MTHFR Questions – Specific products and Marmite.

This week, I’d like to get to some questions that listeners have been kind enough to leave on the website and within the community.

The first comes from Liana O and she says “Specific 5-L-methyltetrahydrofolate supplement recommendations and dosing, please?”


This is actually a really common question, and I’m probably not going to answer in a way that is satisfying because everyone is so different. Also, the products available to people vary so widely that the best I can give is guidelines.  In terms of people first starting on this journey, the absolute best, easiest, and most painless way to start is with a multivitamin that doesn’t have any folate or B12.


To my knowledge, there is only one such product on the market, which is made specifically for MTHFR  and by a fellow MTHFR mutant. It’s called Optimum Start by Seeking Health. This is a great product, and Seeking Health will ship internationally from their website, which is great, but as everyone who isn’t in the US knows, international shipping for something like this often makes it cost-prohibitive. I do have an affiliate account with Seeking Health, so if you’re ordering products I would so appreciate it if you’d do it via the link from tohealthwiththat.com to support the work I’m doing here.


Outside of that, there are a number of great multivitamins with low doses of methyl folate that can be really great for a starting place. One of my favorites is the Smarty Pants kids multi gummy.  It has a mere 37.5 mcg methyl folate per gummy. This won’t give you an adequate dose of everything else you need, but if you’ve had trouble with methylated folates before, it can still be a great way to start. Smarty Pants also has some great adult gummy vitamins that can be a good way to ramp up your intake slowly because typically the dose is split between 4 gummies, and also gummies are easy to cut in halves or quarters.


If you prefer capsules, look for high-quality multivitamins that have multiple capsules in the dosage and are made for adolescents or teenagers so the doses per capsule aren’t high. Some examples are junior nutrients from Pure Encapsulations, which has 100 mcg folate per capsule.  Thorne Research multi-encap is also a good choice at 130 mcg folate per capsule.  
In general, I prefer to buy from companies that follow good manufacturing practices and who sell primarily through practitioners. This includes companies like Thorne Research, Integrated Therapeutics, Pure Encapsulations, Xymogen, and NuMedica.  Divinci Labs also makes some nice products, as does Jarrow. 


At the end of the day, what matters most is local availability, even if it’s via amazon or a similar mail order service, and ingredients. Always look for doses on the low end of the spectrum, especially with methyl folate and B12. You can add in higher doses of those ingredients separately, which is the best strategy because it gives you more flexibility overall.


I know this seems like a non-answer to this question, but the most important to find something that works for you individually.

The second question is from Tim and is quite honestly, sending me on a bit of a hunt. He asks….

So, even though Marmite says it has Folic Acid, you’re saying it’s actually NOT Folic Acid, is that correct? You have me so scared of Folic Acid that I don’t want to be eating it. Thanks.

Now, you all know of my obsession with Marmite. It is a yeast extract quite similar to the one that was used in the initial research that found folate to be an important nutrient for pregnancy. Outside of being a huge fan, I have also always been under the impression that it was unfortified and that all the folate present was directly linked to the natural byproducts of the yeast.  I am at this moment, fearful that I might actually be mistaken about this.

These two pieces of information aren’t the same. But why? The answer is yet to be found.


I have a question pending with Unilever, the current manufacturers of marmite, but so far it remains unanswered. The label information is somewhat frustrating. The Food Standards Agency, which is the UK’s food regulation authority, also has a folic acid fortification program with wheat flour, but I can not find out whether or not the terms “folic acid” and “folate” are considered to be equivalent legally. If anybody from the UK can shed some light on that matter for me, I’d appreciate it.

I do know that the bottle in my pantry lists the ingredients as Yeast extract, Salt, Dehydrated Carrots, Spice Extracts, Dehydrated Onions. And that’s all. There is no mention of additional vitamins or fortification, which in Canada is a legal requirement. The label is definitely following Canadian guidelines otherwise, as it has all information in both official languages.

I called the information number on my bottle and left a message, which has yet to be answered.

Also, I “spoke” with the marmite website chatbot and I hate to say, the chatbot listed ingredients that I don’t see on my label. According to the marmite bot, it includes vitamins and one of those is folic acid. Sigh.

So, obviously, this still requires some investigation because if there is folic acid on there, why isn’t it on my label? Also – how much is actually in there? Is the entire 100 mcg dose listed as the amount per 8 g serving folic acid? It’s all a bit confusing.

