S2E27: What is Really Going On With MTHFR Basic State?

Basic state is something that we’ve talked about before, but I want to dive a little bit deeper into why I feel it’s important when other fantastic practitioners, like Dr. Ben Lynch, aren’t really into it. Honestly, there is no right answer here.  So let’s look a little more closely.

The idea of over and under-methylators came originally from the research of Dr. Walsh from the Walsh Research Institute.The main thrust of his research was that mental and emotional disorders often stem from an imbalance or deficiency of nutrients in the brain. 

This research was not based on genetics and had nothing whatsoever to do with the MTHFR polymorphism, or any polymorphisms in the histamine pathway. It was based on Dr. Walsh’s clinical observations over years of working with vast numbers of patients. The terms “overmethylator” and “undermethylator” were his own and based on what he theorized was happening. The names, in my opinion, are a bit misleading because we don’t actually know what is happening with the genetics or if the DNA is really overmethylated or undermethylated. Hopefully, that research will happen eventually, but it certainly hasn’t happened yet.

The reason I like using basic states as a guidepost, is because it’s an easy way, especially in the beginning of your MTHFR journey, to guess how you might respond to certain supplements and drugs for mental health.  This can be hugely helpful because we all have a tendency to dive into the deep end with this, and believe me – taking a big dose of methylfolate if your body isn’t ready for it can scare you off of taking methylfolate for a very long time. 

Also, since the basic state is based on observable personality traits, allergies, and measurable signs and symptoms, we’re not looking at just one gene. We’re looking at how the totality of a person’s genes plays out in real life, because how they look on paper isn’t always how they act and how they act is what really matters at the end of the day.

Also, this is something that can be determined without any genetic testing, without any specialized help from practitioners and without the need for any fancy interventions at all. That makes it extremely valuable because for every one  person who thinks they have an MTHFR polymorphism who is working with a knowledgeable practitioner, there is another hundred who are doing this on their own.

For that, basic state is invaluable. Also, I love the fact that it’s based on what is called phenotype, or genetic expression, not genotype, or genes as they’re written. What that means, is that elements like personality traits or high or low histamine, represent the way all of your genes come together to express, which is by far more valuable information clinically than the actual gene polymorphisms themselves. 

There are so many genes involved in each pathway – when you look at actual gene expression, or phenotype, you’re seeing the way all the genes come together, which is more relevant than just the status of one gene or another. Also, all of your genes express or don’t express depending on a variety of factors including lifestyle, nutritional status, other health factors and even your mother’s health status while you were in utero. It’s far more complicated than just this or that gene, but looking at who you are as a person and how your personality expresses is actually a great way to sum up this information.

Knowing your basic state can give you some well informed starting places in terms of how you will respond to supplements, pharmaceutical drugs, and even the types of doses you might expect to be optimal. It isn’t 100% accurate, but it gives you a better idea of starting places than you would otherwise have. Still always start low and go slow, but knowing your basic state can speed up the process of discovery. 

The MTHFR Basic State Mirror Image

When you’re trying to determine your own basic state, it’s most helpful to think of them as flip-sides of the same coin with opposite traits on either side.  Your basic state will come down to how many traits you have from each side.

For instance, the traits of overachievement and perfectionism show a subtle but important difference. Both under and over-methylators express these traits, but undermethylators tend to be perfectionistic and overachieve in all areas, where overmethylators hyperfocus on the areas that are important to them and let the rest slide.

There is a very important difference in allergic response as well. High histamine type allergies and sensitivities are like classic hay-fever, where you open a window and the pollen instantly makes your eyes stream and starts the sneezing.  That is an undermethylation, high-histamine type reaction. Overmethylators, on the other hand, show more chronic allergies and sensitivities – the low-grade headache, neck tension, entire season with a blocked nose that doesn’t particularly change whether you’re indoors or out. That is a low-histamine sensitivity pattern. Also, overmethylators tend more toward chemical and food sensitivities, where undermethylators tend more toward histamine intolerance in foods.

High, for everythingAchievement and DriveHigh for the thing that matters to them, low for other things
Typically follows rules and social norms wellRules and guidanceFollows rules that make sense to them, disregards others. Follows the beat of their own drum.
Typically pushes for achievement in everything they doAchievementPushes for achievement in the things that matter to them, but not interested in other things
High histamine and seasonal allergiesHistamineLow or normal histamine with chronic allergies/sensitivities
Typically lowerPain ToleranceTypically higher
Often intolerant to histamine in foods, but less often to foods themselves.Food reactionsTypically has sensitivities to specific foods and chemicals
High fluidity (saliva, tears, etc…)FluidityLow fluidity (saliva, tears, etc…)
The MTHFR Basic State Mirror Image

At the end of the day, trying to decipher the big picture by looking at each particular gene SNP can lead to a really messy situation in which you can end up taking supplements that look good on paper, but aren’t actually addressing the issues you have in real life.  This is far less likely to happen if you’re working with a good practitioner, but sadly I’ve seen some practitioners fall victim to this mentality as well. Even worse, you can end up taking one supplement for each gene SNP and getting completely overwhelmed by a cumbersome protocol that costs a lot of money and time, but doesn’t get you anywhere.

If you’re looking for a MTHFR basic state refresher, you can follow this link to learn more about the idea in general. Here’s a link to dive deeper into the undermethylator picture and here’s one for overmethylators.

Thank you so much for listening today, and if you haven’t done so already, check out the show notes at tohealthwiththat.com. There are resources, downloads, links to research, and best of all an email list where you can sign up to be sure you’re the first to hear about exciting new courses, free resources, and other great things.

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Checking In With Progress On The MTHFR Journey

Let’s check in with what is going on so far. If you’ve been following the process this season, you will have noticed that I haven’t really addressed what we’re doing in a while, so let’s touch base.

There are some reasonably long stretches in the MTHFR journey in which we aren’t really changing things, doses are just staying the same, and it might seem like not much is happening. The reality, in fact, is that lots of things are happening in your body but none of it needs additional input from you.

This phase of the journey is what I like to call “Burning Through The Backlog.” When you first start diet changes and methyl folate or SAMe or whatever workaround you’re using, you see the immediate activation of the methyl cycle and some immediate health changes. Usually, that feels like a better mood, less anxiety, etc… After that initial balancing phase, the progress slows down but it isn’t because your body has stopped doing things.

This part of the process involves unpacking your body’s to-do list. All of the things it couldn’t do in the past because methylation just wasn’t happening fast enough. It’s a time of more subtle change where neurotransmitters are slowly coming into balance, toxins are slowly being eliminated, inflammation is slowly decreasing and oxidative stress is balancing out. Even your hormones and energy levels are being influenced in this process

How To Make Sure You’re Burning Through The Backlog Efficiently – Check Your Basics

In this phase, it’s easy to forget some of the basics so the first thing I want you to do this week is to take a look at things you should be doing and tighten up where needed.

