S2E6: B Vitamins with MTHFR

If you’re following along with our step-by-step process, then you’re well ahead of most people who start their MTHFR journey with Dr. Google. Congratulations. This week we’re going to talk about avoiding one of the biggest mistakes that people make in their MTHFR quest for health, and that is, forgetting that methylfolate isn’t everything.

This is truly the mistake most likely to be made, followed closely by trying to change everything all at once and getting into a tangle.

It’s really easy to think of MTHFR as a “folate thing,” forgetting that the twenty other steps in the pathway that have to happen for MTHFR to have any impact, need other nutrients. Even the one step we’re obsessed with needs other nutrients.

While our mutation does have “folate” in its name and that seems like a compelling reason to focus on folate, if folate is all you focus on, it isn’t going to work out.

I’m not sure if anybody remembers S1E1 when we talked about how MTHFR was like a magic chair, but lets revisit that idea.

MTHFR is a gene. A tiny genetic code that help your body to build an enzyme of the same name. Enzymes are a special type of protein that I like to talk about in terms of being a magic chair. The magic that happens in this chair is like alchemy – it’s a lead to gold type of transition. Essentially, the magic chair turns something reasonably worthless into something incredibly valuable. Like I said, alchemy.

The MTHFR magic chair turns folate, folic acid, and folinic acid into the active form of the nutrient that actually does something in your body. This folate-gold, is called methylfolate or 5-L methyl tetrahydrofolate, if we want to be specific. Without the magic chair, the methylfolate never happens. If methylfolate doesn’t happen then things start breaking down.

MTHFR in the simplest terms possible – it’s a magic chair.

We see errors in cellular reproduction, problems with turning on or off particular genetic signals, trouble building neurotransmitters, inability to kill off damaged cells, toxins piling up, and big issues with conceiving babies, carrying babies, and building the central nervous systems on which healthy babies rely. The methylfolate gold is vital in helping us prevent cancer, prevent heart disease, reproduce, and maintain our mental, physical, and emotional wellbeing. It really is gold.

So for genetically “wild type” humans, which is what researchers call people with the typical MTHFR genes, this enzyme functions as well as it can given their nutritional status. It can still be compromised by lack of quality folate and lack of cofactors, but those are the only things slowing it down.

For MTHFR folks, the different mutations, most commonly C677T or A1298C, cause the chair to change shape a bit. Essentially, they give the chair a lump somewhere really important, like the seat or the headrest. Something that makes it hard for the folate to effectively sit in the chair so it can undergo the magic that turns it into methylfolate gold.

MTHFR mutations that matter are A1298C and C677T

So as the very basic point, I’m hoping you understand that you need the chair and the folate to click together. What we haven’t talked about, is what is needed for the magic to happen. Remember back to our alchemical change here – we’re making lead into gold and that’s a big deal. So obviously some magic happens, and in this particular case that magic needs another nutrient in order to spark. That nutrient is riboflavin. Riboflavin isn’t in the name of our mutation and Dr. Google doesn’t talk about it as much as he or she should.

So circling back to the initial statement, the biggest mistake that I see in people who have been treating their own MTHFR stuff by themselves, is that they forget about other B vitamins.

I have to point out an obvious fact that is easy to overlook. There are no “C vitamins” or “D vitamins.” There is a vitamin C, singular, and a vitamin D, also singular. So why, then, are there so darn many Bs? The bottom line is that the Bs are all Bs because they function largely as a group. No one B vitamin is involved in any big process that doesn’t also involve some or all of the rest of the B vitamins.

Vitamin C is off doing its own thing as an antioxidant, but the Bs are a team. They are all working together all of the time. Folate is a B. Riboflavin is also a B. Guess how many B vitamins you need for all of the functions related to healthy methylation? Well, the trick answer there, is all of them. Especially when you get off into making things like cellular energy or neurotransmitters and detoxifying things. The Bs always work as a team and if you’re missing Bs, then the process is stalled. Riboflavin is nowhere in the name of our mutation, but it is as necessary as folate because riboflavin makes the magic happen.

Is Riboflavin the only other B vitamin you should be taking? Nope. They’re a team, remember? So as you’re following along with the program, now is the time to start the other B vitamins – preferably in a multivitamin. It’s a great way to get everything in one swift stroke, rather than taking an individual pill for each thing.

The issue is that we don’t want folic acid, because it’s essentially toxic for us MTHFR folks, and we aren’t ready to start 5-LMTHF as a supplement yet either. So what can we do? Well, Ben Lynch, another MTHFR mutant who had the foresight to start a supplement company, called Seeking Health, that caters to genetic issues, made some great multivitamins without anything methylated just for this purpose. They can be a great way to start the journey by giving your body the rest of the “B team” without getting into weird territory with the folate.

If you can’t get those particular products, look for a multivitamin that has 5-LMTHF as the form of folate in the lowest dose possible. One a day multis are not the best choice because they usually have 400 micrograms or more just to meet the daily requirement. Many good multis will be in a two per day or even 4 per day format and a lot of times if you start one of those at the lowest possible dose (like taking 1 out of the 4 pills per day that you’re supposed to take) then you can get a reasonable background of B vitamins with a very low dose of methylfolate. Again, make sure the only folate in the product is methylfolate or folinic acid which is also safe for us.

The goal here is to get ready to start a methylfolate supplement by having a great background of other B vitamins.

By this time you have a couple of weeks of symptom tracking since stopping folic acid and since adding in food sources of natural folate. You may have noticed some changes. From those changes we might be able to predict how your methylfolate start will go.

