Over the past few months, a handful of patients have asked what they can do if they have the MTHFR C677T mutation. Recommendations can vary depending on whether an individual has a heterozygous (1 copy of C677T) or a homozygous (2 copies of C677T) mutation. While there is definitely conflicting information in the literature, the following is intended to provide a small amount of clarification and guidance.
A quality prenatal for those with this defect requires methylfolate, folinic acid and no folic acid. These prenatals are very hard to find.
Begin by taking the most important supplement first (depending on your individual circumstances) in a small amount for at least a few days to see how you respond. If you respond well, continue taking it and add in another supplement. This way you can easily identify if a specific supplement or nutrient is giving you problems.
NOTE: If you are not sensitive to supplements in general, then it is recommended to start with a comprehensive multivitamin and multimineral as this supports numerous biochemical functions within your body. It also provides a fast testing ground to see if you respond well to numerous nutrients.
If you do not tolerate a multivitamin well, this is a sign that you must proceed more slowly and work on healing your digestion and dietary intake and lifestyle habits first.
Those with 1 copy of the C677T MTHFR mutation do not need as much methylfolate. The MTHFR enzyme is working at nearly 70% or so effectiveness in heterozygous individuals while in homozygous individuals, it is working at approximately 30% effectiveness. To determine how much methylfolate you need, it is best to start low and work up. This allows you to safely identify how much you tolerate without triggering very undesirable side effects. It is highly encouraged that you proceed cautiously in order to prevent side effects from excessive methylfolate.
NOTE: If you begin supplementing with methylfolate and you have inflammation unchecked, your symptoms may worsen. This is why it is critical that you are tolerating and taking probiotics, krill oil, turmeric along with improving your diet and lifestyle first.
Common undesirable side effects of methylfolate include:
If side effects occur, then the amount of methylfolate you are taking needs to be taken under consideration and likely reduced. Many times one is not yet ready to take methylfolate. There are other steps that must be taken prior to supplementing with methylfolate if these side effects occur. If side effects occur, taking Niacin helps bind the excessive methyl groups which are likely causing the issue. Consider taking approximately 100 mg of Niacin (not a whole tablet) if these symptoms occur. Flushing is common from taking niacin in the most active form, nicotinic acid. This is not harmful and will subside in about 20-30 minutes.
Supplements and pharmaceuticals are designed to support methylation. Methylation is severely disrupted in those with C677T MTHFR mutations – especially homozygous individuals. Methylation requires balance. If methylation becomes excessive, side effects will occur as noted above. This requires adjustment of your protocol. There may be a need for routine adjustment as our bodies are dynamic. Adjustments may range from:
If you are feeling improvement consistently, then you are on the right track. If you begin to feel heavy, tired, dry mouth, irritable, ‘toxic’, or otherwise ‘not right’, then something in your protocol needs to change. These are all signs that you are potentially increasing the circulation of toxins and not eliminating them properly. These side effects can be eliminated quite quickly through a pure vegetable and fruit juice diet for at least one day. This means producing your own juices at home using a quality juicer. Prepare mostly vegetable juices with some fruit juices to increase the taste. Taking niacin also helps offset many side effects.