Checking In With Progress On The MTHFR Journey

Let’s check in with what is going on so far. If you’ve been following the process this season, you will have noticed that I haven’t really addressed what we’re doing in a while, so let’s touch base.

There are some reasonably long stretches in the MTHFR journey in which we aren’t really changing things, doses are just staying the same, and it might seem like not much is happening. The reality, in fact, is that lots of things are happening in your body but none of it needs additional input from you.

This phase of the journey is what I like to call “Burning Through The Backlog.” When you first start diet changes and methyl folate or SAMe or whatever workaround you’re using, you see the immediate activation of the methyl cycle and some immediate health changes. Usually, that feels like a better mood, less anxiety, etc… After that initial balancing phase, the progress slows down but it isn’t because your body has stopped doing things.

This part of the process involves unpacking your body’s to-do list. All of the things it couldn’t do in the past because methylation just wasn’t happening fast enough. It’s a time of more subtle change where neurotransmitters are slowly coming into balance, toxins are slowly being eliminated, inflammation is slowly decreasing and oxidative stress is balancing out. Even your hormones and energy levels are being influenced in this process

How To Make Sure You’re Burning Through The Backlog Efficiently – Check Your Basics

In this phase, it’s easy to forget some of the basics so the first thing I want you to do this week is to take a look at things you should be doing and tighten up where needed.

  • Folic Acid – Make sure folic acid is out of your diet and supplements and isn’t creeping back in without you noticing.
  • Balanced Diet With Natural Folates – Get lots of fruits and veggies, as much fiber as you can pack in, moderate protein, and plenty of good food sources of natural folate like lentils, black beans, spinach, asparagus, dark green leafies, avocados, marmite, and any kind of bean or pea you feel like eating.
  • Multivitamin – Keep up with the background of other B vitamins – this is usually in the form of a good basic multivitamin. All of the processes that are happening now, from neurotransmitter formation to detoxification, to energy production, to balancing your oxidative stress and reducing inflammation needs a good solid basis of all the B vitamins.
  • Sleep and Rest – I really enjoy the paradox presented by this particular issue. Most of my clients say they would love more sleep and rest, but it’s always the hardset possible thing to actually accomplish. Just keep trying to work actual sleep and actual rest into your schedule.
  • Moderate Exercise – because generally, MTHFR folks do best with regular exercise, but not extreme exercise. Ironically, there are lots of us who are professional athletes and serious competitive athletes, but for those people it’s important to make sure methylation is balanced and to compensate adequately for the extra damage being done to their bodies.
  • Detox Support – since detoxification is such a huge part of Burning Through The Backlog, it’s important to give your body the support it needs. This can be in the form of gentle detox teas, castor oil topically, sweating it out, extra dietary fiber, or some mish-mash of all of these things. We’ve done posts on detox support before as well.

Burning Through The Backlog Efficiently – Optimizing Your Dose Of Methylation Drivers

The supplement or supplements you’re taking that specifically support methylation should be dose-checked occasionally. Maybe quarterly in this whole process. This could include any one of the following supplements:

  • 5-LMTHF or another form of methylated folate
  • Folinic Acid
  • SAMe

These supplements are all pushing the methylation cycle forward and so may need an occasional check-in to see if you’re still on the right dose. Usually, this means trying to increase your dose to see how you feel.

Generally, in this process, you increase by the smallest increment you can and make sure you’re using your symptom tracker for a couple of weeks before and after so you can see if there are small changes that you might not notice otherwise. If you feel fine with the higher dose, that’s great. Keep using the higher dose unless you start to get symptoms that indicate that your dose is too high. If you get symptoms right away or within the first two weeks then go back to your original dose.

Symptoms That Your Dose Is Too High

Typically too high a dose of anything that drives methylation feels hyper-caffeinated. It’s anxious, restless, can’t settle down, fidgetty, has a racing heart, or feels like all-out panic. If you’re noticing any of that – even if it’s a small change, then your balance will be better with a slightly smaller dose.

What About Other Supplement Routines?

