MTHFR Questions - Specific products and Marmite.

This week, I'd like to get to some questions that listeners have been kind enough to leave on the website and within the community.

The first comes from Liana O and she says "Specific 5-L-methyltetrahydrofolate supplement recommendations and dosing, please?"

This is actually a really common question, and I'm probably not going to answer in a way that is satisfying because everyone is so different. Also, the products available to people vary so widely that the best I can give is guidelines.  In terms of people first starting on this journey, the absolute best, easiest, and most painless way to start is with a multivitamin that doesn't have any folate or B12.

To my knowledge, there is only one such product on the market, which is made specifically for MTHFR  and by a fellow MTHFR mutant. It's called Optimum Start by Seeking Health. This is a great product, and Seeking Health will ship internationally from their website, which is great, but as everyone who isn't in the US knows, international shipping for something like this often makes it cost-prohibitive. I do have an affiliate account with Seeking Health, so if you're ordering products I would so appreciate it if you'd do it via the link from tohealthwiththat.com to support the work I'm doing here.

Outside of that, there are a number of great multivitamins with low doses of methyl folate that can be really great for a starting place. One of my favorites is the Smarty Pants kids multi gummy.  It has a mere 37.5 mcg methyl folate per gummy. This won't give you an adequate dose of everything else you need, but if you've had trouble with methylated folates before, it can still be a great way to start. Smarty Pants also has some great adult gummy vitamins that can be a good way to ramp up your intake slowly because typically the dose is split between 4 gummies, and also gummies are easy to cut in halves or quarters.

If you prefer capsules, look for high-quality multivitamins that have multiple capsules in the dosage and are made for adolescents or teenagers so the doses per capsule aren't high. Some examples are junior nutrients from Pure Encapsulations, which has 100 mcg folate per capsule.  Thorne Research multi-encap is also a good choice at 130 mcg folate per capsule.  In general, I prefer to buy from companies that follow good manufacturing practices and who sell primarily through practitioners. This includes companies like Thorne Research, Integrated Therapeutics, Pure Encapsulations, Xymogen, and NuMedica.  Divinci Labs also makes some nice products, as does Jarrow. 

At the end of the day, what matters most is local availability, even if it's via amazon or a similar mail order service, and ingredients. Always look for doses on the low end of the spectrum, especially with methyl folate and B12. You can add in higher doses of those ingredients separately, which is the best strategy because it gives you more flexibility overall.

I know this seems like a non-answer to this question, but the most important to find something that works for you individually.

The second question is from Tim and is quite honestly, sending me on a bit of a hunt. He asks....

So, even though Marmite says it has Folic Acid, you're saying it's actually NOT Folic Acid, is that correct? You have me so scared of Folic Acid that I don't want to be eating it. Thanks.

Now, you all know of my obsession with Marmite. It is a yeast extract quite similar to the one that was used in the initial research that found folate to be an important nutrient for pregnancy. Outside of being a huge fan, I have also always been under the impression that it was unfortified and that all the folate present was directly linked to the natural byproducts of the yeast.  I am at this moment, fearful that I might actually be mistaken about this.

I have a question pending with Unilever, the current manufacturers of marmite, but so far it remains unanswered. The label information is somewhat frustrating. The Food Standards Agency, which is the UK's food regulation authority, also has a folic acid fortification program with wheat flour, but I can not find out whether or not the terms "folic acid" and "folate" are considered to be equivalent legally. If anybody from the UK can shed some light on that matter for me, I'd appreciate it.

I do know that the bottle in my pantry lists the ingredients as Yeast extract, Salt, Dehydrated Carrots, Spice Extracts, Dehydrated Onions. And that's all. There is no mention of additional vitamins or fortification, which in Canada is a legal requirement. The label is definitely following Canadian guidelines otherwise, as it has all information in both official languages.

I called the information number on my bottle and left a message, which has yet to be answered.

Also, I "spoke" with the marmite website chatbot and I hate to say, the chatbot listed ingredients that I don't see on my label. According to the marmite bot, it includes vitamins and one of those is folic acid. Sigh.

So, obviously, this still requires some investigation because if there is folic acid on there, why isn't it on my label? Also - how much is actually in there? Is the entire 100 mcg dose listed as the amount per 8 g serving folic acid? It's all a bit confusing.

I will certainly update you when I hear from Unilever and also from the Canadian helpline because the contradiction in information doesn't make sense. It could be that there is a difference in the formulas depending on the country, but it seems like the label would be easier to change than the product.

To address the second point in the question, Tim mentions the fear of folic acid. This is something I want to talk about because while I"m not a fan of folic acid, the problems actually occur when it's folic acid in high doses. Small amounts just slowly labor on in the process of being converted to something useful like 5-LMTHF, but they do eventually get there. So a small amount of folic acid isn't going to be a problem if you're just getting it from one source, like marmite, which still has good natural folates as well.

When it becomes a problem is when it's the only source and you're getting it everywhere. All the fortified grains, your multivitamin, some prescriptions, etc... Then is when we see folic acid building up and also folic acid gumming up the works of the methylation pathway. There is probably a safe threshold, but to my knowledge, that research really doesn't exist yet. So at this point, minimizing intake is the safest bet.

Are There Other Yeast-Based Products Like Marmite?

Since Marmite is now in uncertain territory, I will give you some options. One of my favorites is nutritional yeast. It has a delicious cheesy-nutty-umami flavor and is easy to sprinkle on popcorn, add to sauces, sprinkle over veggies, or use as an additional flavor burst in things like salad dressings.

Like everything else with food, it's a bit complicated. If your package doesn't mention anything, then it is likely fortified, which means they've added extra B12, folic acid, and probably a few other B vitamins to the mix. This is kind of standard and so if they just say it's a good source of B vitamins, then they've probably done this. Also, the fortification gives the flakes a bright yellow color - more like a true yellow.

Nutritional yeast is available unfortified as well, but you have to hunt for it. I can't find unfortified at any of my local stores, but I can on amazon so I order a big bag once a year and that's that. The unfortified tastes just as good but the color is a bit more gentle - more of a buttery yellow rather than a bright yellow.

If you have some in your pantry right now, check the color - I'll put a picture below so you can compare.

Thanks so much for listening today and thanks Liana and Tim for the great questions. Make sure you're signed up for the email list so you're the first to know about upcoming courses.