What Is The Goal With MTHFR?

I know this sounds like a bit of an odd question – the goal is to get healthy, right? And yes, of course it is. But sometimes people have mistaken ideas about health goals, so I think it deserves a little bit of a conversation.

First off, What Concrete Goals Are We Looking For?

This is actually pretty simple.

  • Normalize lab values like homocysteine, B12 and folate levels.
  • Feel reliably better
  • Minimize the risk of chronic illness both related to and unrelated to MTHFR.

Simple, right? Except that we are a society used to taking a pill to fix things and then eventually being done with that pill. That is where we get into trouble with MTHFR.

MTHFR Is For Life

This isn’t a get balanced and then go back to ignoring it kind of problem. MTHFR is a genetic difference. It has always been with you and it will always be with you. There is no quick fix for that. I believe we can achieve the goals above – get your basic numbers back in line, get you feeling great, and reduce your risk down the road. Absolutely all of that is possible, but it is also ongoing.

Your body and your health are dynamic. You respond to changes in diet, in stress level, in weather, in close relationships, in sleep quality in very real ways that might be easy to perceive or might be hidden. Still, every one of those factors and hundreds of others besides add up to your total state of health on any given day or in every moment. Essentially, it’s a lot of moving pieces and in any day there could be hundreds of small factors that determine how your body functions. That is a lot.

For example. Say you get up in the morning, have an extra coffee because your dog/cat/spouse/hookup decided they wanted to sleep on your pillow. You grab a whole grain bagel with cream cheese and run out of your door, only to get stuck behind the slowest driver on the face of the planet. You can feel your blood pressure escalating and you try to take a few deep breaths so that you don’t just run into the back of their car four or five times to vent some spleen. When you get to work your boss pulls you aside and thanks your for the amazing job you’ve done on your latest project. Nice! After work you go to the gym but the parking lot is full and you end up driving around for 15 minutes before you decide you’re too tired anyway and head home…

This day is filled with pretty normal things:

  • not ideal sleep
  • extra coffee
  • food choices
  • rush and stress
  • frustration and maybe a bit of road rage
  • surprise good news
  • inconvenience
  • sedentary lifestyle

Plus, there were all the things you weren’t aware of that your body was dealing with – that tiny little pocket of inflammation in your arteries, the virus that has been lurking around the office causing your immune system to ramp up, the low-pressure system that is floating in, the minor vitamin C deficiency you never knew you had, and the lingering emotional stress that comes from a strained relationship with auntie Mabel. Add to all of that your hundreds to thousands of polymorphisms.

Every one of those seemingly tiny factors affects your physical state of health in some way. We all know the emotional impact, of course, but physically every one of those factors affects your cortisol and sex hormone levels, inflammation, metabolic pathways, neurotransmitters, parasympathetic functions like digestion, and gut flora. Every small thing ripples out into the much larger picture of who you are and how your body feels and functions. Frankly, it’s a wonder any of us can get out of bed in the morning.

Outside of Goals, What Is The Actual Aim?

This, to me, is a whole different thing. The goals are tangible. We can check them off of a list and be done. The aim, is perhaps a bit softer than that. In my opinion, the aim of working with your MTHFR and your methylation pathway is about reaching potential. Every human has strengths and weaknesses, we all have ups and downs and as far as I can tell, that is the crux of being human. I know precisely zero people who have perfect states of being. We just have to slog through the mud sometimes. So my aims in my own MTHFR journey, and for you as well are:

  • Live up to our potential as flawed humans. This isn’t about being superman or superwoman. It’s not about being a TV character – glossy and perfect. I actually think fostering the idea that we CAN be that is damaging. This is about feeling well, have a positive impact on the people around us, and feeling like we’ve done something worthwhile.
  • Maximize health for whatever years we have. Nobody, even with a perfect diet and self-care, can actually predict what their health is going to be like throughout their life. People with perfect diets get cancer too. We can work to make it better than it might have been, but that doesn’t mean we’ll all be blessed by the perfect health fairy. It doesn’t work like that. When we reach the end, I want us all to be able to look back and know we cherished ourselves and treated our bodies like they mattered.
  • Have more good days than bad days. Of course, we want good days – lots of them. But it is also important to live into the bad ones and not be discouraged by them. This means continuing to develop a toolkit of coping strategies for the not-great days.