  • Folic Acid – Make sure folic acid is out of your diet and supplements and isn’t creeping back in without you noticing.
  • Balanced Diet With Natural Folates – Get lots of fruits and veggies, as much fiber as you can pack in, moderate protein, and plenty of good food sources of natural folate like lentils, black beans, spinach, asparagus, dark green leafies, avocados, marmite, and any kind of bean or pea you feel like eating.
  • Multivitamin – Keep up with the background of other B vitamins – this is usually in the form of a good basic multivitamin. All of the processes that are happening now, from neurotransmitter formation to detoxification, to energy production, to balancing your oxidative stress and reducing inflammation needs a good solid basis of all the B vitamins.
  • Sleep and Rest – I really enjoy the paradox presented by this particular issue. Most of my clients say they would love more sleep and rest, but it’s always the hardset possible thing to actually accomplish. Just keep trying to work actual sleep and actual rest into your schedule.
  • Moderate Exercise – because generally, MTHFR folks do best with regular exercise, but not extreme exercise. Ironically, there are lots of us who are professional athletes and serious competitive athletes, but for those people it’s important to make sure methylation is balanced and to compensate adequately for the extra damage being done to their bodies.
  • Detox Support – since detoxification is such a huge part of Burning Through The Backlog, it’s important to give your body the support it needs. This can be in the form of gentle detox teas, castor oil topically, sweating it out, extra dietary fiber, or some mish-mash of all of these things. We’ve done posts on detox support before as well.

Burning Through The Backlog Efficiently – Optimizing Your Dose Of Methylation Drivers

The supplement or supplements you’re taking that specifically support methylation should be dose-checked occasionally. Maybe quarterly in this whole process. This could include any one of the following supplements:

  • 5-LMTHF or another form of methylated folate
  • Folinic Acid
  • SAMe

These supplements are all pushing the methylation cycle forward and so may need an occasional check-in to see if you’re still on the right dose. Usually, this means trying to increase your dose to see how you feel.

Generally, in this process, you increase by the smallest increment you can and make sure you’re using your symptom tracker for a couple of weeks before and after so you can see if there are small changes that you might not notice otherwise. If you feel fine with the higher dose, that’s great. Keep using the higher dose unless you start to get symptoms that indicate that your dose is too high. If you get symptoms right away or within the first two weeks then go back to your original dose.

Symptoms That Your Dose Is Too High

Typically too high a dose of anything that drives methylation feels hyper-caffeinated. It’s anxious, restless, can’t settle down, fidgetty, has a racing heart, or feels like all-out panic. If you’re noticing any of that – even if it’s a small change, then your balance will be better with a slightly smaller dose.

What About Other Supplement Routines?

For some people, taking supplements that take an alternate route through the methylation pathway, rather than methylation drivers, is the best path forward. Especially if you’re starting out from a kind of messy health place. These are supplements like methionine or choline. Methionine just gives you more of the raw ingredients to make SAMe and choline cuts through the middle of the methylation cycle as a viable short-term work around. These are great band-aids, but probably not the thing you want to be relying on for the long-term. If you are looking for long-term solutions but really can’t manage any of the true methylation drivers – methylfolate, SAMe, or folinic acid – then choline is the better of these two options. You still need the other B vitamins, and as much natural dietary folate as you can manage.

Moving forward, it’s a good idea to check in with your body quarterly to see if your dose is sufficient or if you’re getting enough for your body’s needs right now. Your dose will always be somewhat dynamic. Eventually, you will actually catch up with all of the things on your body’s internal to-do list and need a far lower dose, so watch for those anxious/hyper symptoms and keep it on your radar that your best dose might need to decrease too.

Thank you so much for listening today and give some thought to joining us in Genetic Rockstars – the MTHFR community. This month we’re talking about some of the links between MTHFR and histamine, and it’s a great way to meet people who understand what you’re going through and who have great information to share.

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S2E18: What is the MTHFR Lifestyle?

I mention the MTHFR Lifestyle a lot, but don’t always clarify what I’m talking about, and at this phase of the journey, it matters a lot. If you’re following along with the process in this podcast series, then you have done a number of remarkable things. You’ve:

  • Taken folic acid out of your diet and supplements
  • Added a good foundation of other B vitamins
  • Started 5-LMTHF, folinic acid, or SAMe – whichever of those options is the most easily tolerated for you.

Chances are you’re feeling better – clearer, more energetic, happier, less anxious, and generally like you’re on the right track. And you are. You are doing amazing and I am so proud of you for coming this far.

When I talk about the MTHFR Lifestyle, it’s really to remind people that our genes are for life. We will always have them, and when we happen to have MTHFR it can stand as a great reminder that we will thrive the best when we actually make health a priority.

Many people ignore their health until the wheels fall off the cart. That usually looks like a heart attack or a big diagnosis, or hitting some kind of health and functioning wall. Some of us may have done the same. The thing is, with MTHFR we will always do the best when we are making space in our lives to take care of our bodies. We will always do the best when we’re living the MTHFR Lifestyle.

What Is the MTHFR Lifestyle?

Put simply, it’s a life that puts physical health, mental health, and even spiritual or soul health on your radar every day. This isn’t something that we have the dubious luxury of forgetting – when we have something like MTHFR, it matters to make health a priority. To always be mindful of how we are treating ourselves and how we are caring for ourselves. It’s easy to rail against it and think that it’s unfair we have to pay so much attention to this when other people seem to be able to do whatever they want, but it’s also a blessing in disguise.

Living the MTHFR lifestyle gives us permission to make our own self-care a priority every day. That is actually kind of huge, when you think about it. It’s a good reason to take the best possible care of yourself.

What is the MTHFR Lifestyle in concrete terms?

This lifestyle involves making health a priority without getting too extreme. It focuses on things like:

  • Discovering and avoiding your food sensitivities.
  • Clearing as many toxins and chemicals out of your diet, home, and water as you can.
  • Keeping healthy fruits, veggies, beans, and pulses in your diet.
  • Making good sleep a priority.
  • Mindfulness meditation or some other mind-taming activity.
  • Moderate exercise (not too much and not too little).
  • Moderate protein (not too much because it can raise homocysteine).
  • Good hydration.
  • Gentle detox support like hot baths, saunas, dry skin brushing and castor oil.
  • Taking time for rest, relaxation, and joy.

When you look at it like this, it sounds sort of idyllic. Good sleep, relaxation, joy, some exercise, great food. This is the MTHFR lifestyle we’re striving for.

I know, being a realist, that it’s hard to maintain this kind of lifestyle in a busy, overstressed, modern world. I also know, that taking small steps towards it can have a huge impact on your wellbeing and quality of life. When you think about it, who do you know who doesn’t need a bit more self-care?

I feel like it’s especially important now, in this time of global pandemic and the related stress because even if you don’t consciously feel like it’s a stressful time, there is an underlying chunk of mental burden related to covid that we don’t normally carry. For everyone this is new, and for everyone it adds another weight. All we can do is take better care of ourselves so we can support that weight more gracefully.

