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Sleep and MTHFR

MTHFR and sleep are intertwined, so here are some of the most important things you can do to get the best sleep moving forward.

MTHFR gives us a number of tendencies that can interfere with sleep, especially some of the personality traits and mental tendencies that are common in those of us with MTHFR or other methylation dysfunction. This includes anxiety, perfectionism, the tendency to over-obsess about the things we’re dedicated to, high sensitivity, addictive tendencies, and overt mental health issues. Physical issues that come along with MTFR can interfere with sleep as well including thyroid disorders, inflammatory disorders that cause pain, blood sugar imbalances, It isn’t that all of us have all of these issues, we’d never function in this world. The issue is that all of us have something that has the potential to knock sleep off course. So let’s talk about the biggest factors.

Right Dose of Folate and Methyl Donors

The big issues with MTHFR come down to poor activation of folate, which in turn messes up methylation, which is the issue that has the most health consequences. This means, to effectively manage the MTHFR mutation, you need both the right amount of an MTHFR-safe folate, preferably methyl folate, and the right amount of methyl donors. These amounts are extremely variable from person to person, and the worst part is that doses that are too low, interfere with sleep and doses that are too high interfere with sleep. There is a sweet spot in the middle for you that will actually enhance sleep and help you get good rest, but finding it can be fiddly.

The best way to find your perfect doses is to make sure you’re only changing one thing at a time, and also that you’re tracking your symptoms, including sleep quality and energy, every day while you’re finding your perfect dose. It sounds like a pain because it’s one more thing to do, but it can save you months of difficulty and uncertainty. If you haven’t done so already, there is a free symptom tracker download when you sign up for the mailing list on

Good Food for Good Sleep with MTHFR

With MTHFR, sleep can suffer if you have significant amounts of synthetic folic acid in your diet and supplements, so getting it out of your diet and supplements really matters. Many people that I have worked with report better energy and better sleep just from this. I’m not going to tell you it’s easy to get folic acid out of your diet, but it is extremely difficult to make signficant progress with MTHFR without doing this step.

Folate, however, is not the only dietary factor that matters for sleep with MTHFR. Blood sugar matters too. Not just the routine blood sugar testing you do at your doctor’s office, but also how much your blood sugar is swinging up and down each day, even if your numbers are technically normal.

We’ve talked a lot about the blood sugar issue before, so I won’t belabor a point, but if you’re looking for more info, I suggest watching the series of Tuesday tips I posted on Youtube about it.

So let’s talk about the smaller steps you can take with MTHFR once you’ve found your optimal dose of folate and methyl groups.

Bedtime Routine for Good Sleep Hygene with MTHFR

Of course sleep hygiene is a big topic, so there are a lot of things you can include, but these are the factors that are most important for MTHFR folks in my opinion:

  • Low light 1-2 hours before bed – this is especially important if you also have slow COMT, which can make you very sensitive to stimulating things. Low light also includes keeping screens out of your life for this time.
  • Melatonin – melatonin is your body’s main sleep hormone, and it’s also seratonin that has been methylated, so for many of us with MTHFR, we don’t have quite enough of this to go around.
  • Balanced evening meal – A good evening meal is like a plate divided into four quarters. One quarter goes to protein, two to veggies, and one to complex carbs. If there’s a dessert, make sure it happens after the meal, and takes some of the space out of your complex carbs pile. This type of meal will help to keep your blood sugars balanced overnight so fluctuations aren’t waking you up. Don’t mess it up by reaching for the snacks after dinner. Cut the kitchen off after dinner is finished.
  • Wind-down activity – this could be a gentle yoga session, a meditation, breathing exercises, or coloring in a coloring book. Whatever helps you to untangle your mind and have a moment of calm will do.
  • To do list/idea pad – We tend to be thinkers and possibly, ahem, obsessers. It helps to have a notepad, your journal, or whatever you use to record your thoughts by your bed, and to make a habit of writing down whatever is swirling around in your brain before sleep. That way, you know you have it to look at tomorrow so you can let it go for tonight.
  • Magnesium at bedtime – This technically has nothign to do with MTHFR, although it is helpful if you have slow COMT. But also, so many people in the western world are magnesium deficient that it is relevant on this list. Especially consider this one if your mind won’t shut down, if you have restless legs, or if you tend toward constipation.

