[mrsD]

Yes, you can take them separately.

I bet the Metanx does not say empty stomach either?
Unless that has changed recently.

You can get the methylcobalamin and take 5mg daily for 3 months on an empty stomach. It is very inexpensive. Swanson's, Puritan's Pride, Vitacost etc.

The methylfolate is OTC too, and Solgar makes one at 800mcg.
One of these a day is enough. Folate is not typically a player for PNers, unless they have that genetic mutation...MTHFR polymorphism. I agree with you that massive doses of this are not needed. You might want to watch your foods, and try to keep folic acid levels down, since some papers now suggest that folic acid in fortified foods may compete for methylfolate at the blood brain barrier. This will probably cost the most for you...iherb.com may help with that. There may be other brands now out there less expensive, but Solgar brought it out first OTC on the second round of availability after Merck company refused to sell it OTC! That was a huge scandal, but is now over.

P5P by NOW is a good brand, and is enteric coated as well. It is not expensive. There is a movement now by a drug company to take THIS off OTC status so it won't compete with a new P5P being developed RX...I hope this is till available therefore.

One of each of these a day should help you in a way similar to Metanx.

[Marie33]

Originally Posted by mrsD

Yes, you can take them separately.

I bet the Metanx does not say empty stomach either?
Unless that has changed recently.

You can get the methylcobalamin and take 5mg daily for 3 months on an empty stomach. It is very inexpensive. Swanson's, Puritan's Pride, Vitacost etc.

The P5P is OTC too, and Solgar makes one at 800mcg.
One of these a day is enough. Folate is not typically a player for PNers, unless they have that genetic mutation...MTHFR polymorphism. I agree with you that massive doses of this are not needed. You might want to watch your foods, and try to keep folic acid levels down, since some papers now suggest that folic acid in fortified foods may compete for methylfolate at the blood brain barrier. This will probably cost the most for you...iherb.com may help with that. There may be other brands now out there less expensive, but Solgar brought it out first OTC on the second round of availability after Merck company refused to sell it OTC! That was a huge scandal, but is now over.

P5P by NOW is a good brand, and is enteric coated as well. It is not expensive. There is a movement now by a drug company to take THIS off OTC status so it won't compete with a new P5P being developed RX...I hope this is till available therefore.

One of each of these a day should help you in a way similar to Metanx.

MrsD Thank you for your quick response,
Are you saying you agree I should stop the Metanx because of the high level of folate. You mention massive dosages are "not needed", if I keep taking the Metanx at this high dose could it be harmful or is it just being wasted?..Metanx goes on about how the high levels , Methylfolate being the highest dose 3mg per pill are what makes this medical food different and works best. You are correct no mention on how to take it, with or with out food.
I will shop for L-methylfolate 800mg as you suggested. (right now I have about 2 weeks samples of Metanx from Dr)
How much P5P is effective and safe? Should the bottle read only P5P (for the B6) or can it read P5P B6. Which is the better or correct way to buy B6 and at what dosage per day? Im a bit confused being I never bought them converted before. (Some companies have both B6 P5P and just P5P.)
massive doses of this are not needed. You might want to watch your foods, and try to keep folic acid levels down, since some papers now suggest that folic acid in fortified foods may compete for methylfolate at the blood brain barrier. This will probably cost the most for you... MrsD Im a bit confused with the above statement where you wrote about "cost", what will cost the most for me? Did you mean "cost" by it could affect my health, or more costly (expensive). sorry for my confusion and all my questions. Thank you again as always for your help!!!!

[mrsD]

Massive doses of methylfolate are used to try and treat some depressions. It is not working out as they planned however.
Some people get agitated on high dose folate.

Also there is a situation of very high dose folic acid in young women increasing the rate of colon cancer. This is thought to be due to pre-cancerous lesions gobbling up the folate and that is stimulating growth. But no one knows for sure yet. Some young women take 5mg or more of folic acid before and during pregnancy, especially if they have had a child with neural tube defects already. Because colon cancer is not common in this age group it is a concern, but not proven yet.

Metanx (just because is RX) is not really approved for efficacy by the FDA. It is under an umbrella called "Medical Food". It is only RX because it contains more than 1mg of folic acid and there is a rule that anything over 1mg requires RX in US. But studies were not needed for its status for releasing to the American Public.

