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Methylfolate Dose Changes – The MTHFR Journey Over Time.

If you're wondering how to dose methylfolate, here are three different strategies.

We’ve talked about folate dosing strategies because the best dose of methyl folate for your body will change through the course of your MTHFR journey. The three strategies we have covered are:

  1. Intuitive dosing – this is my favorite and is perfect if you and your body communicate well together. When you’re stressed, have a difficult day coming up, feeling not perfect, or know you’re doing some extra detox work, increase your dose slightly. If you’re feeling amazing and don’t need extra support, then don’t take it. Just listen to what your body needs at that moment (I do this with all my supplements, not just methylfolate).
  2. Mixed dosing – this is better if you’re a routine kind of person. You like the stability of taking a small dose each day (smaller than your maximum tolerated dose) and you can add up to your maximum on days that are harder.
  3. Pulsed dosing – this is the method championed by Ben Lynch. He says if you feel great, decrease your dose and if you feel poorly, increase.
If you're wondering how to dose methylfolate, here are three different strategies.
If you’re wondering how to dose methylfolate, here are three different strategies.

These dosing strategies cover day-to-day fluctuations, but at the beginning of your MTHFR journey, you will have longer-term fluctuations. Let’s talk about that.

Long-term Changes in 5-LMTHF Needs

First off, what is going on here? Why do 5-LMTHF needs change over time? Can’t this just be easy?

When I get frustrated with the general weirdness of MTHFR, I try to remember the amazing journey my body has been on with this mutation for my entire life. That journey goes something like this:

  • Birth – My bucket is mostly empty (if you don’t know what I’m talking about, click here), I”m fresh and clean and the world hasn’t started to hammer me with crazy crap yet.
  • Childhood – Things are moving along. Life has some stressors like navigating family, socialization, schooling, and eating my greens, but mostly things are pretty good. My bucket is taking a few hits, but it isn’t full yet.
  • Adolescence – The hormones kick in, the moods kick in, and full-blown teenage angst really adds a bunch of stress to that bucket.
  • New Adulthood – Life starts getting a whole lot more real. There are bills and jobs and maybe even career prospects. There are relationship stressors, toxin exposures, new car smells, and ratty apartments. That bucket is getting close to the top.
  • Your Bucket Fills Up – This can happen anytime, really, but for many people, it is in adolescence or new adulthood. Some people are lucky enough to wait until their later years. Your body has dealt with enough stressors that your bucket (which is your natural tolerance for stressors given your genes, nutrition, and epigenetics). This is when big symptoms start, and the wheels fall off the cart. This is also when a lot of people go digging through their medical stuff and find out they have MTHFR.
  • You Start To Work With Methylation – This is quite possibly the moment when you’re reading this post or listening to the podcast. Awesome! At some point you’ll add in 5-LMTHF. I’m hoping you start with a low dose and don’t make any sudden move – in the beginning, tolerances change slowly.
  • There are Some Bumps On the Road – this happens and it’s all totally normal.
  • Your Dose Increases – Gradually, you’ll find that your body can tolerate more methylfolate without having a total meltdown (if you haven’t experienced the meltdown yet, please be confident that this is a thing that happens on the MTHFR journey, and it’s going to be ok.) Bear in mind that you will try some dosage changes when your body isn’t ready and have mini-meltdowns, but slowly and steadily your dose will increase. This phase can last for months or even years.
  • Suddenly, The Dose You’ve Been Taking For Weeks/Months/Years is WAY Too Much – because MTHFR is like that. We talk about this a lot in Genetic Rockstars, which is our MTHFR Community, but too much 5-LMTHF feels crazy. Anxious, hyperactive, jittery, sleepless, or completely black depressed. It’s a bit different for everyone, but if you’ve ever felt it, you know exactly what I’m talking about.
  • Your New “Normal” Dose Is Lower – you don’t need as much 5-LMTHF most days, and you can start to use intuitive dosing. Take a little more if it’s a more stressful time for your body, and a little less if it’s easy breezy. This phase can comfortably last the rest of your life.
Over the course of time, the dose of 5-LMTHF has increased
Over the course of time, the dose of 5-LMTHF has increased

But Why Does My Body’s Need for 5-LMTHF Go Up And Down?

Let’s take a behind-the scenes look at what is going on in the above progression.