Now, please be clear that I’m not the type of health cheerleader to ever tell you your life/diet/self-care or routine all need to be perfect. Sometimes the thing you need most for your wellbeing is a churro. Or a Christmas cookie, or a gin and tonic. A healthy lifestyle has lots of wiggle room for treats. Also, if your foundation is solid, then small treats bring benefits rather than harm. I am never going to be the one to preach to 100% clean. If you can get to 90% then you’re doing amazing.

Also, be gentle with yourself. I’ve been doing this for years, have a doctoral level education in how to take care of myself, and I still go through ups and downs. It’s human nature. Sometimes my self-care is rocking – I’m doing everything right and I”m on fire and it’s amazing. Sometimes, it isn’t. I go through periods where I’m just not as motivated to do it all, or I don’t have the bandwidth, or the rest of my life has eaten my self-care. That’s ok too. This is all a process of continuing to make the choice, every day, to make caring for yourself a priority. There isn’t any judgment, there isn’t any winning or losing, it’s just a process that allows you to take steps toward a richer life.

Thank you so much for listening today, and I really hope this inspires you to give yourself just a little more care. Also, I”d love it if you’d take the time to sign up for the mailing list -there are so many great things coming up this year and I want you to be the first to know.

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S2E16: Hydration and MTHFR

Water is so talked about that it’s incredibly easy to ignore. Like everyone knows we need a ton of water, so that can’t be the key to anything, it’s just too common. Too simple, too “normal.” I get that. We talk about it so much in every health format, that people just skim right over it because they’ve heard it before. It’s easy to wear-out an idea in this way so that the value of the thing gets lost, and unfortunately that has happened to many of the pillars of health. Things like eating your greens, drinking enough water, exercising regularly, and even mindfulness. Yeah, yeah, we’ve heard all of that.

I know. I do understand and I can be guilty of disregarding the simple things too. But I want to emphasize a point here – it isn’t just water, it’s hydration. Hydration matters for MTHFR, in fact, hydration matters for humans, MTHFR or not.

Why Are Hydration and Water Not The Same Thing?

Hydration, the way I’m using it here, doesn’t mean how much water you drink. It doesn’t even mean how much water you absorb. In its most important context, it means how much water gets into your cells.

This might seem like an odd benchmark, so let’s talk it through.

First off, I have seen many, many people who drink a ton of water, but who are still chronically dehydrated. That seems like a thing that shouldn’t happen but it does, and frequently.

Do you remember in chemistry class in high school learning about osmosis? I’ll put a picture of it here to jog your memory.

Osmosis is the diffusion of water through a semipermeable membrane down its concentration gradient. This file is generously licensed under creative commons and is from OpenStax online Anatomy and Physiology Text. https://openstax.org/books/anatomy-and-physiology/pages/3-1-the-cell-membrane

The osmosis experiment shows water moving across a semi-permeable membrane (which is most of what humans are made of, but certainly cell membranes qualify). The water moves so that the concentration of salts, minerals and solutes in general (which means things dissolved in the water) is equal on both sides of the membrane. To say it a different way, it shows water following salt and minerals through a semi permeable membrane.

This is exactly what happens in real life, too. Not just in high school chemistry or biology. Water follows salt and minerals and goes where those concentrations are the highest.

Great! So What Does This Have To Do With Hydration?

Well, everything. The goal is not just getting water in, but getting it into your cells. This means that salt, minerals, or some other good things that your body likes to pull into your cells could actually pull water with it.

Let’s say, for the sake of a vivid argument, that you drink distilled water all day long. Distilled water has no or extremely little of anything other than water in it – it is very pure and free from mineral contamination. That sounds good, and as you drink it, your body absorbs it into your bloodstream. Also good.

Now it’s in your bloodstream diluting your blood so your body pushes some of it into your cells. This seems good – it’s all going according to plan. Except, as you continue to drink more, the balance is getting too watery on the bloodstream side so your body does something that most semi-permeable membranes can’t do. It pushes salts into your blood to help balance things out because our cell membranes have active transporters as well. That wasn’t in the chemistry experiment.

So now salt is going out of the cells, and that’s not great. That means the cell won’t draw in as much water in the near future until it gets its salts and minerals back.

What are these salts and minerals of which we speak? They’re electrolytes, and the reason why most sports drinks have them is that they do actually help to push water into cells because your cells are hungry for them so they grab them up, then water follows along behind.

The Key to Hydration is Electrolytes.

Electrolytes are irresistible to cells and the higher quality the electrolytes, the better. Every time you drink water, try to remember to put a dash of electrolytes into it. You’ve got a few options.

  • Himalayan pink salt or good quality sea salt. These are rich in sodium, but also balanced with other minerals including the trace minerals your body might be lacking the most. Just a pinch in a 16 oz glass will do. The water shouldn’t taste salty like sea water, it’s just a small amount to help absorption.
  • A squeeze of lemon or lime juice. Hydrating and yummy at the same time. Total bonus. Lemons and limes are rich in minerals, have small amounts of fruit sugars (which your cells also gobble up) and will also help that water get to the right places in your body.
  • A splash of organic apple cider vinegar. Again, this doesn’t have to be enough to make your throat burn like hellfire, just enough to add a good healthy dose of minerals and yeasts from apples.
  • “Half-salt” or “No-salt.” This is actually a potassium-sodium blend (or potassium only) and is great for those on a sodium-restricted diet.
  • Powdered Magnesium. There are a number of magnesium powders you can add to your water and these are perfect if you tend to be tense or anxious. Remember, we’re not looking for the dose on the package here, we’re just adding a pinch to make your water more hydrating.

Now, I know you’re thinking that there are sports drinks for this type of thing. That is true, but anybody who drinks 64 ounces of sports drink daily isn’t going to be in good health. Sports drinks are pretty good for during or after activity in which there is a lot of sweating and burning of calories, but for sitting behind a computer they’re pretty much the salty equivalent of a big gulp.

Sports drinks are meant to replenish a large amount of electrolytes in a short amount of time and aren’t appropriate for all-day drinking. We’re looking for much smaller doses spread through a lot more water.

Just remember, it isn’t how much you drink, it’s how much you get into your cells that matters. Keep your cells nice and plump and watery with simple additions to your drinking water.

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S2E15: What To Do For Detox Symptoms

Two weeks ago we talked about some of the symptom patterns that can arise as you’re working with MTHFR. Honestly, they can show up for lots of people, but detox symptoms are especially common for us MTHFR folks. So let’s talk about a few things we can do to tackle this feeling. Remember, step one is to recognize your pattern of detox symptoms, so start there. Go through your symptom tracker and see what symptoms seem to flare up together, and if any of those might just be related to detoxification.

There are a few ways we can cope with detox symptoms and they fall into two general categories.

  1. Decreasing the amount of stuff your body has to do that day
  2. Increasing the ease of actually eliminating whatever it is you’re detoxifying.

Detoxification is a process that is happening when you have detox symptoms coming up. It is happening because you have junk that needs to go, and it stops when the junk is gone. So our goal is to get the junk gone faster. How’s that for creative use of the English language?