For some people, taking supplements that take an alternate route through the methylation pathway, rather than methylation drivers, is the best path forward. Especially if you’re starting out from a kind of messy health place. These are supplements like methionine or choline. Methionine just gives you more of the raw ingredients to make SAMe and choline cuts through the middle of the methylation cycle as a viable short-term work around. These are great band-aids, but probably not the thing you want to be relying on for the long-term. If you are looking for long-term solutions but really can’t manage any of the true methylation drivers – methylfolate, SAMe, or folinic acid – then choline is the better of these two options. You still need the other B vitamins, and as much natural dietary folate as you can manage.

Moving forward, it’s a good idea to check in with your body quarterly to see if your dose is sufficient or if you’re getting enough for your body’s needs right now. Your dose will always be somewhat dynamic. Eventually, you will actually catch up with all of the things on your body’s internal to-do list and need a far lower dose, so watch for those anxious/hyper symptoms and keep it on your radar that your best dose might need to decrease too.

Thank you so much for listening today and give some thought to joining us in Genetic Rockstars – the MTHFR community. This month we’re talking about some of the links between MTHFR and histamine, and it’s a great way to meet people who understand what you’re going through and who have great information to share.

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S2E11: Starting 5-LMTHF or SAMe with MTHFR

This is it! The big methylfolate start. You’ve got all of your preliminaries done – folic acid is out of your diet, or at least 80% out. It’s out of your supplements too (100% please!) You’ve ramped up the natural folate from food sources and you’re tracking those symptoms. You’ve even got a good background of other B vitamins on board. Now…. drumroll please… the moment you’ve been waiting for.

Starting 5-LMTHF or SAMe.

I know, I know. No other vitamin gets this sort of wind up so let’s talk about it.

First off, I do want everyone to start with a small dose of 5-LMTHF, but if you hit a dealbreaker scenario then it could be a good idea to switch to SAMe instead. If that happens, it’s best to treat SAMe the same way you would 5-LMTHF because it can cause a lot of the same symptoms if the dose is wrong, so follow this same process there as well. So let’s talk about the different things that can happen in a methylfolate (or SAMe) start.

5-LMTHF Dealbreaker Scenarios.

There are two scenarios that mean you are probably not going to tolerate 5-LMTHF, and so it’s important to know what to watch out for.

  1. Your tiny starter dose is too much already. This is a thing that happens. You start out with a tiny baby dose of 5-LMTHF and right out of the gate you’re starting to feel crazy-pants. Wired, wound-up, uncomfortable, restless, hyper, anxious, irritable. These are all words that I’ve heard (or experienced) to describe the this-dose-is-too-much feeling. Also it can be physical symptoms like heart palpitations, racing heart, flushed skin, hot feeling, prickly or itchy feeling, or difficulty sleeping. This usually means that even this tiny baby starter dose is pushing your body too fast. Now. I do want you to be honest. If your tiny baby starter dose was 1000 mcg, then re-assess your idea of a starter dose. If it really was a small dose – like 200 mcg or less – then you might just not be able to tolerate the 5-LMTHF. For some people in this category, even small amounts of natural folate in foods push them over the edge. If this is you, stop the methylfolate and wait a few weeks. We’ll talk about what options there are for non-tolerators, I promise.
  2. Methylfolate makes you fall into the darkest, blackest, pit of despair possible. This happens very rarely, but it certainly happens. This happens to a small segment of the population whose serotonin levels are perilously low to begin with and adding folate of any kind drops the bottom out of this neurotransmitter pathway. It’s interesting because folate actually increases serotonin production, which sounds like it should make a positive impact, but it also up-regulates something called SERT even more, SERT is a selective serotonin reuptake transporter that helps to clear serotonin out of your synapses and pulls it back into the releasing neuron. When SERT is unregulated the serotonin you have becomes less effective because your body doesn’t get very much time to enjoy it before it’s gathered up. If your serotonin is extremely low then this can push you over the edge and make it just not worth it to take folate. We talked about this in Season One Episode 12 (Methylfolate Makes me Feel Bad) and that one is a good review of the serotonin situation.

