This Is MS Multiple Sclerosis Community: Knowledge & Support

From following the Wahls diet for the past 7 months) and going from 130 pounds to 114 pounds - am male, 5'11" , so am concerned,
i saw my neurologist who requested the following tests:

I am from the UK so some of these tests may be called something else in the US.

the tests and results are as follows:
TEST - VALUE - RANGE
Vitamin B12 - 765 pg/mL - 191 - 663 - HIGH
Serum Folate - > 20.00 ng/mL - 4.6 - 18.7 (folate result assumes no folic acid supplement on day of sampling)
Alkaline phosphatase - 50 IU/L - 40 - 129
Albumin - 52 g/L - 34 - 50 - HIGH
Phosphate - 1.18 mmol/L - 0.87 - 1.45
C-reactive protein - <0.6 mg/L - 0-5.0
Sodium - 141 mmol/L - 135-145
Potassium - 3.9 mmol/L -8 3.5 - 5.1
Urea - 5.0 mmolL - 1.7 - 8.3
Creatinine - 57 umol/L - 66-112
Estimated GFR - >90 - mL/min/ 1.73sqm

ESR - 4 mm/hr - 1-5
White cell count - 3.25 - x10^9/L - 3.0-10.0
Red cell count - 4.08 - x10*12/L- 4.4 - 5.8 LOW
Haemoglobin - 13.1 g/dl - 13.0 - 17.0
HCT - 0.382 L/L - 0.37 - 0.50
MCV - 93.6 fL - 80 - 99
MCH - 32.1 pg - 27.0 - 33.5
MCHC - 34.3 g/dl - 32.0 - 36.0
RDW - 13.8 % - 11.5 - 15.0
Platelet count - 211 - x10^9/L - 150 - 400
MPV - 10.3 fL - 7-13
Neutrophilis -64.0% 2.08 - x10^9/L - 2.0-7.5
Lymphocytes- 24.3% 0.79 - x10^9/L - 1.2-3.65 LOW
Monocytes - 11.1% 0.36 - x10^9/L - 0.2 - 1.0
Eosinophils - 0.3% 0.01 - x10^9/L - 0.0 - 0.4
Basophils - 0.3% 0.01 - x10^9/L - 0.0 - 0.1
Bilirubin (total) - 7 umol/L - 0-20
Alkaline phosphatase - 50 IU/L - 40-129
Alanine transamininase- 20 IU/L - 10-50
Albumin - 52 g/L - 344-50 HIGH
Thyroid stimulating hormone - 4.05 mIU/L0.27 - 4.2
Free T4 - 14.5 pmol/L - 12.0 - 22.0


One that does concern me was :
ESR - 4 mm/hr - 1-5

as just in September gone had this ESR test at my local doctors and the result was:
Erythrocyte sedimentation rate = 2 / mm/h / 2-12 which apparently is good as shows low inflammation

My red cell count was low and so was Lymphocytes
Creatinine was low so yesterday starting taking 5g creatine monohydrate with my breakfast smoothie to raise my low levels,
albumin was slightly high again but i didnt drink any liquid before the morning test on that to calm my frequent urination, so im sure this is why the Albumin was slightly low.

- i know B12 is important for myelin and folate for brain function, but as my levels are high, could this be a problem?

Any thoughts/opinions on these reults would be much appreciated
thank you

i'm not much help with this kind of lab work - much easier to interpret with more nutrient values in the mix... for me at least!

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

oh and, no your body should just pee out any cobalamin it can't use.

that said, i had a look for a cobalamin msds to see if i could find an LD50 value.. 5g/kg oral cobalamin killed 50 of tested mice. http://www.americanregent.com/documents ... 13msds.pdf

that's CYANOcobalamin mind you. and mice. but you get the idea. to my recollection i've never taken more than 0.025 g/kg oral cobalamin (and i much prefer methylcobalamin anyway)

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

I personally ALWAYS ensure I see my uric acid levels. It's also a standard measurement as part of liver function tests I think.

And in regards to B12, I take a sublingual 5MG tablet, which is 83333% of the %DV (No I did not forget or miss a decimal place). Its suggested use is 1 daily. So I guess too much should not be a problem.

i was given this blood test form before blood was drawn, so as renal and liver are ticked, im sure these tests were done,
i just need to work out which is the renal and liver test out of that big list
does anyone know?







JL, based on my HIGH B12 result and that i take a b50 daily, do you see any benefit in me taking a Methylcobalamin supplement too?

cureorbust, can you tell from my tests whether uric acid was tested?

I just noticed there was a measurement for "Urea" so had to check my results. On my blood tests, there is a specific line for "Uric acid" in addition to one for "Urea". I also checked if they were aligned (I had a history of four tests) and the "Urea" and "Uric acid" historically moved in different directions and sometimes the same direction; ie there does not appear to be any correlation between the two measurements. So, I would say no.