Decreasing Your Tasks For The Day

Your body has a whole list of stuff it has to do every day. There’s cell division, cell repair, and cell elimination when they’re too damaged to fix. There’s all of the normal stuff you do like pumping blood, collecting and distributing oxygen, and fighting off the constant stream of invading bacteria, viruses, fungi and other pathogens. There’s digestion and elimination and the manufacture of all of the enzymes and fluids involved in that process. There’s blood to be filtered and waste to be eliminated. It’s hard work, running your body.

Of course, as the wearer of the meat-suit, you don’t have to think about any of that. You can just happily go about doing all of the things you normally do while your body handles it all. Pretty amazing, when you think about it.

So on days when detox symptoms are coming up and you haven’t had a big exposure (like you didn’t go out drinking, drive all day in a formaldehyde soaked new car, or accidentally eat the lead paint), then it means your body just has too much on it’s plate that day. The stuff on your body’s plate is what I like to refer to as your bucket. Your bucket is filled up with all of your body’s work that is going on right now because of things you’re doing right now like breathing and eating and maintaining homeostasis. When your bucket overflows, that’s when you see symptoms. These detox symptoms are no exception – that bucket is too full.

Long-term there are lots of things that you can do to take a chunk out of your bucket, like eliminating food sensitivities, cleaning up your diet, getting better sleep and clearing some of the toxins out of your home and environment. But what about short-term? Like these detox days when your bucket is overflowing.

Intermittent Fasting

In good news, there are short-term bucket clearers too and one of my favorites is intermittent fasting. Fasting, which essentially boils down to not eating, is a great way to take some of your body’s to-do list off of the table. If you’re not eating food for a little while then your body doesn’t have to do all of the digestive things it normally does. It doesn’t have to make so much of the enzymes and fluids, it doesn’t have to do all of the mixing and moving that food requires, and it doesn’t have to absorb, sort, or eliminate anything. In fact, not digesting takes a huge chunk of work out of there and your body can use those resources for other things.

Now, obviously not eating long-term isn’t a great strategy – you need to eat at some point, but if you wake up feeling gross and like you’re detoxing, stick to water for the first part of the day. If you can, stick to water only (with some hydration support like salt, a squeeze of lemon or lime, or even some apple cider vinegar) until dinner time. Then, eat a healthy dinner and head to bed.

So actually, this day is easier than normal because in addition to not doing the metabolic work of eating you also don’t have to cook or find food. Bonus! Of course it does get in the way of all of the Covid-eating we’re all doing these days, but maybe that isn’t a bad thing to miss for a day as well.

Increasing Elimination

The other strategy to help your body over the hurdle of detox symptoms is to help your body detoxify faster or more efficiently. There are a few things you can do towards this goal.

Liver Support

The best liver support for this type of day is something gentle like a detox tea, or a digestive aid like bitters, apple cider vinegar, or a digestive enzyme with ox bile before meals. These are gentle things that are unlikely to push you further into symptom territory and that will give your liver a bit of a boost to get through whatever it is working on this particular day. I don’t suggest liver supportive supplements unless you’re working with a practitioner, simply because for MTHFR folks some of the liver support supplements can push just a little bit too hard and actually cause symptoms instead of helping to resolve them.

Gentle Detox Aids

There are a number of gentle detox aids and I’ve talked about many of them before. These are ways you can physically help your body to detox without pushing your liver or detoxification pathways too hard. In fact, these things will help when you have symptoms. My favorites are:

  1. Sweat It Out – Sweating is a great way to boost circulation and to eliminate small amounts of toxins including heavy metals, which MTHFR folks have a hard time eliminating because they need to be methylated. Sweating it out can be accomplished in a wet or dry sauna, a hot bath, a hot car, or even with a great workout. Just make sure you wash the sweat off afterward because you can reabsorb lots of things from your skin. Also, you’ll smell better.
  2. Castor Oil – Castor oil is one of my favorite old-timey remedies and one of the most effective things you can do to support detoxification. It should not be taken internally – you would regret that – but it can be applied topically. My favorite way to use it is to slather up before bed, put on my castor oil pajamas, and go to sleep like that. I’m sleeping and detoxing all at once. I talked quite a bit about castor oil last season in Season 1, Episode 24 on Gentle Detox Strategies. If you need a refresher on using castor oil, that’s a great place to look.
  3. Fiber or Clay – Fiber and clay can both be taken internally, although make sure your clay is actually food grade before you mix it up and drink it. Both of these are what is called a “gut sponge,” meaning they bind to toxins and carry them out of your body so that they are actually eliminated and not reabsorbed. Human bodies are incredibly thrifty and we tend to eliminate toxins, then go back through what we’ve eliminated and pick them up again. Especially if they look like fats or other precious resources. That means hormones that need to be eliminated are especially susceptible to this reabsorption because they are built on a cholesterol backbone and our bodies have been well trained through the millennia to keep cholesterol around. Fiber and clay both have big porous structures and toxins get bound to them, then they can’t be reabsorbed so they are effectively eliminated.
  4. Magnesium – Magnesium is a mineral and it’s very common to be deficient Your body uses more of it when you’re detoxing and taking magnesium can help if you get stalled out somewhere. Also, magnesium helps encourage healthy bowel movements, muscle relaxation, and sleep. I prefer to take magnesium before bed, but a small dose in the morning if you feel like you’re detoxing can be helpful too.
  5. Antioxidants – When your body is doing a lot of extra work, it is also creating a lot of extra free radicals and detoxification is no exception. Also, with MTHFR our master antioxidant, called glutathione, can be compromised so bolstering this system is a good idea. I’m not married to any one antioxidant and actually I prefer to rotate through different ones because each has an affinity for different tissue types. Essentially when I buy an antioxidant product, I buy something different each time. I’ll go from vitamin C, to vitamin E, to something like resveratrol, to a mixed product. The more coverage, the better. We talked a lot about antioxidants and glutathione in Season 1, Episode 14 and if you need a refresher, that’s a good place to start.
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S2E10: Why Starting Methylfolate Can Cause Symptoms.

Most supplements are a piece of cake. You start them and the worst part is swallowing a pill or choking down some kind of liquid concoction. Not so with methylfolate. It can be easy, but it can be a bit of a nightmare as well. If you’re following along with this process, then next week is the week when we actually *start* methylfolate so this week let’s get all prepared for what you might expect.

Why Methylfolate Causes Symptoms

Vitamins are called vitamins because they have two specific attributes. One is that they are absolutely vital for the normal functioning of the human body. The other is that we can’t manufacture them ourselves. This means all vitamins must come from outside of us, and if they don’t, we start to see systems that don’t work very well, symptoms, and potentially even growth or developmental problems.

With MTHFR, we typically have a functional vitamin deficiency. This means that even if the nutrient is available, we have a harder than average time actually utilizing it. Once you start taking 5-LMTHF, then magically you bypass this entire problem – at least you do if you’re also taking the other B vitamins as we’ve talked about because remember you need cofactors for this to work as well.

