S2E5: Patience with MTHFR

I’m pretty sure that this is the most frustrating part of the whole MTHFR shebang. Not the crazy symptoms, the issues if we take too much methylfolate, the dietary changes, or the problems we have from MTHFR in the first place, but the tooth-grindingly frustrating requirement for patience.

I am not a patient person. My nature is to rush headlong into everything, and consequences be damned. It’s actually a family trait – my grandfather once rear-ended a moving vehicle the highway because they weren’t going fast enough. Of course, both vehicles were land-yachts, as was the norm at the time, so the worst that came of it was a very startled driver in the other car. My mother physically can’t stand still, and if there are more than two people standing in one place then it’s a line, and she’s not interested.

My family is not good at resting on our literal or proverbial laurels.

Interestingly, this is a trait shared with many MTHFR folks, which always makes me question whether the universe actually is some giant cosmic joke – a huge “gotcha!” situation in which every human is required to muscle through the tasks that are the hardest for them as individuals to tolerate. It certainly seems to be the case with MTHFR, because so many of us like to push forward and push through, and we are generally capable of doing so.

In general, MTHFR folks fall into two categories, or basic states. Those are overmethylators and undermethylators. If you don’t remember what I’m talking about, this is your MTHFR basic state and represents the two halves of the MTHFR coin. Both faces of this coin have many commonalities, but the differences come down to whether your body likely overmethylates your DNA or undermethylates it. Another way to look at the whole thing is by looking at your histamine levels. Both sides of this coin react to lots of things in the outside world, but undermethylators react in a high histamine way – picture sneezing, hives, watery nose, itchy eyes. Overmethylators react in a low histamine way – think constantly blocked nose, allergy headaches or muscle pains, chemical sensitivites. This idea was proposed and researched by Dr. Wash of the Walsh Research Institute. To brush up on the basics, follow this link to S1E16 on MTHFR basic states.

Overmethylators

Overmethylating MTHFR folks are known to push themselves through all manner of agony for their passion project of the moment. Typically, it is some kind of activism, some sort of making the world better, something that helps others, or an art form they are offering to the world. It could be a skill taken to the level of art or anything these amazing MTHFR folks choose to push forward. If you want more detail on overmethylation, check S1E31 which did a deep dive into the state of overmethylators.

Overmethylators, you’ll recall, tend to excel at the things they’re interested in and the rest of it can go hang. These are often the brilliant children whose parents don’t understand how they can know and understand every map, level, move, and function in a complex video game, but won’t learn to read. These MTHFR folks aren’t concerned with doing well at everything, but they will go above and beyond at the things that interest them. These are the folks who forget to eat, sleep, or do anything while they’re in the flow of their work or interest. As a whole, patience isn’t the watchword here.

Undermethylators

Sadly, patience isn’t something these people possess in great quantity either. Undermethylators are our perfectionists and overachievers and they make up about 45% of the population. There are also people who are methylation neutral, but people with MTHFR mutation tend not to be. Undermethylators are the people who will push themselves until they collapse to be the best at whatever it is that they do. They’re the prima ballerinas, the professional athletes, the CEOs, and the people who generally push until they are the best that they can be at everything they do. They are typically perfectionists and expect themselves to excel at everything. If you want a refresher on undermethylators, it can be found in S1E32.

As you can see – both of these groups push forward no matter what, and that typically doesn’t involve patience. But in this game, patience is the essence of what is needed.

Why So Much Patience?

Patience is necessary with MTHFR simply because we are dealing with a pathway that is inherently compromised and that pathway is responsible for many things, but utterly dependent on a couple of nutrients. This creates a situation in which there is a mountain of pressure in all of those un-done responsibilities on a very narrow platform of nutrients. In short, this is a situation that can get messy in a heartbeat.

I think far less patience would be required if we all started managing our methylation at birth. Babies would be raised with all of the good active methylfolate that they need and the other B vitamins would be available too so that there wasn’t a chance for this slightly compromised system to create a backlog of unfinished business.

Most of us are not raised like that. Most of us have a good 20, 40, even 60 years of backlog built up before we actually figure out that there is even an issue with MTHFR, and so we need patience. Changes must be made slowly for a few reasons.

  1. If you make too many changes at once then you can’t tell what is doing what. So if you have any kind of reaction, bad or good, you don’t know what to link it to. So confusing.
  2. If you make a great change, like adding 5-LMTHF, but add too much too quickly, you can get into super scary too-high-a-dose symptoms, which mostly feels like you could peel the paint off the walls just by looking at them hard enough. It’s not fun and it usually makes people give up methylfolate forever or at least for a few years until they get brave enough to try again.
  3. If you make a conservative change – like adding a small dose of 5-LMTHF, but then don’t wait for your body to settle in and be ready for the next step, then you get into massive symptom territory again.

Essentially, the MTHFR journey is like walking a very long boardwalk through a crocodile-infested swamp. You want to stay on the path and not veer off into the muck. There, be dragons.

I know that everyone listening wants the next step. Right now. Do not pass go, do not collect $200. I know that. But the next step is actually waiting to see how you feel without folic acid in your diet and with the addition of food sources of natural folate. It’s symptom tracking.

Some of you won’t notice too much. That’s ok.

Some will notice an improvement, and that’s a great sign that you’ll be able to take the next steps post-haste. This tends to be overmethylators, who typically tolerate 5-LMTHF reasonably well.

A few, will notice that without the folic acid things were looking brighter but adding in the foods high in folate doesn’t work for them. Or, it makes them worse. In fact, some of you might have already known that none of the high-folate foods I’ve mentioned work for you at all. This could be an indication that you’re not going to tolerate folate – and that’s ok. Think of this as an early warning system. We will still eventually try to add in a tiny dose of 5-LMTHF, but the red flags are already up – we know in this scenario to take it extra slow and to watch for bad reactions.

Thanks for listening and just as a heads up – I am launching a patreon page because I love making this podcast and I want there to be as much free information out there for MTHFR folks as there can be. If you feel like you’re getting some help with this information, I would be delighted if you could contribute a bit there. My page isn’t live yet, but it will be by next week, so stay tuned.

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