6 Helpful Steps to Manage MTHFR

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.

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.

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.

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.

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

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).