What can I do about this? Am I doomed to be ill and die early with this mutation? The short answer is no. There is a lot you can do.
This post has proven to be much harder to write than I anticipated. It turns out explaining MTHFR was the easy part. Figuring out what to do about it is the hard part.
I think I’ll start with what you shouldn’t do. Do not take any vitamins containing folic acid or regular b12. It is best to avoid foods fortified with folic acid as well. Folic acid, remember, is the inactive form and will compete for those folate receptors in your body if you can’t convert it into methyl folate (and if you have a MTHFR mutation you are greatly impaired in your ability to do this.) Also some research shows that the gut will actually preferentially absorb folic acid over the active forms of folate from your food. This means that if you have a meal with lots of folic acid and methyl folate you just might miss out on the methyl folate because the body absorbs all the folic acid instead.
Do consume whole foods in as close to their natural state as possible and prepared in traditional ways. Long before food scientists and dietitians arrived on the scene the people in ancient cultures figured out how to get the most out of the foods available to them. For example, kefir made with cows milk is high in folate while milk itself isn’t. Be sure to include lots of foods rich in folate and food source b12 as well as plenty of methyl donors. Since we have lost a lot of our ancient wisdom about what to eat for health and are facing a never before seen level of toxins in our every day life, just eating what seems right isn’t going to work for most of us.
Methyl-related nutrients are found in three groups of compounds: B Vitamins, Betaine and SAMe, S-Adenosyl-Methionine. In food sources, methyl-related nutrients can be found in foods rich in natural folate, or Vitamin B9, including strawberries, citrus fruits and leafy green vegetables. Good sources of Vitamin B12 are fish, meat, milk, and eggs. Choline oxidizes to form a source of methyl called Betaine, which is found in its highest concentration in beef liver. Toasted wheat germ and eggs are also excellent sources of choline, with cod, beef, brussel sprouts, broccoli, shrimp and salmon being good sources as well. Two large eggs contain 252 mg choline, nearly half of the recommended 550 mg per day for men.
All of those veggie sources of folate are great but this is the real superstar of folate.
Raw duck liver. 738mg per serving. WOW!
No wonder I tend to crave poultry livers despite despising the taste. In this area birds beat beef hands down (beef has more iron and is often thought of as a better liver as far as nutrients are concerned). Chicken liver is 588 mg while beef liver a paltry 290mg. Spinach, which many think of as a terrific source of folate, has only 194mg per serving and gives you a huge dose of oxalate to boot. Turnip greens are a low oxalate choice and also have 194mg per serving. These two are the highest of the leafy greens.
You can check out some of your favorite foods with this tool. Just select the food group and then scroll down and select vitamins and then folate. It will organize those foods from highest to lowest. I found the information fascinating. This does not tell you want kind of folate these foods contain and those of us with MTHFR mutations especially need methyl folate. I was unable to find anywhere that explained which forms of food folate are higher in which foods. Food sources have a mixture of different forms of folate only some of it is methyl folate. The rest needs to be converted.
If you don’t live on top of a mountain in Tibet you may need more than just a nourishing diet. You also need a clean environment. I talked about that some in my post Why Should I Detox? and I plan to talk more about avoiding toxins and removing the ones you have accumulated in other blog posts in the future. People with MTHFR mutations are really impaired in this area. Toxins will just keep building up unless you are proactive about avoiding and removing them. I am speculating that this is a big part of why I am still so sick after 2 years of strict GAPS plus other aggressive measures to detox my body and find healing. I can shake those toxins loose from their storage spots but with my ability to detoxify severely impaired by my MTHFR mutations I can’t get enough of those toxins to leave my body. I am very hopeful that focusing on supporting my methylation cycle through supplements and a focus on folate rich foods I will be able to finally get rid of my stored toxins and find my way to health.
Ok standard disclaimer: I am not a Dr. I don’t even play one on TV. I’m just a person with a MTHFR mutation and lots of health complications sharing what I have learned along the way. Proceed at your own risk. Your mileage may vary.Step one for many people is to go to your Dr and get tested for the MTHFR mutation. I know Lab Corps and Quest both run this test. I’m not sure about other labs. This will only tell you about the 2 best known mutations but it is a good start. There are certain risks that are associated more with one or the other of those so knowing what you are dealing with in regards to those specific mutations can be helpful in directing your treatment. In addition it is good to also test your homocystiene. This is often elevated with MTHFR mutations and is a sign of increased risk of heart attacks and strokes and other problems caused by blood clots. Even without elevated homocysteine there are health risks associated with MTHFR mutations but that one is easy to screen for. Coming up negative on those tests doesn’t mean that a MTHFR mutation isn’t in your health picture. It simply means that those two mutations that were tested for aren’t. As I said in my first post there are 7 common mutations and more than 50 total that have been identified at this time. Also as I said BPA and some other toxins can also cause problems with the enzyme that the MTHFR gene makes so even if you don’t have this mutation the toxins in your life may make it so that you functionally are impaired just like someone who does. If you have children that have symptoms of MTHFR mutations, get mom and dad tested first. If they don’t have one to pass along then there is no point in testing the children and if the kids test positive then mom and dad need to know what they are dealing with too for their own health.Which brings me to the part of this blog post that most of you are looking for: what can to be done to fix this. The good news is that this can largely be mitigated with the right vitamin supplements. There are no expensive patented drugs with risky side effects to consider. However exactly which vitamins and how much is a little tricky. I will lay out some of the main supplements suggested and point you toward places where you can get more information and make up your own mind. Of course we are all individuals and so what works fabulously for me may do nothing for you or even make you feel worse. Also, you need to be aware that once you correct for the deficiencies that