Toelichting bij methylation test

En dit is de toelichting die ik kreeg op mijn resultaten van Rich Van Konynenburg in person:

Hi, Marlene.

Here are some comments on your lab test results:

You have glutathione depletion (based on low Glutamic acid lactam (pyroglutamic acid)).
You have a B12 deficiency, probably a functional B12 deficiency (based on low glutathione and low methylcobalamin). Note that MMA is not elevated, probably because it is masked by deficiencies in vitamin B6 and biotin.

You have a partial block of methionine synthase, which links the methylation cycle with the folate metabolism (based on low-normal SAM, high SAH, low-normal 5-methyl THF and low THF).
You have loss of folates from the cells (based on low levels of most of the folates).

In view of the above, I would say that you have the vicious circle mechanism that characterizes ME/CFS, as described by the Glutathione Depletion--Methylation Cycle Block hypothesis, and that a methylation protocol would be likely to help you.

The low red blood cell folic acid level indicates that you have oxidative damage to your cell membranes, which is to be expected with low glutathione.

In addition, you have low vitamin B6 (based on low pyridoxic acid, and low or low-normal values for the first five amino acid metabolites).

Your glycolysis appears to be operating somewhat more slowly than normal (based on low-normal pyruvic acid).
Your body is not in ketosis, and fatty acids are not undergoing omega oxidation at an elevated rate. This is somewhat surprising, because the low citric acid level indicates that the Krebs cycle is being fed at a lower than normal rate, and in fact, your Krebs metabolites are low in general. This would likely produce fatigue. Perhaps the thyroid and adrenals are not stimulating the gene expression of enzymes in glycolysis and the Krebs cycle as much as normal. I understand that your thyroid hormones may be a little low.

I don't know whether Alkala N would cause this, but I suspect it wouldn't. Usually when a person's glycolysis is slow, I see the fatty acid markers go up, indicating that the cells are trying to burn fat in order to make up for the lack of carbohydrates, but your fatty acid markers are not raised, and your citric acid is low.

I forgot to mention that your vitamin B5 level is also low, and that could be contributing to the low citric acid, because B5 is needed to make coenzyme A, and Co A is part of acetyl CoA, which reacts with oxaloacetate to make citric acid.

Your B2 looks O.K. I don't have data for your B3. Both B2 and B3 are needed for burning fatty acids.

You might have low vitamin C or low copper (based on high-normal HVA with low-normal VMA). Low vitamin C would be expected with glutathione depletion, because glutathione normally recycles vitamin C.

I don't have a unique explanation for the abnormalities in your sulfur metabolites. You might have elevated production of hydrogen sulfide by bacteria in the gut or possibly due to the partial methylation cycle block combined with an upregulating polymorphism in the gene for cystathionine beta synthase (CBS).

Also, you might have a polymorphism in the gene for the sulfite oxidase enzyme, or you might have a molybdenum deficiency. Your high thiosulfate together with low thiocyanate, combined with your history of cyanide intolerance suggests that you might have a polymorphism in the gene for rhodanese, which is the enzyme that normally converts cyanide to thiocyanate by reacting it with thiosulfate. I'm not able to sort this out with the available data.

You could do the home test for hydrogen sulfide in the urine that is supplied by ProteaPharma there in Belgium. You could also run the stool test offered by RedLabs in Belgium to see what the bacterial populations are in your gut. If you do that, I suggest that you ask them to add the Desulfovibrio genus from their library when they run the analysis. Genomic testing would show whether you have the polymorphisms I suggested. You could run tests for the metals at the ELN lab in the Netherlands.

I hope this is helpful.

Best regards,

Rich