Many people with MTHFR mutations find that methylfolate, the very supplement that they are advised to take, doesn’t seem to agree with them.
“Methylfolate makes me feel awful.”
“Methylfolate makes my child go crazy!”
“I am never taking methylfolate again!”
I’ve heard all of these many times on facebook forums for people with MTHFR mutations. Yet, methylfolate is the most commonly recommended supplement for people with MTHFR mutations – and with good reason.
Amongst the bad advice that many MTHFR patients receive, the two biggest mistakes I see are:
- recommending high-dose folic acid; and
- suggesting that people with MTHFR should go straight out and take methylfolate.
I have already addressed the folic acid question in my previous article, so this article is going to talk about taking methylfolate, and why you shouldn’t rush into that!
So… you’ve found out that you have the MTHFR gene mutation. Since that results in lower levels of methylfolate in your body, and methylfolate is kind of critical, you think you should take some methylfolate.
That makes sense!
So you buy some, you take a capsule, and then …. it gets bad.
Not for everyone. Some people are lucky. But at least 90% of people have side effects.
These are the most common stories I hear:
“I felt jittery, shaky, anxious, ‘weird’, ‘wired’ or panicky.”
“I hurt all over. Every joint and muscle ached.”
“Every symptom I’ve ever had came back at me with a vengeance.”
“I felt nauseous and nearly threw up”
“I had a six-day long migraine”
Children sometimes react a little differently:
“He was bouncing off the walls until midnight!”
“She just cried and cried all day – everything that happened in her day was taken as a total disaster and she just lost it.”
“Meltdown city!”
“I have never seen him so hyperactive in all his life.”
“She had a high fever for two days and was really tired” (I’ve actually heard this story from two different parents, and it kind of perplexes me as it’s a bit of an unusual reaction, but as I’ve learned, with methylfolate reactions, almost anything is possible.)
And my personal favourite – the child who literally destroyed a grand piano when given a dose of Deplin (a very high-dose prescription methylfolate supplement.. and one I would never use).
What causes these reactions? We need this stuff, right? How can a natural nutrient that is already in your body create such havoc?
Let me take you on a little imagination trip:
The body makes methylfolate to perform a function called methylation. (If this is a new area for you, you might want to read my MTHFR primer first.)
Methylation is a critical process that detoxifies steroid hormones, heavy metals, and environmental toxins of all kinds. It also makes neurotransmitters and breaks them down, amongst other things.
Now imagine that methylation is a pipe. But because of your MTHFR mutation, not much methylfolate has been made, so there is a block in your methylation pipe.
Unfortunately, your body has no respect for the fact that your methylation pipe is blocked, so it keeps making steroid hormones, breathing in toxins and pumping out neurotransmitters. (Probably for the best that it does, really!). And just like if you keep pouring waste down a blocked drain, “gunk” has been building up behind that blockage. Ew.
Imagine then that we suddenly remove that blockage – just like that, gone. What happens then? Well, as any plumber can tell you, all that built up gunk immediately flows down the pipe (which can be pretty gross.) Now remember that pipe is your body, as I take you through the top five reasons why you may react to methylfolate……
You started too fast
This is one of the most common mistakes.
Whatever you do, DON’T take the full capsule the first time! Start slowly.
Imagine that pipe is your body. Don’t you think it would be much less disgusting to let just a little of that gunk out at a time, so that it doesn’t flood the whole rest of the pipe beyond the blockage?
You’d be right. Go slow.
One way to go slow is to take a smaller dose, and the other way to go slow is to take it on a full stomach so that the food slows the absorption of the methylfolate. I recommend combining both strategies at once. Your body has to detoxify all of this gunk.
Give it a chance to do that at a pace it can handle.
You overmethylated in response to the sudden increase in methylfolate
This one can get a bit complicated and there is a LOT of misinformation on the web about overmethylation.
Let me just say that overmethylation is not something you do all the time. You are not a permanent overmethylator. That’s simply not possible, despite what some people may have labelled you as.
However some people are prone to overmethylating when they increase their intake of methyls – temporarily.
It’s when your body just can’t keep up with the sudden increase of neurotransmitters in your brain. The brain says ‘hey wow, haven’t had many methyl groups lately, now that we’ve got plenty, let’s go to town on the making of all this stuff we’ve been unable to make for a while!’
But then, seconds later it says ‘ah but hang on, we aren’t used to having so many neurotransmitters around so we’re not equipped to break them down that fast!’ This tends to result in symptoms of feeling ‘weird’ or ‘wired’.
I’m also pretty certain it’s responsible for the angry outburst/meltdown/hyperactive type reactions in children too. It’s akin to unblocking your pipe, only to find that the pipe beyond the block is a bit too small to accommodate the flow of water down the pipe now.
But it’s ok – unlike pipes, your body can adjust to the new flow, and it will. Going slowly also helps to prevent overmethylation reactions. Giving extra niacin (vitamin B3) also helps a lot. Most people only need extra niacin temporarily, but a standard dose of niacin should always be included in your B vitamin regime. Get professional help to know how to handle this type of reaction – overmethylation reactions can be very serious, particularly in persons with mental illness, anxiety or depression.