Aiming for perfect is misguided

amy neuzil, tohealthwiththat.com

The point is that aiming for “perfect” is misguided. People reach for it in health, looking for a meaningless continuity of perfect days. Culturally we reach for it in goal setting, and self-perfect and it becomes both unattainable and deeply damaging. There is no perfect. Ever. Embracing that is freeing. What there is, is BETTER.

Thanks for listening this week – don’t forget to rate me on your favorite podcasting app, and tune in next week for some gentle detox strategies, because god knows we MTHFR folks need them.

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What to Expect When You’re Starting Methylfolate

If you’ve already:

  • Taken folic acid out of your diet
  • Added in natural folate
  • Started a multivitamin or B complex without folate or B12 

And you’re tolerating these changes well, then you’re at the point where you might consider adding some extra 5-LMTHF. We talked about it in a whole post here. As a quick recap, you can expect one of three big reactions.

  1. This is the miracle of miracles.
  2. This started really great and went south.
  3. This is a nightmare.

No matter which of those big reactions you fall under, there can still be a bit of an adjustment when you’re starting. I couldn’t describe my adjustment reaction to you in any way other than to say that my brain felt “weird.” It wasn’t awful, it was just not normal. If it is awful, then stop dosing and read the above post to find out your immediate steps. Here, I want to talk about longer-term expectations and what you might see.

Good Days and Bad Days

As you continue for longer periods on your MTHFR journey, the good days and bad days smooth out and things get a lot more regular and predictable. In the beginning, though, your body is still struggling out of its own personal sand pit and so you’re a little more susceptible to ups and downs. This is normal and expected and gets so much better over time. Just be gentle with yourself and on days when you’re feeling a little yucky, add in some great self-care. That could be scheduling a little nap or some outdoor time, it could be a hot bath or taking 5 minutes to meditate. It could be sitting and staring at a wall for 15 minutes, unplugging, or even watching funny videos during a break to get your dose of laughter. Just be extra gentle with yourself and take some extra care. Your body is working hard and some days it needs extra love and support.

Starting methylfolate can be rough, but things smooth out with time.

Detox Symptoms

One of the biggest processes that is happening with appropriate methylation support is detoxification. This is great news and we want it to happen, but if detox is happening too quickly, then it can feel crappy. Like, really crappy. Detoxing too quickly looks like:

  • brain fog
  • headaches
  • nausea
  • irritability
  • general yuckiness
  • usually it reminds you a lot of a hangover.

This means you’re pushing your body to detoxify, but it’s getting stuck somewhere.  Here is what you should do:

  1. Decrease your dose or take a break from any methylated supplements or methylfolate that you’re taking. Your body needs a break for a minute.
  2. Rest more
  3. Get extra water and some good mineral support (like adding a bit of Himalayan pink salt, lemon juice, or apple cider vinegar to your water).
  4. Do some gentle detox. This could be:
    1. Sweating in a sauna, hot car, hot bath, or wherever else you can sweat.
    2. Hot bath with Epsom salts (for the sweat, and the magnesium)
    3. Castor oil pack
    4. Boosting your fiber intake
    5. Taking something to bind to toxins like bentonite clay (food grade), activated charcoal (also food grade), or spirulina.
    6. 24 – 36 hours of fasting.

As an MTHFR mutant, gentle detox is going to be part of your life, so it really helps to familiarize yourself with your body’s toxic signals. My first one is always irritability – it’s a sure sign that I’m pushing too hard.

Learn Your Boundaries

I feel like one of the biggest and most important factors to really taking care of your body as an MTHFR mutant, is to learn to understand your body’s tolerances and limits. None of us like the word “limits” it implies that we aren’t superhuman, that we have to stop some time or take breaks. It *almost* sounds like a weakness. We have got to change that idea, and fast. Understanding and listening to your body if it is approaching a threshold helps you to avoid the big fallout times, the horrible days, the emotional days, the exhausted days (or weeks), the brain-foggy-can’t-focus days. Believe me, without those, your potential skyrockets and it’s like you’re launched to the next level of life as a human, both personally and in your professional or creative life. This is a lot like learning the subtle language of your body so that you can stop problems before they start.

The best way I know of to start this process is to use a symptom tracker – maybe even daily. Rank symptoms and also traits from 1 – 10 every day and after a while, patterns will pop out at you. Like I said above, if my irritability starts to rise I know to add in some extra detox. If I don’t do that, then I can expect 2 – 3 days of headaches, irritability, brain fog, and general misery. Believe me – it’s better to just make time for that hot bath and convert those to good days.

