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.

I'm just going to post my Methylation SNP status here as well. I'm still working on understanding the results, but it's nice to have someone else's results to compare them to.

This link explains the VDR taq gene combinations:

http://resqua.com/702188759/what-is-...a-vdr-taq-gene

http://mtrra66g.com/

BHMT08:
http://www.snpedia.com/index.php/Yasko_Methylation

Those are your big 3.
The Yellows can be looked up on Google by just typing in
the abbreviations into the keyword search. Yellows are intermediate meaning some partial activity is possible.

Some of my results say no call.

Do you all have any suggestions?

I used Genie, then Prometheius.