You were lacking one of the other nutrients required to use methylfolate
This is kind of like unblocking the pipe, but then finding that the pipe beyond the block had holes and cracks – all that gunk had to travel down a pipe that wasn’t fit to carry it.
It’s important to have all of the other nutrients in place that are required to break down toxins and neurotransmitters and work with methylfolate.
These include zinc, magnesium, all the B vitamins, iron and others. This doesn’t mean that you need to be supplementing all of these, but you may need some or all of them if you don’t have enough body stores, or have other genetic mutations that mean you need more of them than you have.
I would say that inadequate B12 is the most common reason I see why people who have started methylfolate slowly have reacted badly. B12 takes the ‘methyl’ from methylfolate and uses it to recycle homocysteine.
If you haven’t got enough B12, the methyl group can’t come off the folate so it gets ‘stuck’ there, unable to be used. (You may have heard others refer to methyl-trapping. This is the phenomenon I’m talking about.) Moral of the story: get the rest of your nutrients in place, especially B12, before starting folate.
The form you are taking may have other ingredients that don’t agree with you
Some of the prescription methylfolate drugs, such as Enlyte, also contain large doses of folic acid.
If you don’t already know why that’s bad, then you might like to read this post.
There are also often other additives in supplements, particularly the high-dose prescription ones. Watch for added colours, sweeteners, folic acid and goodness-knows-what.
This may be the simplest solution to reactions: get a pure, trusted brand, with all excipients declared!
You’re taking too much
To treat the nutrient like a drug and make a patented product, some pharmaceutical companies are making methylfolate products like Deplin with milligram quantities of methylfolate.
In reality you’re unlikely to need more than a few hundred micrograms. Doses such as 15mg of methylfolate have no place in anyone’s body and greatly exceed the amount of methylfolate that any normal person makes, even if they eat a folate-rich diet.
I am amazed that anyone tolerates these products, to be honest.
Stick to low dose supplements (bearing in mind that you may eventually need to take a few capsules, or not) and don’t believe the hype that you need a truckload of this stuff.
The fact is that you don’t need much more than the average person makes from their food folate, which ain’t all that much.
And That’s the Ballgame
There you have it, methylfolate reactions explained.
Work with your practitioner as always, especially when it comes to finding out what other cofactors you need, and most especially if you have had some issues with overmethylation, or know that your genes make you prone to it.
The good news is that I have yet to come across any of my patients who needed methylfolate who could not tolerate it once all of these factors were addressed appropriately. It can be tricky, but in my experience it can almost always be done if it has to be. Best of luck!
I have the mutation gene MTHFR C677T detected Heterozygous my Dr has no ideas on how to help me also said my children an grandies don’t get tested free anymore cold you pls help me I have low thyroid just in March this yr had a cryoblation on heart values have also a Bullous auto immune disorder my body is turning on it’s self I also have dyslexia thanks heaps for your info luv jewels Xoxo
Hi Julianne,
Sounds like you are having a tough time! If you would like to get some specific help for your situation I would need you to make an appointment. You can do that online here. Hope to hear from you soon.
I have MTHFR C677T homozygous. The worst one. I can’t go on much longer with the anxiety and depression I have. It’s been years that i have been looking for a doctor that knows how to treat this.
I can’t tolerate any supplement with methylation. Even the smallest amount.
I’m so sorry to hear this Jean. Firstly I would say that the MTHFR mutation may indeed be a large part of the cause of the problem, though you will need to work with a good practitioner who understands all of the interlinking parts, including other genes and environmental factors. If you live in Australia I would be very happy to give you an appointment if you would like to make one. If you are outside Australia, please feel free to send me a message via the ‘contact’ form on this website and I can recommend someone else that you could see who does how to treat these conditions appropriately. Best of luck, Nicole
Hello!
I have been taking methylfolate for about four years now. Sometimes I feel very jittery from my prenatal vitamins which contain methylfolate. I have found that I handle the vitamins much better when I am very well hydrated. On days where I forget to drink very much water, I feel very jittery, anxious, and strange. Just wanted to mention this in case it may be helpful to someone.
Thank you for your great article!
Do you know of a doctor near St. Louis, Mo. ?
Sorry, the only practitioner I know of in the USA is Dr Ben Lynch, but I don’t know where he is. If you can consult him via skype or in-person, he’s very good.
People wrongly assume that if one is an “under-methylator” that taking methyl folate is some kind of heavenly prescribed and preferred option. This is not the case.
True, it’s definitely more complicated than that!
Just have to say: I’ve been researching and dealing with MTHFR misery for over 3 years, and this is the most well-written, easy to understand article I’ve read. And I’ve been to ALL the websites. WOW! Thank you! Will be sharing this.
Thanks!
I agree!
