Recent Episodes

Supplements For Anxiety With MTHFR

We’ve talked about how MTHFR and Anxiety are linked a couple of times and had an interview with anxiety expert Jennifer Bronsnick, but all of that still doesn’t answer one of the biggest questions about anxiety that I get, which is, “What can I take to help me fix it?”

Good question. Obviously, everyone responds differently to different supplements, just like they do with medications, but here are a few of my favorites with some perspective about how they interact with MTHFR. I’m hoping it goes without saying, but balancing your methylation should always be the first step to dealing with anxiety. The rest of these are to clean up anything that is left.

GABA

GABA is, in my opinion, a highly underrated supplement. It is an inhibitory neurotransmitter, meaning it decreases the likelihood that the neuron will fire or send a signal. In the overactive brain of someone with anxiety, this is precisely what we want. It is also crucial to healthy brain functioning, with an estimated 60 – 75% of all neurons being GABAergic (or responsive to GABA.)

There has been a long-standing debate in the research world whether or not GABA that you take by mouth can possibly cross the blood-brain barrier. It is certainly well absorbed and blood levels rise sharply within thirty minutes of taking it, but it is much harder to demonstrate brain levels in a study. Research evidence and theorizing exist on both sides of the fence, but due to its potent clinical effects, I tend to think it either does cross the BBB or it takes action on something else which has a calming effect on the central nervous system and that is just as good.

GABA is probably most known as a sleep aid, helping to calm restless minds into healthy sleep. For anxiety, however, it reduces your feeling of actual anxiety and tension, but also helps to reduce cortisol levels, increase parasympathetic nervous system activity as measured through the vagus nerve (which means your nervous system is trending more toward relaxation than stimulation). The doses used in research tend to be between 30 – 100 mg. There is a great systematic review article about GABA and its effects on anxiety from Frontiers in Neuroscience here.

GABA is the type of supplement that I feel sneaks up on anxiety. What I mean by that is taking a dose regularly that is just below the dose that would make you sleepy (this might take some trial and error) isn’t necessarily going to change your life in that first week, but it does help to get your body into a rhythm of functioning without as much hypervigilance. I love this because it takes the edge off so that you can actually work on mindfulness or breaking mental bad habits in a more protected mental space – like the GABA makes it easier to see the things your mind is doing that it doesn’t need to be doing.

As an aside, GABA also shows remarkable clinical promise for Type I Diabetes, which is insulin-dependent. In much larger doses than those taken for anxiety, GABA helps to boost insulin response in fasting and non-fasting conditions and may help to both protect and restore pancreatic beta cells. While this has very little to do with anxiety in the way we tend to think of it, there is a link between anxiety and blood sugar.

MTHFR and GABA

There is only one relevant study pertaining to MTHFR and GABA levels. This study shows mice with MTHFR polymorphisms to have altered levels of many neurotransmitters, including GABA, in different brain segments relative to wild-type mice. This study showed that mice who were heterozygous for an MTHFR SNP showed altered levels of both GABA, which is inhibitory, and glutamate, which is excitatory, in the amygdala, cerebellum, hypocampus, and thalamus.

Passionflower (Passiflora Incarnata)

Outside of having one of my favorite names in all of herbal medicine, passionflower is remarkable as a calming and soothing agent for anxiety. It can be used for short-term anxiety, such as to help patients remain calm before dental or surgical procedures or long-term for such neuropsychiatric conditions as generalized anxiety disorder and post-traumatic stress disorder. In both cases, passionflower shows remarkable benefits.

A comparison study between liquid passionflower extract and the pharmaceutical drug oxazepam, which is a benzodiazepine, showed equivalent clinical effectiveness over a period of 28 days.

Passionflower has also been used to help people who are addicted to opiates to successfully withdraw. Studies showing passionflower as an addition to clonidine, which is the standard of care, demonstrate better handling of mental symptoms in the clonidine plus passionflower group than the clonidine alone.