Likewise, if I start feeling my stress-levels ratchet up, or my level of work-obsession rise, then for me that is a signal that I need more methylfolate, more antioxidants, and more exercise. A couple of days of that will right the balance and put everything into perspective again.

My signals are probably going to be different from your signals, but by using a symptom tracker you will start to see those repeating patterns and can use them to develop coping strategies to keep most days as good days.

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5-LMTHF vs. Folinic Acid. Which is Best For MTHFR?

I am sure everyone would like a simple answer so they can just buy a product and move on with their lives, but like everything else about MTHFR, this is an individual question.

The very short answer, is both forms will get you there in the end. Don’t worry, I’ve got the much longer answer all ready for you too.

One caveat before we get going – we are entering into unresearched territory here. The effects of 5-LMTHF vs. folinic acid in MTHFR mutants have never actually been studied as a comparison, so the only useful data I can use here in my own clinical experience with myself and my clients. MTHFR is a reasonably new area for scientific research and the research has focused primarily on health risks and disease correlations, as well as basic information about how disease risk changes with folate status, but we are nowhere near the point where we are actually looking at how MTHFR folks feel well.

Fast vs. Slow

In a very real sense, what we are dealing with here, is incredibly fast action, vs. slower steadier action. 5-LMTHF is the active form of folate. As soon as it absorbs, it is useable in a very rapid way. For some MTHFR folks, this is a miracle, but it’s all too much for others. Folinic acid, on the other hand, still has to be converted to the active form, and so has a much slower action because you can only use it as fast as you convert it. For some people, this isn’t enough. For others, it gives the benefits of methylfolate without the scary burst of energy (which can feel like anxiety, heart palpitations, or restlessness if it’s too high.)

If you look at the diagram above, the enzymes are highlighted in grey. You can see that 5-LMTHF is the end-product of all of this. It doesn’t need to be changed into anything else, because it’s already what we’re after. Folinic acid, on the other hand, still needs the MTHFR enzyme, but bypasses “DHFR Slow,” which only folic acid uses (and you know what I think of folic acid) and the “DHFR Fast” which is used by other forms of natural folate. It’s an efficient way to get good active folate even if your MTHFR is slow, just as long as you don’t have folic acid in your diet slowing everything down.

Doesn’t Every MTHFR mutant Need The Active Form?

No. Every MTHFR mutant needs good sources of natural folate, but this could be food sources of natural folate (NOT FOODS FORTIFIED WITH FOLIC ACID), folinic acid, or 5-LMTHF. Ultimately, they are all working on solving the same problem they just do so with different levels of efficiency. Here are some quick facts for you.

  • Natural folate, folinic acid, and 5-LMTHF are all useable by MTHFR mutants as long as they don’t have folic acid in their diet.
  • Folic acid makes natural folate and folinic acid less useful because it blocks receptor sites and slows down the methylation pathway.
  • 5-LMTHF is the only form of folate that bypasses the MTHFR enzyme entirely,
  • Natural folate, folinic acid, and 5-LMTHF are all-natural forms of folate.
  • Folinic acid is easier for many MTHFR mutants to tolerate because it is metabolized more slowly.
  • Often, taking folinic acid for several months will help a person who couldn’t tolerate 5-LMTHF to tolerate a low dose.
  • Some MTHFR folks will never be able to tolerate any forms of folate.
  • Because folinic acid metabolizes more slowly, it typically generates fewer side-effects than 5-LMTHF.

Do MTHFR Mutants Need Both Folinic Acid and 5-LMTHF?

The short answer is that we think so, but maybe not.

Here’s why. Folinic acid converts to 5-LMTHF reasonably easily (using the MTHFR enzyme) but 5-LMTHF has to go through a much more complex backward process to convert back to folinic acid. WE think it is important because these two substances feed into different pathways most easily.


  • Bypasses the MTHFR enzyme
  • Supports methylation and production of SAMe
  • Can cross the blood-brain barrier easily
  • Methylates substances like serotonin (to make melatonin), norepinephrine (to make epinephrine)

Folinic Acid

We are nowhere near the point where research is actually asking the question, “How do MTHFR mutants feel well.”

Amy Neuzil, tohealthwiththat.com

Next week we’re going to talk about what to expect when you’re starting to supplement with folate, what symptoms you might see, what is going on in your body an what to do about it.