So suddenly, your body can do a whole bunch of things that it had a hard time with before and that isn’t always pretty. Here’s why:

  1. Neurotransmitters – These guys are a high priority for your body, and the methylation pathway feeds directly into the making of them. Changing neurotransmitters, even a little bit, can produce big changes in mood, behavior, personality, and generally how your mind, physical head, pain levels, and digestive processes work. It has the potential to feel strange, uncomfortable, or downright scary.
  2. Cellular Energy – A lot of what you consider your energy level is actually a reflection of your cellular energy levels and production. Cellular energy can take a big (as in giant) upswing when you start methylfolate or methyl B12, and that can feel pretty scary as well because too much energy feels overcaffeinated, anxious, restless, irritable, and sometimes like flat-out panic. More energy is good for a lot of people, but drinking out of the firehose is always drinking out of the firehose. Too much of a good thing isn’t good anymore.
  3. Vasodilation – Another of your downstream products with methylfolate is nitric oxide, which is your body’s main vasodilator. Vasodilators open up bloodflow, decrease blood pressure, and are generally a great thing. But, when you start making them in larger quantities it isn’t always a smooth and steady release, sometimes it’s fits and starts which means general fluctuations in circulation and blood pressure. That can mean some pretty strange symptoms like dizziness if you stand up suddenly, weird energy highs and lows, and even changes in vision, ringing in your ears, and all kinds of bizarre symptoms.

The bottom line is that there is a lot of symptom potential in the changes that are happening. They are ultimately good changes, but this is really the reason why we take everything so slowly. Even good changes can feel uncomfortable at first.

Other Reasons Why 5-LMTHF Causes Side Effects

To add to the symptom potential, there are other factors. This chemical pathway is vastly complex and it interconnects with all of the other things your body does on a daily basis. That means, there are literally thousands if not tens of thousands of things that can cause minor hitches.

Minor hitches are nothing to your body – you can handle hundreds of minor hitches at once, but you may notice some of them. Picture rolling a big fat tire down a rocky path on a hill. Will the tire do it? Absolutely. Will it roll over all the bumps, dips, rocks, roots, and branches? Sure it will. Will it be a smooth ride? Nope. There will be zigs, zags, little jumps, and dips. Sometimes the tire will go faster, sometimes slower. It will wobble in some places and you might even think it’s going to fall over, but that tire will make it to the bottom.

Adding 5-LMTHF is a lot like rolling that tire down the hill. The tire is going to move forward, your body is going to use the methylfolate. This whole cycle is going to spin no matter what. But, it’ll be a bit bumpy.

The more we do the prep work, the smoother that trail becomes. This is why starting with a good foundation and doing the preliminaries is so important – it’s like smoothing out that trail on the hill. The whole point of moving so slowly and systematically is that we’re trying to minimize the bumps. We probably can’t take them away completely, but we can make them smaller and easier.

5-LMTHF Makes Your Body Change and That Can Feel Like Symptoms At First

The final reason why starting methylfolate causes symptoms is that it is pushing your body to change in a profound way. The stronger the change, the stronger the response, and frankly, changing almost anything feels weird. That is just the basics of medicine. We need change to get better, but that doesn’t always mean that it’s easy or neat.

The whole reason we’re talking about this is so that you don’t go into this blind. If you know there might be some symptoms then it’s a lot easier to have some faith, when those symptoms pop up, that you’re on the right track and that symptoms don’t mean this is the wrong direction for you. Also, hopefully, so you don’t just start with the first massive dose of methylfolate that you find. That route does work for some people, which is great, but it also backfires for some people so I like to caution people to go low and slow.

Thanks so much for listening today and for caring enough about your health to be here. If you want to meet other people who care about their health too, I’d love it if you’d join us in Genetic Rockstars – it’s a community for people who are making their health better. We’ve got Tuesday tips, monthly themes, polls, questions, and discussions all for you. Also, if you’re enjoying this podcast and have the means to do so, I would so appreciate your support on Patreon. Go to patreon.com/thwt and join for all kinds of perks and to keep this podcast coming.

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S2E14: What To Do for MTHFR When You Don’t Tolerate 5-LMTHF

A couple of weeks ago we talked about two different dealbreaker scenarios where you did everything right with the methylfolate start, but you just couldn’t tolerate it. So let’s talk about what the next steps could be if you find yourself in this scenario.

5-LMTHF Nontolerator – Low Doses Feel Too High

If you were in this group, you started with a low dose of 5-LMTHF and immediately felt the symptoms of too high a dose. That usually feels like agitation, restlessness, wound-up energy, anxiety, intrusive thoughts, panic attacks, or something along those lines. Like way too much caffeine. There are a few things to do here.

Evaluate the dose you started with – Because methylfolate is available in so many giant dosage sizes, people tend to go bigger than they need to. I’ve had conversations with plenty of people who say “I started with 1000 mcg – that’s a low dose.” Actually, it’s a bit of a high dose. Even 400 mcg, which is the recommended daily allowance in most countries, is not a low dose. If the dose you started with was anything more than 200 mcg, reevaluate your definition of low and try again. The best thing to do is give your body a week away from any methylfolate and try again at a much lower dose.

My dose really was low! – This happens too. Plenty of people take a low dose – 200 or even 100 mcg – and it’s still too much. In this case, I want you to think about whether or not you tolerate food sources of natural folate.

I tolerate food sources fine. In this situation we can really work on boosting food sources of folate and maybe add a low dose folinic acid for a while. Food sources of natural folate and folinic acid both still need to go through the MTHFR enzyme, so it’s especially important in this scenario to be folic acid free. Because they still depend on the enzyme, your body makes 5-LMTHF slowly so you don’t get that big rush of methylfolate that feels like too much. This might also mean that you’re short on methyl groups. Take methylated B12 if you tolerate it, and also think about trying a methyl-donor like SAMe or TMG, which stands for trimethylglycine. Trimethylglycine, or betaine, can donate methyl groups just like SAMe can and help to move the pathway forward. With both SAMe and TMG, start the dose low and don’t change anything else for a week or two. Symptom track and let your body tell you how it’s doing. Also, don’t start those two things at the same time – try one or the other, you probably don’t need both. After a few months of this routine, it’s a good idea to try a low dose of 5-LMTHF again because chances are you’ll be able to tolerate it in the end.

I don’t do well with food sources of natural folate – This indicates that you likely won’t tolerate 5-LMTHF, maybe even ever. That’s ok – there are work-arounds in every scenario. These folks should try a low dose folinic acid, then wait a couple of weeks to make sure you tolerate that before moving on to a TMG (trimethylglycine). If you don’t tolerate folinic acid either, then we’ll keep doing the other B vitamins, try to get a methyl B12 if you can, and skip folate all together. Just go for TMG at a low dose and if you can later on, we’ll add in SAMe as well. If you don’t tolerate TMG, then choline can be a good substitute. It isn’t methylated, but it still helps. This scenario needs a lot of trial and error to find what works best for your body, but there is always a way forward. Just take it one day at a time.