Passionflower can be taken as a tea, a liquid extract, or as a capsule or tablet. As with all herbal medicines, quality matters and it’s important to find products that follow the highest standards of manufacture and testing.

While passionflower hasn’t been specifically studied for use in folks with MTHFR mutations, it works well clinically in a wide range of people, and I’ve seen great results in my own clients, the majority of whom have MTHFR polymorphisms. Also, it’s pretty easy to tolerate and side effects are not common.

Adaptogenic Herbs For Anxiety

Adaptogens are herbs that help the human body resist stressors of all kinds. They quite literally help us adapt to all manner of situations with grace and strength, both literal and metaphorical. The most well-known adaptogens are herbs like ginseng, ashwagandha, and licorice which might just as well come with a sub-heading that says “Strong Like Bull.”

While there is, sadly, no research specific to MTHFR and adaptogens, there is a literal boatload of research on adaptogens and anxiety. Ashwagandha, for instance, has been shown to reduce both the feeling of anxiety and also cortisol levels after 60 days in adults with a history of chronic stress.

In general, the effects of adaptogens on cortisol levels and conditions associated with excessive cortisol, including anxiety, fatigue, abdominal obesity, and metabolic syndrome, are extremely well known. These are wonderful therapies for the management of long-term stress and anxiety disorders, although they should be used with practitioner supervision and guidance.

Licorice, for instance, is one of my favorite herbs of all time, but it is known to elevate blood pressures and so is perfect for skinny, high-strung, anxious women like myself, but not a good option for someone who struggles with blood pressure or cardiac issues.

There are, of course, hundreds of other supplements for anxiety but these are three of my go-to staples. Don’t forget to sign up for the mailing list, or join our MTHFR community here.

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S2E20: MTHFR and Anxiety – An Interview with Jennifer Bronsnick

This week on the podcast we’re trying something new. An interview with an anxiety expert who has also gone through her own recovery process with anxiety. The interview was clipped for the podcast episode but you can watch the full thing, on zoom, here.

MTHFR and Anxiety – an Interview with Jennifer Bronsnick.

Jennifer Bronsnick’s suggestions for Anxiety

Jennifer mentions a few tools that have been helpful for her. Here they are!

  • Eliminating alcohol
  • Cutting down or eliminating refined carbs like white flour and sugar
  • HeartMath – for more info about this, click here.
  • Existential Kink – the book by Carolyn Elliott.
  • Getting quiet to actually hear what your body might be trying to say.

Let me know what you think of the interview format – I can do more of this, or not. Just depending on you.

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S2E19: MTHFR and Anxiety

MTHFR and anxiety are intimately linked, mostly, we presume, because your body needs folate to make serotonin, dopamine, epinephrine, and norepinephrine. Those are most of the major neurotransmitters that affect mood and mood disorders including anxiety and depression.

More specifically, a folate molecule is needed to convert BH2 to BH4, and BH4 is needed to convert the amino acid precursor tryptophan into serotonin and tyrosine into dopamine, norepinephrine, or epinephrine. We did a post about it here.

Because of this link, working on optimizing your methylation can have a huge impact on anxiety and depression, but it isn’t the only thing you can do. Of course there are pharmaceuticals for anxiety and I’m not really going to cover those because those will probably be your doctor’s first go-to solution. And that’s fine, but there are other things as well. We’ve already talked about anxiety as a mental bad habit, and also about breaking mental bad habits. So today, let’s talk about steps you can take in your own real life to reduce anxiety.

Eat Regular Meals

This kind of sounds like a soft-ball. Like it couldn’t possibly make a difference to anybody’s anxiety level because it’s just too simple. In reality, keeping your blood sugars balanced and stable can cause a huge drop in anxiety levels, and here is why.

When your blood sugars drop, either from a skipped meal or after a sugar rush and the inevitable sugar crash that follows, your body has a low-sugar stress reaction. Sugar is absolutely vital to the functioning of your brain and so your blood has a tightly regulated amount. If that amount drops, your body literally goes into panic mode, activates your HPA, which is your hypothalamic-pituitary-adrenal axis, and pumps out stress hormones to bring your sugar levels back up.