I will certainly update you when I hear from Unilever and also from the Canadian helpline because the contradiction in information doesn’t make sense. It could be that there is a difference in the formulas depending on the country, but it seems like the label would be easier to change than the product.

To address the second point in the question, Tim mentions the fear of folic acid. This is something I want to talk about because while I”m not a fan of folic acid, the problems actually occur when it’s folic acid in high doses. Small amounts just slowly labor on in the process of being converted to something useful like 5-LMTHF, but they do eventually get there. So a small amount of folic acid isn’t going to be a problem if you’re just getting it from one source, like marmite, which still has good natural folates as well.

When it becomes a problem is when it’s the only source and you’re getting it everywhere. All the fortified grains, your multivitamin, some prescriptions, etc… Then is when we see folic acid building up and also folic acid gumming up the works of the methylation pathway. There is probably a safe threshold, but to my knowledge, that research really doesn’t exist yet. So at this point, minimizing intake is the safest bet.

Are There Other Yeast-Based Products Like Marmite?

Since Marmite is now in uncertain territory, I will give you some options. One of my favorites is nutritional yeast. It has a delicious cheesy-nutty-umami flavor and is easy to sprinkle on popcorn, add to sauces, sprinkle over veggies, or use as an additional flavor burst in things like salad dressings.

Like everything else with food, it’s a bit complicated. If your package doesn’t mention anything, then it is likely fortified, which means they’ve added extra B12, folic acid, and probably a few other B vitamins to the mix. This is kind of standard and so if they just say it’s a good source of B vitamins, then they’ve probably done this. Also, the fortification gives the flakes a bright yellow color – more like a true yellow.

Nutritional yeast is available unfortified as well, but you have to hunt for it. I can’t find unfortified at any of my local stores, but I can on amazon so I order a big bag once a year and that’s that. The unfortified tastes just as good but the color is a bit more gentle – more of a buttery yellow rather than a bright yellow.

If you have some in your pantry right now, check the color – I’ll put a picture below so you can compare.

Thanks so much for listening today and thanks Liana and Tim for the great questions. Make sure you’re signed up for the email list so you’re the first to know about upcoming courses.

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The Dangers of UMFA in Pregnancy

UMFA or unmetabolized folic acid is something that has been popping up on research radars more and more frequently in recent years. The combination of food fortifed with folic acid, multivitamin use, the popularity of B complex supplements for energy, and the standard practice of hyper-dosing women with at-risk pregnancies has led to UMFA becoming a common problem. Last week we discussed the remarkable results methyl folate produced in couples with infertility relative to the current standard of care, which is supplementing with folic acid. This week, I’d like to talk about the risks of too much unmetabolized folic acid or UMFA during pregnancy.

First, Let’s Talk Useable Folate

One very wisely designed study published in the American Journal of Clinical Nutrition, compared serum and red blood cell levels of total folate, 5-LMTHF, UMFA, and MeFox which is a methyl folate oxidation product – kind of the 5-LMTHF version of UMFA. The reason I call this study design “wise” is that it gives us a good window into what is actually happening here. Serum levels test the amounts in the fluid part of the blood, which is not yet inside the cells. This isn’t really a functional space for folate – it’s been absorbed digestively, but hasn’t reached useful cellular tissues yet. Red blood cell levels, however, measure the amount that is actually inside of the cell spaces and therefore doing something useful. This study didn’t differentiate between MTHFR or non-MTHFR, or at different forms of folate intake. It simply compares two different doses of folic acid.

One group received about 1.1 mg of folic acid in their prenatal vitamins. The other group received the prenatal vitamin amount plus an additional 4 mg to bring the total to 5.1 mg, or 5100 mcg of folic acid.

What they found in this study, was that the RBC folate level, which is the functional folate, didn’t differ significantly between the two groups. The high-dose folate group did have higher serum levels of total folate, UMFA, and even 5-LMTHF. Other parameters didn’t differ significantly.

The researchers came to the conclusion that there was some kind of tissue saturation happening, where more folate just can’t get into the cells, which makes sense. They also suggest that higher UMFA concentrations in the women receiving the high-dose folic acid indicates that these doses are “supraphysiologic.” That is a fancy way of saying the dose is just too high.

So What is All that UMFA Doing In Pregnancy?

Another study, also published in the American Journal of Clinical Nutrition, studied UMFA levels in cord blood relative to autism spectrum disorder. Cord blood is the blood that remains in the placenta and the attached umbilical cord after delivery.