If you don’t tolerate methylfolate your options are:

natural folate from foods

folinic acid






The Second Scenario – 5-LMTHF Makes Me Depressed

This is a very particular scenario that happens only, as far as I know, to undermethylators with extremely low serotonin. It isn’t common, but when it does happen it’s extremely vivid. Folate normally has a beneficial effect on depression, and technically it also helps you make more serotonin, but in this scenario it has a net negative effect. The reason is that folate boosts something called SERT. SERT is a serotonin transporter and it carries serotonin back into the neuron, or brain cell, that released it. Serotonin can only produce signals when it’s between neurons in what is called the synaptic cleft, and SERT is busy cleaning it out of the synaptic cleft for recycling and reuse. For this tiny group of people who fall into a deep dark hole when they take folate, the boosted activity of SERT overwhelmed the benefits of taking folate.

For these folks, it doesn’t mean you will never be able to take methylfolate, but it does mean we have to get your serotonin out of the tanks before you do. In this situation serotonin is often so profoundly low that a prescription or two might need to be on board to bring it up. If you’re opposed to prescription antidepressants, then we can start with SAMe. SAMe is a methyl donor that can substitute for methylfolate to help your body recycle homocysteine, and it can keep the methyl groups circulating to get all of the downstream pathways moving too. It also helps to boost serotonin.

SAMe by itself is probably not going to be enough, so something like St John’s Wort, which has an incredibly body of research showing that in some cases it boosts serotonin as much as an SSRI medication, can be really helpful. For a person with higher serotonin I wouldn’t suggest trying these two supplements together without professional guidance because too many things that boost serotonin can boost it uncomfortably high, but for poeple whose serotonin is so low that they don’t tolerate any folate, that is far less likely to be a problem. Just be sure you’re working with a professional if you are taking medications and supplements together because it’s important to have someone looking at interactions for you.

The bottom line with this group is that we need to get serotonin levels up before any kind of folate is going to be possible and for some people, it never will be possible. That is ok too – there are work-arounds for our work-arounds.

Another work-around is the amino acid methionine, which is a good option if nothing else is tolerable. Choline bypasses the MTHFR gene as well, but it’s a short-term solution. There are always option because your body has so many redundancies for every system. You and I are made up of layers and layers of fail-safes so that anywhere there is a problem, there are ways to get around it. Your body is a miracle of design and it’s important to always remember how much it is doing for you at every given moment.

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S2E13: Patterns In Your Symptom Tracking for MTHFR

I know, I know. I can hear you rolling your eyes at me already, but symptom tracking is a huge and valuable part of this journey, so just get used to me talking about it.

By now, I’m hoping you have a feel for how your symptoms usually look, and how they look when something is going on, or at least some inkling that there are times when different symptoms seem to get worse together. Part of this whole process is decoding which symptoms mean what for you, so that you can actually begin to tackle them.

Now, for women, we have the added complication that all of our symptoms tend to also change with our cycle, which can be hugely frustrating and make it a whole lot harder to keep track of what is doing what, but we’ll talk about that too.

For MTHFR specifically, there are a few patterns that I want you to watch for. Those are:

  • Your normal
  • Your detox symptoms
  • Your bucket symptoms
  • Your too-much methylation symptoms
  • And for women who are menstruating, your hormonal symptoms.

Let’s talk about these one by one.

Your Normal Symptoms

These are, as you might expect, the things you struggle with on an ongoing basis. This is the easiest pattern to nail down because it’s probably why you started this journey in the first place. Chances are, you can already rattle these symptoms off no problem.

Your Detox Symptoms

These symptoms might be a little bit harder to nail down. Detox symptoms happen a lot on the MTHFR journey simply because most of the work around MTHFR deals with unpacking unfinished business out of your backlog and finishing it. Lots of the unfinished business is toxins that you just couldn’t get to the first time around. Detox comes up for us and it often mimics a mild hangover. There could be some irritability or easier frustration, brain fog, mild nausea or stomach upset, headaches, stiffness, or even a feeling of fullness or tenderness in your abdomen, especially around the right side where your liver lives. For me, there is always a good degree of achiness and joint pain, but that’s my body’s go-to distress signal.

Days with detox symptoms will seem to arise apropos of nothing. No warning, no real rhyme or reason, and typically without the fun that precedes a normal hangover. It can seem like you’re getting broadsided by these bad days, but it’s actually your body doing a lot of work and proverbially biting off more than it can chew. Unfortunately, I don’t know of any way to eliminate these days completely, but recognizing them can help you take some proactive steps to minimize your symptoms. It also helps to understand that your body is actually working on something good, not just randomly breaking down all over the place.

Some of recognizing this pattern will be just time and familiarity, and it really helps if you’re watching out for it. Geek out with your symptom tracker for a bit and see if you can spot some detox days.

Your Bucket Symptoms

Your bucket, if you’ll remember, is all of the stuff that your body has to deal with on a daily basis. This is the foods that you eat, the air you breathe, the water you drink, the stressors in your life, the chemicals you’re exposed to. This is the day-to-day junk.

Bucket symptoms, then, appear when your body has had to deal with more than it can handle. This means that an actual hangover, although it’s the classic detox symptoms, is actually a bucket symptom because this is what happens when you ingest too much of a toxin. So actually it’s legitimately detox and bucket. Bucket symptoms can also come up during allergy season – many of you are familiar with what that overflowing bucket feels like. Also, bucket symptoms can be the headache you get after walking through the perfume department of a store or from the fumes after you paint he house. They can also be symptoms that might arise after you eat a food that you’re sensitive to.

For example, I get bucket symptoms if I choose to eat wheat. I know I’m going to get them and I know they’re going to come up, but occasionally I choose to eat wheat anyway. These symptoms include a blocked nose, puffy face, stiff body, painful joints, and foggy disconnected brain. It isn’t pretty. I also get bucket symptoms in the perfume department and those are milder – more along the lines of headache, irritability, and brain fog.

These are symptoms that are a direct response to something you took in from the environment. Usually, these are easier to spot than other types of symptoms because you can spot the trigger too.

Your Too-Much Methylation Symptoms

At some time in this journey, every MTHFR person hits this wall. This is the I-took-too-much-methyl folate picture. It could also be caused by too much methyl-B12, or too much SAMe. In any event, these symptoms typically happen following a dosage change, so that can help you to identify them. Bear in mind that the symptoms aren’t always the day after the dosage change. They can easily be two weeks after a dosage change, which is why I like to take this journey so slowly and so methodically. If we go too fast, you might have increased your dose twice before the symptoms from the first increase show up. Believe me, that is a fresh hell you do not want to enter.

These symptoms typically look like anxiety, intrusive thoughts, increased frequency of panic attacks, manic energy, unpleasant energy, agitation, sometimes itchy/prickly/tingly feelings in your body, sometimes visual changes. It’s generally not fun, but all of us will be there at some point because part of getting through the backlog that comes up on the MTHFR journey is actually pushing your body to do it, and that means increasing your dose.

Your Hormonal Symptoms

Women on the MTHFR journey have an added complication, and that is our hormones. Now, having the MTHFR gene means we have a bit of a harder time processing hormones to begin with, and if you have a double-whammy with MTHFR and the COMT genes, well, sorry sisters. That means hormone processing is just going to be a bumpy road. I talk a bit about why MTHFR and estrogen are in bed together in Season 1, Episode 7, and if you want a refresher, that’s a good place to start.