Skipping meals is incredibly stressful for your body – and that translates to actual stress hormones that affect your level of anxiety. Keeping your blood sugars balanced through the day is far more important than you realize, and if anxiety is an issue for you, then it’s important to back some of the sugar out of your diet and make sure you eat regularly.

I know plenty of people who run on adrenalin and skip meals regularly because they’re too busy, there’s no time when the kids are running around, etc… but making time for this simple self-care can have a huge impact on how stressed you feel and also on the long-term effects of stress like sleep quality, weight gain, belly weight, and fatigue. Interestingly, blood sugar fluctuations and their corresponding changes in insulin levels are also highly linked to brain fog.

Clean Out Your Medicine Cabinet

Oddly a number of medications are known to increase anxiety. Some of those are because they have a negative effect on folate status, like birth control pills or methotrexate. Some are because they cause a caffeine-like reaction (or actually contain caffeine). These include cough and congestion formulas, many pain pills, and cold and flu medications. Also, medications for weight loss are well known for causing anxiety. Also if your dose of thyroid medication is either too low or too high it can lead to anxiety.

Decrease Your Caffeine

First, a disclaimer. I am a *huge* fan of coffee and will never, ever, ask you to stop drinking it. Having said that, different people have different levels of sensitivity to caffeine and also, women at different points in their cycle have different sensitivities to caffeine. It can help to experiment with your caffeine intake to see what works best for you, but keep a symptom tracker for a few months and try different caffeine levels – you might be surprised. In truth, any human with more caffeine than their body can easily process, is going to experience more anxiety, more edginess, and more irritability. That is just biology, so it can be a good idea to check in with your body every now and then and see if the amount you’re getting is ok for you.

Many medications contribute to anxiety, especially those like methotrexate or birth control pills that decrease folate levels.

Exercise, Yoga, and Meditation

These are all well-known moderators of anxiety, so I won’t belabor the point, but there are a few tips.

  • According to a study published in Psychiatry Research, higher intensity exercise like jogging or fast walking shows better results for reducing anxiety than gentle stretching.
  • Yoga shows better effects for anxiety than stretching or resistance training in Parkinson’s disease, but that effect may translate out to the general population as well.
  • Mindfulness meditation (as opposed to other forms) has been well documented to reduce anxiety symptoms.

There are, also, a number of supplements that are helpful for anxiety as well, but we’ll cover that in a separate post.

Thank you so much for listening today and please sign up for the mailing list at tohealthwiththat.com – we’ve got some great things coming this year and I want you to be the first to know.

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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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S2E17: Happy Holidays and How To Make A New Years Resolution You Will Actually Keep.

First and foremost I want to say happy holidays this week. Spend time with loved ones if you can, and if you aren’t able to be with the people who matter to you, then make sure they know they matter in some way or another. This is the season when we all need to give and receive as much love and care as possible.

The holidays can be a hard time for a lot of people. If you’re struggling this season as so many people are, please reach out to someone. It could be a friend, a practitioner, family, a shelter, or hotline. Ask for help if you need it – you will be surprised at how much help is available.

This year is coming to a close and that brings with it a measure of self reflection and the almost inevitable decision to make some changes. For many of us those changes will come in the form of a New Years Resolution, and this year I’m proposing something a little bit different. Here’s why.

Saying “I love you” to yourself is surprisingly powerful. It only takes a second – try it right now.

2021 has been a tough year. Partly, because it followed 2020, which was also a tough year. Never-ending the global pandemic, many of us have faced some pretty extreme changes to the way we chose to live, the way we socialize, the way we work, the work we do, and our perceived level of freedom. I want to take a minute to acknowledge how much stress we as a collective are actually under and to honor that.

