What’s up with this genetic mutation, MTHFR, people are claiming to have that can impact their mood and quality of life? There has been lots of recent chatter about the role of genetics and depression as it relates to what we eat and the supplements we take. Cutting edge doctors are starting to take notice of how your genes can impact your quality of life. And it begs the question, could folic acid be making you sick? It’s very possible if you have a genetic profile that makes folic acid more difficult to process. And if that is the case, you have a very common genetic mutation called MTHFR or methylenetetrahdrofolate reductase. You’ve trusted Mamavation to bring you topics like how to get most of your vitamins from whole foods, how to know if you are deficient in iodine, & 10 plastic-free products we highly recommend, now join us as we cover the MTHFR gene and it’s impact on our health and the folic acid we consume.
Disclosure: This post was written by Dr. Robin Miller, M.D., an Internal Medicine doctor who also serves as the medical director of Triune Integrative Medicine.
The MTHFR or Methylenetetrahdrofolate Reductase
MTHFR or methylenetetrahdrofolate reductase is a very common genetic mutation. MTHFR is a gene that codes for how enzymes in the small intestine process folic acid. Folic acid, or vitamin B9, is an essential vitamin only obtained from food or supplements. When you consume folic acid as a supplement or folate in foods, enzymes in the gut work to turn them into L-methylfolate. This is the precursor or building block for serotonin, dopamine, and norepinephrine–the hormones that make us feel happy and give us energy. People with the inability to process folic acid into L-methylfolate also have trouble producing serotonin, dopamine, and norepinephrine, which can impact mood. In order to process folic acid in the body, it requires the presence of a specific enzyme named dihydrofolate reductase. Many people have less of this enzyme.
What’s Happening in Your Genepool? Two Types of MTHFR.
Is it possible you have a genetic mutation? Well, it’s very possible because it’s very common. And here’s a description of the two possible gene mutations. There are over 40 possible MTHFR mutations. At this point in time we are able to check two of the MTHFR genes. One is known as C677T. The other is A1298C. The C677T has been studied more than the A1298C. On each gene are 2 alleles. If you have one mutation on one of the alleles on a gene, you are said to be heterozygous. If you have mutations on both alleles on a gene, you are said to be homozygous.
If you have one mutation on either MTHFR gene, your ability to convert folic acid is down by 34%, it will be down 71% if you have two. What does this mean? Read on.
Effects of MTHRF Genes on Health
When a person with one of these gene mutations is given L-methylfolate as a vitamin, their mood, and energy level may improve. And that’s because their body doesn’t have the ability to fully change folic acid into the hormones needed, so when it’s given in the form that they are able to handle, things change. When people who are sensitive to folic acid are given folic acid, it remains inside the body and can create side effects including changes in sex hormones, mood changes, trouble concentrating, inability to sleep, and deficiencies in certain nutrients like vitamin B12. Here are some additional symptoms of someone with MTHFR genetic syndrome.
- Constipation, bloating and irritable bowel syndrome (IBS)
- Poor immune function; frequently getting sick
- Changes in mood, including irritability
- anemia and pale skin
- canker sores inside the mouth and swollen tongue
- Chronic low energy, including chronic fatigue syndrome
- Developmental problems during pregnancy
- Prematurely graying hair
Studies have found L-methylfolate improves mild depression quickly. A study of elderly depressed patients found the response rate at six weeks was a whopping 81%! Results are often seen in 2 weeks. When I’m treating my patients, if a patient has one mutation, I recommend 7.5 or 10 milligrams of L-methylfolate. For two mutations, I recommend 15 milligrams of L-methylfolate.
Something that most people do not realize is that the gut is lined with brain cells. Serotonin, dopamine, and norepinephrine are all important for health as well. If a person suffers from irritable bowel syndrome (IBS) and has these mutations, I’ve noticed in my practice that often their IBS improves or goes away entirely with proper supplementation. Personally, I have one mutation on each gene, so I am heterozygous for both. I have always considered myself to be a happy person, but I must admit after I started taking my L-methylfolate, I felt REALLY happy and found I had a lot more energy and my IBS went away!
MTHFR and Pregnancy, Heart Attack, Dementia & Rheumatoid Arthritis
There has been quite a bit of publicity for MTHFR recently as it pertains to pregnancy. There are studies that have shown elevated miscarriage rates in women with MTHFR mutations and elevated homocysteine levels that occur with the C677T pattern. Treating women with L-methyl folate and B vitamins would be essential. MTHFR mutations have been associated with fetal loss, preeclampsia and certain birth defects as well.
The homozygous C677T pattern of MTHFR mutations has been associated with stroke, heart attack and dementia. If you have this set of mutations, taking L-methylfolate can be protective.
Patients with rheumatoid arthritis are particularly problematic when doctors are unaware of the MTHFR genetic mutation. Many patients with rheumatoid arthritis are treated with methotrexate. This drug is toxic to folic acid metabolism. That is why after treatment patients are given a high dose of folic acid also known as the Leucovorin rescue. Those patients with the MTHFR mutations are more prone to toxicity from methotrexate. That is because they should probably be given l-methylfolate following the treatment instead of folic acid.