If you happen to hit one of these dealbreaker scenarios, then we’re going to stop methylfolate and look to an alternative. The alternative could be folinic acid or SAMe or something else – stay tuned for more on this topic in a few weeks. Until then, just hang tight with other B vitamins, no folic acid, food sources of natural folate as much as you can tolerate and healthy lifestyle choices.

5-LMTHF Start Expectations

Most people who start 5-LMTHF won’t hit anything like a dealbreaker scenario. Those happen to a tiny minority of people – especially when you’ve done all of the groundwork properly. But even when things go right, stariting methylfolate can feel weird.

When I first started the things I noticed were nothing like what I was expecting. I felt a bit buzzy in a pleasant way, my vision seemed brighter, and my head felt strange. Like my physical head, not my brain or mind. I have no idea why my head felt strange, but in good news all of those feelings wore off after about three days. Here are some other things that I’ve heard from folks just starting methylfolate:

  • Don’t notice anything at all – I feel totally normal.
  • Ringing in ears
  • More talkative
  • A bit grumpy or moody
  • Sweat more
  • Dreams are more vivid
  • I feel amazing.

Let’s face it – we’re moving around some big internal chess pieces, so a few minor changes can be totally normal and for most people they go away quickly. By far, the biggest group either feels nothing, or feels great.

There is another group who feels great at first and then a couple of weeks down the road starts feeling like they’re taking too much. Like they’re feeling speedy or buzzy or anxious in an unpleasant way. This is really normal too.

What Can I do To Make This Easier?

Honestly, I am erring on the side of overly cautious so most of you will start 5-LMTHF and wonder what all the fuss was about. That is completely ok. I would rather you were over prepared than underprepared. Also, it is likely that as you’re working through the MTHFR process, there will be some point at which you take too high a dose of 5-LMTHF. Since you’re prepared, you will know what is going on and not freak out. At least, that’s the goal.

Having said that, if you tend to be sensitive to supplements or if you just want to give your body the best start you can, then make sure you are doing some of the basics.

  • Drink plenty of water and add some lemon juice or a pinch of sea salt for optimal hydration.
  • Sleep more. Sleep helps everything.
  • Don’t overstuff your schedule during this time – take it a bit easy if you can.

What Can I Do If I Take Too High a Dose of 5-LMTHF?

During this whole process of working with your MTHFR, it is really normal to have feelings of too high a dose at least once (if not a number of times.) It isn’t a problem, as far as we know you aren’t actually doing any harm to your system. What it is, is great information. Your body is telling you something and all you have to do is listen. This is your signal that the dose is a little too high and you could decrease it. Here are some ways to manage this:

  1. Decrease your dose – Decreasing your dose can mean finding a lower dose supplement, or finding some kind of alternate schedule like one day on, one day off. Even one day on, two days off. It just depends on how your body responds.
  2. Stop your dose entirely – if your symptoms are extreme, then this is the best course of action. Just stop, take some other steps to help your body calm down, and re-assess after a couple of weeks.
  3. Exercise – if you’re in the middle of symptoms of too-high a dose, exercising can help your body to use up some of those methyl groups and get you through the strange symptoms faster.
  4. Niacin – 50 mg of niacin in the straight “niacin” form helps to eat up those excess methyl groups as well and can help to relieve symptoms. The only problem is that it can cause a flushing reaction, which feels like a hot flash complete with red face, itchy or prickly skin, sweating, and generally feeling super weird. It doesn’t last long, but it’s very vivid. You can re-dose after an hour, but don’t do this more than 3 times total in a day and watch your blood pressure because niacin can really lower it.

In any event, this week is the week we start. Make sure 5-LMTHF is the only thing you change right now and that you’re starting with a LOW dose – 200 mcg or less. Also, keep symptom tracking and make note of anything new that pops up. This should be the only change you make for at least two weeks but four is better, just to give your body time to get used to this new thing and to tell you if the dose becomes too much. Remember that symptoms can pop up after a week or even two of being on the same dose, so don’t make any sudden moves.

Thanks so much for being here and for doing this process with me.

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