With MTHFR, it is wise to buffer ourselves from stressors like this one, and for many of us, this pandemic has worsened anxiety, increased depression, or deepened or reactivated addictions. Not only that, there is evidence that Covid affects people with MTHFR who have high levels of homocysteine more strongly than it does other folks. I want you to take just a second, take a deep breath, and say something profound. I want you to look in the mirror, right into your own eyes, and say three simple words. “I love you.”

For some of you, that will be kind of awkward or odd, for some it will trigger a smile and for some it will trigger tears. No matter what happens, this is a powerful thing you can do for yourself in only a second and it matters this year.

Now, back to the issue of New Years Resolutions.

I honestly feel that precisely zero people need more stress or striving right now. What we need is more joy, so I’m proposing a different kind of resolution this year – one you might actually keep beyond January 3rd. Here’s how to do it.

  1. Write a list of things that make you happy that you don’t take the time to do right now.  It could be big things (like travel or vacation or family camping trips) or little things (sketching, hiking, or having fresh flowers in the house). Think of at least 20 things.
  2. Take out the ones that are impossible  for some reason (costs too much, borders are closed, have to stay close to home to take care of elderly parents, etc..)  
  3. Make sure there are at least ten good things on your list and if there aren’t, repeat steps one and two until you’ve got ten or more
  4. Make your resolution, just like the big bold one below.

In 2022 I will do one wonderful thing from my happy list every week.

– Love, me.

How’s that for a resolution you can keep?!?

We all need a little more happy and a little more ease right now and putting pressure on yourself, guilting yourself, or being hard on yourself, or setting yourself up for failure isn’t going to help anybody – especially not you.

This year, make a resolution that will make your life better.

Happy New Year, Everybody! Love, Amy.

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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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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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S2E9: MTHFR Questions

I love it when listeners leave me questions so here is this month’s roundup!

I don’t have a doctor that advises me about MTHFR. A mental health provider suspected the mutation because of years of resistant depression. She did a swab to test genetics for specific medication absorption which included MTHFR testing.we found that I have compound heterozygous mutations. I’ve been on high dose methyl folate and B12 for a few years and wonder if I should be getting regular tests for levels etc. where should I go? I have researched the topic myself online but it’s very confusing and there seems to be no general consensus. Can you help me? Thank you,

– Jamie L

This is a great question, Jamie because so many MTHFR folks are out there doing it on their own. Unfortunately, online and between practitioners, there is absolutely no consensus on the best way to do this, so really it comes down to finding the right way for you.

I notice you mention methylfolate and B12 and that is great, but make sure you’re taking the other B vitamins as well because they are all necessary for this to work – especially riboflavin. Also, if you’ve been taking high doses of methylfolate without other Bs, then cut your dose down before you start them because the dose might be too high once you get the other pieces of the puzzle in there.

In terms of testing, the things we want to look at specifically for MTHFR are folate, B12, and homocysteine. Testing every couple of years is fine. Testing folate is complicated because unmetabolized folic acid can be mixed into your total so the test isn’t so valuable except to show us trends (like it’s getting higher or it’s getting lower). B12 testing is straightforward as is homocysteine testing and if you aren’t familiar with homocysteine, check out Season 1, Episode 40: Homocysteine by The Numbers.

Outside of testing, the biggest determinant of whether or not you’re on track is your symptoms. How are you actually doing? If you’re not where you want to be, then maybe it’s time to work with a practitioner who has knowledge about MTHFR and can help you on your path.

Hi! I have an 8 year old boy. He was diagnosed ADHD at the age of 6. We started him on methylphenidates at age 7. We have tried nearly all of them and none of them agreed with him. We had gene testing done earlier this year and MTHFR came back as “Low to Intermediate activity”. Majority of the ADHD medications came back with lower odds of response. What do I do with this information? We have family history of bipolar and anxiety disorders. The adhd medications really brought out a lot of anxiety in my child. He is very competitive. He is obsessive. My son has a terrible issue with skin rashes that started when he was 4. We had skin patch testing done. He’s allergic to hydrocortisone, formaldehyde, fragrance. Once we took gluten out of his diet as well his rashes were more under control. Every time I listen to your podcasts I think some of my son’s issues point back to his MTHFR. Do I take this to his pediatrician? Do I work with his psychiatrist? Do I see a functional medical doctor? What do we do next?