Morning Routine for Good Sleep Hygene for MTHFR

  • Bright light – Bright light first thing in the morning either from the sun or from a full spectrum lamp for this purpose boosts dopamine and seratonin, establishes a solid circadian rhythm, and generally helps everyone.
  • Savory breakfast – Starting the day off with a savory breakfast, or a meal centered around the protein, fiber, and good fats (rather than the sweet starchies we get from morning pastries or cereals) helps to keep your blood sugar balanced through the day.

Bonus Things To Include For Good Sleep with MTHFR

  • Good exercise session – People with MTHFR often get extra benefit from exercise, especially if you tend toward restless anxiety. This is of course partly because of the literally hundreds of benefits that you’ve already heard from other sources, but also because exercise helps your body process extra methyl groups, which can be a bonus for us if we’re feeling scattered or restless.
  • B vitamins and methyl groups in the morning only – These nutrients tend to give us energy and put the brain into high gear, so keeping them to the morning at first is really helpful. You may find a small early afternoon dose helpful if your energy tends to slump, but do your symptom tracking carefully because B vitamins and methyl groups too close to bed can keep you awake and keep your brain active.

Of course every MTHFR person is different, but this is a good place to start if you have both MTHFR and sleep issues.

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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. Thank you so much for your article. I wish you lived in AZ. Our family has the MTHFR mutations. My son and husband have the homozygous C766 and I have the heterozygous however each copy of mutation. Our daughter I assume has however will know which copies soon. Our son is 21 now. Unfortunately at age 12 he was diagnosed w Crohns which has not been an easy journey. He is doing well now however the on and off prednisone also hasn’t helped with his adrenals and sleep hormones. I currently have home on Methylated B complex, Vit D, C, Phophatidyacholine,adrenal support, Omegas, Zinc. His issue with sleep is his brain not quieting. He definitely can sleep but unfortunately has to play catch up in day sometimes. I know there is also issue with COMT w MTHFR as well which I believe he has warrior . If you have any insight that has helped would so appreciate as I know the methylation issues doesn’t help with neurotransmitters like Sam-e Methione also.

    Thank you, Jen

    • Hi Jen,
      I’m so sorry to hear about your son’s journey with Crohn’s – it can be such a difficult condition to live with. The prednisone can cometimes interfere with sleep, and he’s probably already mentioned it to his doctor, but sometimes adjusting his dosing schedule can help. If he hasn’t explored that, then maybe have him ask the prescribing physician about it. Also, sometimes high night time histamine is an issue with sleep, especially with the noisy brain factor. He could try a low histamine meal for dinner or something to help process histamine after dinner and see if that might help. Maybe some of the histamine or cortisol tips in this article could be helpful. Thanks for reaching out!

  2. Any advice on supplements to take for sleep. I have the MTHFR gene and sleep a”3 hours a night. I have no problem falling a sleep but wake up 3 hours later. I cannot stay a sleep. Thank you

    • Oh my goodness, Stacey – that is not very much sleep! It must be so frustrating for you to wake up so consistently. I don’t so much have supplement suggestions because this sounds like a more systemic problem. Blood sugar fluctuations can often wake you up on a schedule like that – like maybe your blood sugar is bottoming out 3 hours after you fall asleep? If that’s the case, try a high protein, high fiber dinner (meat and green veggies if you eat meat or beans and green veggies if you don’t.) If this is the problem, it will take work to balance your blood sugars overall through the day, etc… but at least trying the high-protein nighttime meal will give you some idea. If it isn’t that, then it could be adrenal issues, so maybe you could look into that. There’s a bit more about adrenals here: and also in the podcast. I hope this helps!!

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