I think you will need a specialist to evaluate these results.

Folic acid is in American food as an enrichment product... in fact quite a bit. But it is NOT the methylated form Methylfolate.
If you cannot methylate it? With the error? That creates a
problem.

If you take 1000mcg of methylB12...you only absorb about 10mcg of it. That is only about twice as much as from food.
I'll have to look this over. But I think a specialist is needed
and you should consult one who understands methylation chemistry.

I also think..given the recent revelations about compounding pharmacies and epidural drugs made there....you should find out what drugs were used on the cervical epidurals you had.
It is possible there is a connection there. Protein in the CSF?
I'd really check this out if I were you. I personally believe this problem with "cheap" substitutes for brand name SoluMedrol,
were being made for many years, and could also be contaminated. The media has not yet released this risk, but I do think it exists, since the company was warned in the early 2000's about cleanliness etc.

Did you ever have a homocysteine test? was it elevated or normal?
I see your MTHFR is +/- which is a mixed mutation. This is not as serious as a +/+... full mutation. People with +/+ mutation here cannot methylate B12 or folic acid properly. Partial mutation means only some methylation. Methylation means moving a -CH3 group from SAMe to the desired location to activate it. People with MTHFR mutations cannot use B12 or folic acid properly.(and would need the methylcobalamin and methylfolate instead of other forms for these vitamins.)

I think at this point you should only pay attention to +/+ presence of mutation (shown in red)

The neurotransmitters in the the brain are methylated and activated by -CH3 group via enzymes. With the mutation showing +/+...you have a decreased capacity for it.

Some of the comments refer to the autistic community because many of them have methylation problems. Often methylB12 is used as a high dose injection for them.

To read more about psychiatric and autistic methylation issues,
consult Pfeiffer Institute online.

Here is some information on COMT:

http://en.wikipedia.org/wiki/Catecho...yl_transferase
wiki

http://rheumatology.oxfordjournals.o.../47/5/572.full

COMT has more information about it, concerning psychiatric conditions, behavior and emotionality. But there are a few references to pain threshold changes in people with mutations in this enzyme. The second link discusses that near the end.
It appears from what I can see, that some studies could not replicate what others found, so at this time, the pain connection is not fully explained.

Your comment about "toxicity" is really a bit strong. Intolerance would be better. Methylation has a link to autism and psychiatric conditions. The Pfeiffer Institute has postulated this.
http://www.alternativementalhealth.c...s/pfeiffer.htm
Errors in methylation according to Dr. Walsh, can result in behavioral imbalances.

This link discusses the MTHFR mutations in detail:
http://findingtherootcause.blogspot..../02/mthfr.html
on that link is this link with a MTHFR diagram/map that is very
interesting:
http://www.mindmeister.com/12694596/...ealth-problems
There is an error on that map showing methylB12 not absorbed orally, and that is not true we know today. I don't know for sure about the other entries however. So I can't vouch for it all, but it remains an interesting graphic.

The word methylation is a general term and applies to many types of chemical reactions in the body. Disruptions in methylation are thought to be involved in bipolar disorder, cancer, etc. The methylation of B12 to methylcobalamin and folic acid to methylfolate is only one small aspect of methylation in general.
http://en.wikipedia.org/wiki/Methylation
It is a fairly large complex biochemical process, that is just being elucidated.

For your purposes of the tests, methylation is explained in your results in specific ways.

In regards to injections you had in your cervical area in the past:
One reason this was not explored in the current emergency involving
the meningitis outbreak, is that the vials cannot be tested from the past, to see if they were contaminated or not --they are gone. The batch that caused this recent outbreak of fungal infection in tissues (mostly the CNS) but there were some joint infections also...had an expiration of 3mos on the label. And it was only a fluke that one doctor examined a patient and found this fungus. In the past, it could have been there a long time and never discovered. I personally believe that people who received this product anytime in the past 10yrs or so could have a festering fungal infection somewhere in a joint or spine (CNS).
Most of the people who died were elderly. With time I think the age of the patient, and other factors may be brought to light about this terrible event. Doctors don't look for fungus infections in people with intact immune systems. People with AIDs are the most likely to have them or those receiving strong chemotherapy for cancer.
The injection of contaminated drugs by doctors, therefore, becomes a iatrogenic issue and sounds like a huge nightmare to me!

Thanks for you research on this. The injections were an attempt to help the burning. This started well before that. So, the injection theory, at least in my case doesn’t fit.