For hormonal symptoms, it helps to combine your symptom tracking with period tracking so you can start to notice patterns. Now, most of us are familiar with the times of the month that are hardest for us so you probably know all about your hormone symptoms already, but occasionally you’ll find a symptom that is associated with your cycle that surprises you.

Typical hormone symptoms include cramping, bloating, acne, skin changes, mood changes, headaches, food cravings, even weight fluctuations. Less typical symptoms can be anything from swollen ankles to dizziness, to nausea. It all depends on your body. When you’re tracking be aware that symptoms can happen at any point in your cycle, we just know they’re hormonal because they happen at the same point in your cycle most months. It can be pre-menstrual, during your menses, during ovulation, or really any other time – the key here is that it repeats most cycles at that same time.

Okay – I Have Symptoms. Now What?

Knowing there are different symptom patterns can really help to bring some order into your life. Partly because when your body is doing something bizarre, you understand it a little bit better. It isn’t just another bad day, it’s a bad day because of something. Partly, also, because if you understand what is causing those bad days then we can take active steps toward fixing it. This is huge – all of a sudden you go from a person besieged by all kinds of bad days, to a person who is actually responding appropriately to those bad days and gaining control.

In the next few weeks, we’ll talk about some strategies around all of these different kinds of bad days and how you can learn to listen to what your body is telling you, and respond in a way that makes you and your body feel better. This is the start of a long and glorious communication with your body that can bring you to an entirely new level of health.

Thanks so much for listening today, and if you enjoy the show and want some different ways to connect, consider becoming a patron on Patreon. There is a patron-only podcast, if you’re interested, called MTHFR Stories. As you might guess, it’s stories from MTHFR folks just like you, ideas about what has been most helpful for them, and memories of their MTHFR experience. Thanks for listening!

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S2E12: Week One of Methylfolate And What Is In Your Baggage?

I want to give you a big congratulations – if you’re doing all of this with me, then you’re one week into your methylfolate start. Now, this could mean that you started and had symptoms of too high a dose and so stopped and that’s okay too. This is all a process of learning more about your body. So let’s review the different scenarios that might have come up this week and also what to expect over the next few weeks.

Four Possibilities For Your Methylfolate Start.

As far as I know, there are four things that can happen in your first few days on methylfolate, and so chances are you hit one of these scenarios. If, by chance, you hit a different scenario then please reach out because I would love to hear about your experience.

  1. You hit a dealbreaker. – In this first scenario, you started methylfolate and hit a dealbreaker right out of the gate. If you’ll remember from last week, there are two hard-stops in this game. One is that you have symptoms already of too high a dose. Again, this feels like wound up energy, anxiety, panic, restlessness, intrusive thoughts. All the uncomfortable upper-type feelings. Hitting this kind of wall doesn’t mean you’ll never be able to take methylfolate, but it does mean you should stop for now. We’ll talk about options for this scenario in just a couple of weeks. For now, hang tight, keep taking your B vitamins and getting as much natural folate as you can tolerate in your diet. The other scenario is that you fall into a pit of despair, an absolute emotional black hole of depression. This one is a hard stop and probably means that you won’t be able to take methylfolate because your serotonin is perilously low. We talked about this scenario a bit last week, but also in Season 1, Episode 12 and that is a great place to brush up on the whole SERT transporter and serotonin issue. We’ll talk about it in more detail later on this season as well. For now, stop the 5-LMTHF and try folinic acid plus something that will help to boost your serotonin instead. With serotonin issues it’s best to work with a doctor or practitioner because medications for low serotonin don’t mix well with natural supplement.
  2. You felt a little strange for a few days, but it’s going ok. – This is great news. This is the essence of the successful 5-LMTHF start. The first few days can feel a bit abnormal, but if you’re able to keep taking 5-LMTHF without major fallout, then you’re doing great. Just stick to this dose and keep symptom tracking for at least 3-4 weeks before you consider bumping the dose up slightly. It’s ok to wait longer, too.
  3. You feel amazing. – This is also a successful 5-LMTHF start and I’m thrilled to hear you’re doing great. It’s easy in this scenario to just want to take more, but stay on this dose for at least 3-4 weeks because weirdly, the dose you’re taking can turn into a too-high dose a couple of weeks after you start it with no warning. It’s inconvenient, but true. Plus, the “too much” reaction gets worse if it’s way too much than it feels if it’s just slightly too much so jumping up in doses too quickly can lead to some pretty nasty scenarios.
  4. You felt strange or even amazing, then hit a “too much” feeling – Don’t worry, this is totally part of the journey. This means the dose is pretty close to what you need, but still a bit too much. Stop for a few days to let your body calm down and keep supporting your health, then start again at a lower dose. If you can manage to half the dose you were taking before, that is perfect. If getting down that much is hard, then try something like one day on, one day off or one day on, two days off. We can get creative with this.

You’re On The Right Path, Now What?

If you hit a dealbreaker, then we’ve still got some work to do. Hang tight, we’ll get to you guys. For everyone else, you are on the path. Your feet are in the right place now you just need to keep taking steps forward. You are on the cusp of the second phase of your MTHFR journey, which I like to call “Burning Through The Backlog.”

This second phase is the meat of the MTHFR work and it involves catching up with all of the junk that your body has put into storage over the years because it didn’t have the methylfolate necessary to do whatever it was that it needed to do.

The first things your body will tackle are immediate things – like daily tasks, healthier cell reproduction right now, decreasing homocysteine, boosting nitric oxide, boosting glutathione and helping to balance neurotransmitters. This is all very immediate and in the moment. It won’t all change overnight, but you’ll get closer to caught up every day.

After that, it’s all about the backlog. This is a collection of products that needed to be methylated, tasks half-finished, and most importantly, toxins stored where they would be the least harmful while your body was waiting for resources. This is part of why this journey can be so up and down.

Unpacking toxins from storage is a task your body desperately wants to accomplish, but it can be messy and unpredictable. This is the reason why symptom tracking is so important – you are going to want to keep track, partly so that you can recognize detox days when they happen and give your body a bit of extra support. This whole burning through the backlog phase is a long period, for me it was about three years, in which symptoms keep slowly improving, but days can be up and down and detox symptoms pop up.

Keep in mind, you’re more likely to have more detox days popping up in the beginning of this process and shortly after making upward dosage changes because that pushes your body to do some work. As the journey continues to move forward the detox days will become less and less frequent, which is lovely. Sure, you can still induce a toxic feeling day when you do something to fill up your bucket, but you aren’t being blindsided by detox days anymore. If I sound like a crazy woman to you with all of this backlog and bucket nonsense, it might be a good idea to check out Season 1, Episode 51, which goes in-depth about the bucket, backlog, and what those mean to you.