– Mindy J.

ADHD on top of MTHFR is very common and it’s a difficult situation because the medications that help so many other kiddos just don’t work here. I DO think that addressing the MTHFR is the next best step. I would talk with both his psychiatrist and his pediatrician and see if either of them is comfortable fielding this issue in a way other than prescribing massive doses of folic acid, because that won’t be helpful.

If they aren’t familiar enough with MTHFR, then find a practitioner who is. It’s always best to work with someone local, but if you can’t find someone then I do still work with people one-on-one. Check the Amy + Health Coaching link at the top of the page on tohealthwiththat.com

This is why MTHFR folks need other Bs. It isn’t just about folate.

Hi! I am compound heterozygous so I of course have the C/T and A/C copies. I am hoping to start trying to get pregnant soon and I want to know what vitamins I should be taking that will work with the copies that I have. I am on 5mg of l-methylfolafe right now but no B vitamins. I tried a b complex and it made me very mean and hateful so I have been scared to try anything else. I want to have the best chance at a healthy pregnancy, thank you!

– Breonna H.

Congratulations on future baby-making, Breonna. That is such an exciting time. I’m so glad you brought this up because it’s really common for people to start 5-LMTHF before other B vitamins or B12 and then have weird reactions to other Bs when they start.

It is absolutely crucial that you do start other B vitamins. I think the reason why the B complex made you mean and hateful before was that with the other B vitamins there, suddenly your dose of 5-LMTHF was way too high so it was actually that causing the mood and attitude changes and not the Bs.

Basically what is happening in this situation is that your MTHFR enzyme is still really limited because it needs other B vitamins to work – riboflavin is a direct cofactor and without riboflavin, it just won’t go. So your dietary intake of riboflavin was maxing out the amount of 5-LMTHF that you can use.

So you do need to add a B complex back in there, but before you do, drop your 5-LMTHF down to 1mg for a couple of weeks and then add the B-complex. Also, check the B12 in the B complex because some people have a weird reaction to methyl-B12 too. Here’s a post on all the different forms of B12.

When you do give this a try, let me know how it all goes!

How do my folate levels drop after starting Metanx and multivitamin with active folate?

– Human

This is another great question, and I’m actually guessing a bit because I don’t know where your folate levels were before you started. I can say that what I see often in clients is that they come in with super high folate on lab tests, but functional folate deficiencies. Once we eliminate the folic acid and get them started on active folate then blood levels are technically getting lower because we’re clearing out the unmetabolized folic acid that hangs around in there cluttering up the works. Or at least that’s what we hope to do. Even as folate levels look like they’re dropping, the person is symptomatically improving.

I see that happen a lot, but if that doesn’t sound like what is going on for you, reach out again and give me a bit more detail so I can answer more thoroughly. Just remember that serum folate measures everything in the serum – usually that includes natural folate, 5-LMTHF that has been made by your body, whatever folate you’re taking, PLUS any unmetabolized folic acid that is still kicking around. It isn’t a great test on in terms of value on its own, but what we can do is exactly what you’re doing, which is compare numbers over time. But typically we want this to drop a bit as the unmetabolized folic acid (or UMFA) is leaving your system.

I *love* listener questions and I’d love to answer yours. If you happen to have a question, let me know. There is a video-ask for questions on the home page of tohealthwiththat.com. I’ll try to do an answer podcast every month or two just depending on how many questions come in. I also love meeting you guys in Genetic Rockstars, it’s an MTHFR community away from the craziness of social media with lots of inside information, polls, tips, and generally other MTHFR folks who are talking about their experiences. Please join us at community.tohealthwiththat.com.

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