6 Helpful Steps to Manage MTHFR

Remove synthetic folic acid from your diet

You should be particularly concerned about synthetic folic acid from dietary supplements, vitamins, prescriptions and especially fortified foods. Synthetic folic acid is not only ineffective for people with MTHFR variants; it’s actually counterproductive. Studies have pointed to folic acid as being responsible for unmetabolized folic acid which can complicate health and even be connected to cancer.

This is the REALLY IMPORTANT ONE...

Add a quality L-Methylfolate supplement to your nutrition routine. Start with a lower dose (400-2,500 mcg) and slowly increase if you have symptoms or conditions which suggest you might do better with a higher dose. Take some time to review our dosage details and methylfolate side effects information if you have concerns about how much L-Methylfolate to take.

Also, check out our Methylation Protocols page which provides different FREE protocols which target various MTHFR symptom sets. Each protocol guide gives step by step details for nutrients, dosage increments and product options.

Prescription Medical Foods with L-Methylfolate Calcium

If you’re considering L-Methylfolate to target a specific condition, there are prescription products which were developed with just that in mind. NOTE: these contain dyes, allergens and extra fillers. See a comparison chart below (pay particular attention to the dosages of active ingredients to give you an idea of what you might want to target).

Get Serious About "EATING CLEAN"

Try to adopt as many of these healthy eating habits as you can, even doing one of them is beneficial. Don’t think of this as an “all or nothing” list.

Consider taking key cofactors that benefit those with MTHFR

IF you tolerate them well, of course. And as with all nutrients, please LISTEN TO YOUR BODY and do what’s best for you – not everyone tolerates all ‘beneficial’ nutrients:

Reducing toxic burden

Lower your exposure to toxins and work to rid your body of them by taking some of these steps:

The easiest places to start:

Sweat regularly (get in the sauna or exercise)
Don’t eat, drink or especially store in plastic containers that have BPAs or phthalates
Watch out for BPAs in unexpected places (most receipts are printed on paper with BPA)
Avoid using nitrous oxide increasing drugs (i.e. laughing gas at the dentist)
Drink “clean water”
Use the recirculating fan in the car when behind other vehicles in traffic (especially the big dirty ones spewing fumes – like semi-trucks, buses, garbage trucks, etc.)
Consider a whole-house air purifier/cleaner
Have mercury metal fillings removed by a qualified dentist
Consider replacing carpet with tile or wood (low VOCs)
Install a whole house water filter (remove chlorine/chloramine)

Above and beyond:

Receiving a diagnosis that requires lifestyle changes can be incredibly overwhelming. Remember, this is not an “all or nothing” set of rules to follow. Start where you can, and as your body responds, you will learn more, then as you slowly get used to the ideas, gradually take more steps.

Remember, this whole process is like running a marathon, not a sprint.

Be encouraged - your healthiest life is within reach!

Quick Personal Note from Methyl-Life® Founder, Jamie Hope

"I had my serotonin level tested before starting a methylfolate and active B12 regimen. My result was 85, significantly low (normal range for the test was 125-185).

3 months later after taking 5 mg of L-Methylfolate and 5 mg of active B12 each day, I had my level tested again and it came back at 136 (significantly improved and within normal range).

Not only did I feel so much better (my mood was lifted), but my IBS symptoms began to melt away (much to my surprise). As I continued taking the nutrients over the next 6-9 months many things just got so much better. It really was quite an amazing transformation for me, a slow but steady healing. So don't underestimate the power of bioidentical methylfolate and B12 nutrients for not only mood improvement, but also repairing the gut.

Find your own sweet spot, where the amount of methylfolate you take makes you feel better.

It is worth noting that some people may never feel a big change like I did right away. Dr. Neil Rawlins says it may take some as many as 4 months (at a therapeutic dose - for some that is as much as 15 mg) to notice that they are actually feeling better.

Some people may just take methylfolate because it is recommended for them and reduces their homocysteine as well as disease risks (i.e. heart attack, miscarriage etc.) and helps clear toxins/metals/BPAs out of their system via glutathione boosting. These folks may not notice as much of a difference in how they 'feel', everyone's experience is unique."

