More Than Methylation: Using The Trifecta™ Model of Health to Build a Roadmap to Recovery

Off-Protocol Support Guide Using The Trifecta™ Model of Health

So you are using the B12 Protocol (including Iodide oil, Selenium oil, Molybdenum oil, and Activated B12 oil), you have taken steps to ensure that your product application is done effectively and consistently, and have even included Protocol Support to bolster your results.  Is there anything else that can be done to accelerate progress?  With respect to biochemical individuality, there are likely other supports you can add that will give your body a gentle nudge toward healing.

Protocol Support was designed to provide many additional supports and to also be well-tolerated, which means that it includes those supports that are helpful to most people yet recognized as having low risk of side effects for the general population.  Naturally, this does exclude some other supports that might not be right for everyone, but notably helpful for others.

The B12 Protocol is about healing the biochemistry that goes awry in many modern chronic diseases.  In order to explain the healing that is brought about by the B12 Protocol, it is helpful to present a model that I call The Trifecta Model of Health.

Using The Trifecta™ Model of Health to understand the interconnectedness of Methylation Capacity, Redox Capacity, and Mitochondrial Output

I created this model to help explain how common support measures used in autism (and other chronic health conditions) often lead to symptom improvements and/or lab test changes in areas outside the anticipated effects of said support measure.

Generally speaking, an improvement of one aspect of the Trifecta will impact all three in the same direction, with possibly different magnitudes.  This is due to the inescapable interconnectedness of the human body.  Many of those details should become more clear in a biochemical sense upon reading this relatively brief guide.

This conceptual model can be visualized as a triangle that has each of the three components at a different corner of the triangle.  The three components include:

•        Methylation Capacity
•        Redox Capacity
•        Mitochondrial Output

This post is intended to present some of the more common off-protocol measures that you can look into in regard to improving methylation capacity (which is the main goal of the B12 Protocol from a biochemical perspective), improving redox capacity (which determines the body’s ability to control oxidative stress), and supporting mitochondrial output (energy supply).  I will also briefly touch upon additional body support measures that fall outside this model’s limited confines.

Note that I often refer to children as the primary recipient of these supports, but everything herein can be applied to adults.  With that said, if you are a parent with a medically-complex child, the B12 Moms & Kids Facebook group has excellent guides on other modalities that compliment biomedical treatment, such as homeopathy and low-dose immunotherapy.  Though mentioned throughout, they are beyond the scope of this guide and therefore will not be discussed much herein.  What is presented here is not meant to be a representation of every biomedical support within the Trifecta framework either, but it does cover the most common and effective supporting measures.

In order to keep this resource accessible to a large number of people, I will refrain from going into much depth on the included topics.  Also, at the risk of coming across as condescending, I leave you with the advice that this guide does not serve as a replacement for working with a knowledgeable physician, rather, it is meant to be a resource that informs you of some of the options available to you for consideration and discussion with your personal physician.

Before you decide to invest your resources in any of the tests or supports I list here, I highly recommend that you work with a practitioner who has experience interpreting that particular test or advising on the proper use of that particular support.  Most of the test panels I list as options will cost between $200-400 and would be wasted if you do not understand what to do with the results.  Similarly, biomedical treatment that may work exceptionally well for one person may be not helpful (or even detrimental) to another person.  We are more alike biochemically than we are different, but sometimes that little bit of individuality leads to a significant difference in how each person responds to an intervention.

One more important message before I get into any testing or supports.  I should give a preamble of sorts to this guide.

For the parents reading this, we have all been put in different situations with our children’s eating habits.  My comments on diet are not coming from a place of judgement.  However, know that if your child is eating an unbalanced diet or one that is comprised of processed food and seed oils, you should expect that some of the utility of the B12 Protocol and that of the off-protocol supports listed here will be used up in counteracting the deleterious effects of their diet.  Cleaning up their diet, to the best of your (and their) ability can go a long way in supporting the Trifecta and beyond.

I am keenly aware that many parents are using this protocol to heal from severe food intolerances and may not have enough safe foods to comprise a balanced diet - yet.  As you progress with the healing stages and acquire a greater number of tolerated foods, the importance of diet can become a higher priority for you.  Until then, continue to focus on the protocol framework and supportive healing modalities that are moving you in the right direction.  Do not get discouraged by what I am about to say here about diet.

Do your honest best (not someone else’s best) with that and give yourself grace knowing that perfect does not exist in this world.  Your efforts, no matter how short they fall of perfect, are extraordinary.  So take some time to appreciate the personal and spiritual growth that this journey is bringing about in you and your child, especially when you sense  some discouragement.  It can go a long way in refueling your motivation.  The B12 Moms & Kids Facebook group is an excellent resource to lean on in those moments when victory seems out of reach.

Assuming that a person is able to tolerate a variety of foods, the most impactful support you can provide to the Trifecta is often a balanced diet that includes an ample amount of protein from animal flesh (especially ruminant animals, such as beef), some carbohydrate, and some fat.  That balance should be provided within the confines of any medically necessary dietary restrictions.

Saying that a diet is “balanced” can mean many different things, so to clarify how I define the term, we can say anywhere in a range represented by at least 20% of daily calories from each of the three caloric macronutrients constitutes a balanced diet, assuming that those calories are coming from minimally processed foods.  Carbohydrates are essential for growth and keeping insulin levels high enough to promote healthy thyroid function, but exceeding 60% of calories from carbohydrates may have negative effects on energy regulation.  Exceeding that amount should be avoided.  Macronutrient composition of the diet can sometimes be represented as a ratio of calories coming from protein/carbohydrate/fat.

The following are all examples of macronutrient ratios that could be considered balanced:

•        20/40/40
•        20/60/20
•        25/50/25
•        30/50/20
•        40/40/20
•        40/20/40

Most often, meeting these criteria requires that we focus on including more animal flesh in our children’s diets for the sulfur component that only it can adequately provide.  For some, it may mean also reducing processed grains.  Take whatever steps are needed and within your reach.  For those with religious reasons for avoiding animal flesh, fish, eggs, and dairy can be acceptable sources.  Stricter adherents may need to supplement L-methionine.

Many people use apps that track macronutrient intake to make this process easier, such as Cronometer, which has a very useful free version for both Android and Apple devices.

That message about diet is important, which is why it precedes the following sections.  Now, we can talk about the three components of the Trifecta.

 

1.   Methylation Capacity

The first component of the Trifecta is methylation capacity.  Methylation capacity is defined as the body’s ability to transfer methyl groups.  This process of transferring methyl groups is an integral part of epigenetic regulation of the genome, direct regulation of neurotransmitter activity, phase 2 liver detox, and production of phosphatidylcholine, carnitine, and creatine.  Biochemically speaking, one main purpose of the B12 Protocol is to improve methylation capacity.  It accomplishes this primarily by restoring function to two enzymes that are often the weak links in the methylation cycle, MTHFR and MTR.

Here is a diagram that represents the biochemical workings of the methylation cycle, courtesy of Genova Diagnostics:

                                                                                                                                  

Each blue rectangle represents an enzyme, each white oval represents a molecule (product of one enzyme/substrate of another enzyme), and vitamin B12 is represented as either a red circle or green circle depending on whether it is activated or deactivated.  Other cofactors, such as Zn, SAM, B2, B3, etc. are shown next to the enzyme that they help catalyze.  When deciding on which supports to include, we often can look at the ratio of product-to-substrate for each enzyme, and if that ratio is low, it means the enzyme is underperforming.  An underperforming enzyme can bog down the pathway.  In many cases, providing the cofactor(s) for such enzymes in greater amounts than what the person was getting at the time the lab specimen was collected, the activity of said enzyme can be increased.

The diagram extends to also include transsulfuration (and beyond), which is regulated in part by methylation capacity.

Let this diagram be something you can refer back to.  With this guide in particular, I don’t intend to get lost in the details of it but present it here for your future reference.

In the context of the methylation cycle, the B12 Protocol itself directly targets activity of the enzymes MTHFR and MTR.  But every enzyme of the pathway is at least indirectly impacted due to the inescapable interconnectedness of it all.  For example, activity of the enzyme MAT is highly dependent upon mitochondrial output.  Mitochondrial supports almost always improve methylation capacity because of this and other interconnected aspects.  Likewise, because improved methylation capacity will upregulate CBS and potentially lead to increased glutathione production, this can improve redox capacity.  Furthermore, redox capacity and mitochondrial output are strongly correlated, showing one example of the Trifecta being fulfilled.

a)   Lab Tests for Methylation Capacity

The simplest measure of methylation capacity is a ratio of SAM-to-SAH.  Measuring additional metabolites that occur within the methylation cycle, folate cycle, and transsulfuration will give even more actionable insight.

Some off-protocol lab tests that can be used to assess and address methylation capacity are the following:

• Best: Methylation Pathways or Methylation Pathways Extended Panel (Health Diagnostics & Research Institute)
• Good: Methylation Panel (Genova Diagnostics)
• Okay: Methylation Profile, Plasma (Doctor’s Data Inc.)

 

b)   Off-Protocol Methylation Supports

You can look into which of these off-protocol supports are most appropriate based on your individual results. Each supplement listed here serves a specific role in methylation similar to how each maintenance step you perform on a vehicle serves a specific supportive function for how that vehicle performs.  For example, a tire rotation and a brake replacement may both affect how a vehicle handles, but they do not substitute for one another.   It is similar to how nutrients listed here may all support methylation capacity but in specific and non-interchangeable roles.  That is where proper lab interpretation and experience prevail.

