There’s a lot of conflicting information available about MTHFR (methylenetetrahydrofolate reductase) on the internet, so this article is designed to break it all down for you and give you the facts.
Your body has many processes going on all the time that maintain our health, and one of those processes is called the methylation pathway. MTHFR is a regulatory enzyme in this pathway, specifically the homocysteine pathway that is folate-dependent. This basically means that your body needs folate in order for that methylation pathway to work correctly.
Dysfunction in this pathway has been linked to infertility in both sexes, recurrent miscarriage, risk of venous thrombosis (blood clotting disorders), mood disorders and mental health problems, and autism spectrum disorders.
There are two genes relating to MTHFR that are relevant. They are the C677T gene, and the A1298C gene. Having a problem with one or both of these genes may result in a reduced capacity for homocysteine methylation. With the genes, there can be heterozygous (one copy) or homozygous (two copies) issues with each gene. A dysfunction in the C677T gene is considered more serious than in the A1298C gene. As an example, if you are heterozygous for the A1298C gene, this is not associated with increased homocysteine in the blood (i.e. methylation is working correctly). However if you are heterozygous on the C677T gene, this IS linked to increased blood homocysteine and the above mentioned health risks. Being homozygous for either gene is also problematic, as is being heterozygous for both genes.
If you’ve had your MTHFR gene test done and you’re worried about the results, please don’t stress. These variations in genes are known as polymorphisms, and we all have them. Sometimes they don’t affect us, and sometimes they do. The degree to which we’re affected is the main issue, but quite often there are ways to mitigate any problems associated with particular polymorphisms.
In the case of MTHFR, we work around this by focussing on using the best forms of supplements. Folate (vitamin B9) is what your body uses in the methylation pathway. If your diet is deficient in folate from not eating fresh vegetables, then you will need to supplement that deficiency. Most supplements (in particular prenatal supplements) will use a synthetic form of folate called folic acid. This form is very poorly utilised by the body, especially in people with MTHFR gene defects. This is also the form that is used in fortified foods such as non-organic flour and breakfast cereals. Being inadvertently exposed to folic acid when you have an MTHFR defect can be problematic for your health, so please keep that in mind when making food choices.
In the supplements I prescribe to my patients, the more bio-available versions of folate called folinic acid and methylfolate are used. These forms bypass the enzyme issue in MTHFR and are able to promote healthy methylation, including in people with an MTHFR gene defect. These sorts of supplements are unfortunately not usually available on the market for people to purchase at shops, so you will need to see an allied health practitioner such as myself for access to these better quality supplements.
I offer MTHFR gene testing to all my fertility patients during their initial consultation. Regardless of the result I still tend to recommend the better quality supplements to all my patients, considering how poorly utilised folic acid is within the body.
Have you been tested for MTHFR yet? I’d love to hear your story so feel free to leave a comment below. Please note that all responses are considered to be informational/educational and do not replace the advice of your doctor.
Skype consultations for fertility patients are now available to anyone worldwide (please make sure to convert the time to your local time zone!). Click HERE to book a fertility Skype consultation or in-person consultation.
Photo credit: Drew Patrick Miller
Disclaimer: All information in this blog post, and all responses to questions are to be treated as educational information and do not replace the advice from your doctor or health professional. Kim Gatenby Acupuncture makes no claims as to the accuracy of the information contained herein.
Hi Kim
I have been undergoing IVF treatment for 9 months now. All transfers have failed to implant and most recently I had surgery for kidney stone removal (I am only 30 and eat very strict clean diet). I pressured my GP to refer me for MTHFR test and it has come back hetero for both A12 & C677. He says this means nothing, so does my Fertility specialist however I am very aware this could be the reason for constant failures. I am struggling to find direction as every gp or nurse I speak to doesnt even know what it is or brushes it off. I have changed to Tresos Natal and added extra Vitamin B too. I eat gluten free and organic. Have removed all chemicals from home, changed to natural hygiene products and make up. I get accupuncture regularly and am using detox methods such as dry body brushing, infared sauna and Natural detox products on feet and armpits.
Should I be adding a Methyl 5 product to my supplementation or is Tresos Natal enough to deal with being hetero to both genes?
Hi Courtney.
I’m not allowed to make individual recommendations outside of a clinical consultation, but you should be under the care of someone who can prescribe the correct supplements for your situation. Self-prescribing can cause a lot of problems, including taking the wrong supplements and overdosing. If you’d like to become a patient I offer Skype consultations worldwide (Just head to the bookings page – be mindful of timezone differences). There appear to be a few things that may have been overlooked in your case (although obviously I’m sure you didn’t mention all previous testing).
Don’t add extra supplements on top of a prenatal unless prescribed by a qualified healthcare professional.
I hope you book in, because I’d love to be able to help you on your journey.
Kim.
Hi Kim,
I have recently found out I am Hetero A1298C. My husband and I want to TTC soon. I am on eagle tresso prenatals. Just wondering if my husband should be taking something too? I’ve been on them for 2 months so will wait 3 months until starting to try. Is 1
Month of him supplementing before we try enough time? He has no known gene defects
Hi Claire,
If you use the search bar on my site you’ll be able to find an article I wrote called Male Infertility and Sperm Health which talks about supplements for men. Sperm is similar to eggs in that it takes roughly 3 months to see the changes, however 1 month of supplementation will still have had a positive impact.
Good luck!
Hi!
My daughter and I are both heterozygous for both genes. She is on Deplin. Does anyone know anything about Deplin and how it helps or doesn’t help with MTHFR?
Thanks
Deb
Hi Deborah,
My understanding is that Deplin is just the active form of folate, which is the correct type to be taken in people with MTHFR gene defects. It would be used to help methylation work correctly. While this blog is generally focussed on fertility, MTHFR defects are also linked with depression and mood disorders, so I presume that is why it was prescribed to your daughter? Monitoring of homocysteine levels can give an indication of whether methylation is working better.
Yes it was prescribed by her psychiatrist. I would like to take it too but I can’t afford both scripts. It costs $65 a month.
Thanks!
Hi Kim, we’ve been trying to conceive for over 3 years. I was taking elevit all this time but have been told to stop as I tested homozygous for the 677 mthfr gene mutation after I asked to be tested due to a miscarriage earlier this year. My doctor however has prescribed a higher dose of folic acid (megafol 5) which completely contradicts everything I’ve read so I’m concerned I’m only making matters worse. My homosysteine levels apparently are normal (8.5) .. is there another test I should be asking for to make sure I’m put on the right supplements? I’m almost 40 and dream of having my own family. Thanks
Hi Wannabemama,
Higher levels of folate aren’t the current recommended approach for MTHFR patients. We have access to products now in Australia that contain the 5-MTHF (levomefolate calcium) so there’s no need to take lower quality supplements like folic acid. It’s good that your homocysteine levels are normal though.
You should be under the care of a fertility specialist (even if not planning on doing IVF) so they can advise on further testing, whether that be hormonal, genetic testing, or sperm testing etc. It’s also worth having a natural medicine practitioner who specialises in infertility as part of your health care team. Be sure to take all previous tests to your first appointment with them.
You might want to check out my post on Ovarian Reserve & Egg Quality as well.
Good luck 🙂
Hi Kim,
I was taking megafol 5mg straight for 2years ( after having a child with a NTD ). I am hetero A….