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How to Dose Methylfolate for MTHFR

MTHFR is for life, and you’ll feel best if you are working on making your methylation great for the rest of your life. That doesn’t usually mean finding a dose of whatever you’re taking and sticking with it, it means rolling with the punches and allowing your body to change and evolve as your health changes and evolves. Generally, there are three different dosing strategies that can be used.

I certainly find that in myself and my clients, times of higher stress of any kind usually need more methylfolate. If I get sick I usually need a little more, if I’ve had less sleep than usual, or if I’m starting a new project and my brain is constantly churning I find I need more. Also, at those times I might need more support of different kinds. Likewise, if things are breezy in my life and I have good sleep, time to relax and lower stress then I probably don’t need to take anything – I just keep a good diet. 

It gets easier to adjust and listen to your body as you get more familiar with your own red flags – both when you’re low and need support and when you’re a bit too high and need to stop for a bit. By really understanding your signals you can dose in my favorite way, which is intuitive dosing. We’ll also talk about Dr. Ben Lynch’s “Pulse Method,” and a mixed dosing strategy.

Intuitive Dosing – how to dose methylfolate and other supplements.

Intuitive dosing, to me, is the absolute ideal way to dose your supplements because you can check in with your body to see what you actually need that day – you don’t have to have any supplements that you take every day like clockwork, it can all be much more individualized to your own needs in the moment. There are two things you need to understand for this to work and those are:

  • Your personal red flags (which are easy to see if you use a symptom tracker) and your energy level.
  • What each supplement does for you.

To do this effectively, you need a symptom, and you need an appropriate response. I’ll give you some examples from my own life just to help you understand.

If I get up in the morning feeling sluggish (symptom), I definitely take my multivitamin, 5-LMTHF, and a vitamin E with breakfast because the multi and methylfolate will give me an energy boost and the vitamin E will help to neutralize any oxidative stress that might be happening because I’m tired. I also add electrolytes to my water and really focus on getting enough water for the day because that can also help with energy. (Appropriate response to boost energy and counteract any excess stress on my system). Also on these days I try to support my body more with lifestyle factors. I get to bed earlier in the evening or try to fit a short nap into my schedule, give myself some down time and generally take better care. 

If I’m having a bit more joint or muscle pain (symptom) that day, which is my biggest issue, then I am likely to also add a high dose of fish oils for their anti-inflammatory properties and boost the magnesium in my water (appropriate response for inflammation and pain)

There are also some supplements that I take just to maintain good levels in my body, like vitamin D.  I don’t take these daily, but I incorporate them when I’m taking other things – so if I’m having a day where I need some supplements, then I’ll throw a vitamin D into the mix just to make sure I’m getting it regularly. 

Some supplements need to build up in the bloodstream to certain levels to be effective.  For example, I have mold allergies that will typically activate in the fall.  If I take my allergy supplement as needed, it is less effective then if I take a higher loading dose for five days then a steady lower dose for the duration of the season. So this one I do take regularly and not on an intuitive basis so that I don’t have to experience any allergy symptoms.

There are some things that must be taken daily. Those include:

  • Prenatal vitamins and supplements while you’re trying to conceive, building a baby, or nursing because that is an unusual situation for your body and you do need extra support.
  • Prescription drugs from your doctor must be taken as directed – always. 
  • Support when you’re acutely ill. When you’re actively going through a disease process, sick with a short-term illness, or starting an intensive weight loss program you probably need more consistent support.

Benefits of Intuitive Dosing:

  • You get what you need, when you need it.
  • You save money on supplements because you’re not taking them every day
  • You retain optimal absorption – I believe anything your body gets absolutely every day is easily ignored and gets lower priority, in terms of absorption, than things that show up sometimes but not others. 
  • Less waste because typically if your body doesn’t need something, it just washes it out in urine or feces, so if you’re’ taking something when you don’t need it, it is essentially just washing through (unless it’s building up to harmful levels, which is actually worse).
  • Easier to avoid toxicity reactions – there are things that build up in your system and just because it’s helpful when you need it doesn’t mean it isn’t harmful when you have too much!
  • You become more aware of your body’s needs, which also makes it easier to maintain a great MTHFR lifestyle.