  • All the Stages Before Your Bucket Fills Up – In these phases, your body is meeting stressors and it’s ok. You have enough resources to keep up and enough room in your bucket that you aren’t having major symptoms. Toxins are constantly coming in, and if you can’t deal with them you just pack them away into your long-term storage, the backlog.
  • Your Bucket Fills Up – Symptoms start and it can feel like your body has completely changed overnight, but it actually hasn’t, it just reached the tipping point where your bucket ran out of room and so ALL of the things that have been hiding under the surface are coming out into the open. It’s pretty messy!
  • You Start To Work With Methylation – you eliminate folic acid, add in natural food sources of folate and finally add 5-LMTHF. There are up and down days, but mostly things are moving forward. Your body is starting to work on the bucket and you’re actively taking out stressors (like folic acid, which is harmful to MTHFR folks, and like the nutritional deficiencies around methylation, which also adds to your bucket).
  • There Are Some Bumps on The Road – as your body gains resources and starts to move toward more balanced methylation, it can start to take a look at some of the toxins in long-term storage. This is your backlog. Backlog can cause bumps because if your body gets too excited and mobilizes too much, then you can feel toxic. Backlog is also behind the dosage increase.
  • Your 5-LMTHF Dose Increases – as your body gets stronger and the flow of methylation resources gets more stable and reliable, then the trickle of backlog increases to more of a flow of backlog. Your body is really digging into this and so your need for methylation increases. This process can last for months or even years. For me, I took 5-LMTHF for somewhere between 2 and 3 years before I hit the next phase.
  • Suddenly, Your Usual 5-LMTHF Dose is Too Much – actually, when this happened to me it took me a few awful days to figure out what was the cause of my sudden burst of manic energy. I had been taking 3 mg 5-LMTHF most days for the last couple of years and it didn’t occur to me that it was suddenly causing problems, but it was. This was the point where the eager flow of backlog tapered down to a trickle again. My body wasn’t so urgently clearing out the long-term storage anymore because it finished dealing with the worst and most pressing of my backlog baggage.
  • Maintenance – now, at a lower dose, your body can do its daily work (your bucket) and its trickle of backlog without so much extra support. Awesome! This is where we want to stay.
methylfolate makes me feel bad.
Too much methylfolate makes me feel like… THIS. Photo by Andrea Piacquadio from Pexels

This progression is completely normal, and not as smooth as I’m making it sound in this blog post. Over the years there are ups and downs with dosage and there can even be weekly or monthly fluctuations. Still the overall trend follows this predictable pattern. It’s important to remember that your bucket is never completely empty because there are always stressors around and your backlog is never completely gone because we’re humans in a toxic environment of our own making.

It’s also interesting to note that if you stop supporting your methylation completely, then things will stay stable for a while, but as your body runs out of the resources to methylate, then your bucket begins to refill as does your backlog. Eventually, we’re back to the crisis point where your bucket overflows. It is far easier just to stay in maintenance mode.

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MTHFR is a common genetic mutation that can contribute to anxiety, depression, fatigue, chronic pain, infertility, and more serious conditions like breast implant illness, heart attack, stroke, chronic fatigue syndrome, and some types of cancer. If you know or suspect you have an MTHFR variant, schedule a free 15-minute meet-and-greet appointment with MTHFR expert Dr. Amy today.

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Amy Neuzil
Amy Neuzil

Dr. Amy Neuzil, N.D. is a leading expert in MTHFR and epigenetics, and she is passionate about helping people achieve optimal health and wellness for their genetic picture. She has helped thousands of people overcome health challenges using a simple, step-by-step approach that starts with where they are today. Dr. Neuzil's unique approach to wellness has helped countless people improve their energy levels, lose weight, and feel better mentally and emotionally. If you're looking for a way to feel your best, Dr. Amy Neuzil can help. Contact her today to learn more about how she can help you achieve optimal health and wellness.

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  1. I did the gene testing 2 years ago and upon finding I have the mutation my NP recommended I take methylfolate. I’ve been taking 15mg for 2 years straight as I wean off of antidepressants. What are your thoughts? Based on what I’m reading this seems way too high.

    • Hi Frances,
      Honestly, if you tolerate it well, which it sounds like you do, then 15mg sounds like a great dose for you. You might not need that much forever, but if you’re not having side-effects then it’s probably just right for now.

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