Stopping folic acid made me feel:Adding natural folate makes me feel:5-LMTHF will probably…
BetterWorsebe difficult for me to tolerate so start with none or the very lowest dose possible.
BetterBetterbe a bit easier for me to tolerate. Still start low, but finding a good dose should be smoother.
Worse – – – I’ve never actually seen this so I don’t know.

Interestingly, we can also predict a bit based on your basic state. Last week we talked a bit about basic state so we don’t need to do so again, but overmethylators generally tolerate higher doses of methylfolate than undermethylators do. It’s a guideline and not a general rule so it’s important for everyone to start slowly and carefully.

Make sure you’ve got all the other B vitamins in there first and avoid the most common pitfall people experience when they are relying solely on Dr. Google.

I’m really excited to say that I’m in the process of building a Patreon page, which is a great way for you to show support for this show if you feel like you’re getting something out of it. I love doing the show and I want to keep putting great information out there for free so that it’s reasonably accessible to people of all financial means. But also, at the end of the day, I have to be able to support myself and contribute to my family’s wellbeing. So if you’re able to become a patron on Patreon, I would really appreciate it and I have lots of special content planned. Now, my site isn’t live just yet – I”m in the process of building it out – but when it is it will be found at Patreon.com/thwt. I’ll see what I can do to get it live before next week’s episode.

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These Vitamins Are Absolutely Essential for MTHFR.

The Methylation pathway seems relatively minor. Your body moves a 1-carbon group around. Big deal. And yet, it ties into the major processes of cellular energy formation, waste excretion, neurotransmitter formation, antioxidant recycling, and utilization of key nutrients. This can lead one to believe that folate is the most important nutrient in the universe, but the truth is – there is another vitamin that is necessary for MTHFR. A whole group of them! In fact, we need all the B vitamins for methylation to happen. So let’s take an in-depth look at not only the pathway but also the other nutrients (outside of the main player, folate) which are necessary.

the MTHFR lifestyle matters because of the way these cycles all interconnect.

The Methylation And Folate Cycles In Gory Detail

The image below shows the methylation pathway and the folate cycle in all their glory, with the cofactors necessary showing in color (click on the image to see a bigger version because it’s eye-crossingly small). You will notice that although folate, which we’ve spent eons talking about, shows up twice, riboflavin, which we haven’t even mentioned yet, is in there four times. With MTHFR issues, it’s easy to start to think it’s all about folate. The truth is, B vitamins function together. MTHFR folks need other B vitamins. Folate doesn’t ever function in isolation and before someone with an MTHFR issue even begins to supplement folate, they should supplement the B vitamins that aren’t directly involved in methylation. This is B1, B2, B3, B5, B6, and B7.

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

With MTHFR issues, it’s easy to start to think it’s all about folate. The truth is, B vitamins work together. MTHFR folks need all of the B vitamins, and they should start the other Bs before they even begin to supplement with folate (B9) or cobalamin (B12).

Amy Neuzil, tohealthwiththat.com

What About The Kreb’s Cycle?

I’m pretty sure that is a question that no-one has actually ever asked, but still. The Krebs Cycle is how your cells generate energy and so we kind of have to discuss it because without the kreb’s cycle, your cells have no energy and if your cells have no energy, you don’t either. Turns out, the feeling of no energy is a common issue for MTFR folks, so this really matters. Take a look at the full cycle below.

As you can see, the various B vitamins in this cycle don’t even include folate – although the folate cycle does join up, so MTHFR folks aren’t out of the woods yet. This figure was taken from: Kennedy, David. (2016). B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review. Nutrients. 8. 68. 10.3390/nu8020068. and adapted with color.

If Folate is MTHFR’s Wife, Riboflavin is the Other Vitamin For MTHFR. Riboflavin Is The Mistress.

In fact, Riboflavin, or vitamin B2, is actually a cofactor in the MTHFR reaction itself. Meaning that if you are low on riboflavin it doesn’t matter if your MTHFR is working perfectly, it still isn’t going to happen. For this reason, MTHFR folks need riboflavin just as much as we need folate. Maybe even more so.

Start The Other B Vitamins First.


It may sound counterintuitive, but when you’re starting on your MTHFR journey, it really matters to do things in the right order.

  • Step one (as we’ve discussed) is eliminating the toxic folic acid from your diet and supplements. It’s a good idea to start up an MTHFR lifestyle here too – get a little cleaner, take out as many chemicals as you can, and generally start to avoid toxins.
  • Step two is to incorporate food sources of natural folate.
  • Step three is to add a B vitamin supplement that has all of the other B vitamins, but not any form of folate or cobalamin because MTHFR folks might have different reactions to those and so it’s nice to add them separately. At this time, I believe the only one on the market is B Minus from Seeking Health
  • .After this we can try to optimize your dose of the different types of folate, as well as the different types of cobalamin to make your health perfect.

If You’d Like To Order:

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Please note this is an affiliate link which pays me (Amy) for the referral. Thanks!

It’s easy to forget that nutrition is best when it isn’t just bits and pieces, but rather a complete and balanced diet and supplement routine. Preferably, diet. In an ideal world, we would get all of this from our food, but of course, it’s the real world and sometimes we need to supplement. Regardless, don’t get so hyper-focused on folate that you miss the rest of the B vitamins. B vitamins for MTHFR are all necessary – these are your basic building blocks..

If Folate is MTHFR’s Wife, Riboflavin is MTHFR’s Mistress.

– Amy Neuzil, tohealthwiththat.com

Thanks for listening and join us next week for a deep dive into MTHFR and glutathione, the master antioxidant.

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