I don't think the short course of samples is a concern, but if you get agitated with that high folate, you could just take one instead of two a day.
I prefer this product because it is enteric coated. P5P is not stable in stomach acid:
http://www.iherb.com/Now-Foods-P-5-P...60-Tablets/740
One of these a day, is plenty.
B2 is included because it is the cofactor for pyridoxal kinase to convert B6 to P5P... that is why it is in there. The enzyme works on other B6 present in your foods.

[Marie33]

Originally Posted by mrsD

Massive doses of methylfolate are used to try and treat some depressions. It is not working out as they planned however.
Some people get agitated on high dose folate.

Also there is a situation of very high dose folic acid in young women increasing the rate of colon cancer. This is thought to be due to pre-cancerous lesions gobbling up the folate and that is stimulating growth. But no one knows for sure yet. Some young women take 5mg or more of folic acid before and during pregnancy, especially if they have had a child with neural tube defects already. Because colon cancer is not common in this age group it is a concern, but not proven yet.

Metanx (just because is RX) is not really approved for efficacy by the FDA. It is under an umbrella called "Medical Food". It is only RX because it contains more than 1mg of folic acid and there is a rule that anything over 1mg requires RX in US. But studies were not needed for its status for releasing to the American Public.

I don't think the short course of samples is a concern, but if you get agitated with that high folate, you could just take one instead of two a day.
I prefer this product because it is enteric coated. P5P is not stable in stomach acid:
One of these a day, is plenty.
B2 is included because it is the cofactor for pyridoxal kinase to convert B6 to P5P... that is why it is in there. The enzyme works on other B6 present in your foods.

Thank you MrsD!
So far I do not feel any agitation from the folate so I will continue (if its just about the agitation and is relatively safe to take at this high dose) with what I have. Just alittle jitter but i think its from either the Rlipoic acid (100mgs), Im having a hard time with the AL-Carnitine even at 250mg, guess my system is very sensitive to stimulating type meds.
I went searching for the B12 -methylcobalamin. I can only fnd it in either 1,000 or 5,000. I was thinking I would go with the 1000 because my B12 level is already at 1280. (Im nervous bout taking higher doses because Im already at 1280, dont want to make things worse) but I wanted the "benefits" of the 5,000 as so many people have reported they are using the higher dose and feel better with no side effects. Oh what to do Thank you!!

[mrsD]

I find the lipoic acid to be quite stimulating. I take it early in the day therefore.

Each person is different. You may not need the carnitine if you suspect it of jittering you.

This is why I suggest people start up one thing at a time,
to see what works and what is not necessary.

The folate thing didn't hit me until later...it was not a fast
response. I've tried several times to take the methyl form and each time I get anxious! go figure!

[Marie33]

Originally Posted by mrsD

I find the lipoic acid to be quite stimulating. I take it early in the day therefore.

Each person is different. You may not need the carnitine if you suspect it of jittering you.

This is why I suggest people start up one thing at a time,
to see what works and what is not necessary.

The folate thing didn't hit me until later...it was not a fast
response. I've tried several times to take the methyl form and each time I get anxious! go figure!

MrsD Thank you for your response,
I think the R lipoic Acid at 100mg is too much , I thought it caused me to have an anxiety attack ysterday, becuase it came on about 1 hour after taking it. (I had been taking it everyday for a week so far with no major problems, but now im thinking of breaking it in half.) But now after reading how the folate affected you Im wondern if the anxiety was triggered by high doses of the folic acid (6000mg in Metanx ,3000 2xday, doctors orders) . Are you still taking the folate at 800mcg? hows that working for you?
So you think 800mcg is all I need. That means I am taking 5999.2 mg too much. By taking one 800mcg that would mean my dosage would be reduced to .8mgs per day. Does this sound correct to you? Do you think such a small dose compared to Metanx would be enough or be helpful?
Also, on the P5P should I get one that has the B2 cofactor, the P5P dont all list the B2 as in ingredient. Thanks much!!!!

[mrsD]

You can take the lipoic acid every other day for a while.
I started at 50mg (before we learned about the stabilized form) and then went to 100mg.

But unlike some other members here I couldn't increase to 200mg a day on the lipoic.

No, I gave up on the methylfolate...obviously it wasn't for me.
I think I methylate okay, since I was never low in B12 to start with. (849 to start). Now we have the gene tests, to clarify for those who wish to spend that $$ and learn more.
23andMe.

I think 800mcg of methylfolate is enough for most people.

The enteric coated product is what you need to look for in P5P.
The presence of the B2 is optional. Not all P5Ps are enteric coated, and hence protected from stomach acids.