Homocysteine Test

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After the enormous amount of hours I have spent researching, I have settled on a theory that my MTHFR mutation is causing me to be undernourished and suffering from malabsorption (yeah, it sounds crazy, but so is debilitating arthritis at 42).

There is a lot of information on the internet about MTHFR, but not much in cold, hard print. The only really relevant text I could find was The Homocysteine Solution by Patrick Holford, so this is the one I’m going to base my initial lifestyle changes on in an attempt to reduce my arthritic pain.

For good measure (and because Amazon was clever enough to show it to me in the “also bought” section), I am also reading a copy of Say No To Arthritis by the same author.

Finally, just so I can have some kind of verification of what’s going on, I have ordered a homocysteine test at great expense (£149+postage). This is an enormous amount of money to drop on a something out of the blue, but I am at the point of desperation for answers and results, and nothing works like cold hard numerical analysis. I am eagerly awaiting its arrival.


Solving The Joint Pain Problem

The first thing I need to do if I’m going to get super fit is solve the joint pain problem. I can’t do any decent exercise until I’ve calmed down the pain in almost every joint in my body.

From my toes, through my knees, my hips, my spine, my elbows, wrists and hands, everything hurts. Everything is a struggle.

I was diagnosed with osteoarthritis in September last year, aged 41. Now I’m 42 and the pain is spreading at what seems like an increasing rate. And I really am SO done with it. I can’t function properly as a mother to my three children because my whole body hurts all the time.

So, I have spent every spare minute researching a trail through medical studies and literature to formulate a hypothesis on how to fix myself.

The traditional medical solution is painkillers and bone fusion. That just isn’t an option I want to look at to be honest.

I simply cannot believe that it is normal to feel the way I do and to have a body deteriorating as rapidly as mine seems to be. How the hell am I going to live to be 100 if at 42 I am already falling apart? I have a genuine fear that if I don’t do something radical to change what’s going on in my body, I could well be in a wheelchair by the time I am 50 (and my daughter will be only 9). Again, NOT an option I want to look at.

So, here in brief note-y form are the huge leaps I have taken through medical science to explain my own condition. I am not a doctor, but I am probably more interested in my own health than any doctor is.


Scientists don’t really know WHY cartilage breaks down.

However, joints in patients with OA exhibit a common trait of less viscous synovial fluid (the fluid that lubricates the joints)

My hypothesis 1: Synovial fluid’s primary role is to lubricate and cushion. When faulty it doesn’t do this job properly and cartilage gets damaged through normal joint use, aka, “wear and tear”.

Currently there are no drugs available that can stop or reverse the process of cartilage degradation.

My hypothesis 2: Fix my synovial fluid to prevent new damage.

Synovial fluid contains three things:

  1. Fluid filtered from blood plasma
  2. Lubricin secreted by cartilage chondrocytes
  3. Hyaluronan secreted by the cells of the synovial membrane


Hyaluronic acid (HA) can be injected into the joint, but results are not great.

And oral HA is dubious – HA levels are a tumour marker (though not necessarily causative).

So why would my HA be low, and how can I raise it?

Oestrogen increases hyaluronic acid production (in mice). If my oestrogen is low, my HA would be low.

Evidence: I suffered multiple recurrent miscarriages when trying for a family.

So, if my oestrogen is low, how can I raise it?

Oestrogen is synthesised from androgens, which are synthesised from cholesterol – the primary steroid. Cholesterol is a precursor to several steroid hormones in the body including oestrogen and vitamin D.

The liver, mainly, creates cholesterol (around 20%), but ALL cells make it as it is essential to life.
The body converts cholesterol to pregnenolone which is considered to be the “mother” hormone.
Pregnenolone is then converted to other hormones such as progesterone, DHEA, testosterone, estrogen, cortisol, and dozens of other critical hormones. If your cholesterol is low, these hormones will also be low.

Evidence: my cholesterol is very low : 2.4 mmol/L or 92mg/dL, and so are my triglycerides : 0.49mmol/L or 43mg/dL

I always thought that was a good thing, so I was stunned to discover this is actually quite bad and that it is linked to anxiety, depression, violent behaviour, infertility, suicide, and negative outcomes (ie death) in the critically ill/elderly:





There is very little info on low cholesterol, but it is called hypocholesterolemia.

Why is my cholesterol low and how can I raise it? 

Low cholesterol has me stumped. It can be caused by statins (nope), an inherited genetic disease (nope), a couple of other rare diseases (nope) or an extremely low fat diet (guffaw! Hardly the case for me).

The other general causes seem to be malnutrition and malabsorption. I am fairly slim, but I am certainly not malnourished in the true definition of the word. If I have malabsorption I don’t have the typical symptoms. However, in the absence of any other explanation, a sub-clinical undernourishment problem is what I’m going to go with.

Evidence: I do have a compound MTHFR mutation, which (it turns out), means I am a poor absorber of folate/B9, so perhaps this is not as crazy as it sounds.

The whole MTHFR thing uncovers a host of problems I may have, including low glutathione, and low choline. Choline is also further depleted by pregnancy and breastfeeding, as is cholesterol. I am still breastfeeding my daughter.


My hypothesis 3: My compound MTHFR mutation, combined with three pregnancies, breastfeeding and a poor diet, has resulted in a malnourished state, causing low cholesterol and triglycerides, meaning low steroid hormones, which ends up causing low levels of hyaluronic acid and therefore the deterioration of my joints with osteoarthritis.

