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.
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.
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.
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..)
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
Make your resolution, just like the big bold one below.
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.
Of course in a pandemic we all want to know how it might affect us specifically, with all of our genetic differences. That research takes time and money and usually comes after the big stuff (like how does this spread and why does it kill people.)
In good-ish news, Covid-19 has now officially been around long enough for some of the smaller, more specific areas of research to be done. This includes the very first steps on research into the interplay between homocysteine, MTHFR and covid 19.
This particular study came about because there have been big differences in COVID disease severity, in particular in the death rate, between different geographic areas as well as between the genders. The study I am talking about was published in November 2020 in a journal called Medical Hypotheses, which is not peer-reviewed research, but rather includes important theoretical papers, so I do want to emphasize that this information is theoretical and has not been formally researched yet.
At the date of publication of this research, Covid-19 was associated with an 8.8% mortality rate in those above 60 years of age, and 0.46% for patients aged below 60 years old. Countries with the highest mortality rates are Italy, Spain, France, Iran, and the USA. A recent report from Italy showed that the vast majority of those infected who were critically ill were older men, 68% of whom had at least one comorbidity. The worldwide mortality rate is higher among men almost by a factor of two.
Mortality rate Male:Female = 1.7:1
In Italy, high rates of ICU admission, ICU mortality, and overall mortality have been seen and the deaths from COVID-19 are often associated with high neutrophils, high levels of pro-inflammatory cytokines, abnormal coagulation tests, and disseminated inter vascular coagulation.
The most common comorbidities among the most critically ill were:
The article goes on to summarize the high points of MTHFR:
The MTHFR enzyme is the most important in the methionine pathway.
It regulates fundamental processes such as DNA repair, neurotransmitter function, and membrane transport.
The C677T mutation has been suggested to be protective against certain cancers including colon and acute lymphatic leukemia.
The mutation leads to a thermolabile variant of the MTHFR enzyme in which the dissociation rate of the cofactor Flavin Adenine Dinucleotide (FAD) (this is from B2) is increased, thus reducing the activity of the MTHFR enzyme by 50% or more.
In people with a medium skin tone, the function of the MTHFR enzyme is largely preserved as long as they have sufficient dietary folate intake.
With insufficient folate intake, the production of 5-LMTHF is reduced, which leads to the accumulation of the key metabolite, homocysteine, to toxic levels.
MTHFR is the most common genetic cause of hyperhomocysteinemia.
Low folate status resulted in significantly higher levels of homocysteine in men.
Research suggests that the C677T mutation is associated with a significantly increased risk of coronary artery disease only in homozygous men.
Other risk factors for the development of high homocysteine are:
chronic kidney failure
cancers of the breast, ovary, and pancreas
Acute High Homocysteine
In addition to the risks of high homocysteine that we have talked about before, an acute high homocysteine situation can be triggered, independent of folate status, when a systemic inflammatory process is triggered (like, for instance, by a virus). This process boosts inflammation and releases a tremendous amount of reactive oxygen species (free radicals), which can overwhelm your antioxidant defense systems. This is potentially an even greater issue in MTHFR folks because we have the potential for lower glutathione than average. This whole ugly cascade activates something called nuclear transcription factor (or NF-kB), which accelerates viral replication in SARS Co-V. The study also cites a case report in which glutathione supplementation led to a rapid symptom improvement in two cases of Covid-19.
Interestingly, COVID-19 patients’ plasma homocysteine levels show predictive value for the progression of pathological findings on chest CT. This means the higher the patient’s homocysteine is, the more likely they are to show damaging changes in their lung tissue on a chest CT scan. Also, these changes began to show at a lower homocysteine level than the one that is usually used as a medical reference. Negative changes began to show at 10.58 umol/L rather than the 15 umol/L that is normally recognized as a “high” value.
What Do We Do About High Homocysteine, MTHFR and Covid-19?
This study makes some suggestions.
Patients at high risk with Covid-19, such as the elderly with comorbidities, should also be screened for high homocysteine.
Those with 8 umol/L Homocysteine or above should implement a folate-rich whole foods diet (fruit, vegetables, whole grains, good protein sources.)
These individuals should also add 5-MTHF supplementation.
Folic acid should be avoided by these individuals as supplementation can have the opposite of the desired effect, especially in individuals with the MTHFR polymorphism. This is thought to be because unmetabolized folic acid accumulates, which inhibits MTHFR and also folic acid competes at binding sites with 5-MTHF.
B6, B12, and B2 should be added as well as they are cofactors for the MTHFR enzyme, or in the methionine pathway.
Supplements with demonstrated anti-viral properties can be added, including vitamins A, C, D, E, selenium, zinc, iron, and omega-3 fatty acids.
Strong antioxidants including vitamin C and glutathione have shown positive results for Covid-19 outcomes.
At the end of the day, it looks like taking care of yourself appropriately for MTHFR and following the positive steps to balance your methylation that we have been talking about, is actually the best defense for those of us with MTHFR against the worst of the outcomes with Covid-19. Taking positive steps to manage your MTHFR doesn’t mean that you won’t get Covid-19, but hopefully, it will help to reduce your risk of dying from Covid-19. Keep in mind that this study represents a well-researched theory, and it has yet to be proven in clinical trials.