This study found that babies in the highest quartile of UMFA percentages in the cord blood had the highest risks for autism spectrum disorder. This effect was highest in black babies and significantly correlated with race. This correlation did not apply to the concentrations of 5-MTH or to serum total folate.

Another study, published in the Journal of Allergy and Clinical Immunology In Practice, looked at the association between UMFA levels and food sensitivity and food allergy. This study tested total folate, 5-MTHF, and UMFA levels at birth and again in early childhood.

The researchers found that of 1394 children tested, 507 were found to have food sensitivities and 78 had food allergies. In those children who developed food allergies, the average total folate concentrations at birth were lower and the UMFA levels at birth were higher. Higher UMFA levels later on in childhood didn’t seem to have this same association.

I will quote from the conclusion of this study. “Higher concentrations of UMFA at birth were associated with the development of food allergies, which may be due to increased exposure to synthetic folic acid in utero.”

What To Make Of This?

These are just a few studies and so we really can’t, as much as we might like to, draw sweeping conclusions from them, but it certainly gives us some compelling evidence that too much of what is supposed to be a good thing, can rapidly become a bad thing.

Because we, with MTHFR polymorphisms, are more susceptible to problems associated with folic acid, I think it is important to have an informed and complete conversation with your health care practitioners about the risks of folic acid supplementation in pregnancy for us specifically, and the viable, albeit less well-researched option of supplementing with 5-LMTHF instead.

Links to the research studies I’ve talked about in this podcast are supplied in the complete show notes at tohealthwiththat.com, so if you’re planning a visit to your OB/GYN or midwife, go armed with research to show them.

Thank you so much for listening today and please make sure you’re signed up for our email list – the email list will be the first to know about new courses, programs, and freebies for MTHFR folks.

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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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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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S2E2: Getting the Folic Acid Out of Your Diet.

I know it’s poor planning on my part to start this season off with the hardest part of this whole process, but sadly this is the only good way to start. If you skip this step, you can create mountains of problems for future you. Keeping folic acid in sounds good to so many people, but folic acid actually blocks the other, more useful forms of folate from being utilized. I talked a lot about the technical details in this post. This basically makes all the work you’re thinking about doing to add in natural food sources of folate or to take expensive 5-LMTHF supplements, worthless. All the money you spend on those things becomes wasted as well.

Let’s start with a bang.

Folic acid also hangs out in your bloodstream as unmetabolized folic acid, or UMFA which contributes to many health problems for MTHFR folks and non-MTHFR folks alike, including increased risk of many forms of cancer.

This is step one, and ignoring it is far, far easier than actually doing it, but you’ll regret it in the long run. Honestly, it won’t even serve you in the short term because eliminating folic acid from your diet can show you a lot about how you react to folates in general. It’s a huge part of this journey and skipping it isn’t a great option. I know it’s hard but stay with me.

Folate is vital to our functioning as humans and especially to the healthy making of babies, which is a pretty big deal. Folate deficiency during pregnancy leads to major preventable complications like cleft palate, spina bifida, anencephaly, heart defects, low birth weight, and stillbirth. Because it’s so important, many governments around the world have adopted programs to fortify commonly eaten foods with the synthetic form of folate, which is our nemesis, folic acid.

This public health measure has had a tremendous impact on the rate of these birth defects, which is wonderful. It just doesn’t take into account people with the MTHFR mutation, or a culture that generally over-eats and over-supplements the way we are prone to in North America.

As a caveat to public health in general, even for MTHFR folks some folate in the worst form, folic acid, is better than none at all. This measure makes sense for society. The problems start to happen when either there is too much folic acid, which is now very common, or when there are too many compromised copies of the MTHFR gene.

So this week, if you want to follow along with this MTHFR adventure, you are ditching all of the folate fortified foods and starting with a folic-acid-free diet. Nothing else should change. Just get the folic acid out of there. This includes supplements as well so if your multivitamin, B-complex, energy-booster, or meal-replacement has folic acid in it or says “folate” on the label, then it’s out. If you’re dropping supplements, try not to add anything back in right now unless it’s absolutely necessary – we’ll look for particular things in the weeks to come and there’s no sense rushing out to buy something you might be changing shortly.