You can read here why I personally keep an eye on my Uric Acid, and actually take Inosine religously to boost my Uric Acid.
http://articles.philly.com/1998-01-26/living/25751047_1_uric-acid-myelin-multiple-sclerosis/2It doesn't sound like much (the 4 as compared to 62), but I have seen the statistics calculated on this, and it embarrasses most MS research numbers.
https://www.ncbi.nlm.nih.gov/pubmed/15493114

hi again, no you shouldn't need an additional methylcobalamin supplement.

is the form of b12 in your b50 complex methylcobalamin? if not, here is one b-complex (therapeutic, but NOT a b50 specifically) that does use the methylcobalamin form:
http://www.aor.ca/html/products.php?id=8
http://www.aor.ca/files/infosheets/Bind ... omplex.pdf

the following info comes from www.labtestsonline.org. you can look up in-depth info for a wide variety of tests there.

Alkaline phosphatase - 50 IU/L - 40 - 129.....BONE
Albumin - 52 g/L - 34 - 50 - HIGH.....LIVER, RENAL. MALNUTRITION (LOW); DEHYDRATION (HIGH)
Phosphate - 1.18 mmol/L - 0.87 - 1.45.....THYROID. MALNUTRITION (LOW); RENAL (HIGH)
C-reactive protein - <0.6 mg/L - 0-5.0.....INFLAMMATION
Sodium - 141 mmol/L - 135-145.....METABOLIC PANEL - ELECTROLYTES
Potassium - 3.9 mmol/L -8 3.5 - 5.1.....METABOLIC PANEL - ELECTROLYTES
Urea - 5.0 mmolL - 1.7 - 8.3.....METABOLIC PANEL - RENAL
Creatinine - 57 umol/L - 66-112.....METABOLIC PANEL - RENAL
Estimated GFR - >90 - mL/min/ 1.73sqm......RENAL

Bilirubin (total) - 7 umol/L - 0-20.....LIVER
Alkaline phosphatase - 50 IU/L - 40-129.....LIVER
Alanine transamininase- 20 IU/L - 10-50.....LIVER
Albumin - 52 g/L - 344-50 HIGH.....SEE ABOVE

uric acid is a later step in the urea cycle than urea itself.
urea cycle resources:
http://en.wikipedia.org/wiki/Urea_cycle
http://memo.cgu.edu.tw/chia-chu/c4.html

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

interesting:

A preliminary investigation of the association between serum uric acid and impaired renal function.
http://www.ncbi.nlm.nih.gov/pubmed/19292941
full text http://memo.cgu.edu.tw/cgmj/3201/320108.pdf
Abstract
"BACKGROUND: Hemodialysis for end-stage renal disease (ESRD) incurs huge medical costs in Taiwan. We set out to determine if it is possible to help control chronic renal disease with early treatment of hyperuricemia.
METHODS: Data from Taipei Medical University Hospital (TMUH) health center from January 2004 to December 2006 were analyzed to correlate renal function and blood uric acid concentration. Patients were divided into 5 groups according to their serum uric acid concentration (< 4; 4 approximately 5.9; 6 approximately 7.9; 8 approximately 9.9, and > 10 mg/dl). According to our laboratory data, elevated serum creatinine levels (> 1.3 mg/dL) indicated impaired renal function.
RESULTS: In total, there were 5722 patients, including 2816 (49.2%) men and 2906 (50.8%) women, with a median age of 67. Impaired renal function was noted in 307 (5.4%) cases. Serum uric acid was significantly correlated with blood urea nitrogen and serum creatinine. Groups with a higher serum uric acid level had an increased risk of impaired renal function.
CONCLUSION: Our purpose in this preliminary observation was to try to define a starting point for the early control of serum uric acid, in order to avoid the development of impaired renal function. We found that serum uric acid level to < 6 mg/dl seemed to be associated with less renal function impairment."

5722, that's a pretty kick ass 'n' value..

table 1 is worth looking at in the full text version. excerpt:

Table 1. Comparison of Clinical Indices and Life-related Factors between [impaired renal function] IRF Subjects and Healthy Controls [non-IRF]
Variables.....IRF (Mean ± S.E).....Non-IRF (Mean ± S.E)
..............................n = 307........................n = 5415
Uric acid.............7.48 ± 0.11....................5.87 ± 0.02
BUN.................24.84 ± 0.68..................15.28 ± 0.06
Creatinine...........2.15 ± 0.09....................0.87 ± 0.01

so. doing the conversions, they found that uric acid levels below 6 mg/dl, or 356 umol/L, were associated with less renal function impairment. that's about the same as what you'd be after to reduce risk of gout, too. now, converting the BUN back to SI units for urea in healthy controls, that's 15.28 x 0.357 = 5.46 mmol/L.

