Issue 8 - Compounding News
Trimethylglycine (TMG) is a derivative of glycine that occurs in plants, especially in quinoa, spinach, wheat and beetroot. It is also known as betaine as it was originally isolated from beets, and particularly glycine betaine to distinguish it from other betaines that have been discovered since.
TMG is an important cofactor in methylation, acting as a methyl donor. The major pathway which results in the remethylation of homocysteine to methionine is the well known methionine synthase pathway, which requires methyltetrahydrofolate (MTHF) as the methyl donor. This pathway is shown on the left of the diagram below, where homocysteine is converted to methionine through the action of methionine synthase (MS), vitamin B12 and 5 methyl THF. The diagram also shows the alternate pathway from homocysteine to methionine through the action of the enzyme BHMT (betaine homocysteine methyl transferase). TMG (betaine in the diagram) acts as the methyl donor in this alternate pathway, resulting in the production of methionine from homocysteine as well as dimethylglycine (DMG) .
As both of these pathways increase the production of SAMe, the stimulation of both would be expected to have an anti-depressant effect, as well as the cardiovascular benefits of a reduction in the levels of homocysteine.
This may be a useful alternative route to the MTHF pathway for those patients with a gene mutation causing ineffective MTHFR activity.
Clinical trials show that TMG has an anti depressant effect and can enhance the action of SAMe in patients with mild to moderate depression. TMG is thought to have a more calming and sedating antidepressant effect than SAMe which tends to be more energising. TMG may therefore be a better choice in bipolar depression.
We can compound TMG into capsules or a powder blend. The recommended dose of TMG is 250mg per day.
As always please call or email me if you would like to discuss any compounding questions that you have.