In the US, there are two foods that are fortified with folic acid. Those are wheat and corn, which are pretty much the backbone of every American meal out there. This means your bread, pasta, tortillas, corn chips, baked goods, even the doughnuts have to go. Here’s a bit more about what to eat and what not to eat for MTHFR folks.

This is the moment when people’s eyes bulge menacingly and a tic starts in one of their eyelids. Typically, spittle flies out of their mouths when they say, “But, but, then what do I eat?”

Have no fear. There is actual food left, but you might have to look around a bit. First off, you can still have wheat products as long as they are certified organic. In order to earn organic certification, they have to be unadulterated. In terms of bread, finding an organic option, or a sprouted whole-grain option is probably the best one.

For pasta, there are not so many organic options, but lots of gluten-free options that are not fortified – look for any pasta that claims to be gluten-free, or rice pasta that is made of rice and therefore not fortified.

For the baked goods, you’re going to be in a bit of trouble. There are some gluten-free options but they’re pretty limited if you’re used to the smorgasbord of wheat-based options. Sorry about that. Even baking at home has to be different because wheat flour is mostly enriched. Some whole wheat flour is safe, but some still has added folate so read your labels.

I can see that tic under your eye intensifying, so let me just reassure you that there is also every meat, veggie, fruit, and nut option under the sun. It is really just your major sources of carbs that are taking a hit. I know, that reassurance is entirely too thin for anybody’s liking.

This is the hardest part of the whole thing, so stick with me – it’s all so much simpler from here. Just keep using the symptom tracker that you started last week to see if you notice anything from the folate elimination. People are often surprised to find that something as mundane as bread can be causing them so much mental and physical pain.

It’s a bit last-minute, but I’m just offering a course starting September 15th called Methylfolate masterclass to answer the #1 question I get, which is, “How do I know when I’m taking the right dose of 5-LMTHF?” If you’re interested you can find out more at tohealthwiththat.com but register now because the cart closes at 11:59 pm Monday the 13th.

Thanks so much for listening today and if any of you are brave enough to come back next week, we’ll lighten it all up with talk about some amazing high-folate foods that you can add in to your diet to give your body good sources of natural folate. It will be great! To everyone who didn’t throw their device out the window when I started talking about not eating wheat, thanks for hanging in there!

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S2E1: Preparing To Get Healthy With MTHFR

I know everyone wants me to say “Buy the first 5-LMTHF product you see and gobble it down,” but I just can’t do that to you because after you tried it, you would hate me forever. And with good reason – jumping into 5-LMTHF before you’re ready to do so can create a kind of nightmare scenario for your body in which you’ve suddenly got a resource that has been in short supply, but none of the supportive structures around that resource. So toxins are dumping left and right but can’t actually be eliminated, neurotransmitters are bobbing up and down like pole vaulters, and mood, energy, and sleep are desperately trying to keep up.  In short, starting that way isn’t pretty. 

The only real correlation I can make with the MTHFR journey is the process of pregnancy. You can try to rush it, but it’s going to work out badly 9 times out of 10. You’ve just got to go at the pace of the project and not get ahead of yourself.

This requires laying a good foundation even though that seems like the boring part. Believe me, in this case, we WANT to prevent fireworks. So this week, let’s talk about doing the prep-work at the very baby beginning of the MTHFR journey. This will require 3 things.

  1. A symptom tracker
  2. One heck of a pantry overhaul and some carbo-loading
  3. A talk with the family, significant others, and maybe your pet hamster.

A symptom tracker is key here, even if you aren’t a total data geek like I am.  The goal is to establish your baseline symptoms this week before you’ve made any big changes and while you’re finishing all of the folic-acid enriched food in your pantry.

Knowing which symptoms to track is half the battle.

For many of us MTHFR folks, folic acid enriched food and supplements contribute to the symptom picture and even just the act of taking those out of your diet (which will be next week’s project) will have a noticeable impact on your symptoms. At this point you want to get a feel for what symptoms might be caused by folic acid because that will make things so much easier down the road. Your future self will thank you.

So let’s do a quick rundown of how to use a symptom tracker. That is something you can start today.  First off, there is a free symptom tracker available for download at tohealthwiththat.com – just sign up for the email list and it’s yours along with a couple of other MTHFR-related freebies.  There are also loads of symptom tracking apps if you prefer the technological method. 