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

I recently found out I have a pretty low level of B12. I know this is opposite of your situation; however, my pcp talked to me about this & I also did my own research into this. I have not seen anything that says taking too much b12 supplements can be toxic; however, I have seen where there can be negative side effects. I've also seen where a high-blood level of b12 can be present if you have certain medical problems. It looks like your doctor is being proactive by ordering those blood tests.

b12 deficiency is a differential diagnosis for ms. VERY similar. when evaluating and/or megadosing nutrients known to be low in ms, testing is always important. not accessible to everyone, unfortunately.

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

thank you very very much for these detailed replies, it becoming a lot easier to understand,
the b12 in my Solgar B50 just says "Cobalamin 50mg".


JL, I FINALLY GOT MY ZINC & COPPER RESULTS!!

Zinc: 14.4 umol/l, 11-24
Copper: 10.7 umol/l, 11-20

Bare in mind i didnt take any zinc/copper for 5 days prior to having blood drawn,
so what do you make of these results JL?
The copper is a bit under the range,
- over the last few months i have been taking 50mg zinc picolinate and 2mg copper , daily
should i increase these doses based on my results,

- i recall i took 3x 50mg zinc on a few day trial and my legs /mobility was actually improved!
but bare in mind i eat organ meat daily ( liver / oysters) which contains zinc

thanks

glad you're finding the info useful

i tried searching around the solgar web site to find out what specific form of cobalamin is used. no dice. i suspect no news is not good news in this case.

now those results are awesome to have! yay! lol i love your enthusiasm

i had a hunt around for my old search for a copper target, and here is the relevant piece:
"so, 100-114 ug/dL or 17.3-18 umol/L looks like a plausible 'sweet spot'."

there's another case study i had found previously where copper deficiency mri findings resembled those seen in b12 deficiency. note the part about resolution of mr findings, verrry interesting. in that case the patient's serum copper level was only 50 ug/dL (7.85 umol/L!). 10.7 umol/L converts to 68 ug/dL so you're not in quite as bad shape, but definitely a long way from 100-114 ug/dL (or 17.3-18 umol/L)

Copper Deficiency Myeloneuropathy Resembling B12 Deficiency: Partial Resolution of MR Imaging Findings with Copper Supplementation
http://www.ajnr.org/content/27/10/2112.full.pdf
"Serum copper and ceruloplasmin levels were markedly decreased at 0.05 ng/mL (0.75–1.45 ng/mL) and 1.37..."

so. i'd say definitely yes, amendments are required.

the copper post i did previously has a bunch of research, also a little bit on healthy food sources too (you should be okay in that regard). here's the link anyway (lots of other interesting info to read)
general-discussion-f1/topic19529.html#p188525

your zinc levels still need to go up, but it looks like the copper is more important in the short term. here is some wiki info on supplemental forms (needs a little cleanup apparently):

"Different forms of copper supplementation have different absorption rates. For example, the absorption of copper from cupric oxide supplements is lower than that from copper gluconate, sulfate, or carbonate... Many popular vitamin supplements include copper as small inorganic molecules such as cupric oxide. These supplements can result in excess free copper in the brain as the copper can cross the blood-brain barrier directly. Normally, organic copper in food is first processed by the liver which keeps free copper levels under control... copper absorption is enhanced by ingestion of animal protein, citrate, and phosphate. Copper salts, including copper gluconate, copper acetate, or copper sulfate, are more easily absorbed than copper oxides..."

so, the takeaway point seems to be, avoid cupric oxide. my zinc supplement is balanced with copper citrate, but i haven't had copper levels done in a while so who knows what my current absorption is like!

given all that, i wonder what form of copper you are supplementing? if it's a good form, consider a short term therapeutic megadose at the upper limit (10 mg/d) for two weeks, then wash out and retest. backup for the upper limit here: http://hc-sc.gc.ca/fn-an/nutrition/refe ... bl-eng.php by the way i think RDAs are ridiculous by and large. they're only about preventing deficiency, not ensuring optimal health.

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

HEY you edited since i started writing anyway, the liver is good for both copper and zinc.

wish i knew what your zinc levels got up to when you were doing 150mg/d! (not what i would think of as safe by the way.. even the UL is only 40.. did i suggest you try that? also.. why the heck is your level stuck down at 14 :S .. hmm, you get lots of vit E am i right?)

_________________
my approach: no meds so far - just balanced whole foods (partial 'paleo', much less outright elimination), science, supplements, & bloodwork
my regimen - www.thisisms.com/ftopict-2489.html
www.whfoods.com, www.nutritiondata.com

i have emailed solgar directly to find out the cobalamin form

as i dont eat nuts, seeds or legumes, being on the wahls diet, i will have to just supplement,
i have been taking thos 2mg copper supplement for years:
http://www.zipvit.com/cgi-bin/popupprod ... phabetical

what copper dose/form do you suggest taking instead?


also as my zinc levels are on the low side, should i increase from 50mg zinc picolinate to 100mg daily? i would then need more copper right?

you did suggest a short term super dose of zinc, but my legs/mobility were better when taking.

i take 400iu vit E daily this one: http://www.hollandandbarrett.com/pages/ ... 623&cid=69

thanks