Drawbacks of intuitive dosing:

  • This can be hard, especially for people who are really out of touch with their bodies or who have had a lot of physical or emotional trauma and tend to dissociate, because they may not notice what their body is feeling. It is beneficial to work on it in the long run because it will help you tune back in to your body and work through some of the trauma, but that can be a process.
  • Some people really need a routine to help them remember supplements. For these people, a mixed dosing strategy might be the most appropriate.
  • This takes some practice for you to learn to trust your body’s signals and respond appropriately.
  • It can be difficult to keep track of what your supplements are doing for you. It is important for everyone to learn, but especially important if you’re dosing intuitively.

Times when you are more likely to need to take higher doses of supplements:

  • If you’ve had a bad sleep
  • If you’re going through a stressful time at home or work
  • At particular times in your menstrual cycle – this varies from woman to woman, but if you have a time in your cycle that tends to be difficult, you may need extra support.
  • During cold/flu season or if everyone around you is getting sick
  • If you’re actually sick
  • If you’re not being as careful with your diet
  • If you’ve had alcohol or other substances
  • If you’ve had exposure to something toxic (like if you’ve just done some home renovations and had to use solvents or caulk or any other chemical).

Pulse Method of Dosing as Per Dr. Ben Lynch – how to dose methylfolate.

In his book DIrty Genes, Dr. Lynch talks about the Pulse Method of dosing. In this method he says to:

  • Stop or reduce a supplement when you feel great. 
  • “First lower your dose—then keep lowering it, until you’re down to little or no dose at all.”
  • “If you feel bad again over time, you can increase the dose gradually.”
  • “If you start getting different symptoms, that might mean you’re taking too much.”

In many ways, this is similar to intuitive dosing – you’re still using your own symptoms as a guide and when you feel great, you probably don’t need much, when you feel poorly, you need more. This would also take a little bit of practice to perfect, but works for lots of people.

Mixed Dosing Pattern – How to Dose Methylfolate.

This is the best way to dose methylfolate and other supplements if you feel like the other two are too difficult or if you’re a person who thrives on routine.

Here’s the routine:

  1. Take a low-dose mutli and low doses of whatever you take routinely every day. This shouldn’t be your maximum tolerated dose, it should be maybe half of that.
  2. Take weekends off of everything (I still want some days away to optimize absorption)
  3. If you feel bad, take a little extra of the thing that is most likely to help.

Benefits of Mixed Dosing:

  • This type of dosing adds a level of routine and stability that some people really thrive on.
  • It still gives you some flexibility to add when you need additional support
  • Because you’re taking a lower than your maximum dose daily, we’re minimizing your risk of causing overdose reactions.
  • You get a break on weekends

Drawbacks of Mixed Dosing:

  • It still helps to know when you need extra support because on those days you can adjust your dose. If you’re not good at knowing that, then you may not be getting optimal dosages on those days.
  • You may be taking supplements on days when you could have skipped them entirely.

No matter what, with MTHFR, it is important to know what works best for you. If you’re a routine person, mixed dosing might be best. If you are in good touch with your body and your symptoms, intuitive dosing is just right. If you like being flexible but want simple ground rules, then Dr. Lynch’s Pulse Method could be the best way forward.

No matter what, with MTHFR, it is important to know what works best for you.

– dr. amy neuzil, tohealthwiththat.com
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I Have MTHFR, How Do I Start 5-LMTHF?

Once you’ve adjusted your diet, you have a new baseline. This is your new normal and it may be great, it may just be getting there (but not great yet). Make sure you give yourself about a month on your new diet — with MTHFR it’s way better to go slow and give your body time to adjust to things properly before you jump into something new. This is when you should start to think about supplementing.

Three rules to successfully start 5-LMTHF supplements:

  1. Always start low – use the lowest dose you can find. You can always add more, but once you’ve taken it, it’s hard to get it back out. Start with a low dose.
  2. Always go slow – give your body time to get used to the low dose before you increase. At least a week, but two if you know you’re particularly sensitive.  It is really common for someone to be able to take something for three days and then start to have symptoms because the dose is actually a bit too high and they’re pushing too hard.  Make changes slowly and be as willing to decrease the dose as you are to increase the dose. There is no right dose for everybody, only the right dose for you.
  3. Change only one thing at a time – I see it happen all the time that people get excited about a new health journey, add five supplements from internet research, then have some kind of symptom and have absolutely no idea where it came from or what is causing it, so they end up dropping all of those supplements.  This isn’t the best way forward. If you make small changes with only one supplement at a time, you can avoid this problem and you’ll always know exactly how you respond to something.  That doesn’t mean that adding another supplement might not change the dose you need of something else, but at least it helps you to know where to look.
Be like the snail when you start 5-LMTHF

Start 5-LMTHF:

If you’ve already:

  • Taken folic acid out of your diet
  • Added in natural folate
  • Started a multivitamin or B complex without folate or B12 

And you’re tolerating these changes well, then you’re at the point where you might consider adding some extra 5-LMTHF. 

Start with the lowest dose you can find and if you can only find high doses, cut them (if they’re tablets) or take the powder out of capsules and divide it. If you typically react strongly to things you take, which is common for in MTHFR issues, then start even lower than you think you need to.

The Three Possible Reactions to 5-LMTHF

  1. Miracle! – It starts out as a miracle (although it might feel weird the first couple of days because your body is adjusting), it keeps being a miracle and everyone is happy.
  2. Bait and switch – It starts out amazing and you love this thing. A couple of weeks later you find yourself either spackling minuscule cracks in your ceiling at midnight because you have too much energy and can’t sleep (overdose), or hating everything and everyone because you feel toxic (too much, too fast).
  3. 5-LMTHF is the devil – If it always feels bad, there is a good chance you will either never tolerate it, or only tolerate tiny doses later on in the process.

It is normal to feel a little strange for the first few days. Remember, 5-LMTHF is the only form of folate that bypasses the MTHFR enzyme and that means it can feel a bit odd the first time you take it. That enzyme has been dysfunctional, to some degree, your whole life and your body is going to need a minute to adjust. For me, the only way I could describe it was that my brain felt “different.” This is a useless description, I know, but there wasn’t really anything I could put my finger on, it was just … “different.”

5-LMTHF has the potential to change your neurotransmitters, your cellular energy, your antioxidant balance, and lots of other things very quickly, so it can feel a little odd. Your body has probably never experienced this before.

Outside of a normal adjustment reaction, it is also possible to have a bad reaction. The most common ones I see are anxiety or restlessness, edginess, depression, or difficulty sleeping. 

Remember, 5-LMTHF is the only form of folate that bypasses the MTHFR enzyme, and that means it can feel a bit odd the first time you take it.

amy neuzil Tohealthwiththat.com

Any big uncomfortable symptom should be considered a bad reaction and if that happens, stop the 5-LMTHF and wait until the symptom clears before you try it again. If the symptom was really bad then try again at a much lower dose. Even if you can tolerate natural folate in food, you might not handle 5-LMTHF well. 

If you have an adjustment reaction, but it clears in a few days and you’re tolerating the dose of 5-LMTHF that you’re taking, that’s great news! Stay at this dose for a couple of weeks and then try increasing it by a little bit. Dosing is very individual with MTHFR and there isn’t any way to give you a target dose, but there is a right dose for you out there somewhere.  It’s just a matter of slowly working your way up until you find it. 

What If I Can’t Tolerate 5-LMTHF?

This is a surprisingly common issue. If you just can’t take any 5-LMTHF at all, try a tiny dose of folinic acid instead. Folinic acid is metabolized differently than 5-LMTHF, but it’s a natural form (like the natural folate in foods) and is often easier to tolerate for MTHFR folks, even though it still needs the MTHFR enzyme to be activated.  If you need a refresher on folinic acid or the different forms of folate, check out this post. Here is a diagram of the methylation cycle showing where the different types of folate come in.

Folinic acid still goes through the MTHFR enzyme, but it bypasses the DHFR (slow) enzyme and the DHFR (fast) enzymes. For many MTHFR folks, it gives them the benefits of natural folate but is easy to supplement as a pill form (which natural folate isn’t because it isn’t shelf-stable) and it metabolizes more slowly than 5-LMTHF, which means that most people have fewer side effects. 

Once you’ve taken folinic acid for a while you might be able to tolerate a small dose of 5-LMTHF because some of the accumulated problems from a functional folate deficiency have been worked out, so your body might be better able to handle it. Again, start low, go slow and change only one thing at a time. You might still find you can’t take 5-LMTHF, but this whole journey evolves so just because something was true when you began the journey doesn’t mean it will be true three months in, three years in, or three decades in. Remember, MTHFR is for life.

Next week we’ll talk about dosing strategies because for many of us, taking the same dose every day isn’t a great idea. After that, we’ll dive deeper into what to expect when you first start taking 5-LMTHF, what to do if symptoms arise, and how to manage any reactions you might be having.

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