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Minor cognitive impairment (MCI) - Printable Version

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Minor cognitive impairment (MCI) - Murray - 10-15-2017 05:17 PM

I have just found this blog by chance, and I don't understand how these things work so don't know where to introduce myself. My elderly? wife has been diagnosed with minor cognitive impairment (MCI), and I have spent a year learning everything I can about it and how it might be reversed. She is also compound heterozygous C677T and a1298c, is slightly hypothyroid, and has been very low in glutathione. The reason I want to post is that she had another condition that just doesn't seem to be recognized - it is possible and problematic to have too low homocysteine. Please see this paper http://www.drkendalstewart.com/wp-content/uploads/2011/09/Significance-of-Low-Plasma-Homocysteine.pdf . I have read at least 1400 abstracts and 450 papers on various aspects of MCI and this is the only paper that I can find that deals with the problem. The author implies a healthy range for homocysteine from 4 to 8 umol/l, but one could infer that 3.5 to 10 should be OK. When first tested my wife was at 2.2 a couple of years after having had very high CrP (ignored by our doctor) probably caused by a period of severe care-giver stress. She had been supplementing with folic acid and cyanocobalamin and her serum levels were way high, especially folic acid. After learning about her MTHFR I switched the B9 to methylfolate and the B12 to methylcobalamin. In a few months her folate dropped to the high end of normal, her B12 to the top 3rd of normal and her homocysteine was up to 7.0. Her glutathione was back to the bottom end of normal. Unfortunately I recently found that when our lab reports a reading as folic acid it is really total serum folate, so I am guessing that her serum folic acid was off the charts high while her methylfolate was just normal the one time it was tested in prior years. Extreme cases in the NHANES population have had folic acid at 75% of total serum folate, while the 75th percentile of healthy subjects is about 6%. I believe it was stress induced inflammation that drove the homocysteine and glutathione so low, and high serum folic acid that that kept them low. I also suspect that her tissue B12 was low due to impaired methylation while her serum B12 was high, but low B12 did not cause elevated homocysteine, because of the high folic acid. I think that most MTHFR folks now know not to supplement with folic acid or cyanocobalamin, but probably don't know that folic acid can be so dangerous, and may not know that they have to seriously question what their labs are really measuring.
Note in fig 3 of the referenced paper that people can have methionine in a perfectly healthy range (10-40) and still have homocysteine dangerously low.
I hope this info will help some of your followers. Murray

Oops! Forgot one point - doctors and researchers constantly conflate folate and folic acid. They are emphatically not the same thing. "Serum folate" is composed of methylfolate as a principle component in healthy people, unmethylated folic acid (UMFA) usually in low levels from 2% to 9% depending on level of supplementation, and about 4 other folate variants. Folic acid gets "methylated" into methylfolate that the body can use by an enzyme in the liver that is in short supply. It can methylate only enough folic acid to supply healthy needs and the rest (UMFA) accumulates in the bloodstream and can reach extremely high levels. Folic acid is not a B vitamin, is not directly water soluble and does not get cleared by urination. It is also not folate, it is a folate precursor that either gets methylated or stays as UMFA. Folic acid does not participate in the methylation cycle. In people with impaired methylation it simply accumulates in the blood to dangerous levels. "Experts" need to stop the conflation of folic acid with folate and the rest of us ned to be very aware of the difference.


RE: Minor cognitive impairment (MCI) - Andrea - 10-15-2017 08:41 PM

Thanks for sharing, Murray! I have split this post off and put it into its own thread on MCI - I am sure the info will help others!


RE: Minor cognitive impairment (MCI) - Murray - 10-16-2017 11:14 AM

(10-15-2017 08:41 PM)Andrea Wrote:  Thanks for sharing, Murray! I have split this post off and put it into its own thread on MCI - I am sure the info will help others!
Thank you Andrea.