels are low, consider support with SAM-e along with B complex. There are two supplement sources of SAM-e: enteric coated tablets that are well protected from oxidation and a foil wrapped uncoated tablet. When sulfur levels are high on a HMT or UEE, then the preferred form of SAM-e to use is the foil wrapped tablets. If sulfur levels are not an issue, and/or initially the decision is to break the SAM-e into smaller doses using only ½ or ¼ tablet, then the enteric coated form is preferred.
SAH ( S adenosyl homocysteine) SAH can inhibit COMT. This can be a particular issue for those who are COMT ++. High levels of SAH may also generate increased uric acid via a pathway that utilizes adenosine deaminase (ADA). High levels of ADA may be associated with hemolysis, thus with increased bruising and bleeding and potentially anemia. High uric acid may be associated with gout, diabetes, and kidney stones. Approaches to reducing uric acid include Pantothenic Acid, which is part of Ultimate B, Quercetin, and Dandelion Root. Tart Cherry Extract along with Advanced Joint Support nucleotide blend may also be a help for gout or high uric acid. Quercetin is also helpful for high histamine and oxidative DNA damage, but it may be problematic for those who are COMT ++, because it further slows down this enzyme function. High SAH can drive the methionine cycle in a reverse direction and reduce the production of SAM-e. Consider using sodium bicarbonate, if you can use bicarbonate for low pH, and/or low dose Ion Transport compound.
Homocysteine High levels of homocysteine are risk factors for a number of health conditions. Support for both MS/MTR/MTRR and BHMT enzyme function to convert homocysteine to methionine should be considered. Basic methylation support includes All in One, Phosphatidyl Serine Complex (PS/PE/PC), DHA and Methylation Support nucleotide blend. Once lithium is in balance on a HMT, then consider using low dose Methylmate A, Methylmate B, and extra B12. Check lithium on a HMT prior to adding extra B12 or increased levels of Black Bear Spray or Black Bear Drink as a source of B12 and molybdenum.In addition, support to process homocysteine via the transsulfuration pathway can also be considered, especially if taurine is low on a UAA, if sulfur levels are not too high on a UEE or HMT, and if cysteine and/or cystathionine are low. To support the transsulfuration pathway, consider Ultimate B and, if needed, additional low dose B6 or P5P. However, you do not want taurine to climb above normal range on a UAA from transsulfuration support or adding B6/P5P.Also, be sure that sufficient transsulfuration pathway support is present to process sulfur groups generated by supporting the transsulfuration pathway, including B12, Molybdenum, Black Bear Spray or Black Bear Drink, which is a source of both B12 and molybdenum. Be sure lithium is in balance on a HMT before adding extra B12.

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Related Tests to Run

A UAA test gives important additional information about methylation cycle intermediates, including the levels of methionine, taurine, cysteine, and cystathionine, as well as the levels of the oxidized species of homocystine, cystine and methionine sulfoxide. A HMT and UEE give valuable information about cobalt levels, which are a measure of B12, as well as lithium and sulfur levels that are also related to methylation cycle function. A MAP test yields information on FIGLU and MMA which reflect methylation cycle function, or a need for folate and B12 respectively.

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