Make a list of all of the symptoms you notice on a daily basis, things like brain fog or fatigue, or whatever it is that is your normal. Also, the ones that show up every now and then, like maybe headaches or menstrual cramps. It doesn’t matter if you think they’re related to MTHFR or not, just add them to the list. Every day, rate each symptom on a scale from 0 – 10. If you’re not experiencing that symptom, it’s a zero. If it’s the worst it could possibly be, it’s a 10. What you’re trying to figure out is your “normal” state.

The goal is to be able to tell when you’re progressing or when a change has been worth it, and when it really hasn’t. Also, when adding something might be causing problems because that is really common for us. Responses to different supplements are incredibly varied with MTHFR and so it is important to keep track of what works for you because there isn’t any one-size-fits all.

What we want this week is to get a clear picture of where you are right now. This is because next week we’re going to make a BIG change. Next week, we’ll take all of the synthetic folic acid out of your diet and supplements. 

Taking synthetic folic acid out of your life has to happen with MTHFR.  There is really only one study done in this area, but it’s hugely compelling and essentially indicates that taking folic acid for people with the MTHFR mutation (or taking too much folic acid for everyone else) actually hinders the pathway it is supposed to help. So instead of converting into the active form of folate, which is 5-LMTHF, folic acid blocks up the conversion process and gets in the way of an already compromised enzyme pathway. The bottom line is that with an MTHFR polymorphism, taking folic acid will make your symptoms, and your functional folate deficiency, worse. 

This Vitamin Could Be Hurting YouAt high doses, folic acid is toxic.

This week, to prepare for that pretty major step, I want you to enjoy your bread and pasta. Wheat products are the most commonly fortified foods globally, and they’ve been fortified with folic acid as a public health measure to prevent birth defects. In that regard, it’s a highly successful program, it just isn’t the best program for MTHFR folks.  I do want to say, however, that if it is a choice between no folate at all and synthetic folic acid, then the synthetic folic acid wins. Some folate is better than none in a starvation situation even if it’s the worst possible form. Assuming that nobody listening to this podcast or reaading the blog post is in a starvation situation, it’s best to avoid folic acid as completely as possible.

If you want to learn more about this, go back to S1E9, This Vitamin Could Be Hurting You podcast episode, or the show notes including research, here.

When you’re shopping for next week, if you want bread it’s going to have to be either gluten-free, which doesn’t have wheat and is therefore generally not fortified, or organic whole wheat, which is also typically not fortified, but check your labels. If it says folic acid or folate anywhere on the label, then it has aded folic acid and you should exclude it.

In good news, the gluten free and organic options have come a long way and there are many more of them. In bad news, the US recently extended their fortification program to include corn products as well, so check all of your labels including those on things like corn chips and tortillas. Also, double check the regulations in your own country. In most places, wheat is the most commonly fortified food, but there could be others as well. 

It is truly important to get the folic acid out of your diet as completely as possible because for many people, it’s actually causing symptoms. This could include depression, anxiety, inflammatory conditions like pain or overarching issues like fatigue or insomnia.

Also, check your vitamins, supplements, energy bars, meal replacement powders, energy drinks, birth control pills, and prescriptions.  If your doctor has given you a prescription that includes folic acid it is important to talk with them before making any changes and find an alternative that will work better for you.  Especially if you are on an antifolate agent such as methotrexate.

Remember, you’re not actually starting the folic acid elimination this week – you’re just doing the prep work. Clear out the pantry, finish your bread and pasta so it isn’t wasted, check your vitamins, supplements, and prescriptions and talk with any practitioners or doctors to make sure everything is smooth and ready for the transition. I don’t know if anybody remembers the movie Office Space, but what we’re doing here is Planning to Plan.

If you’re looking for a free resource about foods commonly fortified with folic acid, there is one in the MTHFR Library in Genetic Rockstars, our MTHFR community. It also has some ideas for MTHFR-safe substitutions.

The third thing that is probably a good idea this week, is talking to the people close to you. This is a process and you may need some support through it. You may also need to tell people why your favorite brunch place is off the menu for a while, because avoiding wheat products is super strange at first and culturally it’s a big committment. We make everything out of wheat, so this is the hardest change you’ll have to make on this entire journey.

I’m glad I warmed this season up with the hardest thing I’ll be asking you to do. That is great marketing on my part. If any of you stay with me, next week we’ll actually start taking the folic acid out of your life. After that, I should have eliminated my audience completely. Thank you so much for listening and I really hope you stick around for all of this.

I have a plan to get healthy with MTHFR, I promise.
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