This is a great article. Very easy to understand for people that are not in the medical field congrats. I have been severely depressed and with chronic pain for most of my life. I am 41 yrs old. I found out 10 years ago I have 1 Gene of MTHFR (C677T) I was on deplin 15 mg and B12 for about 6 months with no benefit. I have been on at least 20 or more antidepressants and had bad side effects. I am on cymbalta and 1 mg of l- methyfolate. Cymbalta was working at first (but not with out sideffects) now it’s not. I recently tried rTMS ( magnetic therapy). I had high hopes that this would work. I didn’t see any benefits it’s been 2 months now. Over the past couple years my symptoms have gotten worse including anxiety, lethargy insomnia and memory problems. I had a brain MRI, CT scan and other tests. They all came back negative. I am convinced MTHFR is most of my problem. The dozen Dr.s I have seen have not helped much. Any help or advice would be greatly appreciated. Thank you.
Thank you for the compliment on the article, I’m glad you found it easy to understand.
There are a lot of unwell people out there who find out that they are MTHFR positive and hope that this will be ‘the thing’ that fixes all their problems. I’m very sorry to say, but that is almost never the case. As my ‘bigger than MTHFR’ article outlines, it’s only one of a very large number of genes that all impact our susceptibility. However – and this is a big however – susceptibility does not equal disease. What we know now is that environmental influences (gut bacteria, diet, air and water quality) and even more so, spiritual issues (beliefs, stressors, bitterness, unforgiveness, fears, self-hatred etc) play a MUCH bigger role than any genetics do. I know of very many people who have become completely well just by addressing the spiritual issues. If you really want to be well, no matter how much it may cost you (not in terms of money, but in terms of effort and self-examination and humility) then please feel free to use the contact form to let me know where you live, and I will try to refer you to someone who can help you in this way.
In the meantime, your comment has reminded me that I need to write another article on the insignificance of genes compared to these other factors. Thank you.
Thank you for the article. I started Enlyte, and I’m curious as to why folic acid is in it if it’s so bad? I have a reputable physician and I’d be surprised if she was in that dark on that. Thank you!
Unfortunately very few medical doctors have more than bare minimum training in nutrition. As a result, even the most reputable physicians have almost no clue about how bad folic acid is – most are indeed in the dark. Perhaps you can refer her to the folic acid article here if she’d like to learn more!
So I have not tested to see whether or not I have any mutations on the MTHFR gene, but yesterday I began Methylfolate (200mcg/day) and TMG (4g/day) simply for general health benefits – nothing specific. Today I am beyond dragging. I am very fatigued mentally and physically. I’m giving it time before I draw up any conclusions, but do you see any correlation between my added supplementation and my symptoms? Something is definitely going on, I just don’t understand how or why exactly. Thank you so much for your time.
Hi Casey – yes, those supplements can make you feel worse if they aren’t needed or aren’t the right forms for you. To be honest, I do not think that it is a good choice to take that sort of thing for a general health benefit. You may well end up finding out that it results in a general health detriment. That is a fairly large dose of TMG – I can think of at least 3 possible negative effects from that straight off the top of my head. As for the folate – that can deplete vitamin B1 which you may have a higher need for than you realise. That’s on top of all the potential side effects from the methylated form. Really, such supplements should only be taken under the guidance of a practitioner who knows your whole health history and has seen your test results. If you really want to take something for general health, a low-dose multivitamin (one containing low dose of methylfolate or folinic acid, not folic acid) would be the safest bet. Better yet, try to get in to see a good practitioner for some more specific guidance.
I have the mthfr c677t gene mutation. My pcp says she may not be able to treat me. Lack of knowledge. I live in Graham Washington and I need to find a mthfr specialist.
hi Tina,
Unfortunately I’m not familiar with practitioners in the US, so I can’t help you out much with that, however please be aware that MTHFR isn’t necessarily a big part of your picture, or maybe not a part at all. If you are otherwise doing well with your pcp there’s no need to move to a specialist as such. Just avoid folic acid in all foods and supplements – aside from that, you may not need any specific treatment for the mutation. It doesn’t affect everybody.
Hi there,
Thank you for your website. Your articles are well written and so informative. I have the C677T and A1298C mutations. About Sox months ago I went from being completely normal and high functioning to a complete mess. I stopped sleeping and had anxiety and depression that was nearly debilitating. My doctors put me on ssris but they just made me a bit better. In addition to the MTHFR Gene, I have the slc-6 a4ss and comt Val Val. About a week ago my doctor put me on bed light. My reaction was immediate and amazing but unfortunately short-lived. I became irritable and I after getting my sleep under control, stop sleeping well again. Now I am taking a much lower dose, about 500 MCG. Since I started on that lower dose I feel great during the day, but I only sleep well every other night. I am very confused by this. I’ve been adding low dose niacin which seems to help. Other than the insomnia I have no other symptoms at this point.
I’d appreciate any advice you have for me. Thanks.
Thank you Jennifer for your comments.
Unfortunately every 2nd night insomnia has me pretty stumped too. I do agree that lower doses of methylfolate are usually better than the very high ones, so glad you dropped down.
The main thing I would advise would be to look at what happened just before you became ‘a complete mess.’ In all likelihood there was an emotional stressor, though sometimes it can be a chemical stressor such as a round of antibiotics or big chemical exposure. Most often however the emotional/spiritual aspects of our personhood are the keys when there has been a sudden downturn, so I would really recommend you put the focus there.