Methylation Pathway | Second Opinion Physician

Methylation Pathway

methylation pathway methionine SAMe

Why Walsh-trained doctors test for homocysteine and histamine prior to supplement recommendations

Homocysteine and Whole Blood Histamine are tested together when testing for undermethylation or when planning to prescribe methylation support. This is because any increase in methionine or SAMe, methylators or methyl donors, also tends to raise homocysteine. Homocysteine is one of the most important markers for cardiovascular inflammation. It is considered to be a better test than cholesterol for heart disease, stroke, dementia and vascular compromise. When treating undermethylators, as determined by the whole blood histamine test, homocysteine is first addressed if it is found to be elevated, particularly in persons who plan to take methylators on an extended basis or else who have any cardiovascular or stroke risk.

The reasoning for this is, that prior to methylation therapy, supplements can be taken to reduce of homocysteine. So depending on if someone is an overmethylator or undermethylator, a specific regimen will be given. All depression supplement therapies are not the same. It is important to manage low serotonin (undermethylation) depression differently than high serotonin (low folate, overmethylation) depression. 

The good news is that by lowering homocysteine, when elevated, it can be diverted with supplements to produce glutathione, the body’s most important and most prevalent antioxidant and detoxification element of the liver. With undermethylators in particular supplements can be given to convert homocysteine into additional methionine, thereby increasing methylation.

Folates are often given, along with B12 to help with homocysteine. While this helps with reducing homocysteine, also through this one-carbon methylaton pathway, folates are not advisable for undermethylators who have mood disorders. That’s because folates have an epigenetic effect of lowering serotonin and dopamine activity via the neurotransmitter reuptake transport protein mechanism.

Given the complexity of this issue it is always advisable to consult with a trained practitioner before supplementing to treat homocysteine and methylation imbalances.

Lab reference ranges for elevated homcysteine are often indicated as elevated when at or above 15uM. A more conservative, functional medicine approach would treat the homocysteine levels if elevated to >7uM. Homocysteine is also recognized as a major cause of Alzheimer’s Disease and dementia in general. Dale Bredesen’s video explains this and other risk factors for Alzheimer’s.

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