MTHFR and Processed Foods
Many processed foods like bread & cereals are fortified with folic acid and therefore are also problematic for people with the MTHFR genetic mutation. Since 1998, the FDA has been requiring food manufacturers to add folic acid to enriched grain products, including breads, cereals, flours, pasta, rice and other packaged goods. The good news is the organic standard prohibits the use of synthetic vitamins, like folic acid, from being added to organic food. Therefore, shopping organic would be beneficial for anyone with the MTHFR genetic mutation to avoid the buildup of folic acid in their body.
What Should You Do If You Want to Get Tested?
MTHFR mutations are very common. If you are interested in finding out if you are one of the 60% of Americans who has a form of this mutation, the MTHFR test can be done with a cheek swab or blood test. It is Medicare approved and many insurances will pay for it especially if you are a pregnant woman. Regardless, you should think of doing the test if you have a family history of heart disease or dementia and/or someone who is taking methotrexate and especially if you are being treated with medication for depression. The L-methylfolate can augment your treatment and perhaps help you lower your dose or stop it entirely. If insurance doesn’t pay, the usual cost is about $150 or so.
If you would really like to get this done on your own there are a couple of things you can do like:
- MTHFR.com $150 (direct reporting)
- 23&Me $199 (you’ll need to download “raw data”)
- Ancestry.com $89 (you’ll need to download “raw data”)
Another route is getting your testing done at 23&Me or Ancestry.com and downloading the “raw data” and then uploading it to another platform. Here’s information on how to pull out your raw data from 23&Me. Once you have your raw data, upload it here for methylation analysis and interpretation:
Read More About MTHFR And What You Can Do About It
Dr. Robin Miller wrote a book called Healed: Health & Wellness for the 21st Century that expands on what you are used to hearing from a medical doctor. Your diet and the supplements you take have an impact on how well you feel and how your body is relating to its environment. Click below to view it on Amazon!
Mamavation Recommendations for L-Methylfolate Supplements
Because some people just can’t process folic acid effectively, it’s recommended they switch to L-methylfolate instead. According to the National Institute of Health, the recommended dietary allowance for folate for those who process it normally is:
- Infants and babies–65 micrograms/day
- Children ages 1 to 8–80–150 micrograms/day
- Teens ages 8 to13–300 micrograms/day
- Adult men and women (above age 14): 400 micrograms/day
- Pregnant women–600 micrograms/day (note this is 50% higher than when you are not pregnant)
- Women who are breastfeeding– 500 micrograms/day
- Dr. Robin Miller recommends 7.5-10 mgs. for someone with one gene mutation and 15 mgs for someone with two gene mutations.
For adults, you should identify a folate product with a dose between 400 and 1000mcg. You should also pay attention to the form of folate, as some forms are more bioavailable than others. Mamavation recommends the following brands with superior folate sources!
- Megafood Balanced B Complex vitamins with L-methylfolate
- Megafood Baby & Me Pre-natal & Post-natal Multi-Vitamin with L-methylfolate
- Now Foods Methyl Folate 1000 micrograms
- Pure Encapsulations 400 micrograms
- Pure Encapsulations 1000 micrograms
- Solgar Folate 1000 micrograms
How to Get More Folate Naturally From Food
Eating a well-balanced diet will increase your chances of getting enough folate from your food. In order to do that, here are some heavy sources of natural folate:
- Soybeans (edamame)–482μg folate per cup (155g)
- Lentils–358μg folate per cup (198g)
- Asparagus–268μg folate per cup cooked (180g)
- Spinach–263μg folate per cup cooked (180g)
- Broccoli–168μg folate per cup cooked (156g)
- Avocados–163μg folate per avocado (201g)
- Mangoes–71μg folate per cup (165g)
- Lettuce–64μg folate per cup (47g)
- Sweet Corn–61μg folate per cup cooked (145g)
- Oranges–54μg folate per cup (180g)
About the Author:
Dr. Robin Miller is currently is practicing Internal Medicine and serves as the medical director of Triune Integrative Medicine, a highly innovative Integrative Medicine clinic in Medford, Oregon. She is also a producer and multimedia expert. Robin is the medical reporter for KOBI-5, the NBC affiliate, a medical columnist for The Daily Courier in Grants Pass, Oregon, and an expert contributor to Health, Woman’s World and First Magazine. She has produced the award-winning health series, “Is there a Doctor in the House,” which is shown on the Wellness Channel nationwide. Her Health Smarts tips are seen regularly on Sharecare.com. She has been a guest on the Dr. Oz Show. Lastly, she has a weekly radio show on Kiss FM called, “Kiss Your Health!” Robin has authored a number of books: Kids Ask the Doctor, coauthored The Smart Woman’s Guide to Midlife and Beyond, and the recently coauthored: Healed: Health and Wellness for the 21st Century.