Increase purified water intake (without chlorine / chloramine / flouride) - Consider 1/2 your weight in oz

Cut out antibiotic and hormone fed foods

Try gluten & dairy free - it makes a difference (dairy contains a folate binding protein that can compete for folate receptors)

Get as much nutrition from whole foods as possible

Eat smaller servings more often

Remove inflammatory foods (get an IGG or IGA food allergy test to reveal offending foods)

N-acetylcysteine ( NAC / NACET )

Vitamin E

Probiotics

DHA/EPA

Vitamin C

Glutathione

Silymarin (Milk Thistle)

Curcumin

Vitamin D3

Zinc

Citicoline

Nattokinase

Riboflavin-5-Phosphate

Additional Resources

Review Methylfolate Dosage Details

MTHFR Supplementation Protocols

Best Bioidentical B12 Forms

Prescription Medical foods with L-Methylfolate Calcium Table

Medical Food Product	L-Methylfolate	Active B12	Other Actives	Inactive Ingredients	Rx Only
Cerefolin® NAC Dementia Alzheimer’s prescription targeting brain health	L-Methylfolate 5.6 mg	Methylcobalamin 2 mg	N-Acetylcysteine (NAC) 600 mg	Microcrystalline Cellulose, Opadry II Blue 07F90856 (Hypromellose, Talc, Titanium Dioxide, Polyethylene Glycol, FD&C Blue #2-Aluminum Lake, Saccharin Sodium), and Magnesium Stearate (Vegetable Source)	Yes
Deplin® 7.5 Adjunct Depression prescription targeting increased serotonin production	L-Methylfolate Calcium 7.5 mg	none	none	Dibasic Calcium Phosphate Dihydrate, Silicified Microcrystalline Cellulose 90, Silicified Microcrystalline Cellulose HD 90, Opadry II Blue 85F90748 (Polyvinyl Alcohol, Titanium Dioxide [color], PEG 3350, Talc and FD&C Blue #2[color]),L-methylfolate Calcium, Magnesium Stearate (Vegetable Source), and Carnauba Wax	Yes
Deplin® 15 Adjunct Depression prescription targeting increased serotonin production	L-Methylfolate 15 mg	none	none	Dibasic Calcium Phosphate Dihydrate, Silicified Microcrystalline Cellulose 90, Opadry II Orange 85F43102, (Polyvinyl Alcohol, Titanium Dioxide [color], PEG 3350, Talc, FD&C Yellow #6[color], FD&C Yellow #5[color], FD&C Red #40[color] and FD&C Blue #2[color]), L-methylfolate Calcium, Magnesium Stearate (Vegetable Source), and Carnauba Wax	Yes
Metanx® Diabetic prescription aimed at neuropathy	L-Methylfolate 3 mg	Methylcobalamin 2 mg	Pyridoxal-5-Phosphate (B6) 35 mg	Dibasic Calcium Phosphate Dihydrate, Microcrystalline Cellulose 90, Microcrystalline Cellulose HD 90, Pyridoxal-5´-Phosphate, Opadry II Purple 40L10045 (Polydextrose, Titanium Dioxide, Hypromellose 3cP, Hypromellose 6cP, Glycerol Triacetate, Hypromellose 50cP, FD&C Blue #2, FD&C Red #40, Polyglycol 800), Microcrystalline Cellulose 50, Opadry II Clear Y-19-7483 (Hypromellose 6cP, Maltodextrin, Hypromellose 3cP, Polyglycol 400, Hypromellose 50cP), Lmethylfolate Calcium, Magnesium Stearate, Methylcobalamin, and Carnauba Wax	Yes
NeevoDHA® – Prenatal Prescription aimed at healthy pregnancy	L-Methylfolate 1.13 mg	Methylcobalamin 1 mg	Pyridoxal-5-Phosphate (B6) 25 mg	Gelatin (Bovine), Glycerin Blend (glycerin, sorbitol), Titanium Dioxide (color), FD&C Blue #1, Ethyl Vanillin, FD&C Red #40 Contains Soy	Yes

Prepare the Methylation Biopathway with Cofactors

Start Supplementing with NAC / NACET to Boost Glutathione

According to Dr. Neil Rawlins, NAC is one of the best nutrients to begin with if you have MTHFR (NACET is a superior absorption form to substitute). NAC / NACET helps replenish intracellular glutathione in the body which is especially helpful for protecting organs and detoxifying things like heavy metals, BPAs, phthalates, etc. Consider starting on a dose of 600-3,600 mg a day (1,200-3,000 mg being a solid range for most) - based on tolerance). Take the NAC / NACET for 1-2 weeks before beginning with the main active nutrient [Methylfolate] discussed in detail in step 3. Methylfolate will promote & utilize the intracellular glutathione, so you'll want to be sure you've got that onboard and have already "primed that pump", so to speak. NAC / NACET is the most affordable option for increasing intracellular glutathione levels. Those dealing with bipolar disorder, peaks and troughs (or other challenges where neurotransmitters build up or deplete quickly) can often benefit from a monoamine reset. NAC / NACET can help with this at the higher dosage levels, ~4,000 mg a day. NOTE: NACET is approximately 10-14x more potent than NAC, so adjust the amount you take accordingly.

A Clean Multivitamin cofactors without folic acid or B12

Consider taking a clean multivitamin that has no folic acid and no B12 (specifically cyanocobalamin which is a cheap, synthetic form of B12 that is not absorbed well and contains cyanide - stay away from it). A multivitamin without folate or B12 can be VERY hard to find, but it will help you prime the methylation pathway before you introduce the active ingredients specifically designed to support the MTHFR variants.

