The remethylation and transsulfuration pathways (see dia-
gram) are the two avenues that our bodies use to dispose of homocysteine. To make these pathways work you need adequate levels of vitamin B12, B2 (riboflavin), B6, and magnesium. Often, deficiency in one or more of these cofactors causes an elevation in homocysteine so supplements are often required. Additionally, increased homocysteine levels can be a result
of a problem with the enzyme 5,10-methylenetetrahydrofolate reductase or MTHFR (red circle). This Enzyme is responsible for turning Folate into its active form 5-methyl THF or L-methylfolate. The MTHFR enzyme is coded for by a set of genes. It is esti- mated that 42% of the general population has at least one copy of the gene that doesn’t work well. It’s also estimated that up to 75% of people with depression have this mutation, since it is critical for neurotransmitter production, but that is an entirely different article. When patients are found to have high homocys- teine levels or present with the conditions mentioned (like de- pression, fatigue, migraines, and fibromyalgia), they should be checked for MTHFR mutations. If the MTHFR mutation is present, one needs to supplement with the active form of folate (L- methylfolate or 5MTHF) – (blue circle) in order to bypass the roadblock.
In summary, there are many reasons that homoscysteine can
be elevated and a variety of factors that contribute but often it is a result of inadequate elimination. Here is my treatment protocol to reduce homocysteine levels:
Please send your questions to
AskDrWiggy@NaturalTriad.com
• Limit methioine-rich foods: particularly red meats and dairy products
• Regular exercise can modestly reduce the levels • Eliminate alcohol, coffee, and smoking • Get tested for the MTHFR gene mutation and take 5-MTHF / L-methylfolate as needed • Take Vitamins B2, B6, B12 along with Magnesium depend- ing on deficiencies
Please work with your doctor to customize your plan. Be Well Triad.
Dr. Weston "Wiggy" Saunders is an Integrative and Functional Medicine Physician finishing his residency in Family Medicine at Cone Health. He will be joining Robinhood Integrative Health in July and will begin accepting new patients and scheduling appointments on June 1. See ad on page 12.
Dr. Wiggy can be seen at 6:45am Tuesdays and Thursdays on WXII- 12 News Mornings.
506-A South Elm Street
Greensboro, North Carolina Appointments: 336.412.2646
www.salonboho.com
Natural Triad Magazine MAY 2012 23
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