- Critical to the manufacture of DNA and RNA, the body’s basic genetic material;
- Essential for several important neurological processes;
- Required for the manufacture of adrenal hormones, which affect all sorts of bodily functions, including sleep, energy, temperature regulation, and neurological functions;
- Responsible for several detoxification pathways, allowing your body to get rid of toxins, including excess medications, supplements, dead viruses or bacteria, as well as environmental toxins.
- Detoxification doesn’t work well (as explained above) so toxins build up in your body;
- Less serotonin, dopamine, and melatonin (all directly linked to sleep dysfunction as well as depression) are produced, as well as less of other neurotransmitters;
- Decreased production of adrenal hormones;
- Elevated levels of homocysteine, which can lead to cardiac problems;
- Decreased cellular energy production aka mitochondrial dysfunction, leading directly to fatigue and post-exertional malaise;
- Possibly also an underlying mechanism for depression (see note on serotonin and dopamine above).
Methylation’s Role in Infections
You may not recognize or understand all of the components, but this diagram shows how each step leads to another step and how interrelated the 3 different cycles shown here are to create the full methylation process. You can also see some of the important inputs to the process: proteins, amino acids, vitamin B12, folate & folic acid. And I think it is quite clear that if any one part of this process breaks down – for instance, there isn’t enough B12 or folate – then the entire process will fail, leading to the kinds of problems listed above.
- 400 mcg 5-MethylTetraHydroFolate (5-MTHF) (we use Doctor's Best brand - but we followed Rich's recommendations at first until he got up to this dose and could take these capsules)
- Xymogen ActivNutrients multivitamin with no Iron or Copper (rec by our biochemist - we buy it at cost through her office but there are online sources - apparently, it is important to leave out Iron and Copper when you have infections)
- Xymogen ALAMax and Resveratin to assist in mitochondrial energy support (I take a different brand of alpha lipoic acid and Jamie is currently off ALA temporarily while we get his yeast problems under control).
- Calcium D-glucarate for detox support
- S-Acetyl Glutathione for detox support and energy (studies have shown people with ME/CFS to have low glutathione levels)
- N-Acetyl Cysteine (NAC) - Jamie is off this temporarily until his yeast problems are gone, but I increased my dose after reading that 1200 mg per day can help with weight loss (it did!) plus it is critical to detox and liver support in ME/CFS.
- Milk Thistle - brand varies, taken at end of day and helps with detox - critical for liver support.
- Vitamin B12 - Hydroxycobalamin injections 1000 mcg twice a week (Jamie); daily combination B12 product for me (more on B12 in the next post)
NOTE: Someone reminded me that I didn't mention SAMe in this summary. if you look at the diagram above, you can see that SAMe is a part of the methylation cycle; however, it is not recommended that all people with ME/CFS supplement with SAMe. My son tried it and got worse. Here's the way that Rich Van Lonyenburg explained it to me:
"This was initially included in the protocol I proposed, but so many people could not tolerate it that I took it out. SAMe will come up automatically if the partial block of methionine synthase is lifted by the methylation protocol. I think that some people have difficulty dealing with all the sulfur if given NAC and SAMe. The sulfur must all pass through the sulfite oxidase reaction, and if it can't handle it, sulfite builds up and gives headaches, difficulty in breathing, and/or rashes. It also further lowers glutathione."
One of the common genetic defects related to methylation causes an inability to metabolize sulfur compounds, and this is relatively common in people with ME/CFS (both my son and I both have this defect and have reacted badly to sulfa antibiotics), so perhaps this is part of the reason why supplementing with SAMe sometimes makes ME/CFS patients worse. So if you do try it in spite of Rich's warning, watch for negative reactions which may worsen over time.