Get a Bioidentical Active form of B12 onboard

Consider taking bioidentical B12 forms in conjunction with L-Methylfolate because they work synergistically together in the body on the methylation pathway and can amplify its benefits. Stay AWAY from cyanocobalamin in supplements and fortified foods! Methyl-Life® carries affordable, vegan versions of active B12 in a tasty sublingual tablet (some products even include L-Methylfolate).

Bioidentical Active B12 Forms:

Hydroxocobalamin - harder to find, expensive, typically well-tolerated and used for pernicious anemia among other things
Methylcobalamin - fairly available and found in some supplements, most active for methylation Note: it's not always well tolerated
Adenosylcobalamin - harder to find, expensive, the most well-tolerated and often used in muscle recovery

B12 does NOT absorb well via the gut, so be sure to get a product that allows you to dissolve the B12 under your tongue. Sublingual transport is the best way to get B12 absorption (research has proven it's even better than B12 injections for increasing B12 sufficiency). If B12 blood serum levels test "high", consider Methyl-Life®'s Non-Methylated Multivitamin.

Learn more about the best bioidentical B12 forms to take.

Consider Taking Magnesium, an Important Cofactor

Magnesium helps methylfolate with the production of SAMe which is responsible for generating our neurotransmitters, including serotonin which is responsible for our mood. Magnesium is also required for the proper function of (COMT), the enzyme responsible for metabolizing catecholamines (our stress response released as neurohormones). Impaired COMT activity has been linked to cardiovascular issues, particularly hypertension. Another critical enzyme with a high magnesium requirement is glutamine synthetase, which drives glutathione synthesis (responsible for detoxification - and which methylfolate ignites). Magnesium is responsible for over 600 enzymatic functions in the body and is an important co-factor you want to have onboard. Most are deficient in magnesium, so getting a healthy dose (400-600 mg daily) of a highly bioavailable form is extremely beneficial (consider a liposomal-like delivery). Possible bonus benefits: it may bring more calm, help normalize some stress responses, provide better balance to sleep issues, and may even lower hypertension.

Be aware of Vitamin B6 as Pyridoxal-5-Phosphate (or P-5-P)

Some will do well with higher doses of this vitamin (over 6 mg) as this can help reduce homocysteine when taken in conjunction with methylfolate and an active B12 (methylcobalamin), but others absolutely will not. Other genetic challenges can cause P-5-P buildup or toxicity in the body for some, which can be identified by tight-band headaches that go away when the P-5-P (B6) supplementation is stopped. Consider taking a multivitamin that has a lower dosage of P-5-P (B6) to start, unless you know you tolerate this vitamin form well.

High Homocysteine Levels? You may also want TMG / Betaine

TMG (Trimethylglycine or Betaine) may be helpful for some. TMG, like NAC / NACET and methylfolate can also help reduce homocysteine. So if you have high homocysteine levels (between 5-9 is considered optimal), you may benefit from taking higher doses of TMG. Consider a dose of 600-1,800 a day depending upon your homocysteine levels.

NOTE: Not everyone with an MTHFR variant has high homocysteine.

DMG (Dimethylglycine) is similar to TMG in that it reduces homocysteine, however, some might find it more helpful than TMG. Both TMG and DMG reduce homocysteine levels by sending methyl groups into the methyl pool (this produces SAMe [S-Adenosyl methionine] from the homocysteine).

Methylfolate Ranges for Specific Health Conditions

If you’re targeting a particular condition, try a dosage level specific to that need. NOTE: L-Methylfolate crosses the blood-brain barrier, unlike folic acid.

Pregnancy/Fertility - target dosage is ~1-4 mg methylfolate per day

Diabetes/Cardiovascular Health - target dosage is ~3 mg methylfolate per day

Lowering Homocysteine levels - target dosage is ~3-7.5 mg methylfolate per day (NAC/NACET, TMG and Glutathione can also help with this)

ADD/ADHD/Focus and Attention - target dosage is ~1-5 mg methylfolate per day

Cognitive Health/Dementia/Alzheimer's - target dosage is ~5-6 mg methylfolate per day

Depression/Bipolar/Mental Health challenges - target dosage is ~7.5-15 mg methylfolate per day

Eye Health - target dosage is ~1 mg methylfolate per day

What side effects could I encounter?

Remember, these are vitamins, so the number and type of side effects experienced are going to typically be much lower than it would be for a pharmaceutical drug. But be smart. If you’re very sensitive to drugs, vitamins and supplements, then START LOW and GO SLOW to increase.

Make only one change at a time – whether you increase your dose of the same nutrient or add another nutrient into your routine.

Some side effects you could encounter: