9/98 METHIONINE LOADING TEST Dr. David Martin

Recommendation

1. 12-hour fast
2. Schedule laboratory for the end of the 12^th hour to draw a fasting Hcy.
3. Take Methionine with water (dose: 0.1 gm/Kg body weight)

    

   Rx L-Methionine 500 mg (Tyson & Assoc.)

    

   Weight:

   90 - 110 pounds	10 capsules (5 gm)
   111 - 130	12
   131 - 150	14
   151 - 170	16
   171 - 190	17
   191 - 210	19
   211 - 230	20
   231 - 250	21
   > 251	22

    

    

   # ______ capsules (30 capsules/bottle)

   Take indicated number of capsules with water.

   Note time capsules taken: ____________

4. Fast for an additional 4 hours and arrive at the laboratory early enough that the blood sample can be drawn 4 hours from the time the capsules were taken.

 

DISCUSSION:

The above protocol would provide appropriate information regarding the absorption (bioavailability generally = 0.52), biotransformation and clearance of serum homocysteine. The dosage used is 0.1gm/kg or 0.04545 gm/lb. The pharmacy can dispense the exact amount but I recommend the consistent use (i.e. same mfg) of a pharmaceutical grade product like Tyson & Assoc. (supplied in bottles of 30 capsules). Products from Health Food Stores may contain mixtures of d & l isomers or poor consistency in dosages.

 

Interpretation: Fasting levels should be below 9 mu/L. 4-hour post-load levels should be below 11.0 mu/L.

 

Treatment: (Assuming patient is currently taking Genesis's High Potency Vitamins & Antioxidants -- 2 tablets/day or equivalent) + the following is recommended:

Fasting level < 9 & 4 hr load < 11 (1 Cardiovascular Hcy at bedtime)

Fasting level > 9 - 11 & 4 hr load < 11 (1 Hcy bedtime)

Fasting level > 9 - 11 & 4 hr load > 11 (1 Hcy a.m. & h.s.)

Fasting level > 11 & 4 hr load > 11 ( 1 Hcy t.i.d.)

Fasting level > 20 & 4 hr load > 11 ( 1 Hcy t.i.d. & h.s.)

Repeat testing 3 months after start of therapy if Fasting level was > 15 and in 6 months if Fasting level was < 15 to insure levels are in the safe range.