Folic Acid Awareness Week 2014: Want Awareness? Here You Go

Optimizing the health of unborn children is my passion.

I am pleased to state that January is named National Birth Defects Prevention Month by the National Birth Defects Prevention Network and the CDC. This month is broken down into four parts with each part focusing on a key component of birth defect prevention.

While I should be completely supportive of this fantastic cause, I am not. In fact, I am totally and utterly against one of their causes blended in with reducing birth defects.

Why?

Because it has to do with folic acid. My arch enemy. And it is also the arch enemy of unborn children – and children in general.

Folic Acid Awareness Week extends from January 5 – 11. Happily, I am extending the Folic Acid Awareness cause for years to come – only my cause is to establish folic acid as an anti-nutrient which is causing significant harm.

Yes, there are countless research papers out there which show that folic acid reduces neural tube defects. This is true. According to the Harvard Medical School:

In countries that require folic acid fortification, including the United States and Canada, the rate of neural tube defects has fallen by 25% to 50%. 

What these papers and institutions don’t tell you is what folic acid does to people who have difficulties turning synthetic folic acid into usable forms of folate.

After all, folic acid has no use biochemically in the body until it is converted into these other forms of folate such as:

  • Tetrahydrofolate (THF)
  • 5-formyltetrahydrofolate (Folinic acid)
  • 5-10-methylenetetrahydrofolate
  • 5-methyltetrahydrofolate (Methylfolate)

Let’s view how folic acid is changed into usable forms of folate by the body:

folic-acid-metabolism

That appears to be a lot of work right?

It is.

And this is a very simplified outline of what it takes to convert folic acid into usable forms.

Imagine a mother – or child – or father – who has a problem in any one of these genes.

Then add on a potential deficiency of vitamin B12 (which is fairly common and often goes undiagnosed for years).

What happens is far from good.

You see the ‘Folic Acid’ moving to ‘DHF’ in the diagram above? Note how it states this is a ‘slow’ process?

Now note the dashed black arrow moving from ‘Folic Acid’ to ‘UMFA’

What is ‘UMFA’?

UMFA is the sound your body makes when you ingest too much folic acid. ‘Ummph’ It hurts.

Truly? UMFA = unmetabolized folic acid

What does that mean?

It means folic acid didn’t get processed by the body into usable forms of folate so your blood just has this synthetic nutrient floating around in it.

Is that ok?

According to researchers Obeid and Hermann:

Evidence of a negative health effect of free folic acid (FA) in blood is not consistent and suggests rather artificial factors. FA has no known cofactor function that would increase the likelihood of a causal role for free FA in disease development.

This means that since folic acid is totally synthetic, it doesn’t do anything to the body’s enzymes thereby rendering it harmless.

Let’s look at a compound which is a known killer: Carbon Monoxide.

How does carbon monoxide kill? Carbon monoxide kills because it preferentially binds to your hemoglobin 210 times stronger than oxygen which means your hemoglobin cannot bind oxygen well in the presence of carbon monoxide. The higher the levels of carbon monoxide, the less oxygen is bound to your hemoglobin causing decreased oxygenation and cell death.

Does folic acid do the same thing?

Yes, if you examine how folic acid binds to folate binding proteins (these carry folate around your body, the developing baby and breast milk) and folate receptors (these pull folate inside the cell and out of the blood) in the human body. Folic acid binds preferentially to folate binding proteins and folate receptors. This means that the folate binding proteins and folate receptors in your body, which are intended to bind methylfolate or folinic acid, are more likely to bind to synthetic folic acid.

The Annual Review of Nutrition published an article in 1990 states, “A major class, the high-affinity folate-binding proteins, show a preferential and tight binding of folic acid relative to reduced folates . . . Soluble forms of the high-affinity binders are present in serum and [breast]milk. [Folate binding proteins] serve to accumulate and stabilize reduced-folate compounds in milk and they may also facilitate the absorption of folates by the intestinal mucosa of neonates.”

If high-affinity folate binding proteins are bound to synthetic and inactive folic acid, what benefit is there to the developing baby? In fact, it would make sense that harm would occur as reduced folates are needed for DNA production, balance methylation and support neurological development.

How can reduced folates get into the intestinal mucosa of the baby if they are not bound to the folate binding proteins? Are we setting up our new generation with weakened intestinal linings? Food allergies are definitely on the rise.

Autism is definitely on the rise and we all know those with autism have significant gut issues.

We know that synthetic folic acid reduces the incidence of neural tube defects. What about if we used methylfolate instead? Can methylfolate reduce the incidence of neural tube defects?

