It’s so easy to jump to the idea that it’s all about folate with MTHFR issues, because let’s face it. The enzyme deals with activating folate. Of course, folate is the point. I will concede to the logic of that argument, but clinically, so many factors go into a healthy methylation cycle that starting with folate is kind of like building the roof of the house before you dig the foundation.

You’ll remember from this post how vital the other B vitamins are to the whole process, appearing many more times in the chemical chain of events than folate or B12 do.

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

Clearly, all the B family of vitamins need to be supplemented, before you even think about adding a supplemental form of folate (but hopefully, after you have eliminated the toxic folic acid from your diet and tried enhancing natural food sources of folate if you’re following our Start Here Guide to MTHFR.) If you aren’t sure about getting started with B vitamins, there’s a whole post about them here.

What to take before folate for MTHFR
What to take before folate for MTHFR

Is It All About The B’s Then?

The Bs are crucial, but other things matter too because this pathway is complex and connected to some of our most vital bodily functions, therefore, it needs diverse nutrition. So if you’re wondering what else to take for MTHFR besides folate, it’s a mixed bag.


Choline is an essential nutrient – we can make some, but not enough to meet our daily needs (estimated to be about 550 mg per day). It is also intimately tied to folate status and MTHFR. Choline in our bodies is used to make a variety of substances like acetylcholine, phosphatidylcholine, betaine, and sphingomyelin. These are important for:

  • Muscle function
  • Brain function
  • Membrane integrity
  • Cellular signaling
  • Methyl donor (just like SAMe)
  • Fat transport and metabolism

Here’s a great summary article on the health properties of choline. Choline isn’t necessary for all people to supplement, but it’s a good idea to take a look at your diet and symptoms to see if you might need more. The foods highest in choline, like liver and eggs, are animal products, so vegetarians might be at higher risk for deficiency. Deficiency symptoms are rare, but the most notable is non-alcoholic fatty liver disease, which is also common for MTHFR folks.

What else to take for MTHFR (besides folate)? Try choline.
What else to take for MTHFR (besides folate)? Try choline.

Choline function is linked to folate status, especially in MTHFR folks so if you’re having fatty liver issues or if you’ve hit a road block and haven’t tried choline, it could be a good step.


Magnesium is one of the most important nutrients in terms of body functioning and is involved in about 80% of all metabolic processes. Every enzyme that uses or makes ATP (your cells energy source) is magnesium-dependent, and ATP itself is usually bonded to magnesium in something called a chelate. So basically, without magnesium, the wheels come off the cart, fast. Plus, most adults are magnesium deficient – an estimated 60%.

What else to take for MTHFR - try magnesium.
Boosting your magnesium is not as much about being healthy with MTHFR as it is about being healthy.

Boosting magnesium is less about being healthy with MTHFR, and more about just being healthy. Magnesium status is linked to diseases like:

Magnesium is also great for physical and mental relaxation and sleep, and in my humble opinion should be taken by pretty much every human, ever.

If you want to take anything else for MTHFR, try magnesium as well
If you want to take anything else for MTHFR, try magnesium as well


Zinc is another nutrient that is tied up with MTHFR. Zinc isn’t a cofactor of the MTHFR enzyme, but zinc deficiency interferes with dietary folate absorption. This means, if you’re stuck somewhere in your MTHFR journey and can’t find a way to move forward, zinc might be your answer. Zinc is especially important if you’re working on fertility because it is highly involved in the formation of healthy sperm and ovum, hormone regulation, and the growth and development of healthy babies.

In vivo and in vitro studies have shown that zinc deficiency decreases the absorption and metabolism of dietary folate.”

I.M.W. Ebisch, C.M.G. Thomas, W.H.M. Peters, D.D.M. Braat, R.P.M. Steegers-Theunissen, The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility, Human Reproduction Update, Volume 13, Issue 2, March/April 2007, Pages 163–174,

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