I learned where these supports are most effectively implemented by studying the pathways involved, reading about the experiences of others and which symptoms indicate use, and of course some good old trial and error.  These supports are listed from most common to least common, but this list is not all-inclusive, and not necessarily in order of what would be most effective in your particular scenario.

• Vitamin B6
• Zinc
• Magnesium
• L-Methionine (the best source is animal flesh, especially that of rudimentary animals)
• Vitamin B3 (and various NAD precursor vitamers)
• SAMe
• Choline bitartrate
• DMG
• TMG/betaine (I do not recommend this for neurological conditions as BHMT is primarily a liver enzyme only and will not impact methylation capacity in brain tissue)

The next three supports are included here as methylation products, potentially reducing demand for methyl groups elsewhere:

• L-Carnitine and/or Acetyl-L-Carnitine
• Phosphatidylcholine
• Creatine monohydrate

 

2.   Redox Capacity

The second component of the Trifecta is redox capacity.  The term redox stands for “reduction-oxidation”, which are two complimentary chemical processes that occur simultaneously – one substance is reduced by accepting electrons from the substance being oxidized.

Redox capacity primarily refers to the body’s ability to manage oxidative stress via its antioxidant role.  Redox capacity also drives the electron transport chain, neurotransmitter synthesis and degradation, and ROS-related immune response.

The B12 Protocol indirectly enhances redox capacity through its positive impact on methylation, which upregulates transsulfuration via CBS.  Also, selenium functions in several important enzymes in the body called selenoproteins.  The class of selenoproteins associated with the B12 protocol is called Deiodinase, which converts T4 into T3.

Benefits of selenium extend outside its role in Deiodinase, however.  Two selenoproteins that are a big part of the off-protocol benefits include Glutathione Peroxidases (GPXs) and Thioredoxin Reductases (TrxRs).  GPX is needed to put glutathione to work against oxidative stress and TrxR has a broader role in antioxidant defense.

 

a)       Lab Tests for Redox Capacity

Evaluating redox capacity through lab tests can be used to assess the effectiveness of your nutritional regiment in controlling oxidative stress by comparing recent testing to past testing.  This might be especially useful when focusing primarily on refining redox capacity as a function of reduced glutathione to oxidized glutathione.

Since oxidative stress is more compartment-specific than methylation capacity, a test panel that measures as many different compartments of the cell will give a more holistic sense of your redox capacity than any single test.  To get a more compartment-specific assessment of redox capacity, you would want to include one test that includes a water-soluble component and one test that includes a cell membrane (oil-based) component.  The most common test for looking at oxidative damage to the water-soluble components of the cell would be 8-OHdG.  Cell membrane lipid peroxidation, on the other hand, is commonly assessed by testing malondialdehyde (MDA), lipid peroxides, and/or isoprostanes.

If you only assess redox capacity by one measure, I suggest that you look at the ratio of oxidized glutathione to reduced glutathione.  I am aware of two laboratories that perform these assays:

• Health Diagnostics and Research Institute
• Precision Point Diagnostics

 

Some laboratory-offered panels that include the more holistic markers of oxidative damage mentioned above:

• Genova Diagnostics Oxidative Stress 2.0 Urine Test
• Precision Point Diagnostics Advanced Oxidative Stress Test
• Vibrant Wellness Oxidative Stress Profile

View sample reports to see which markers are included in the above panels and whether that test panel is available to you where you live.

 

b)  Off-Protocol Redox Supports

The same context-specific instructions given for supports involved in methylation capacity apply here as well.

• General antioxidant support that covers both water-soluble and membrane bound (oil-soluble) compartments – I use the pseudo acronym “ACES plus Zinc”:
  • Vitamin A and carotenoids
  • Vitamin C
  • Vitamin E (tocopherols and tocotrienols, with alpha-tocopherol being most important)
  • Selenium (part of the B12 Protocol)
  • Zinc
• Taurine
• Silymarin
• Alpha-Lipoic Acid
• N-Acetyl-Cysteine (and NAC ethyl ester, also known as NACET)
• Glycine
• Glutathione (liposomal, transdermal, and S-Acetyl-Glutathione may provide more benefit than L-Glutathione)

 

3.       Mitochondrial Output

The third component of the Trifecta is mitochondrial output.  Mitochondrial output is being defined here as how efficiently the mitochondria can create ATP from a variety of fuel sources.  Our mitochondria are analogous to little engines in each of our cells.  They can run on various fuel sources, but when they become damaged may struggle to run on alternative fuel sources.

There are many factors that come into play as far as mitochondrial output is concerned.  Organic acid testing is often one of the most useful tests of mitochondrial function available since it gives so much information on the various enzymes involved, however, there are other off-protocol tests that have utility in certain contexts.  A skilled practitioner may be able to match your specific symptoms to the most appropriate tests.