Individuals show wide variations in their ability to reduce folic acid (FA). Carriers of certain polymorphisms in genes related to folate metabolism or absorption can better benefit from 5-methylTHF instead of FA. 5-MethylTHF [also known as (6S)-5-methylTHF] is the predominant natural form that is readily available for transport and metabolism. In contrast to FA, 5-methylTHF has no tolerable upper intake level and does not mask vitamin B12 deficiency. Supplementation of the natural form, 5-methylTHF, is a better alternative to supplementation of FA, especially in countries not applying a fortification program. Supplemental 5-methylTHF can effectively improve folate biomarkers in young women in early pregnancy in order to prevent NTDs.

For a moment, let’s move away from how folic acid in utero and see how folic acid affects breast milk.

When looking at how breast milk is affected by synthetic folic acid, one cringes.

“…recent evidence suggests that the somewhat higher affinity of folate binding protein for folic acid than for reduced forms may also decrease the bioavailability of milk folate. . . The markedly lower concentration of milk folate binding proteins compared with prefortification reports along with detectable appearance of unmetabolized folic acid in the milk of even unsupplemented mothers emphasizes the ongoing need to evaluate the potential benefits and risks of long-term consumption of folic acid-fortified foods.”

This means that synthetic folic acid reduces the production of folate binding protein. If folate binding proteins are reduced, then the reduced folates are not getting delivered to the breast fed baby. If the baby is not getting adequate reduced folates, then their methylation and DNA production is negatively affected.

Again, autism is on the rise and so are food allergies – not to mention other neurological disorders and mental/emotional issues. Tough to have a healthy baby with decreased amounts of beneficial folate in their body.

Let’s look at a paper which evaluates how effective folic acid is compared to methylfolate at increasing plasma folate levels. After all, we are looking to increase plasma folate levels in order to reduce birth defects right? There is a plethora of research which associates higher plasma folate levels to decreased rates of birth defects. So let’s look at these two side by side.

The British Journal of Pharmacology published a paper in 2009 entitled, “[6S]-5-methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wild-type 677C–>T polymorphism of methylenetetrahydrofolate reductase.”

plasma-folate2

Need I say more?

I’m going to – and I need to.

Note that the researchers only measured ‘plasma folate’. They did not measure intracellular folate. This is important. Can you think of why? Remember that synthetic folic acid binds to folate binding proteins and folate receptors on the cell preferentially over reduced folates like folinic acid and methylfolate?

If this is the case, then we should actually see a decrease in intracellular folate levels in the presence of synthetic folic acid, right?

We do.

Folic acid supplementation does not reduce intracellular concentrations of homocysteine or any of its closely related substances. Rather, folic acid may disturb physiological regulation of intracellular one carbon metabolism [methylation] by interfering with SAM’s inhibitory effect on MTHFR activity. — Smith et al., Clinical Chemistry and Laboratory Medicine, Aug 2013

That’s bad.

Doctors every day are tricked into thinking their patient’s homocysteine levels are reducing. But what are they checking? They are only checking the blood levels of homocysteine – not intracellular levels nor are they measuring methylation status.

If we want to reduce the incidence of birth defects and optimize the health of unborn children, we need to support one carbon metabolism (aka methylation) in future parents prior to pregnancy. In fact, we really shouldn’t be limiting our attention to folate levels at all – we need to be focused on the bigger picture of what folate actually does – and that is regulate methylation.

Finnell et al say it best: “The effect of one-carbon metabolism on normal neural tube closure extends far beyond just folic acid.”

Then they throw down the gauntlet:

During early embyrogenesis, DNA methylation, which is the chief regulator of gene expression, is epigenetically programmed. Furthermore, it has been well established that methylation of DNA can be influenced by dietary contributions of methyl donors such as choline, folate, and methionine. Any suboptimal methyl-donor supply could alter DNA methylation and provide a ready explanation for a possible mechanism contributing to increase birth defect risk.

Finnell et al. published this in 2010.

It is now 2014.

With the information era exploding with countless ways to access research like this, why aren’t groups like National Birth Defects Prevention Network and the CDC accessing it? I mean, aren’t they wanting to reduce birth defects?

Things evolve.

Folic acid is old hat, out-dated, worn out and needs to go away. And now.

National associations and physicians need to engage, access current research, digest it and implement it.

Lab Testing Your Folate Levels: UMFA, Methylfolate and Others

Some laboratory testing companies are cutting edge and offering UMFA lab testing along with reduced folate testing. Genova is one lab and another is Health Diagnostics. Your doctor can open an account with one or both of these labs and begin identifying your folate levels properly. If you don’t have a doctor or they cannot order it for you for various reasons, you may order the UMFA Test here and the Methylation Profile Test

Here is what the UMFA Lab Result looks like. Note that they show both UMFA and Methylfolate levels.