So keep moving forward and try not to get discouraged if you do have a difficult day pop up because it’s actually a sign that your body is doing the work it’s supposed to. Next week we’ll talk about what to watch out for in your symptom tracker that will help you deal with detox days. A couple of weeks after that we’ll talk about coping strategies for those days and how you can make them easier.

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S2E11: Starting 5-LMTHF or SAMe with MTHFR

This is it! The big methylfolate start. You’ve got all of your preliminaries done – folic acid is out of your diet, or at least 80% out. It’s out of your supplements too (100% please!) You’ve ramped up the natural folate from food sources and you’re tracking those symptoms. You’ve even got a good background of other B vitamins on board. Now…. drumroll please… the moment you’ve been waiting for.

Starting 5-LMTHF or SAMe.

I know, I know. No other vitamin gets this sort of wind up so let’s talk about it.

First off, I do want everyone to start with a small dose of 5-LMTHF, but if you hit a dealbreaker scenario then it could be a good idea to switch to SAMe instead. If that happens, it’s best to treat SAMe the same way you would 5-LMTHF because it can cause a lot of the same symptoms if the dose is wrong, so follow this same process there as well. So let’s talk about the different things that can happen in a methylfolate (or SAMe) start.

5-LMTHF Dealbreaker Scenarios.

There are two scenarios that mean you are probably not going to tolerate 5-LMTHF, and so it’s important to know what to watch out for.

  1. Your tiny starter dose is too much already. This is a thing that happens. You start out with a tiny baby dose of 5-LMTHF and right out of the gate you’re starting to feel crazy-pants. Wired, wound-up, uncomfortable, restless, hyper, anxious, irritable. These are all words that I’ve heard (or experienced) to describe the this-dose-is-too-much feeling. Also it can be physical symptoms like heart palpitations, racing heart, flushed skin, hot feeling, prickly or itchy feeling, or difficulty sleeping. This usually means that even this tiny baby starter dose is pushing your body too fast. Now. I do want you to be honest. If your tiny baby starter dose was 1000 mcg, then re-assess your idea of a starter dose. If it really was a small dose – like 200 mcg or less – then you might just not be able to tolerate the 5-LMTHF. For some people in this category, even small amounts of natural folate in foods push them over the edge. If this is you, stop the methylfolate and wait a few weeks. We’ll talk about what options there are for non-tolerators, I promise.
  2. Methylfolate makes you fall into the darkest, blackest, pit of despair possible. This happens very rarely, but it certainly happens. This happens to a small segment of the population whose serotonin levels are perilously low to begin with and adding folate of any kind drops the bottom out of this neurotransmitter pathway. It’s interesting because folate actually increases serotonin production, which sounds like it should make a positive impact, but it also up-regulates something called SERT even more, SERT is a selective serotonin reuptake transporter that helps to clear serotonin out of your synapses and pulls it back into the releasing neuron. When SERT is unregulated the serotonin you have becomes less effective because your body doesn’t get very much time to enjoy it before it’s gathered up. If your serotonin is extremely low then this can push you over the edge and make it just not worth it to take folate. We talked about this in Season One Episode 12 (Methylfolate Makes me Feel Bad) and that one is a good review of the serotonin situation.

If you happen to hit one of these dealbreaker scenarios, then we’re going to stop methylfolate and look to an alternative. The alternative could be folinic acid or SAMe or something else – stay tuned for more on this topic in a few weeks. Until then, just hang tight with other B vitamins, no folic acid, food sources of natural folate as much as you can tolerate and healthy lifestyle choices.

5-LMTHF Start Expectations

Most people who start 5-LMTHF won’t hit anything like a dealbreaker scenario. Those happen to a tiny minority of people – especially when you’ve done all of the groundwork properly. But even when things go right, stariting methylfolate can feel weird.

When I first started the things I noticed were nothing like what I was expecting. I felt a bit buzzy in a pleasant way, my vision seemed brighter, and my head felt strange. Like my physical head, not my brain or mind. I have no idea why my head felt strange, but in good news all of those feelings wore off after about three days. Here are some other things that I’ve heard from folks just starting methylfolate:

  • Don’t notice anything at all – I feel totally normal.
  • Ringing in ears
  • More talkative
  • A bit grumpy or moody
  • Sweat more
  • Dreams are more vivid
  • I feel amazing.

Let’s face it – we’re moving around some big internal chess pieces, so a few minor changes can be totally normal and for most people they go away quickly. By far, the biggest group either feels nothing, or feels great.

There is another group who feels great at first and then a couple of weeks down the road starts feeling like they’re taking too much. Like they’re feeling speedy or buzzy or anxious in an unpleasant way. This is really normal too.

What Can I do To Make This Easier?

Honestly, I am erring on the side of overly cautious so most of you will start 5-LMTHF and wonder what all the fuss was about. That is completely ok. I would rather you were over prepared than underprepared. Also, it is likely that as you’re working through the MTHFR process, there will be some point at which you take too high a dose of 5-LMTHF. Since you’re prepared, you will know what is going on and not freak out. At least, that’s the goal.

Having said that, if you tend to be sensitive to supplements or if you just want to give your body the best start you can, then make sure you are doing some of the basics.

  • Drink plenty of water and add some lemon juice or a pinch of sea salt for optimal hydration.
  • Sleep more. Sleep helps everything.
  • Don’t overstuff your schedule during this time – take it a bit easy if you can.

What Can I Do If I Take Too High a Dose of 5-LMTHF?

During this whole process of working with your MTHFR, it is really normal to have feelings of too high a dose at least once (if not a number of times.) It isn’t a problem, as far as we know you aren’t actually doing any harm to your system. What it is, is great information. Your body is telling you something and all you have to do is listen. This is your signal that the dose is a little too high and you could decrease it. Here are some ways to manage this:

  1. Decrease your dose – Decreasing your dose can mean finding a lower dose supplement, or finding some kind of alternate schedule like one day on, one day off. Even one day on, two days off. It just depends on how your body responds.
  2. Stop your dose entirely – if your symptoms are extreme, then this is the best course of action. Just stop, take some other steps to help your body calm down, and re-assess after a couple of weeks.
  3. Exercise – if you’re in the middle of symptoms of too-high a dose, exercising can help your body to use up some of those methyl groups and get you through the strange symptoms faster.
  4. Niacin – 50 mg of niacin in the straight “niacin” form helps to eat up those excess methyl groups as well and can help to relieve symptoms. The only problem is that it can cause a flushing reaction, which feels like a hot flash complete with red face, itchy or prickly skin, sweating, and generally feeling super weird. It doesn’t last long, but it’s very vivid. You can re-dose after an hour, but don’t do this more than 3 times total in a day and watch your blood pressure because niacin can really lower it.

In any event, this week is the week we start. Make sure 5-LMTHF is the only thing you change right now and that you’re starting with a LOW dose – 200 mcg or less. Also, keep symptom tracking and make note of anything new that pops up. This should be the only change you make for at least two weeks but four is better, just to give your body time to get used to this new thing and to tell you if the dose becomes too much. Remember that symptoms can pop up after a week or even two of being on the same dose, so don’t make any sudden moves.

Thanks so much for being here and for doing this process with me.

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