QUESTION 1: I have had a few patients who reacted with what I perceived as detox reactions from IV B vits. Its hard because I think that they really do need the vitamins if they are stimulating detox. But it is difficult to get someone to come back to do an IV that makes them feel poorly. Most recently I saw an odd reaction with a patient. She seemed to respond OK to a simple IV with B vits and magnesium but then developed a splitting headache that evening. This waxed and waned for 3 days until she finally discontinued the oral magnesium that I had advised. Then the headaches resolved. I’ve never had someone get severe headache from oral magnesium before, but I suspect some of this may have been at play. The other interesting thing about this patient was that she got debilitating headaches about day 21 of her cycle. However when I tested her hormone on that day they were normal, no progesterone deficiency (which is what I expected). QUESTION 2: I am very sensitive to IV glutathione and I have a couple of patients (usually the sicker ones) who are as well. The reaction is immediate if I push the glutathione too fast. It starts with a unpleasant sensation of muscle cramping in the neck, then also chest tightness and stomach upset. It’s very short lived, usually lasting a few minutes maximum and it goes away with slowing the infusion or stopping it. For myself, I know have a CBS mutation, and from what I understand this is a mutation which accelerates the sulfuration pathway depleting homocysteine in it’s path toward glutathione. Paul, how would you explain this reaction?

ANSWER TO 1: You bring up a good point: Its hard because I think that they really do need the vitamins if they are stimulating detox. It may seem logical, but people (either due to SNP issues or simple depletion / cofactor insufficiency) will have such slow pathways that the addition of the very cofactors (B-Vit and mineral) they require cause previously slow processes to speed up, and the downstream pathways are overwhelmed. These reactions are really not unexpected nor terribly uncommon (maybe 5% of patients at some state). Also, Magnesium can create all sorts of pathway speed changes as it is the main inorganic cofactor for many processes. Also it drives cell GSH activity which on its own can temporarily alter lots of things (like Phase-2 activity) which can create headache, hives and other issues. An important corollary to this is most reactions are greatest after either the first IV or after 3-5 IVs (depending on level of imbalance, SNPs and depletion) but generally go away like they came.

ANSWER TO 2– CBS mutations are in part to blame for such reactions. There are other reasons as well, but yes either a sudden increase or decrease in CBS can affect these reactions. Recall however that it isnt one CBS gene/enzyme code in humans but many, and they are a mixture of fast and slow CBS polymorphisms. For example on a common panel of SNPs the CBS mutations that are Faster C699T; A360A; N212N versus Slower C19150T; A13637G need to be looked at. The balance of fast to slow = CNS speed which is very rapidly altered by Magnesium and pyridoxine. These alterations are transient however, once appropriate nutrients
are replete. (And this is not mentioning the BHMT group which can aggravate all this or be its own CBS-like issue). But yes, a sudden increase or decrease in CBS will temporarily jam the sulfite pathway (which is toxin specific as well as molybdenum dependent) causing lots of these Sx. Glutathione also can jam that pathway. Again, once balance is achieved these reactions are lessened ,and the administration of B Vitamins creates more substrate for CBS so that is why those can trigger all this.

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