Now, I know that this is crazily unscientific, but it does make sense.

So this is what I am going to base my “treatment” on:

Reversing my “malnourished” state and then looking at how to best support my cartilage for regrowth (cartilage does regrow, just very very slowly).

Chronic Pain – Where I Am Now

It’s kind of hard for me to believe that I am where I am. The joint pain I suffer has been niggling on and off for several years, but now it is constant. It is my biggest health issue and it saddens and frightens me that it is as bad as it is.

I was diagnosed with osteoarthritis in Oct 2016. I have hallux rigidus in my right toe, which means I can’t bend it properly anymore because of several osteophytes (little bony protusions that grow and reduce joint mobility so the inflammed joint gets some protection).

My left big toe is slowly getting worse – I am afraid of what this means.

I already walk with a mild limp and roll my foot outwards to avoid bending the toe joint. I can’t walk long distances and running is out of the question. The consultant recommended an orthotic, but my vanity has kept it away (for now).

My treatment options are cortisone injections and then a cheilectomy (osteophyte removal), and finally complete bone fusion.

What is scarier is that the pain is now in my thumbs, wrists, elbows, knees, hips and spine. Those joints all click and crack when just a few years ago they were silent. I can’t open jars, fixing seatbelts hurt my hands and when I bend down it sometimes feels like the shooting pain in my knee will bring me to the ground.

At night my hips feel locked and I have to shift around in bed until they settle, raising my knees to my chest and back again until I free the joint.

My spine feels like a tower of pumice stones that are on the verge of crumbling away.

Joint pain aside, I have the usual middle-aged mother’s complaints. Exhaustion, inability to sleep properly, irritability and a fair dose of anxiety and probably mild depression (over the state of my health, ageing appearance, and the state of the house mainly).

My body is soft and weak, and I am scared of physical exertion because for the first time in my life I can sense the underlying fragility of my structure.

A fall, a twist, could leave me broken.

Isn’t that how you’re supposed to feel when you are nearing the end of your life? Afraid of breaking?

Not at 42, surely.

I have also been suffering recurrent bouts of fever, chills and joint pain. I’ve had five episodes in the last 9 or 10 months. I deteriorate rapidly, going from absolutely fine to shivering and exhausted within around 4 hours. I am then bedridden for 36 hours, completely unable to do anything. I can’t eat and I shake uncontrollably. I recover in a day or two. The fever breaks, and my appetite returns. The exhaustion never really goes away. The last two episodes seemed to be triggered by physical exertion (a night without sleep at the hospital with my daugter and a full day of cleaning and gardening). I think I run at such a deficit of energy and my reserves are so spent that my body just goes into crisis mode to get the sleep it so desperately needs.

My weight is a few kilos over normal, so I’m not battling obesity. My blood test three months ago said everything was more or less okay (low vitamin D and low leucocytes). My skin and my jawline is increasingly sagging, my hair is greying, I have baby liver spots forming on the backs of my hands, a permanent rash on my legs, cracked heels and callouses on my feet.

But I am, as far as the medical profession believes, absolutely fine. With a bit of early onset arthritis.

But I am not absolutely fine. I am at the point where I am finding it hard to cope with my three children, and with the daily requirements of looking after them and the house (spare me the lecture on being an older mother – that is a whole other story for another day). The constant joint pain, shooting pains, exhaustion and slow-thinking I seem to suffer from are bringing me down.

I don’t believe that the body is meant to fall apart in middle age. So this is my quest to work out what I’m doing wrong and reverse it.

Day 1

It’s kind of funny that my first post should be on April Fool’s Day, but hopefully this is no joke.

I’ve decided to get secretly fit and healthy, and to secretly blog about it. And not just a bit fit, I mean super-powered fit and healthy. Strong enough to do an endurance or obstacle event. Olympian fit.

I’m a 42 year old, arthritic, frail, aching, fever-prone, insomniac with three children aged 7, 5 and 1.

Today I stood in the queue at Sainsbury’s, waiting for the woman in front of me to pay (she was a slow mover, we were there a while), idly mulling over the headlines on the front of a magazine displayed at the end of the checkout.

“Beat Bloating”

I’d read that.

“Fight Arthritis”

Crikey, an article about my worst health problem. Magazine content is definitely getting more relevant these days.

“Cheat the Signs of Ageing”

Hmm. I might have to buy it.

“Getting Forgetful?”

Wait. What? What kind of magazine is this anyway?

I scan the top and see that it’s “Healthy Living from Women’s Weekly”. Wasn’t Women’s Weekly a publication for older ladies?

There’s a flash of colour in the top corner containing text that proclaims:

“The health magazine for 40+ women.”


I actually thought I was looking at a copy of Cosmo, or Elle or some other fashionable magazine for young women. But how could it have been? I mean, would Cosmo EVER carry an article on arthritis?

And that’s when it hit me.

The reason that magazine looked so interesting was because I fell perfectly into the demographic. I was 40+, suffering from bloating, arthritis and wondering how I could cheat the signs of ageing.

But mental decline??

It was a shock, really, to suddenly find myself in this domain. Like I’d been moved to a new department at work without anyone telling me it had happened. A department for people who are declining. For people whose bodies are breaking down. For people who are getting ready to die.

I looked at my perky, feisty, rosy-cheeked 1 year old daughter. The checkout man probably thought I was her granny.

I grabbed a copy of the magazine and shoved it next to my shopping.

This is the beginning.