you have your body will be able to start detoxing all those stored toxins and that can be quite uncomfortable. This isn’t to say that all uncomfortable sensations are just detox and should be powered through. Do you see how this gets complicated?So first and foremost Methyl Folate (5MTHF, Metafolin). Clearly people with MTHFR mutations need methyl folate and luckily that is a vitamin that can be taken orally and well absorbed. Pretty much everyone agrees on that at this point in time. Beyond that, you will find as many opinions as there are Dr’s prescribing and researchers researching. You can get this in prescription form from your Dr either by itself or a complex with some other vitamins. It is rarely covered by insurance. The prescription form with just Methyl Folate is called Deplin and comes in a 7.5 mg tablet. There are also a few OTC (over the counter) versions of methyl folate, again either by themselves or complexed with other vitamins. Most of them contain 800mcg of methyl folate (1000mcg=1mg). Some people say that you need a minimum of 7.5mg a day if you have MTHFR mutation and some say that the body won’t absorb more than 800mcg at a time. I personally don’t know enough to know who is right. So there is your first dilemma. Also you may read that one pill or another is the only one with true methyl folate. I believe that there was just one source at one point in time but that is no longer true. Also, despite what some may tell you, folinic acid is not methyl folate and if you have a MTHFR mutation you won’t be able to convert it into methyl folate so it isn’t what you need. A few years ago it was thought to be just as good. Confused yet?Next up is methyl b12 (MB12, methylcobalamin). This is one that most Dr’s and researchers agree on as well. This one however has a huge problem It isn’t absorbed well in the gut. There are a few ways that people get around this. The most common and universally accepted as effective way to take MB12 is injections. They are typically done every third day with a very tiny needle. We have done them here and after some fear at the start the kids got used to them and didn’t seem to mind them (we do use a numbing cream on the kids). These need to be compounded and you need a Dr’s prescription for them. There are only a few pharmacies that make this correctly. It is rather expensive and needs to be kept cold and mailed overnight if you aren’t local to one of those pharmacies. Another option is a Nasal spray. I believe this is also only available with a prescription. My Dr said that many find it to be as effective as the injections. I haven’t tried it but am considering it. Sublingual dosing is an OTC option. Certain pills or liquids are made to be held under your tongue and absorbed that way. B-12 Methlcobalamin is one option for this method.There is debate about how effective sublingual dosing is. Lastly of course there are pills which are generally not very effective because of the trouble absorbing MB12 in the gut but they are also OTC and they are widely available.Two other b vitamins probably should be taken in the active form as well. B6 in the form of Pyrodixyl 5′-Phosphate or P5P and B2 as Riboflavin 5′-Phosphate or R5P. Many say that all the b-vitamins should be taken at the same time to keep them in balance. Many of these are included in the multi type supplements that include methyl folate. Homocystex is one of that type of supplement. You can also order them individually. In addition to these vitamins methyl donors are important. TMG or DMGare commonly taken for this purpose.The other thing that is important to supplement with this genetic mutation is minerals. Especially magnesium and zinc but others as well. The reason for this is that with detox minerals bind together with the toxins and both are excreted together. It is difficult to keep up with your mineral needs through food alone unless you are doing a lot of juicing and drinking a lot of bone broth when detoxing heavily. Some minerals, like magnesium can be difficult to take orally and may need to be supplemented transdermally. Epsom salt baths are a good way to support your detox and get supplemental magnesium. Also Magnesium Oil sprayed on the skin is another good source of magnesium. When I am detoxing I get a lot of muscle cramps and spasms and spraying magnesium oil spray right onto those areas helps to relax the muscles. It can sting when you first start using it. If it does and you can’t bear it simply dilute it and over time as your levels get higher it won’t sting any more. I am going to include some links to videos and websites that should help you figure out what to do next. One important key to this is go slow with the supplements, add one at a time and don’t be surprised if you have adverse effects at first. I have begun to add some of these vitamins to what I take and it is tricky to get the right dose that helps me feel better without pushing me too far. I have adjusted my dose up and down a lot as I take too much or not enough and over time I expect to tolerate more and not have these problems with it but getting started is tricky. I have also started my children on these supplements and am seeing lots of detoxing. My youngest just fell apart one morning about an hour after she had a dose with breakfast (you should always take b-vitamins in the morning because they give most people extra energy). I finally figured out that she was detoxing too heavily and gave her some activated charcoal. She was back to herself quite quickly. Lesson learned. It would be a good idea to keep some activated charcoal on hand for yourself when starting these supplements. You may take enough to cause uncomfortable detox symptoms and rather than suffer through them you can take activated charcoal which will often remedy the situation. The only risks with taking it are it can cause constipation and if you take it with a meal it will inhibit absorption of many nutrients so only take it when you need it.www.mthfr.net Dr Ben Lynch’s siteHomocysteX Supplement Dr Ben put together for MTHFR peoplewww.mthfrsupport.com Video #1 of Dr Rawlins explaining MTHFR Dr Rawlins siteDr Rawlins MTHFR Supplement ProtocolHere is an easy way to see many of the supplements I have suggested in this blog post in one place. There are other brands and other sources that are also good. These are just good respected brands and an easy source to share with you.
This is not intended to be exhaustive or to tell you exactly what you need to do. Hopefully this will give you the framework to understand where to begin tackling this for yourself or family members. I thought the videos that Dr Rawlins did were excellent and explained the situation and what to do nicely but of course not everyone agrees with him on every point. His power point is available on his website as well. Dr Ben is dedicated to figuring out how to support people with MTHFR mutations and offers phone consultations. He also generously answers questions on his website as well. I’m sure that there are other Dr’s who do the same if you can’t find anyone local who knows much about MTHFR.