Hey ,

Let’s start with the most important marker that should be brought back into balance: homocysteïne.

Homocysteïne is an important amino acid. It is part of something we call the methylation cycle. The goal of the methylation cycle is to transport methyl groups from one molecule to another to change and rebuild them.

Homocysteine is formed from an amino acid called Methionine. What happens is that Methionine donates its methyl group to something else and now it transforms as a consequence into homocysteine.

Several ‘fates’ for homocysteine are possible. For the biggest part, it usually gets a methyl group donated from methyl-folate, the bioactive form of folate, and then it changes back into Methionine. The enzyme needed for this conversion is also dependent on vitamin B2

From this report in March, we can see that folate is low. Vitamin B12 we would like to see higher as well compared to what we see on your lab report. Also vitamin B12 plays a role in the methylation cycle as well. If there isn’t B12 or folate present, Homocysteine can not transform back into Methionine.

If you have been addressing B9 & B12 issues I would recheck:
• Homocysteine
• B12 & folate
• Vitamin B2 (it makes your urine yellow, so if this is the case, you at least have absorbed it in the gut)

We would like to know if B12 & B9 are doing their work inside cells. Lab tests that provide us with that information would be helpful. Check:
• MMA – Methylmalonic Acid (Is elevated if B12 isn’t absorbed at the cellular level)
• FIGlu – or Formiminoglutamic Acid (Is elevated if B9 isn’t absorbed at the cellular level)

Red Blood Cell
Since your iron markers are looking good, I would suspect your hemoglobin levels to be much better – have you been tested for Thalassemia (an inherited blood disorder caused when the body doesn’t make enough hemoglobin)?

Thyroid
The test shows low T4, T3, fT4 & fT3.  A deficiency in zinc, copper, and vitamins A, B2, B3, B6 and C will cause a decrease in the production of T4 by the follicles of the thyroid gland. Conversion of (f)T4 to (f)T3 needs in addition selenium and iron. Magnesium plays also a role in thyroid metabolism.

I would test:
• RBC Zink
• RBC Magnesium
• RBC selenium

Vitamin B6
Your OAT earlier uploaded here was done in the same month right? It did show low levels of B6 which can also contribute to anemia. I would probably like to retest that as well if you tried to correct for that. Inclusive Xanthurenate & Kynurenate if that is an option. Those markers elevate with high serum B6 but inadequate cellular B6.

Vitamin B6 is also needed to make a lot of neurotransmitters, like dopamine, (nor)-epinephrine, GABA, serotonin & melatonin. Dopamine & serotonin play a major role in the gut as well and are necessary for the breakdown of histamine since they work together with the DAO enzyme.

Remember I told you that homocysteine had different fates? Homocysteine is also a precursor and necessary to make  Glutathione, Taurine and it is necessary for the sulfate pathway. Taurine is needed for bile production and guess what they all need as a cofactor: vitamin B6.

Without B9, B12 and B6 homocysteine can’t transform and now it could pile up as a result.

Kidney function.
I would also retest your kidney function. Make sure you are hydrated though (i know this is hard), otherwise the markers might get unreliable! Kidneys convert part of the T4 to T3 as well. We need to know how healthy your kidneys are!
• eGFR
• Creatinine

Vitamin D
Did you recheck your vitamin D? Otherwise I would also retest 25 OH Vitamin D3

White Blood Cell Differentiation (WBC Diff)
Your last WBC was low normal possibly the body was struggling to produce white blood cells. White Blood Cells production needs nutrients like Vitamine D, zinc and B vitamins as well. If you have been correcting for these nutrients and the WBC count is still low normal, this together with the low normal Red Blood Cell count (don’t let the blue-colored representation misguide you!) can be an indication of heavy metals. So I would also retest
• WBC + differentiation
• RBC count

Honestly, I don’t know if this answered your question. I still need to replay the group call, so I might miss a bit of context to this question. I also based my answer only on looking at the test and what would be a logical next step based on the information coming from this test.

Hey ,

I personally never had clients with elevated homocysteine. I have seen research with patients who were giving B12, folate and B6 and they saw impressive improvements in 5 weeks. But the research didn’t gave their starting homocysteine numbers.

Now your homocysteine elevation is ‘moderate’. I expect a measurable difference after using b vitamins after a month or so, but perhaps your cardiologist could give you a better indication than I can.

Correcting folate deficiency will also affect the size of your red blood cells. After 3 months usually all red blood cells have been replaced leaving you with smaller red blood cells. Your slow thyroid could possible delay the process a bit. This is something you should get checked after 3-4 months.

Adding B vitamins will do a lot for detoxification. Three  (from the 6!) major detoxification routes are depending on folate, B6 and B12:
• Methylation: yes it is needed for detoxification as well!
• Glutathion conjugation.
• Trans-sulfuration pathway

So adding in B vitamins shouldn’t be done to fast. If detoxification starts up to aggressively and you have some toxicity issues, you could feel worse. Start with the dose you are taking right now, see how you feel.

Once homocysteine starts to drop, you probably start detoxifying better. Sometimes this means that toxins on toxicity tests start to go up first since they come free now.

Zinc
Men need about 11 mg elemental zinc per day. Sometimes it is recommended to boost zinc, but I wouldn’t do this longer then 1 or 2 months since high zin levels can lead to lower copper levels. I personally have boosted with my male clients the total zinc in supplements to 40 mg of elemental zinc if they could tolerate that. Some people can however experience nausea and vomiting with higher dosages so I do recommend to be cautious and go slow there as well. If you decide to try this, perhaps combine this with a little copper.

That depends a bit on your goals. If you want to see if you are making progress, I wouldn’t do the complete test. The test gave a good direction on where to go next. If you are interested in seeing how your general health has developed since then, you could always retest.

But this is what I would do.

I would have my focus first on the B vitamins and homocysteine. You could test homocysteine after 6 weeks of using the B complex, to see if you have moved the needle.

I would (re)test B12, folate & B6 as well.

If you like to see if the B vitamins are being used by the cells you can test MMA and FIGglu to see if B12 & folate are being used – these aren’t in the mineral test, but a (holistic) doctor could do them. Here in Holland we could order those tests in a private lab as well. I don’t know if there are options in the UK for this.

A mineral you would like to retest is calcium in combination with vitamin D and parathyroid hormone (PTH) since calcium was above normal and vitamin D was on the lower end. PTH I didn’t see it on the test so the mineral test won’t provide you extra insight there.

There are some elevations from HDL and the test reveals a slow thyroid, which probably won’t normalise until digestive issues improve. Your thyroid might also be functionally low because you can’t eat much. 

I might redo the test once I have found some relief from digestive issues. 

I do believe a pearl coming from this test that might be worth testing for is Thalassemia. Getting oxygen to the entire body is important. Since your iron metabolism looked fine on the test, but your hemaglobin was low this needs some exploration. Also, this can’t be done with the test above, unfortunately.

Basically, I wouldn’t recommend redoing the test right now unless it’s cheaper to redo the complete test than to do the mentioned labs.

I probably would redo the test once some gut healing has happened or new complaints have developed. So it is a little hard to give you a time indication for that.