Focus: genetic bottlenecks, cofactor traps, and compensatory strategies
Version: July 2025 (v1)

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✅ Overview of Status

Vitamin	Status	Problem Type	Urgency
B2 (Riboflavin)	⚠️ Likely deficient	↓ absorption, ↑ demand, possibly ↓ activation	🔴 High
B6 (Pyridoxine/P5P)	⚠️ Functional trap	↓ activation + ↑ demand from detox/methylation	🔴 High
B12 (Cobalamin)	❌ Severe trap	↓ synthesis, ↓ transport, ↓ recycling	🔴 Critical
B9 (Folate)	⚠️ Moderate slowdown	Folate shunt + methylation support needed	🟠 Moderate
B1 (Thiamine)	⚠️ Functional strain	Aldehyde load from AOX1 → ↑ cofactor loss	🟡 Mild to moderate
B3 (Niacin)	⚠️ Potentially low NAD+/NADPH	NQO1 + detox load raise requirement	🟡 Mild to moderate

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🔬 Detailed Status by Vitamin

🔴 B2 (Riboflavin)

SNPs Involved:

• SLC52A1 AG → ↓ B2 absorption
• MTHFD1L GG, NQO1 AG, MTRR AA → ↑ FAD demand

Symptoms Likely:

• Fatigue, light sensitivity, detox overload, sulfur issues

Traps:

• May not absorb B2 well
• May not convert to FMN/FAD efficiently (FLAD1 status unknown)

Strategy:

• Start with riboflavin 2–5 mg/day
• Add R5P microdoses (0.1–0.25 mg) every 2–3 days if needed
• Monitor neon urine, overstimulation

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🔴 B6 (Pyridoxine → P5P)

SNPs Involved:

• ALPL AG → ↓ P5P activation
• CBS CT, AOX1 AA, MTHFD1L → ↑ P5P demand
• Possibly sluggish MAO/COMT detox → ↑ P5P use in neurotransmitter breakdown

Symptoms Likely:

• Histamine overload, stress reactivity, poor sulfur detox, vivid dreams or nightmares

Traps:

• Pyridoxine likely useless → poor conversion
• High need → even normal blood B6 won’t reflect functional sufficiency

Strategy:

• Use P5P directly: start at 0.25–0.5 mg/day
• Pair with magnesium and trace zinc
• Avoid high-dose P5P (>2 mg) unless tolerance is proven

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🔴 B12 (Cobalamin)

SNPs Involved:

• MTRR rs11254363 AA → severe methyl-B12 recycling failure
• MTR AG → ↓ methyl-B12 synthesis
• TCN2 GT, CD320 AG → ↓ B12 transport + cellular uptake

Symptoms Likely:

• Fatigue, brain fog, vagus sensitivity, histamine overload, poor sleep

Traps:

• Methyl-B12 can accumulate without function, leading to anxiety, histamine flares
• You can’t recycle or transport B12 efficiently

Strategy:

• Use hydroxocobalamin 250–500 mcg every 2–3 days
• Optionally add adenosyl-B12 once/week for mitochondrial support
• Avoid methyl-B12 initially

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🟠 B9 (Folate)

SNPs Involved:

• MTHFR A1298C GT, SHMT1 AG → folate cycle bottlenecks
• MTR/MTRR → ↑ dependence on methyl donors
• Possibly increased need for THF/methyl-THF shunting

Symptoms Likely:

• Poor methylation, sensitivity to methyl donors, histamine, poor resilience to stress

Traps:

• Methylfolate may cause symptoms (headache, irritability, insomnia)
• If B2/B12 is missing, folate won't be processed correctly

Strategy:

• Use folinic acid (not methylfolate), start at 100–200 mcg/day
• Introduce after B2 and B12 are stabilized

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🟡 B1 (Thiamine)

SNPs Involved:

• Indirect depletion from AOX1 AA → aldehyde overload raises need for thiamine
• Needed for energy, vagus tone, aldehyde clearance

Strategy:

• Optional support: Thiamine HCl 25–50 mg or benfotiamine 50 mg
• Use only if fatigue, brain fog, or vagus compression symptoms persist

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🟡 B3 (Niacin)

SNPs Involved:

• NQO1 AG → ↓ NAD(P)H recycling
• MTHFD1L also requires NAD+/FAD for 1C metabolism
• AOX1 dysfunction adds redox stress

Strategy:

• Optional: Niacinamide 50–100 mg (avoid flushing niacin initially)
• May help restore NAD+/NADH balance and energy tone

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🎯 Your B-Vitamin Action Plan (Summary)

Step	Action
1	Start riboflavin 2–5 mg/day for 3–5 days
2	Add P5P 0.25–0.5 mg/day, watch for overstimulation
3	Introduce hydroxocobalamin 250–500 mcg every 2–3 days
4	Introduce folinic acid 100–200 mcg/day, not methylfolate
5	(Optional) Add B1 and/or B3 if energy and detox

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Would you like this summary as a printable PDF or tracking spreadsheet to monitor reactions and titrations day by day?