UMFA-lab

What to do? Action Steps

  1. Throw out all folic acid enriched foods. These are processed foods such as cereals, breads, pastas, energy bars, drinks, snacks.
  2. Throw out all folic acid containing supplements.
  3. Eat folate rich foods. Note that when I state folate, I mean naturally-occurring folates such as dihydrofolate, folinic acid and methylfolate.
    • uncooked leafy greens (more you cook greens, the more folate gets destroyed)
    • beef liver (organic, free range)
    • various beans such as lentils, pinto, garbanzo, black, navy, kidney and lima.
  4. Opt for supplements containing active folates. Many quality supplement companies are moving in this direction. Seeking Health, Pure Encapsulations, Thorne Research, Xymogen are a few.
  5. Test your methylation pathway with your physician and see which forms of folate you are low or high in – then correct it.
  6. Test your genetics and see where you may have blocks in your folate pathway. Knowing this is useful as you can be proactive in bypassing these blocks with various nutrients, avoiding various medications and increasing certain foods.
  7. After you test your genetics via 23andMe, then run your raw data through something like MTHFR Support.

I encourage you, as an individual looking to optimize your health and possibly your future child’s, to inform your physician, friends and loved ones about the dangers of folic acid – and the benefits of reduced folate such as methylfolate.

If you are a physician or health professional, join me this March, and learn more about how to effectively balance methylation in your patient.

If you are not a health professional, inform your doctor to attend. If they cannot attend, I will be recording it and publishing it online.

After all, my passion is to reduce the incidence of disease of unborn children – and I will do this one physician and one person at a time.

Your assistance in speeding this up is appreciated.

Thank you

Dr Lynch

PS – Throw away your folic acid enriched foods and supplements. Today. That is your way to celebrate Folic Acid Awareness Week 2014. Spread the word.

PPS – Read how folic acid fortification may be associated with increased rates of autism.

PPS – Learn about prenatal supplementation

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41 Responses to “Folic Acid Awareness Week 2014: Want Awareness? Here You Go”

  1. Jennifer January 8, 2014 at 8:46 am # Reply

    Dr. Lynch,

    You have no idea how long I’ve waited for this type of explanation. However, I need more help understanding our situation. I would be so appreciative if you email me so I can explain to see if there is anything I can do to correct the situation.

    Thanks!
    Jennifer

  2. Dawn January 8, 2014 at 2:00 pm # Reply

    Dr. Lynch, YOU ROCK. That’s all I can say about this post. :)

  3. Christine January 8, 2014 at 2:49 pm # Reply

    What happens to the folic acid that is floating around in the blood? Thank you for all you do Dr. Lynch.

    • Dr Lynch January 8, 2014 at 7:11 pm # Reply

      Hi Christine –

      The folic acid which ‘floats’ around eventually breaks down into reduced folates but it takes time and is dependent upon other nutrients being available and the folate reducing enzymes functioning as they should be.

      Folates are also stored in the liver. At any one time, we have anywhere from 30 to 50 mg of folate stored in our liver. Ensuring that your liver function is good is important and making sure you are moving bile out of your gall bladder is also important.

      According to one paper, “radiolabeled folic acid to a single female subject and observed substantial catabolism and fecal excretion in folate turnover with an apparent half-life (t1/2) of ∼100 days for the primary folate pool.”

      The issue is while the folic acid is floating around, it is also binding to folate binding proteins and folate receptors thereby reducing the binding of active folates.

  4. Michelle Kennedy January 8, 2014 at 8:15 pm # Reply

    Dr. Lynch,

    THANK YOU! I feel tremendously blessed that I found your website as it has provided me with so much information. Information which I plan to share with my OB/GYN this month at my yearly exam. See, last December (2012) I suffered an early miscarriage in which my doc suspected a MTHFR gene mutation. She was right on the money as my results in Jan. 2013 revealed that I was heterozygous for C677T and A1298C (my paternal grandmother was homozygous for C677T). I had a healthy pregnancy and baby girl in Jan. 2010 and have been unsuccessful at pregnancy since. My husband and I keep trying, although for not much longer as I am turning 35 and he is 36.

    My main concern/question is, what prenatal supplements should I take? I saw on your website a whole list of supplements and vitamins to take to support those with the MTHFR mutation, but I just don’t see myself taking all of them. Aside from a miscarriage, I don’t believe I suffer from any other symptoms of MTHFR. Your guidance would be greatly appreciated!

    Thank you,

    Michelle

    • Dr Lynch January 8, 2014 at 9:06 pm # Reply

      Hi Michelle –

      It depends on what your doc recommends for you.

      The basics for prenatal supplementation are:
      – prenatal vitamin
      – probiotic
      – essential fatty acids of some sort – krill and/or fish oil
      – vitamin D

      Those are the key nutrients.

