Sulfite can form adducts with many enzymes and nutrients in our bodies, causing massive dysfunction. Mopping up sulfite helps to reduce the feed forward activation of HIF-1alpha that leads to more expression and activity of cysteine dioxygenase, which leads to more sulfite production, and when sulfite oxidase is compromised by decreased molybdenum cofactor production or decreased heme production needed for this enzyme, this leads to the ongoing cycle of destruction. Here is a list of possible “safe” ways to mop up sulfite or work around a major block that sulfite is causing in metabolism while trying to restore sulfite oxidase activity.
Known Sulfite Mopper Uppers
(Recommendations are general guidelines and not meant to substitute for an evaluation with a health care provider regarding your individual needs. Please consult with your provider before making changes to your diet, supplements, medications, or lifestyle.)
| Substance | Effects | Supplement? |
| Vitamin B12 | Functional B12 deficiency. Sulfite binds to the cobalt center of B12. This makes binding of methyl groups and adenosyl groups impossible. There is some concern that this can occur in the digestive tract and could be a significant source of B12 deficiency. | Yes. B12 is needed for methionine salvage that helps to regenerate SAMe. SAMe is needed for making molybdenum cofactor (MoCo). Caution for individuals with sleep apnea, B12 is sequestered to the brain. Long-term intermittent hypoxia has been shown to cause cobalt toxicity of the brain. B12 can also induce the HIF-1alpha pathway which should be good, but in the presence of SUOX/MoCo deficiency this can lead to increased intestinal sulfite. Titrating up slowly may be needed. Dose: Injections- 200 mcg hydroxocobalamin or per practitioner Oral – 50 mcg drop (1 drop of pure encapsulations hydrox/cobalamin) every hour. Oral – 250 mcg sublingual every 4 hours (avoid exposure to light as light can degrade B12 into cobalt) |
Riboflavin | Sulfite can irreversibly bind to the ketone group of riboflavin. It has been shown to bind to flavin proteins at the N5 position on the isoalloxine ring, altering enzyme activity. It can decrease the enzyme activity of choline oxidase, glycolate oxidase, sarcosine oxidase, and d-amino oxidase. | Yes. Riboflavin can increase butyrate production in the intestines. The only caution is for those with elevated ethylmalonic acid (EMA) as butyrate is metabolized to ethylmalonyl CoA. Dose: Per individual tolerance. In migraines, dosing is 400 mg per day. However, spacing this dose out would be helpful to buffer sulfite better as riboflavin is lost quickly in urine. AVOID taking riboflavin with molybdenum as in acidic pH of the stomach, riboflavin and molybdenum can make a complex. https://digitalcommons.usu.edu/etd/7173/ ****Riboflavin has been shown to form chelates with other metals such as iron, copper, nickel, cobalt and zinc. Avoiding high doses with meals would be helpful if you struggle with iron, copper, or zinc. |
| Betaine aldehyde | Betaine aldehyde binds sulfite. During free sulfite toxicity, the enzyme choline oxidase can be inhibited by sulfite. This leads to low betaine aldehyde levels. Sulfite can also inhibit the enzyme ALDH7A1 leading to low production of betaine. | Not directly. There are no betaine aldehyde supplements. Choline intake is important due to choline oxidase can make betaine aldehyde, and overall, the choline cycle is impaired by sulfite. Dose: 1-2 eggs per day (Low heat cooking to avoid increase methionine and cysteine conversion to H2S. Avoid taking molybdenum supplement with eggs if you suspect H2S producing SIBO.) 500 mg choline supplement of choice Betaine supplementation can help restore betaine needed for the methionine salvage pathway. This makes SAMe, which is required in order to make choline in the body from ethanolamine. Dose: You could try eating more betaine rich foods if you do not struggle with oxalates or gluten (wheat bran and beets) Start with 250 mg betaine anhydrous and sip (you may start lower if you are a sensitive person). You may work up to tolerating about 500 mg per day—caution is needed in individuals with slow CBS enzymes and high methionine on plasma amino acid. Sci-Hub | Progressive cerebral edema associated with high methionine levels and betaine therapy in a patient with cystathionine β-synthase (CBS) deficiency. American Journal of Medical Genetics, 108(1), 57–63 | 10.1002/ajmg.10186 |
| Vitamin B6 | Sulfite can form adducts with the aldehyde group on pyridoxal phosphate, but also sulfite inhibits ALDH7A1 involved in lysine metabolism, which leads to a build up of P6C and binding of P6C to pyridoxal phosphate making it inactive. | Yes. Avoid pyridoxine forms of vitamin B6 as these can lead to competition for cofactor sites and B6 toxicity symptoms. B6 restores CBS and CSE activity. It can lead to a sudden surge in cysteine production through CBS as well as H2S production. It may lead to sudden increases in polyamine synthesis. In theory, individuals with SUOX/MoCo deficiency grow bacteria to make H2S and polyamines to compensate for lack of production of these in their bodies. Increasing B6 quickly may lead to sudden H2S toxicity and polyamine toxicity. Dose: Start with 5 mg P5P once/day with food. Increase to 5 mg P5P every 4 hours with foods. |
| Dihydro-biopterin(qBH2) | Sulfite reacts with dihydropterin. This may be the cause of high urinary losses of biopterin and contribute to BH4 deficiency. BH4 is needed for healthy nitric oxide production as well as the conversion of phenylanine and tyrosine metabolism. | Unsure. There is not a good supplemental form of BH4 on the market. There are drugs to treat BH4 deficiency such as saropterin dihydrochloride. |