Question: Can anyone speak definitively on whether a homozygous MTHFR gene mutation can be managed by diet alone, diet + juicing greens, diet + greens powder? Does this mutation in its homozygous form require the fancy supplement? In other words, can it be managed with nature?
The story in my head is that this mutation is teaching us to become obligate foliage eaters again, encouraging us to bring the green back to our planet (therefore oxygen), and take it easy on the critters. I can’t help but think cosmically about these gene morphology changes. I’d just love it if I could create a wellness plan that fits into my ideologic little fairy tale world, but only if effective.
Answer: No. MTHFR homozygous mutations cannot be managed by diet alone.
Most foods contain folinic acid while the supplement ideally used for MTHFR is methylated folate as 5-MTHF.
“As complex as this vitamin is in its structure, it is equally as complicated in its interaction with the human body. For example, most foods do not contain folic acid in the exact form described above, and enzymes inside the intestine have to chemically alter food forms of folate in order for this vitamin to be absorbed. Even when the body is operating at full efficiency, only about 50% of ingested food folate can be absorbed.”
Even Women’s Health.gov agrees:
“Can I get enough folic acid through food alone?
The body does not use the natural form of folic acid (folate) as easily as the manmade form. We cannot be sure that eating foods that contain folate would have the same benefits as consuming folic acid. Also, even if you eat a healthy, well-balanced diet, you might not get all the nutrients you need every day from food alone. In the United States, most women who eat foods enriched with folic acid are still not getting all that they need. That’s why it’s important to take a vitamin with folic acid every day.” 
Food typically does not have the methylated folate.
Those with hetero and homozygous MTHFR do have some enzymatic function left which is great; however, the amount of greens one must eat would likely be a lot – and that is difficult for a patient on planet Earth.
In a perfect world with a perfect patient – possibly yes – but given the fast-paced stressful and environmentally toxic planet we live on – no.
Be an interesting study.
One must also look at homozygous mutations from a methylation problem as well which leads to increased toxicity.
This requires detoxification protocols – sauna, peat baths, epsom salt baths, coffee enemas, athletics (sweating) and nutrients –
I regret to say also that all the prescription forms of active folate contain a ton of garbage.
I agree I am quite strict on purity given my passion for environmental medicine – but I am also of the camp of why do pills have to contain ingredients which pose absolutely no benefit to the patient and may even cause harm?
On MTHFR.net, I have an article that has a table with all the ingredients of the most popular forms of prescription meds for MTHFR.
I do recommend the use of the Methylation Profile by Doctor’s Data as it measures s-adenosylhomocysteine vs homocysteine. S-adenosylhomocysteine is a more sensitive marker than homocysteine which may explain why some cardiovascular studies say that lowering homocysteine has no benefit.
My point is this – and my soap box is as well –
If we have the tools to reduce miscarriages, autism, bipolar, cardiovascular issues and cancer – then – as naturopathic physicians – we need to use them – and we do which is awesome.
MTHFR is yet another tool.
I know some of you think I’m over doing it here but I am hearing horrific MTHFR stories every day and most of my day. They pour in. 4 miscarriages in a row, depressed entire life and without work, 4 year old son having a stroke, autistic child, severely chemically sensitive – and most of these patients hear is: “you are heterozygous MTHFR – there is no issue.”
I am also frustrated by the fact that the paternal genetics are not evaluated as often as they should be during prenatal screening – if some docs are doing that – my hat is off and I am greatly thankful.
If we step up to the plate and bat .500 here, we can inform the public about MTHFR, how to handle it and empower them with information so they can control their genetic expression.
It is not about fear – it is about empowerment.
So – in short – I think with the perfect patient in a perfect environment – perhaps homozygous MTHFR may be controlled by diet. Given the massive use of antacids, stress, toxins, chemicals and depleted soils – I don’t think we can in the general population.