Just wondering how long the folic acid may take to leave my busy after stopping? I think it got to the toxic level as I’ve had all kinds of symptoms. I want to start on methyl vitamins now not the synthetic stuff
Hi Bella,
Being heterozygous A1298C isn’t associated with reduced enzyme capabilities or increased plasma homocysteine, but because of your history it’s worth taking the bioactive versions. Your doctor should be able to do some blood tests of folate levels and homocysteine to check how everything is going. Best to get their advice moving forward. You may also need to see a fertility specialist because of your history.
It might also be worthwhile having your partner checked for MTHFR as well.
Hi Kim, thank you for the informative read. I have just discovered I am homozygous A1298C. I have been on either folic acid, Elevit or, Blackmores preconception multivitamins for around 3years now whilst we have tried to conceive. My husband and I now know the primary cause of our infertility, azoospermia due to missing vas deferens (though sperm can be surgically removed) and also abnormally low AMH for me (indicating low egg reserve) I am 31. We have had 2 failed IVF (ICSI) attempts also. I have just learned about MTHFR and my mutation in the past week. I plan to cease the preconception multi which contains folic acid and instead use something like Tresos Natal. Would that be a good first step? Also, is it okay for my husband to take it too? He’s currently on Blackmoores preconception multi for men. We are not yet sure if he has a MTHFR mutation but it seems Tresos Natal is a superior product regardless. We are also on a bunch of other supplements to improve sperm and egg health including Royal jelly, CoQ10, Vit E, Vit C, Zinc, fish oil, Spirulina, L-arginine, eating Brazil nuts for selenium…Am I over doing it? Our next round of IVF won’t be till June. If I switch to folinic or methyl folate now, will that allow enough time to contribute to egg health, or is it best to wait the full 3 months before attempting IVF again? I am also freaking out a little as I’ve recently learned about natural killer cells and wonder if that might be a contributing factor for us. Do you know how one get’s tested for NKC? And is that something you can address at your practice if I am found to have them? (I live in Sydney and am hoping to pay you a visit). Any insights or information you might have for our situation would be greatly appreciated. Thanks.
Hi Briony,
It would be great if you are able to come in to the clinic, as there is still more we can do in terms of Chinese herbal medicine. You may like to read my article on ovarian reserve at http://www.thesupplementstork.com
With MTHFR it’s definitely important to be taking the bioactive forms of folate (5-MTHF and folinic acid) rather than the folic acid in most products. I don’t see any problem with a man taking Tresos Natal, caution should be advised when taking additional supplements though, i.e. taking too much selenium which can be toxic.
Your reproductive specialist should be able to test for NK cells with a blood test, which is less invasive than doing a biopsy. The research suggests that a combined approach of western and eastern medicine gives the best results. You can search my site for “NK cells” and a blog post on it should show up.
In general 3 months is a good amount of time to make a positive impact with nutrition or herbal products, but that doesn’t mean you necessarily need to push back your IVF (particularly with your low AMH/ovarian reserve).
Have a great Easter! 🙂
Hi Kim, I have just come across your blog!
My husband and I plan to conceive over the next few months. I have been taking Elevit for the past 3 months but have recently found out I am heterozygous for both C667T and A1298C. I will stop taking Elevit immediately. I decided to get tested as a family member who has recently fallen pregnant has C667T and suggested I get tested. She has recommended I take Eagle Tresos Natal and Bioceuticals Methyl Max – however after discovering I have both genes, would these be the recommended supplements to take? Any information would be greatly appreciated! Thank you in advance.
Hi Susie,
I think it would be best to see a qualified health practitioner rather than taking advice from your family member about what has been suggested for them. Practitioner grade products are that way for a reason – it can be dangerous to take them when they haven’t been prescribed for you. As an example, if someone has low B12 but they take lots of folic acid/folinic acid (which would happen if taking Tresos Natal and Methyl max at the same time) then it could mask the B12 deficiency which could lead to neurological damage. That’s an extreme example, but hopefully you get what I mean.
While I can’t give you specific advice since you’re not my patient, what I can say is that I prescribe Tresos Natal in my clinic, but I don’t normally add additional products with the same ingredients.
If you want to investigate your own situation further, you could ask your doctor for a homocysteine level blood test. If those levels are elevated, then methylation is impaired.
I hope that’s of some help, and good luck with your future conception 🙂
Hi Kim, I have found out I am 2 weeks pregnant and I have Herero MYHFR. My local naturopath gave me Tresos Natal to take one per day and also gave me Methyl-5 supplement and told me to take Vitamin D. Am I taking too much combining the Tresos Natal with Methyl-5 ? I’m trying to do everything I can as I had a previous pregnancy that resulted in Down Syndrome.
Hi Melissa,
You haven’t mentioned which gene you are heterozygous for. If it’s the C667T location then that’s linked to intermediate enzyme activity but no increase in homocysteine levels. If it’s the A1298C then it’s not linked to reduced enzyme activity or increased homocysteine levels (i.e. pretty much totally irrelevant). If you’re heterozygous for both, then that does involve reduced enzyme activity and an increase in homocysteine levels, which is more serious than being heterozygous for just one location.
Your naturopath may have prescribed high levels of 5-MTHF to counteract the MTHFR gene abnormality, but this would not be your dosage throughout the whole pregnancy. It also depends on how long you have been taking those supplements prior to conception. If you’re concerned about the dosage it’s best to have a chat with the person who prescribed it so they can explain why they chose that dosage, and how long it’s meant to be for.
You may wish to discuss having the Harmony test with your doctor to screen for DS and other chromosomal abnormalities at an earlier timeframe than the nuchal scan.
Good luck with this pregnancy 🙂
Hi Kim, thank you for your prompt reply. I have both C677T & A1298C
I only started taking the Tresos Natal 2 weeks ago along with the MTHF-5 and just found out 1 week ago that I am pregnant (2 weeks Ago) after years of trying naturally and IVF.
Do you think what I am taking is adequate? And do you suggest I go and see someone who specialises in MTHFR right away?. As I said last time I am worried that the MYHFR will cause development problems with the fetus.
My doctor has booked me in for Intralipids and I am on daily cleaned injections and dexmethesone.
Look forward to your reply.
Melissa
If your naturopath has already put you on Tresos Natal and an additional 5-MTHF then it sounds like they’re familiar with MTHFR and are managing it well. Seeing someone new may just create more stress if their opinion/management differs. If you’re concerned I would discuss it with your doctor and ask their opinion. Not sure why they’ve got you on the steroids unless you have NK cells though?
I just found out I tested positive for MTHFR A1298c homozygous mutation. I have one child and had a miscarriage at 6 weeks just a few months ago. I was already supplementing with 400 mcg of L-methylfolate and my prenatal has 650 mcg. Do you think that is a sufficient level of supplementation? I want to try to get pregnant again but do I need to give my body a certain amount of time with proper supplementation before a I try again?
Hi Caligirl,
1050mcg of L-methylfolate is actually above the recommended daily intake. 500mcg from all sources is generally the accepted level required for pregnancy. Miscarriages can occur for a variety of reasons, so it’s possible that your miscarriage was unrelated to the MTHFR defect since you were already taking the correct supplementation for your condition. If you’re concerned going forward I would suggest getting your homocysteine levels checked. If they aren’t high then you’re probably not being adversely affected by the MTHFR gene defect with your current supplementation.
Good luck with your next pregnancy 🙂
Hello Kim,
I am homozygous A1298C and just had a miscarriage at 5 weeks and 5 days. Do you think it’s linked? I read in some cases they perscribe heparin
Thank you
Hi Olazi. Homozygous A1298C mutations have been linked to miscarriages, so it’s possible. Miscarriages can have numerous causes though, including but not limited to chromosomal abnormalities, blood clotting disorders, immune disorders etc. Tests that may be worth considering with your doctor are homocysteine levels, blood clotting factors, and TSH (thyroid). TSH above 2.5 is too high during pregnancy and requires medical treatment. Best wishes going forward.
Hi Kim,
Great article, thank you!
I recently found out that I am A1298C Heterozygous & am hoping to fall pregnant this year. I want/need to be at my optimal health for pregnancy as I am having a child on my own via IVF with a sperm donor therefore my gynaecologist recommended that I start taking Elevit ASAP. Would you recommend I use an alternative due to havIng MTHFR?
N.B. I am not aware of MTHFR causing me any issues to date, however due to my circumstances and having friends with MTHFR I thought I would get tested too.
Thank
Mia
Hi Mia,
It’s great that you got tested to know your situation in advance. Being heterozygous A1298C is not generally associated with any change in enzyme activity or increase in homocysteine levels, so technically normal prenatals are fine. I don’t tend to recommend Elevit for various reasons (too much folic acid, constipating form of iron, etc), however I do let some of my patients stay on it if they want. I personally think even without MTHFR as a factor I would always want to take the best supplement on the market. I’ve done spreadsheets (yep, I’m a big nerd) on the ingredients of the most common prenatals available here in Australia and the one I stock in clinic is the best in my opinion (Eagle Tresos Natal – only available from health practitioners).
One thing that’s worth remembering is that prenatals only do anything if we are deficient in certain vitamins. With a varied (preferably organic) diet that is heavily plant based, that’s not likely to be an issue.
🙂 Kim
Thanks very much Kim, this is great to hear, especially as there are so many conflicting views out there, it’s not easy to determine what’s best individually! I have booked to come and see you next week to discuss this further as i have had low iron in the past and most recently a high/increasing metals (zinc/copper) result in bloods this year. Thanks again & looking forward to meeting you 🙂
Looking forward to meeting you next week. If you can bring along copies of previous blood results that would be great.
Hello Kim,
I was told after a blood test that I could not break down folic. I was then prescribed Methyl-Max. I also take elevet. After falling pregnant (about 6 weeks in now) I have started to question if its safe to be taking Methyl-max as it has serine in it. have I done any harm by taking this?
Thanks
Hi Nina,
Who prescribed the Methyl-Max and said to keep taking the Elevit? These sound like all the wrong supplements for you. Methyl-Max would have been fine before pregnancy, but serine isn’t recommended in pregnancy. Don’t be alarmed, because realistically your body produces serine anyway, but Methyl-Max would not be advised while pregnant. Elevit would also not be advised if you can’t break down folic acid, because it contains 800mcg per tablet, which is twice the RDI to begin with.
I’m not allowed to suggest you stop or start certain supplements, but in my opinion, Eagle Tresos Natal is currently the best pregnancy multivitamin in Australia. It contains folinic acid and 5-MTHF (if you get the new upgraded version) as well as other important nutrients like iron, iodine and calcium etc.
Congratulations on your pregnancy, and I hope you can get in touch with a great pregnancy qualified practitioner to get you some appropriate supplements. (If you’re in Sydney come and see me for a herbal consult if you like).
Hi Kim, Once i had my MTHFR test done it came back as follows: MTHFR C677T detected and MTHFR A1298C Detected both being Heterozygous. From researching does this mean that I still do break down 50% of folic? this may be why they have increased my folic intake?
What damage could i have done by taking the Methyl-Max?
Yes, it’s likely to be about a 50% reduced ability to process the folic acid. The problem is that the 50% that isn’t processed can lead to the high levels of homocysteine. Also there are limits to how much the body can process anyway, so using huge amounts doesn’t necessarily lead to enough being bioavailable for the body. There are also negative effects of excessive consumption of folic acid. I’ve seen numerous doctors prescribe very high levels, but I personally don’t think that’s the right approach based on everything I have researched.
I’m not sure specifically why serine is not recommended in pregnancy, but from what I do know, in pregnancy the way amino acids are synthesised is different than when we’re not pregnant. Serine is not transported to the growing baby, so I wouldn’t be excessively worried. Worst case scenario, too many amino acids and proteins have been shown to lead to reduced birth weight of babies, but you will get measurements throughout your pregnancy that monitor this (I highly recommend acupuncture if low weight shows up as an issue). When you consider that plenty of people will inadvertently continue to have protein smoothies etc while pregnant, and still give birth to healthy babies, you can presume everything will be fine. Check with your doctor if you’re concerned though.
Hi Kim.
I have both genes. Trying to convince for years.
My IVF specialist commended Folinic Acid 120 Tabs – Bioceuticals however my naturopath put on orthoplex mythylfolate l-5mthf with optimal PC. What are the difference in boats and which one is the best to take. Thank you Kul
Hi Kul,
The 5-MTHF is going to have better absorption than the Folinic acid, because it completely bypasses the MTHFR gene, whereas the Folinic acid only bypasses an enzyme step earlier in the methylation chain. Your doctor should also check your homocysteine levels to make sure they’re not high.
Best of luck with conception 🙂
Hi. I have two questions. Is it better to take Folinic Acid or Methyl Folate in a prenatal? Also, how long should you wait to conceive after stopping folic acid and switching to folinic acid/methyl folate? Is 6 weeks enough time to get rid of the unmetabolized folic acid from the previous prenatal? Thanks!
Hi Julie,
The answer to your first question depends on which MTHFR gene variation you have, if any. 5-MTHF is only available from a practitioner so whoever is looking after you would be able to decide what is best in your situation.
I don’t know how long the body would take to deal with any residual folic acid, but you could get blood tests to check your homocysteine levels. If they’re in range then your body isn’t affected by poor methylation of the folic acid.
Good luck with your future conception!
Hi there!
I have a healthy nearly 3 year old who we conceived first try. We are in our 14 month trying for baby #2. I have had 3 early miscarriages in that time (around the 5 week mark for all). I am 38 so I thought my age could be the problem. I had egg quality test that showed my reserve to be good for my age (2.1)
my dr just called and told me I am heterozygous for MTHFR A1298c. In her next breath ste told me that it was insignificant and not the cause of my losses. So I started researching and it seems like there are many woman with 1 copy suffering from early losses. My question is why is this happening early? What is causing it? The folate? My Cbc bloodwork was all fine as well. I’m sometimes anemic or borderline. I’ve just purchased methyl folate with active b12 as well as a prenatal with methyl folate. I started taking low dose aspirin. What else can I do to help make my next pregnancy stick? I’m so confused to if this is in the cause of my losses…
Hi Jamie.
Miscarriage is a tricky area because it can be difficult to determine exactly why it is happening. When it’s later stage testing can be done on the foetus to check for abnormalities, but in early stage we’re often just guessing. MTHFR is one possibility with early stage miscarriage. Now that you’re on better supplements, if MTHFR is the contributing factor, then after 3 months of supplementation the next pregnancy will let you know. The fact that you are sometimes anaemic means your body isn’t functioning optimally, so it’s worth seeing a natural therapist to address the underlying cause of that as well, and they can support you through your journey to a healthy baby.
Best of luck. 🙂
My 11 yr old daughter and I are both heterozygous for 2 genes. My daughter has mental health issues and is on Prozac and Guanfacine but I was recently informed that it would be helpful to supplement with Folinic Acid. My understanding is that Folic Acid can not be broken down by the body if you have an MTHFR gene mutation but folinic Acid is already broken down for you. Is this correct and if so, what is the best dosage for a small 11 year old?
Thanks
Hi Deborah,
Because your daughter is on prescribed medication, the person (doctor) who has prescribed it needs to know if you intend on giving her folinic acid, in case it’s not allowed with her medication, so it’s best to check with them first.
In terms of doses for children, a 12 year old is generally considered an adult in Chinese medicine, and so a 6 year old would be roughly on a half dose, and so on. This of course depends on body size and what is being prescribed. Again, it’s best to have a practitioner who is treating your daughter to assess the appropriate dosage of any medication or supplement.
Yes, folinic acid is a more bioavailable version of folic acid. These days 5-MTHF is also available which is the form that completely bypasses the MTHFR gene. This is only available from a health care practitioner though.
I hope you’re able to get the all clear from your doctor and your daughter gets some benefit. 🙂
Hi there!
I have read your article on MTHFR, I got diagnosed last year after a miscarriage and a range of other hormonal and health problems. Surprisingly to my naturopath I was diagnosed with both genes, which is a rare case.
I have a 4 year old boy, at the time of pregnancy with him I had NO idea what MTHFR even was or that I even had a problem. I was taking elevit and I had a normal pregnancy with him and he is a healthy boy.
With my second pregnancy, I had the miscarriage after a range of problems with the pregnancy and lost the baby at 13 weeks. At this time, I was taking Tresos Natal by coincidence which is rather odd to me because even though I didn’t know I had MTHFR at this stage, Tresos natal has the activated form on follinic acid in it which makes me nervous to take it again however Im not sure the two are linked.
My husband and I are trying again for a baby and Im worried it will happen again, I will be seeing my naturopath today and she will be giving me Tresos Natal again, but a think they have updated the product. Im worried that the baby will be born with problems like a mental disorder, physical disorder or any disorder at all…How can I avoid these things? What pregnancy supplement is safe to take?
Its a daunting time but I want to be excited for the process…Its more nerve racking because I have both genes C677T and A1298C.
Thank you
xx
Hi Ashleigh,
I’ve actually had quite a few patients with both genes, so I guess I don’t see it as hugely uncommon, however I’m treating a very specific subset of the population of course! Don’t be too worried about having both, it basically just equates to a higher percentage of difficulty in processing the folate. It doesn’t mean you can’t, just that it’s harder for your body.
You’re correct about the Tresos Natal having been updated to include the 5-MTHF now, which is the most bioactive version of folate. It’s a great product. I understand your hesitancy, but your Naturopath has chosen well for your situation.
There’s no way to predict the outcome of any pregnancy, but my advice is to just take your prenatal, eat a variety of delicious healthy fresh foods (go organic, it’s so much better!), and focus on enjoying life at the same time. It’s a critical component of health that we often forget about these days.
Best of luck 🙂
Hello!
I was wondering if you could tell me the difference between c677t and c667t. Some sites appear to use them interchangeably, but I wouldn’t think they mean the same thing? I really appreciate it!
Morgan
Hi Morgan, It’s most likely just a spelling error when hastily typing in the numbers, however gene expression is very vast so there are many many genes and it’s very possible both of them do exist but with slight variation.
Hi kim. l had two miscarriages last year ( i was 21 weeks prg in both.. and the babies were alive when they born)..the doctors found that i am compound hetero mthfr in my second pregnancy and also they told me that i need cervical stitch..now i am 6 weeks pregnant and the doctor prescribed me acid folic 5mg, baby aspirin, duphaston, and dially glexane injection…i am worry from the effects of these meds espicially the injections on my pregnancy.. could you please tell me your opinion if i really need these injections or not?.. thank u
Hi Hadel,
Requiring a cervical stitch is unrelated to having a MTHFR gene defect. Most miscarriages that are linked with MTHFR tend to be early stage. Duphaston is a progesterone supplement. It is prescribed to try and keep progesterone levels high in pregnancy, and is quite commonly prescribed in cases of infertility.By “dially glexane” I’m assuming you mean daily Clexane injections? They are a blood thinner and are also commonly given in infertility to prevent blood clots leading to miscarriage. None of the medications you have been prescribed sound unusual, but you should always discuses any concerns with the doctor who prescribed them, or another trusted doctor. However, as my article suggests, folic acid is not the appropriate supplement for people with MTHFR. I would suggest you ask your doctor or health practitioner if 5-MTHF would be more appropriate for you. I would definitely suggest finding a good acupuncturist who specialises in pregnancy care in your area to support you throughout your pregnancy. I hope this one goes well for you. 🙂
Hi Kim, I have Pyrolle Disorder with a level of 252, and am heterozygous for Mthfr gene. My 4 year old daughter is also the same with level of 58! Ever since giving . I also have hypoThyroidism & on 100mg of Thyroxine. Since having my daughter I have had very poor health especially Mental & Gut health. Working with my Chiro/kinesiologist/Natropath I am finally in a good place & considering a second child! Still very anxious it may lead to a down hill slide again but want to be informed before making decisions. My Natropath has talked to me about PreNatal supplements but said I need to find one with Folinic acid not folic acid. I noticed u recommend similar in your practice. Could u please give me advise on how brand & supplement u recommend! Also any other information/recommendations u might think is important for me to consider moving forward! Thankyou for the above information, greatly appreciated & Thankyou in advance for any info u provide me. Lauren
Hi Lauren.
I don’t tend to think much of the “pyrrole disorder” diagnosis – to me it’s just a name for vitamin deficiency that perpetuates the belief in patients that there’s something clinically wrong with them, when they might just be deficient in a couple of nutrients, for various reasons.
Your naturopath should be able to prescribe you a quality pre-natal vitamin that’s practitioner-grade. In my clinic I prescribe the Eagle Tresos Natal pre-natal because it contains equal amounts of folic acid and folinic acid. In your situation you may actually prefer a product by Metagenics that has the 5-MTHF converted form as well as some other nutrients such as B6 and B12. Your naturopath would be able to source this for you as it’s not available in stores.
Try not to worry about the Pyrrole disorder – it’s not studied enough yet to be clinically relevant. Your body may just show up with pyroluria due to stress/anxiety.
Best of luck with your next pregnancy. 🙂
Hi Kim, one of my eight month old twins has been diognosed with mthfr. I am wondering what is safe to give an infant that young? Most mentholated products are for over four. How do I help him till then? Eg before vaccines & after?
Hi Bernadette. Did the person who ordered the test make any suggestions? I’m assuming they did the testing because of some sort of symptom because MTHFR is not routinely tested, especially in children.
Generally though, having the gene defect doesn’t equal having a problem. The homocysteine levels of your child are actually more relevant in this situation. If their homocysteine levels are high then there’s a likelihood that methylation isn’t occurring properly, but if the homocysteine levels are normal then the polymorphism isn’t clinically significant at that time.
I don’t specialise in paediatrics so I can’t comment on supplementation for a baby, but the person who did the testing would be the best person to ask (after homocysteine levels are checked).
In terms of vaccinations, some of my patients bring their children in for acupuncture the day of or day after their vaccine is given to help boost their immune system and rebalance their acupuncture channels to support them at that tough time. They find it settles them and they respond well.
Let me know how you go.
Hi. I am Homozygous c677t and my husband is Heterozygous for the A1298C gene and in our early to mid 30’s. We have recently miscarriaged at 6 weeks. I was taking 500mcg folinc acid once per day in the 4 months prior to conceiving however this didn’t prevent the unthinkable. We would like to try again and I have commence taking Dr Ben Lynch’s pre natal. Should my partner also be addressing his A1298c gene? I’m confused and cannot find any medical practitioners in Adelaide who take this seriously. Most just look at me like I’m stupid when I mention the MTHFR or have no idea what I’m talking about.
Hi Mandy,
Very sorry to hear about your miscarriage. It’s a very complex issue and it’s also possible that the MTHFR isn’t the only issue. Miscarriages can also occur for a variety of reasons such as genetic abnormalities, chromosomal abnormalities, NK cell activity, blood clotting disorders, fibroids etc. The supplement you’ve changed to sounds good, so carry on with that, and you could also get your husband to take it sometimes as well however I’m not sure how much the male factor impacts miscarriage rates. He could also take your leftover folinic acid instead if preferred. He wouldn’t need to have it as frequently though, I’d think every second day would be fine.
If you unfortunately have another miscarriage you could look into getting testing with a specialist to rule out other possible miscarriage factors.
Best wishes, Kim.
Hello I have a 18 year old daughter who has been told to take (Megafold 5 brand) of folic acid every second day. She is taking this due to her Crohn’s disease as she is on methotrexate injections to treat her crohn’s disease. She has been tested for the MTHFR gene mutations and it has come back that she is Hetrozygous for the A1298C mutation only. How dangerous can it be to take these folic acid tablets? Thankyou
Hi Michelle,
Megafol 5 is a doctor prescribed supplement from my understanding. Your daughter’s doctor is the best person to discuss it with, but I would assume they prescribed it to counteract toxicity with the Methotrexate. If you’re worried about her ability to utilise the folic acid due to the MTHFR mutation, just discuss it with her doctor and ask if she could take folinic acid instead. As it has been prescribed by a doctor, they are the only person who should be changing her prescription.
Hope that helps.
Hi, I found out through a nutritionist after a couple of failed rounds of ICSI that I have MTHFR and looks like it is probably one of the worst kinds. I have C667T and A1298C. I’m on a prenatal that the nutritionist told me to take which includes folate and B12. I have had my homocysteine level checked twice and both times it came back normal. I am also taking magnesium tablets. My blood tests have showed that B12 and folate are high but iron is low and my red blood cell MCH level is above what it should be so the nutritionist has put me on iron tablets to try and build up the red cells which would hopefully help the folate and B12 go through the system properly. I have still not become pregnant naturally, is there anything you can suggest which might help?
Claire
Hi Claire,
Sorry to hear about the failed cycles. Has your reproductive specialist given more information as to why they think the cycles haven’t worked? Infertility is very complex and sometimes it’s a combination of factors that need to be addressed. For instance if you’re doing ICSI is it because there is poor sperm quality or your eggs have a tough outer layer due to age etc? From the sounds of your case I would have said the new Metagenics Hemagenics Iron Advanced with 5-MTHF would be suitable for you. It’s available when prescribed by a health practitioner such as a naturopath or acupuncturist (and possibly your nutritionist as well).
Good luck!
Hi Kim, we had ICSI because my husband has a high sperm count but low morphology. Both times we went through ICSI they said my eggs were top quality so they didn’t understand why they weren’t implanting so I was hoping it was due to the MTHFR and maybe the blood being thick in the uterus as I do get painful periods which have eased slightly since taking the medication, well one month it can be ok and the next month it can be painful again, think it depends on how stressed I am that month. I would recommend the iron tablets you have said about to my nutritionist but she has got funny with me before when I saw a chiropractor who also does kinesiology and was recommending some tablets for adrenal glands.
If your nutritionist doesn’t have access to that brand then you might be able to see another practitioner who can get it for you. The fact that your homocysteine levels have come back fine is a good sign, and suggests that it may not be the MTHFR that’s causing the issue. Perhaps it’s worth your husband getting some treatment to improve his sperm quality, as it’s worth remembering sperm are 50% of the genetic material for an embryo, and this is relevant to it’s development and whether a pregnancy results.
Sorry also meant to ask have you had people with the same mutation as me that have got pregnant before?
Hi I just checked the report I got back and I’m 70% as compound heterozygous if that helps.
That just relates to how much harder your body has to work to process the folate. But keep in mind if your homocysteine levels are good (which you said they are) then your body is actually doing ok at this, which is great news. 🙂
Yep 🙂
Hi there
I had three miscarriages in 2015. First two were missed miscarriages at around 6w 4 days with d&c and third was natural at 6 weeks. I have the homozgous c677t gene and am 41 years old.
My fertility specialist did bloods which is how i found out about.the mthfr. He is an advocate for folic acid.
Do you think it would be enough ti take the recommended folinic acid prenatals for a couple months and then try again. I ovulate every month and we get pregnant easily.
Would love to hear thoughts
So sorry to hear about your miscarriages Donna. If you take folinic acid or the 5-MTHF supplements and your homocysteine levels are fine, then it’s unlikely to be the cause. Sometimes our body will miscarry because of a genetic abnormality in the embryo, which is more common the older we get, so that could be an issue as well. As an acupuncturist, if you were my patient I would also be diagnosing you from a Chinese medicine perspective and doing acupuncture and herbs during the pregnancy to try and get you to full term. I would suggest looking into finding a local acupuncturist/Chinese herbalist who specialises in infertility to support you through your next pregnancy. Good luck!
Hello, I am a Homozygous c677t and I my husband is heterozygous for A1298c. We have a child who is heterozygous for both mutations. When she was 6months old she had a ruptured apendix and ended up having an emergency surgery. We then found out that she had a DVT in her portal vein which is why she got tested and so did we. She now has portal vein hypertension. I had an early miscarriage last year and just found out that I am pregnant again. I am afraid of taking prenatal vitamins from the store because a lot of them have folic acid. I took extra folic acid with my daughter when I was pregnant because I didn’t know. What prenatal is safe for me to take? Any suggestions?
Ana
Hi Ana,
With your family history I think it’s important you seek advice from a doctor or specialist who can assess your case. I can’t tell you what prenatal is safe for you because you’re not my patient, but my advice would be to see a specialist or a naturopath/acupuncturist in your area who can prescribe you practitioner-grade supplements that are better quality and more specific than store bought vitamins. Congratulations on your pregnancy and I hope all goes well. 🙂
Hi
I’ve just been diagnosed with mthfr c677t homozygous. I have 2 healthy children with no miscarriages and then trying for my third I’ve had 2 late miscarriages at 16 weeks and 18 weeks as well as 2 early miscarriages. I also have protein s deficiency. I am trying to conceive again, one last try, I am taking 800mcg of metafolin as well as 1000mcg of methylcobalamin. Are these the right things to be taking? I’ve just read your article and you mention folinic acid, should I be taking this instead? Thanks very much, kirsty
Hi Kirsty,
Sorry, the article is on my list of things to update as new information becomes available. What you’re taking is considered the most bioactive form so it’s the correct one. The general advice is to take the supplement for at least 3 months before conception, so keep that in mind, especially with a history of miscarriage.
I’m assuming with your diagnosis that you’re under the care of a specialist? I would think they would have also prescribed something like Clexane??
Best wishes for a healthy full-term pregnancy 🙂
Hi thanks so much your reply. I am in the UK and have had to pay privately for blood work up to confirm mthfr as the NHS won’t test for it. I have done lots of research and decided to take the supplements myself with no medical advice. I am also taking a few different supplements from seeking health.com including their prenatals. I am seeing my NHS consultant today and will tell him I have mthfr and request that he prescribe me clexane so that I start or from the day I get a positive pregnancy test, would you say this is the right thing to do? I didn’t realise I needed to be taking the folate and methylcobalamin for 3 months before conception so thank you for letting me now this. I am also taking low dose aspirin from cd14 every month in anticipation of a positive pregnancy test. Is there anything else you would recommend I do? Thanks south kirsty
I don’t know how much everything costs in the UK but I would really urge you to be under the care of a specialist with your history. Over here Clexane can only be prescribed by a doctor as it’s an injectable medication, but the aspirin is having a similar function. They’re both blood thinners to prevent clots.
My national health service consultant can prescribe clexane, he nearly gave it to me in my last pregnancy as a precaution but decided not to. That ended in a late miscarriage in October 15. Can you recommend any specialists in mthfr in the UK? I have Googled, but am not finding much
I’m afraid I don’t know anyone outside of Australia, but it’s not specifically a MTHFR specialist you need. It’s a fertility/pregnancy specialist who can support you through your pregnancy.
Hi there. I’m 9 weeks pregnant was just diagnosed with MTHFR heterozygous A1298C. Pretty much every woman in my family has some variation on this, and I’m grateful mine seems to be the least bad combo.
This is my second pregnancy of the year (last one ended at 14wks in July- Turner’s Sydrome and severe cystic hygroma) and I have been taking regular prenatals (with folic acid) for a year now.
I also have had high liver enzyme numbers for a year now (GGT high all year, but now ALT and bili have gone up as well).
My question: Is it possible that the gene mutation is causing the folic acid to damage my liver if I’m not processing it properly? With this particular version of the mutation, is the rejection of synthetic folic acid strong enough to cause this damage?
I’d like to start taking natural folate or methylfolate just in case this is the cause, but it hasn’t been approved in australia yet.
Please advise!! I certainly want to make sure my baby is getting enough folate and vit B12!
Hi Stacey,
Congratulations on your pregnancy! I’ve enlisted the help of a doctor/scientist to do some more research on your question, but I thought it’s worth mentioning that registered natural health practitioners in Australia now have access to a product that contains 5-MTHF. It’s only available when prescribed from someone though, so you would need to see a practitioner in person.
Thank you so much for investigating for me Kim! Curious to see what the dr./scientist has to say…..
In the meanwhile, I’m thinking of ordering “Innate Response” prenatal online- it’s all natural, and has wonderful reviews… it certainly can’t hurt to have natural folate over synthetic folic acid…
Plant based folate still needs to be converted with the DHFR enzyme into tetrahydrofolate and then goes through the MTHFR process anyway, so it’s not technically all that different. While I agree that plant based sounds a lot nicer than synthetic, I’m not sure there’s a significant difference in the case of anyone with MTHFR. Folinic acid requires less conversion steps than both folic acid and folate, so it’s still ahead. 5-MTHF is the best bet.
Hi there,
I am compound Hetero for MTHFR and just tested positive for pregnancy. What amount of folinic acid is safe/recommended? Also, is cyanocobalamin safe ? Is there are truth it has a cyanide molecule?
Hi Kellie,
Congratulations on your pregnancy! Most supplements contain around 500mcg of Folinic acid per day, but in pregnancy the recommended amount of Folic Acid is 600mcg per day. The reason supplements don’t give you the full amount recommended is because you’re also going to get some from food, especially since certain processed foods now contain Folic acid. If you are concerned you should check with your doctor about whether they think you should be taking more.
As I’m not a chemist I can’t comment definitively on cyanocobalamin, but the chemical structure is C63H88CoN14O14P while cyanide is CN-. If your doctor has suggested you need a B12 shot due to low B12 you would want to weight up any potential risk of the supplement versus the risk of not taking it. B12 deficiency can lead to permanent neurological damage if left untreated. If you’re concerned you could try and source an alternative form of B12.
Good luck with your pregnancy 🙂
Hi Kim
unfortunately the pregnancy ended in a miscarriage at 7weeks and now i’m researching the whole MTHFR and pregnancy thing again. Looking for a good supplement, just being confused really.
I’m very sorry to hear about your miscarriage Kellie. Very recently there have been advances in the supplements we have in Australia, and there is now access to 5-MTHF supplements which bypass the MTHFR gene. There are also supplements that contain some other active B vitamins as well which is useful. Generally these supplements are available through registered health practitioners such as acupuncturists and naturopaths.
Some tests to consider with your doctor would be folate, B12, and homocysteine. They might give you a more complete picture of what’s going on in your body and whether it has any impact on fertility/pregnancy. Best of luck x
Hi there! I was wondering if you could please provide some clarification on the differences between 5-formyl tetrahydrofolate (5-FTHF) aka folinic acid and methylfolate (5-methyltetrahydrofolate i.e. 5-MTHF).
Everything I am reading indicated that methylfolate is considered the biologically active form of folate.
If someone had polymorphisms affecting MTHFR enzyme, that would affect the conversion of of MTHF (5,10-Methylenetetrahydrofolate ) to 5-methyltetrahydrofolate . FA is converted (via reduction) to DHF (dihydrofolate) via hidydrofolate reductase, which does not involve the MTHFR enzyme. I’m not sure why I keep hearing it repeated that “people with MTHFR polymorphisms can not convert folic acid properly” as the genetic defect does not affect the conversion of folic acid to it’s metabolite, DHF.
I am not sure where folinic acid comes in to play here or if and what enzymes convert it to 5-methyltetrahydrofolate. Could yo u kindly help illuminate this please?
Thanks so much!
Hi Chris,
You’re right, the MTHFR gene defect affects the conversion of both Folic acid and Folinic acid into 5-MTHF, however the issue here in Australia has been that until right now (in the last week or two) we haven’t had access to 5-MTHF in supplement form. So for that reason our advice obviously has to be to suggest the best supplement available for people with the MTHFR gene mutation. Because Folinic acid doesn’t require the DHFR enzyme to convert (it just requires ATP) it is less steps the body has to take, which can then result in a slightly higher conversion ultimately. Having a MTHFR gene mutation doesn’t mean that folic acid (or folinic acid) can’t be converted, there’s just a reduced ability to convert. This reduction in ability varies from 25-75%. Folinic acid is an active metabolite of folic acid, which is why we say it’s more bioavailable. Here in Australia it is the better choice for people with MTHFR. This will change in the coming months as the availability of 5-MTHF increases (currently it’s only one practitioner-grade brand). I hope that answers your question. Kim.
You might also like to check out the study “Pharmacokinetic study on the utilisation of 5-methyltetrahydrofolate and folic acid in patients with coronary artery disease”. It’s worth noting in that study that while the 5-MTHF was 7 times more bioavailable than the folic acid, we don’t know yet what implications the stores of that in the body have on health. The science and studies in this area are constantly evolving, so those of us treating patients just need to keep on top of it and offer our patients the best advice we have at the time, but also be wary of new research and the fact that we don’t know exactly how some supplements will impact health longterm.
Hi Kim. I was reading your blog here and I just wanted to chime in and let you know I didn’t start seeing improvement in my psychiatric symptoms until I added Folinic Acid to my 5-Methylfolate supplement regimen (it is OTC in US). I am hetero for MTHFR A1298C. The transformation from folinic to methylfolate also has to work in reverse both to feed the folate cycle that regenerates BH4 and to build reduced folate stores in the liver. Apparently, that is the part that doesn’t work right for A1298C mutations. Since I don’t have the C677T variant I suspect that the forward function works just fine and the Folinic Acid is all the folate I need to supplement. There are a lot of people saying the methylfolate is the “best” form of folate to use for all MTHFR variants, but I beg to differ. Methylfolate got my blood levels normal but Folinic Acid is what turned the lights back on.
Thanks for sharing your story drankin, it’s definitely very fascinating! I’m glad you’ve found a regime that supports your body. I’m hoping to re-do this blog post in the coming weeks, and include some links to studies which might give us all a more complete understanding of what’s actually going on. I suspect the best way forward is to incorporate blood testing before and during supplementation to see what impacts supplementation is having on homocysteine levels for individual patients as well.
That’s good information, thank you for sharing. Now I’m seeing a potential mechanism of action. So, if I’m understanding correctly, you are stating that with the polymorphism A1298C (I am homozygous) that the back conversion of 5-methyltetrahydrofolate (methylfolate) to 5-formyl tetrahydrofolate (folinic acid) is impaired and supplementing with methyl folate is just solving part of the problem. Is my understanding correct?
The one thing that I cannot understand is why everybody is recommending supraphysiologic doses of methyl folate. I have looked high and low in of email experts in the field, and nobody’s been able to tell me exactly how much methylfolate is produced in the body per day but the universal agreement is that 400 mcg or thereabouts would at least approximate endogenous production, if not surpass it. With that being said, I am not sure why some evil recommend dosages above that level because, at that point, it seems to me that you’re using pharmaceutical dosages, for lack of a better term. Specifically what I mean is you are using dosages that are non-physiologic and the result is you are procuring a pharmaceutical effect. This is similar to taking megadoses of niacin to treat hypercholesterolemia. There’s nothing inherently wrong with that necessarily, but you are certainly not restoring homeostasis in doing so because you’re going way beyond restoring the levels that are inefficiently produced due to the polymorphism.
Yikes, there was a whole lot of voice to text fail there lol. Apologies for my lack of proof-reading prior to posting!
I don’t tend to recommend really high doses of folic acid or similar because my understanding is high doses are a potential carcinogen (although, what isn’t these days) 😉
I would imagine the 400mcg is what was found to keep homocysteine levels within range, which is important to remember with these polymorphisms. Everyone gets hung up on the MTHFR gene and folic acid and forgets that if the homocysteine levels are within range then the body is coping alright. Also I believe in older studies that was the supplement level that produced the reduced risk of neural tube defects in pregnancy, and is therefore the recommended daily dosage. (This is based on memory and I haven’t confirmed it by looking up any studies though)
Thank you for the response. Well, I guess technically, on a milligram per milligram basis, that it has a slightly higher conversion rate purely based on the fact that it is further down the metabolic chain and requires fewer intermediate steps, but that line of logic doesn’t really pan out when you get to the bottleneck which is the fact that people with the MTHFR polymorphism have a significantly reduced ability to convert 5,10-Methylenetetrahydrofolate to 5-methyltetrahydrofolate. Again supplementing with 5-formyl tetrahydrofolate (folinic acid) will raise levels of 5,10-Methylenetetrahydrofolate better than folic acid, but you still hit the same bottleneck ultimately.
Still, after I have done some googling, I see that folinic acid does have some intrinsic physiologic value as it is used for purine synthesis. And there are plenty of anecdotes that people find adding folinic acid to be beneficial symptomatically, although I am unsure of the mechanism of action since, at the risk of repeating myself ad nauseam, folinic acid has all of the same limitations as folic acid in terms of raising serum levels of methylfolate.
Hey I’ve recently been tested for mthfr c677t heterozygous and have come back positive . My father was a homozygous for c677t . I was wondering if being a mthfr c677t heterozygous would it effect my iron stores as I am constantly anaemic ?
Hi Veronica. The MTHFR gene is known to affect homocysteine levels, and high homocysteine levels have been linked in studies to anaemia. Obviously anaemia should be treated by your doctor or other qualified health practitioner through iron supplementation, however supplementing with the bio active forms of folate and B12 as well could theoretically help reduce your homocysteine levels and therefore your anaemia.
Thank you Kim . I did discuss this with my gp but she didn’t seem to know about the mthfr c677t heterozygous mutation. Where in Sydney are you based ?
It’s relatively new research so not all doctors are familiar with it yet. I’m based in two clinics in Sydney, one in St Leonards which is a short train ride from the city, and the other in Dural which is in the Hills District (north-west Sydney). 🙂
Great 🙂 I’ll make an appt to come see you to get some more information . Look forward to meeting you .
Looking forward to meeting you too, Veronica, and helping you! 🙂
I’ve been diagnosed with the MTHFR Gene and have been taking Methyl-Max as I’d like to get pregnant (after many years). Is this a good supplement or what else can you advise. Secondly, I’m about to commence Cellgevity Active to assist my Glutathione levels.
Hi Kristina, the Bioceuticals Methyl-Max contains folinic acid so that’s a good choice. I’m not sure why you would want to be on the Cellgevity though? I wouldn’t normally suggest any sort of product that claims detoxification if you’re actively trying to conceive. Detoxing should only be done before trying to conceive.
Thank you for your reply. I’d like to give Cellgevity a go as I have been told I also have Fibromyalgia and suffer a lot of aches and pains and a lot of fatigue etc. Your thoughts?
As I mentioned, I wouldn’t be putting my patients on something that claimed detoxification if they were actively trying to conceive. I would be more inclined to treat fibromyalgia with a practitioner-grade magnesium supplement and CoQ10 for the fatigue. Plus acupuncture of course 😉
Hi Kim,
I’ve had 2 miscarriages and have found out I have homozygous A1298C. I am currently taking Elevit and my GP has advised me to take high dose of folic acid. Since reading information on your website and others, not sure if this is the right thing to take or if I should be taking folinic acid instead. Should I stop taking Elevit altogether?
I’ve also read that taking baby aspirin can help prevent miscarriages? Is this something I should be taking as well?
I’m confused about what to take and want to be taking the right medication before falling pregnant again.
How long would you recommend I take the medication?
Thank you for your assistance.
Hi Tanya,
In situations where MRHFR gene defects are found it is advisable to take folinic acid rather than extra folic acid, it’s just easier for your body to utilise and therefore you will get more benefit from it. If you don’t have a practitioner who can source the right products for you just ask your local health food store or chemist to find you a prenatal supplement that contains folinic acid, or you could ask for the Bioceuticals folinic acid which they should have behind the counter.
I certainly wouldn’t advise self prescribing any medications (this can be dangerous), but you can chat to your doctor about it or perhaps a fertility specialist would be best based on your history.
The recommended timeframe to be taking folinic acid supplements before conception is a minimum of 3 months.
Best of luck with your journey, I hope your next pregnancy is successful. 🙂
Thanks Kim, I appreciate your help.
Hi,
I was diagnosed with MTHFR gene shortly after a miscarriage when all the women in my family got tested.
My husband and I are wanting to try and conceive but I’m scared of miscarrying again, I am taking elevit (for about a week now) but it’s making me incredibly sick.
Can you recommend a vitamin I can take that will give my body what it needs to support a pregnancy?
Hi Sara, I’ve sent a reply to your email. Best of luck. 🙂
Hi,
I was diagnosed with heterozygous c667t and a1298c five weeks ago and I have been on Thorne pre pregnancy multivitamin since then. I struggled to get pregnant for 15months prior to now however have just received a positive pregnancy test. My chiro /kineseologist who tested for the mthfr gene has told me all I need to do is take the multivitamin and that is all. I’m wondering if you have an alternate opinion? Do you think five weeks on the correct folinic acid supplement is enough to help sustain the pregnancy to full term? Do you have any more advice for me?
