[MWV3]

Long story short I'm 26 and had some tests done for unspecified fatigue, but the results were very odd and make no sense and I've never hear of a profile like this, which worries me:

not vegiterian,
Had a physical -- no abnormalities except the following.
had serum b12 level, b6, folic acid, homocysteine, MMA (serum), etc. -- all normal, except b12 was slightly elevated (900's), folate was slightly elevated, homocysteine was slightly elevated (17), MMA was normal according to lab -- 0.253.

I take a good multivitamin daily (and have for last 10 years). It contains 100 mcg of b12.

I was invited through a friend to try a new intracellular analysis. It said there was a mild b12 deficiency (but no other problems) !! My doctor doesn't think it's possible, but in restrospect, my MMA doesn't look great (though it's normal). She said I could try a sublingual b12 tablet daily for a couple of months then she would retest everything.

I'm relatively familiar now with this stuff, and I understand that MMA is a better indicator than serum b12 level, but how can someone's b12 level be close to a 1000, and they're still deficient?

[mrsD]

The B12 in many supplements is cyano form. This type requires 4 conversion steps to get to methyl form which is the type the body uses.

If you are not converting, it is just hanging around in the blood doing nothing. So I think you should try ACTIVATED B12 (methylcobalamin) for 3 months and then get retested.

People who cannot convert folate and B12 to their active forms have a genetic problem called a MTHFR polymorphism. It is estimated that 1 in 10 people have this. There is a DNA test for it that is even over the counter now! (no doctor needed)

B12 has to be actively transported in the cerebrospinal fluid as well. Serum levels, may or may or correspond to what is in the CSF. Some neuro conditions have been found to have low CSF B12 levels...Multiple sclerosis and Fibromyalgia are two that have papers written about that.

So the bottom line for you would be to use the active forms of both folate and B12. Both are OTC and this thread gives examples of products to buy:
http://neurotalk.psychcentral.com/thread114302.html

Metanx is the RX version, but all 3 activated vitamins are available OTC too. (methylfolate OTC is 800mcg maximum dose).

This is my B12 informational thread:
http://neurotalk.psychcentral.com/thread85103.html

[cat265]

[QUOTE=mrsD;627120]

People who cannot convert folate and B12 to their active forms have a genetic problem called a MTHFR polymorphism. It is estimated that 1 in 10 people have this. There is a DNA test for it that is even over the counter now! (no doctor needed)

What is the name of the DNA test? and where can you buy it otc? Like at a CVS or Walgreens?

[mrsD]

This is the DNA test that was offered with the Solgar Vitamin program.

http://www.genelinkbio.com/products/nutragenetics.shtml

I seem to recall recently that this partnership was terminated, however. (possibly for lack to consumer response)

I am not finding an OTC similar product today with my searching.

You'll have to ask your doctor if his lab does the MTHFR testing.
Many people just try the methylated forms of folate and B12, and if they get better, then that is their answer.

l-methylfolate (Solgar OTC)
methylcobalamin (many companies offer this now).

This is the most well known nutritional testing service:
http://www.spectracell.com/
They are pricey but good.

[MWV3]

Thanks very much for the responses. My doctor started me otc sublingual, but that is going to change to an RX (cerenac or something like that). One thing that confuses me is that from threads here and elsewhere on the internet, I get the sense that methylb12 is better than cyano (and my doctor apparently doesn't like to do cyano injections -- prefers oral or sublingual methylb12 in large 2 doses). But if methylb12 is just one of the two active metabolites, aren't you missing the other important important active metabolite -- adenob12? or does methylb12 meet the same need...

thanks again everyone!

[mrsD]

Both methyl and adenosyl are called coenzymated forms of cobalamin. It is thought that methyl is converted to adenosyl when needed. I have seen claims that people with liver disease or damaged livers, do better when adenosyl is taken with the methyl. Also some body building sites prefer the adenosyl form.
It tends to be a bit more expensive, but there are not many other major differences.

The cyano which doctors inject is neither.

I think you are speaking about Cerefolin NAC?
Here is a link to it:
http://www.pamlab.com/Products,Cerefolin

NAC is a precursor to glutathione production.

It has a very high dose of methylfolate per tablet.
It would be advisable to take this product on an empty stomach to assure that the methylB12 is absorbed properly.