 

a)   Lab tests for assessing Mitochondrial Output:

• MitoSwab Plus by Religen Labs
• Mitochondrial DNA analysis (work with a board certified geneticist)
• Creatine kinase
• Total Carnitine and Acylcarnitine Profile
• CoEnzyme Q10
• Amino acid panel
• Muscle biopsy (highly invasive – MitoSwab Plus may be a suitable replacement in many cases)

 

b)       Off-Protocol Mito Support

• TTFD, benfotiamine, and other vitamin B1 analogues
• Magnesium (especially magnesium malate)
• L-Carnitine and/or Acetyl-L-Carnitine
• Iron
• CoEnzyme Q10
• Vitamin B3 (and various NAD precursor vitamers)
• Vitamin B5
• Biotin
• Hyperbaric Oxygen Therapy (HBOT)
• AKG (and other Krebs cycle intermediates)
• Creatine monohydrate
• Methylene Blue
• Ribose
• Hydrogen water (be careful if you suspect SIBO)
• Red Light Therapy (photobiomodulation)

 

4.       Complimentary Support Measures

While the Trifecta Model of Health explains how many of the support measures fit into an approach centered on strengthening the body’s performance and ability to adapt to stress, it falls short of explaining other areas of health outside of the genetic/epigenetic blueprint.  For example, many children with autism and related disorders also suffer from extreme microbiome imbalances, toxic burden, and/or immune system dysregulation.  While these are often suspected to be a consequence of epigenetic dysregulation, these areas can also be supported directly.  Often, bolstering these systems also results in less burden on the systems involved in the Trifecta.

Here are some of those supports that fall outside the scope of the Trifecta Model of Health:

• Detox therapies, including heavy metal chelation, toxin binders (zeolite, bentonite clay, etc), sauna, Ion-Cleanse foot bath, Epsom salt baths, etc.
• Probiotics, prebiotics, and/or postbiotics
• Digestive enzymes
• Dietary adjustments for specific conditions, such as SIBO
• Antimicrobial treatments for confirmed or suspected pathogens (gut infections, viruses, Lyme disease, strep, etc.) including pharmaceutical drugs, herbal remedies, biofilm busters, binders, or energetic medicine including homeopathy, LDI, and electromagnetic resonance.
• Fecal Microbiota Transplant
• Cell Products (umbilical cord blood, umbilical cord tissue stem cells, PRP, etc)
• Anti-Purinergic Therapy (i.e. Suramin – still in the experimental phase)
• Homeopathic remedies
• Low-Dose Immunotherapy (LDI)
• Treatment for structural abnormalities, sleep apnea, epilepsy, etc.
• High-dose folate treatment to bypass a folate receptor auto-antibody issue
• Therapies targeting specific developmental delays (ABA, speech therapy, occupational therapy, etc.)
• Psychological and emotional trauma healing (benefits can be seen when implemented in the child and/or their caretakers)
• Self development – as we heal our own self, we become more capable of healing our child and raising them to be whole.

 

Final Words

I hope this guide is a helpful resource in your child’s journey as well as your own.  Do not be overwhelmed by the options listed here – in most cases, only a small handful of them are really going to provide a big benefit!  If you are following the B12 Protocol, assuming that you tolerate a variety of food, diet will be the most important next step.

Once you have accomplished that, or if you or your child are not able to practically incorporate a balanced diet, in the meantime, some testing and targeted supports mentioned above may be just what you need to accelerate healing.  If you are struggling with expanding the diet, and it is due to physiological intolerance, homeopathy and LDI may be options to consider.  If the diet struggles are due to fussy eating and you are discouraged with that, one-on-one coaching is available.

Protocol Support was designed to be well-tolerated and provide benefit to the greatest number of people.  It includes methylation support through B2, folinic acid, zinc, magnesium, and choline.

It includes redox support by way of “ACES plus Zn”, the pseudo-acronym mentioned above that covers both water-soluble and membrane (oil-soluble) cellular components.

It includes mitochondrial support by way of B vitamins, chromium, and vanadium (the latter two are involved in regulating blood glucose).

And of course, zinc and magnesium also support the thyroid and gut.

For the simplest and possibly most impactful off-protocol support measures outside of diet, Protocol Support may be it.

And for a limited time, when you add Protocol Support to your cart, you will automatically receive a 25% discount on all transdermal products you include in that order.  Check the product page to see if this offer is still valid.

We hope you have learned something useful from this blog post.  Spectrum Sciences is committed to bringing you the information that you need in order to make informed decisions about your health.  We are also determined to bring you the best Vitamin B12 supplement by various means, including protocol enhancement and new product offerings.