1. Karl Goldkamp ND, L.Ac., Dipl. Oriental Medicine The Center For Natural Medicine Family Practice 81 Halls Road, Old Lyme CT. The Methylation cycle and its common polymorphisms

14. Kilmer McCully get his due 1997 2000

21. This diagram represents both the folate cycle and the methylation cycle (aka the SAM or Methionine cycle).

27. The Methylation Cycle MTHFR Glutathione CBS MS MSR

28. The Betainehomocysteine-Methyltransferase (BHMT) conversion of Homocysteine

32. The Methylation Cycle MTHFR Glutathione CBS MS MSR

33. The Methylation cycle and the Folate cycle glutathione

34. Another way to view it MS / MSR MTHFR CBS Glutathione 5,10 methyleneTHF

35. Think of this as a coupling of different cycles Redox Rep 2003, 8(1): 57-63

36. Methylation -> Trans-sulfuration –> glutathionine synthesis Under conditions where homocysteine conversion to methionine is dominant then folate and B12 are critical micronutrients.

37. During oxidative stress With oxydative stress the conversion of homocysteine to cysteine and glutathione,is the dominant flow and B6 is the critical micronutrient. While the transmethylation of homocysteine to methionine is inhibited.

39. Think of this as a coupling of different cycles Redox Rep 2003, 8(1): 57-63

41. MTHFR ( methylenetratrahydrofolate reductase ) The MTHFR enzyme is an essential enzyme in the folate cycle. It catalyzes 5,10-methylenetetrahydrofolate  5-methyltetrahydrofolate . The later serves as a methyl donor for the remethylation of homocysteine to methionine through B12 to methyl-B12. MTHFR is the most common SNP in the pathway .

43. The Methylation cycle and the Folate cycle glutathione Sulfate

45. Single nuclear polymorphism

52. Where can we supplement

53. Testing 5 year old ASD (Austistic spectrum disorder) child Metametrix labs www.metametrix.com

56. Female 60 years old, Hx stroke, meds lipitor with CoQ10, fish oil, vitamin D

59. Female 60 years old, hx stroke, meds lipitor with CoQ10, fish oil, vitamin D

61. Female 56, Hx ulcerative colitis, meds: sulfalazine, lipitor, Supplements: folate, fish oil, antioxidant drink, coQ10

64. See any patterns?

66. Female 68, recent dx of sarcoidosis

70. See any Patterns ?