The burning started around same time I started taking Amitriptyline. Works on Serotonin and norepinephrine. Also when I took Lexapro and some other SSRI's that’s around same time burning moved to my back and left chest. Also my burning was worse when I then went on Effexor and then Cymbalta. few months after that.Wonder if that has any link to COM++ .

COMT (Catechol-O-Methyltransferase) – helps to methylate dopamine, serotonin, and norepinephrine. Essentially slows down or regulates production of these neurochemicals.

But I am not on any SSRI, TCA, or SSRI for 3 months. Also 5 months after burning started I did have a Botox injection in my UES. Not sure if the Botox in conjunction with what was going on in my body (reaction to TCA + PPI + not absorbing B12/B9) could of be a perfect storm of things going on in my body?


Just a theory.

Basically COMT is a system to reduce or eliminate (metabolize away) neurotransmitters. (removes methyl groups from them to inactivate them).

MTHFR is a methylating system which will MAKE the same neurotransmitters, by adding a methyl group to the substrates.
So these two systems work to balance things out in the long run.

I really haven't had time to find the other variants of the MTHFR's listed.

This stuff is really new and complex and how it shakes out in vivo may be very subtle. Your mixed mutation in the major MTHFR variant means you will have to use methylfolate instead of folic acid, and avoid folic acid if possible, (because it is in alot of foods in the US), because it competes for folate for transport into the brain, it is thought.

I was hoping you'd get the Cytochrome P-450 test DNA evaluation too, to see how you metabolize the drugs you take.

So you tapered off the Cymbalta? I didn't know you did that.

I still believe you have some kind of iatrogenic (doctor caused) problem. You didn't have this before, and only acquired it after quite of bit of invasive procedures.

Some of the COMT information revolves around too much dopamine (since with the mutation the body can't get rid of excess)...and that is something to look into when you have time. Too much dopamine is connected to addictive behaviors, and some forms of mental illness.

Have you been tested for heavy metals load? The MTHFR mutation appears to be very significant for heavy metal toxicity to build up in the body because they can't be methylated and excreted. That one link I gave stressed that possibility.

Also the dietary suggestions for lots of veggies as sources of natural folate, seems important. Methylfolate is now again available OTC. Solgar makes it, and you might start with it to see what happens... 800mcg a day.

I would avoid however, SAMe, as this is a methyl donor and you can't remove methyl groups adequately.

The Cytochrome P-450 Test is not available yet at http://geneticgenie.org. Would the insurance companies pay for it? If so I can ask my PM doctor to order it.
I did get some good info from 23andme.com that lets me know about possible drug interactions. I don’t think it’s as extensive as theCytochrome P-450 Test.

Right now I’m on Lyrica 500mg daily and started Nuedext 5 days ago.
I was tested for metals via blood test and urine. Not sure if there is a special test I need to take in addition?

I do eat a lot of veggies every day and avoid processed junk.

I think I may try this combo based on a response I received from the CFS forum.

http://www.holisticheal.com/hydroxy-b12-mega-drops.html
http://www.luckyvitamin.com/p-7405-m...odqisAgA&#tabs
*edit*

In regards to your methylcobalamin:
Only about 10mcg is absorbed on a good day from this at the 1000mcg daily dose.
That is not enough methyl stimulation to do much damage, as it has to be diluted in the whole body.

Injections however, release far more methylcobalamin and in some cases doctors give them daily or weekly depending. That could become a methyl load quickly. This is common in the autistic community, for example.

Since you have a mixed MTHFR mutation you cannot methylate well yourself. So if you use hydroxocobalamin, it may not get activated as much as you need it to be. So I would consider that.

I think your first attempt should be to avoid food sourced folic acid and to start Metafolin at 800mcg a day, and watch your reactions. You can increase slowly with time if need be. But very high dosing of methylfolate can be very stimulating and disturbing to some people. Best to start small, and see what happens.

In regards to your links to the vits....
They are very expensive. Solgar's Metafolin 800mcg is
http://www.iherb.com/Solgar-Folate-A...-Tablets/13961
A third the cost. Solgar is a well known reliable company.

Hydroxocobalamin tends to be pricey. You may not find much of a variance with it therefore from company to company.

Here is a monograph on your MTGG mutation:

http://www.ncbi.nlm.nih.gov/pubmed/11472746

It appears to be a factor in elevating homocysteine levels.