Thanks
B
Hi B,
Congratulations on your positive pregnancy test! There’s really nothing else to do from a supplement perspective at this point, but if you’re concerned you could see a reproductive specialist to monitor you throughout your pregnancy. Keep in mind the particular supplement you’re taking has very high levels of the folinic acid (in two bioavailable forms) so there’s no benefit to taking anything else related to folic acid in addition to that. The fact that you have conceived since starting that supplement, after 15 months of trying, is a positive indication that it is helping your body. Congratulations again. 🙂
Hi there,
I have been taking Elivit for since 2010 and I had a miscarriage in 2012 (6 weeks) and another in Feb 2015 (5.5 weeks)with constant chemical pregnancies in between.
I have been tested for MTHFR C677T Heterozygous. My Homocysteine levels in 2014 were 11.5 and in March 2015 were 5.5. My concern is that my red blood cells (folate) tests come back very high, my most recent being 2443 with b12 ranging from 697 -1100. I’m very confused as I’ve been told to take Elivit and Megafol 5 and Activated b6 (brand orthoplex, white label). I’ve brought up my concern about my high levels and have been told not to worry about it. Someone recently told me that I should not be taking any of those that I have been taking and instead take Activated Bs Plus Q10 (BioCeuticals).
Would my intake of Folic acid be a cause of my miscarriages and constant chemical pregnancies?
Hi Victoria,
Sorry to hear about your miscarriages. Folate levels are only beneficial within a certain range, where means there’s a bit of a fine line between too little and too much. For that reason I don’t recommend people take Elevit which has 800mcg of Folic acid, when you really only need 400-500mcg from supplements because you can get roughly 600mcg per day from your diet. More is not better, especially for people with MTHFR. Here in Australia our supplements have either Folic acid or 5-formyl-THF which is Folinic acid. In other countries you can get the fully activated form which is 5-MTHF but it’s not yet legal in Australia. So for my patients I recommend taking a supplement that contains the folinic acid, which is Tresos Natal by Eagle. Because it’s a prenatal multivitamin it also contains other crucial vitamins and minerals needed for healthy conception and pregnancy.
With your history of miscarriages it’s important to be under the care of a practitioner who can help assess what’s going on, and also support your body when you conceive. If you’re in Sydney I’d recommend coming in to see me, but if you’re living somewhere else just try and find a good local acupuncturist who can also do herbs for you.
Hi Kim, I was diagnosed with homozygous MTHFR gene mutation and we prescribed high dose folinic acid, to start 3 months pre conception, I’m just wondering if it’s ok to take a regular pregnancy vitamin with folic acid in it, as well as the folinic acid. I’ve read that folic acid blocks the folate receptors in ppl with MTHFR mutations, but does the high dose folinic acid override this? Thanks
Hi Josie,
I’m not aware of any issue with having both folic acid and folinic acid, in fact the supplement I prescribe in clinic contains both versions. The company did this because they can’t ignore all the scientific evidence that folic acid prevents neural tube defects, but they’re also aware that folic acid isn’t absorbed as well by some people, so they include folinic acid. If you’re concerned I would suggest just making sure you’re eating plenty of fresh organic produce and you should then be getting a nice array of vitamins from your food. If you’re concerned about a deficiency in one or two particular vitamins, you could try and find those as singular supplements.
Hi, I’m wondering if you have a blood test that shows that your folate levels are good whether that means you don’t have a problem converting it into folinic acid?
I’m looking to conceive and my folate levels are good but just want to see if that’s any indication on whether my body can convert it.
Hi Alicia,
I’ve seen patients have MTHFR gene defects and high blood folate levels, so I’m not sure. It might be worthwhile getting the MTHFR test (which if you’re in Australia costs $65 privately through a lab) to know for sure whether you even have any reduced ability to convert. If you don’t have a history of infertility or miscarriage then you might choose not to get tested yet.
Hi,I’ve had two miscarriages and I found out recently that I have this gene mutation (A1298C). My doctor advised me to start taking Megafol 5mg. I am just wondering if taking higher dose of folic acid will help?
Hi Maya,
It’s certainly not my place to discount anything your doctor says, as they are your health care practitioner. I can only comment on what I suggest to my patients, which is a folinic acid supplement for easier absorption, without the risks associated with longterm high dosing of folic acid. Perhaps you could discuss this further with your doctor if you feel unsure about what they have prescribed? Best of luck with your journey.
Hi there,
Just wondering what pregnancy multivitamin supplements with folinic acid you recommend. Are these supplements available in Australia?
Thanks!
Hi Suzie,
In my clinic I prescribe Tresos Natal by Eagle, which is a practitioner-only supplement (meaning you need a practitioner to prescribe it to you after a consultation). I’m not sure of retail brands, but you could check with your local health food store or chemist. Generally it’s best to see a practitioner though to make sure you’re taking the highest quality supplements, and only the ones you actually need, without the influence of advertising.
Hello, I’ve had 4 miscarriages ove three years and was only recently tested for MTHFR and I have a moderate mutation (40% reduced capacity I think). I’ve been on folinic acid for about a month and have just had a positive pregnancy test. Do you know how long it takes before the body gets the effect of folinic acid. I’m a bit worried that it wouldn’t have done anything yet. Keeping everything crossed for this pregnancy. Fantastic article. I wish all OB’s tested for MTHFR, I’ve had 100’s of blood tests over 3 years and the only person who has tested me for this was a natropath I was only referred to recently.
Congratulations on your pregnancy Gemma. One month would be considered the minimum in terms of supplementation, so the folinic acid would have had a chance to have some effect. 3 months would be ideal, but you’re continuing to take it, which is the main thing. Have you also been tested for other auto-immune conditions and things like NK cells?
The research on MTHFR is quite new, which is why not all health care providers are familiar with it and performing testing yet. I’m slowly seeing a change and noticing more specialists becoming aware of it though, which is great news for everyone. Best of luck with your pregnancy. 🙂
Hi, I have been taking folinic acid for the past few weeks. I am 10 weeks pregnant, before taking folinic acid I was taking elevit but my brother recently found out he has this gene and his naturopath advised that because I am pregnant and could possibly have gene I am better off taking folinic acid. I just wanted to check, could folinic acid be harmful if I do not have this gene? When I ask my doctors they seem to not know about the gene and advise against taking folinic saying it is unnecessary
Hi Alisha,
Folinic acid is just the converted form of folic acid, so there’s no problem taking it unless you’ve been told not to take folate supplements in any form by your doctor. You may also wish to take a multivitamin that contains folinic acid, or a standard multivitamin so you don’t miss out on the other essential nutrients in pregnancy such as iron and iodine.
Congratulations on your pregnancy 🙂
Hello. This is just what I need. Some advise and hope. I was diagnosed with compound heterozygous. 1 mutation on each. My husband has now been tested. Our clinic has requested an appointment next week but ill go crazy with worry waiting that long. I need some facts about worse case. Can we still conceive no matter the outcome? Just trying to prepare myself. Even though I shouldn’t Google, this is the best write up I’ve seen. I’m hoping you can help. Any information would be great.
I’ve had numerous patients with MTHFR gene mutations who have successfully conceived and given birth to healthy babies. Try not to worry too much. There’s a lot of misinformation out there. I have all my patients with MTHFR gene mutations taking folinic acid as their treatment before and during pregnancy. 🙂
Is folinic acid synthetic?
Hi April. Yes, both folic acid and folinic acid are synthetic variations of folate. If you’re looking for non-synthetic options, your best bet is whole foods that are high in folate.
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