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MTHFR C667T+/- MTHFR C667T affects folate metabolism by limiting the conversion of the inactive folate THE into the active 5-methylfolate. In this process homocysteine is also converted to methionine. Patient is heterozygous for MTHFRC667T and may have mildly elevated homocysteine level and reduced production of methyl groups need for muscle metabolism and gene expressions. Effect can be mitigated by supplementing 5-methyl folate.

2/4 BHMT +/+ ; 1/3 PEMT +1+ BHMT normally provides a bypass pathway for MTR and MTRR by reconverting homocysteine to methionine which is needed in the providing methyl groups for gene repair and energy production. A BHMT mutation may worsen CBS upregulation because it blocks this bypass pathway.
BHMT can be supplemented with Phosphatidylcholine and phosphatidylserine to help recycle homocysteine and control sulfites and ammonia degradation through the alternate pathway. Note that phosphatidylcholine will be a better choice than phosphatidylserine because of the presence of PEMT+/-

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