      This article discusses some prenatal supplementation – ones that I formulated – and recommend.

      Do note that the man also has to take prenatal supplements as well prior to conception. It is not all about the woman’s health – research is showing men’s health matters as well.

      My best to you both.

  5. Sara Smith January 8, 2014 at 9:14 pm # Reply

    How does folinic acid and inability to tolerate it fit into all of this?

    I assume it will also be floating around in the blood unable to be used and blocking receptors.

  6. Ophelia January 8, 2014 at 10:52 pm # Reply

    All this genetic testing targets people who ONLY under-methylate, NONE of this is meant for people who over-methylate. I am one of the very few who do not have either main snp (1298 or 677), therefore, I cannot take anything with a methyl donor or it sets off a chain reaction of pure anxiety. I can only take folic acid because it helps to clear out all the extra fee floating methyls.

    Please do proper research next time, because this type of article will give some people the wrong impression.

    • Dr Lynch January 9, 2014 at 8:59 pm # Reply

      Ophelia –

      That is not true. The lab report which offers measuring various forms of folate, SAM/SAH and more helps identify if one is over supporting their methylation cycle – especially if homocysteine is added. Before accusing someone, be sure to evaluate the article more fully. Also – there is only so much one can put into an article. This article is about folic acid – it is not about overmethylation. However, if the lab is ordered as recommended, then overmethylation may be spotted by a skilled physician.

      Folic acid is not what one should take to clear out extra methyls. No one should take folic acid. Period. If you are concerned about overmethylation – then take less folate in general and support with niacin. This article goes into some detail on methylfolate side effects.

  7. Karen January 8, 2014 at 11:27 pm # Reply

    I would like to thank you for sharing your research and findings. I wish more doctors were familiar with mthfr gene mutations. I was recently diagnosed heterozygous for A1298C mutation. I’ve been suffering from many health problems since the birth of my daughter 16 years ago. It started with severe gall bladder, liver, and pancreas infection due to undiagnosed gallstones. I have fibromyalgia, CFIDS, IBS, and depression. My main concern though is my 16 year old daughter who has been diagnosed homozygous A1298C. What effect are all these folic acid enriched foods going to have on her? She likes to drink Monster which has added B vitamins. Is that harmful to her? Right now I have her taking 1000mcg methylfolate and methyl b12 daily. I cannot find a physician that is familiar with this mutation to treat her. Any advice would be greatly appreciated. I am doing what I can to spread the word to family and friends and refer them to your website. Thank you again and God Bless You.

  8. Debbie January 9, 2014 at 7:32 pm # Reply

    Hi Dr. Ben,

    My daughter, who is 29 wks. along in her pregnancy was just tested for MTHFR and is heterozygous A1298C. I am compound heterozygous for both A1298C & C677T mutations (which is why I told her to be tested). Her blood work also revealed thrombocytopenia (100,000 platelet count) and low RBC, Hgb and HCT. Her OB/GYN just called and is referring her to a hematologist to monitor her.
    She is quite anxious now and googled the mutation and came upon your article below:

    http://mthfr.net/mthfr-a1298c-mutation-some-information-on-a1298c-mthfr-mutations/2011/11/30/

    Our concerns are of course preeclampsia which is listed in this article, and the combo of her low platelets and low RBC, Hgb & HCT are favorable for this. She is not exhibiting HBP or swelling. Also, it sounds as though MTHFR has something to do with folic acid synthesis. Is there anything she should be taking or avoiding?? Very concerned about autism as well, especially since she is having a boy and it is more prevelant.

    As some background, although am Heterozygous for C677T & A1298C, I had two normal pregnancies – no miscarriages. I did have ITP in 1996 and had to have an spleenectomy. (Seems strange because that is not enough clotting and MTHFR can cause too much clotting). I also have many symptoms listed in the above referenced article, including Migraine with Aura. Also I have a Type I Arnold Chiari Malformation (had decompression surgery on 10/8/13) which I am not sure is related, but it is a kid of neural tube defect. I also have had a lot of surgeries (Gallbladder & Appendix removed and partial hysterectomy).

    Would you suggest genetic testing?

    Thank you,
    Debbie

  9. Daniele Ponzini January 16, 2014 at 9:05 am # Reply

    Dr. Lynch,

    What is the normal range of SAM/SAH ? I mean the minimun ratio to understand if I’m undermethilatior and maximun ratio to understand if I’m overmethilator ?

    Thanks

    Daniele

  10. Lindy January 19, 2014 at 1:45 am # Reply

    Is there a relationship between MTHFR defect (mother, father or child) and sex chromosome trisomies? (XXX, XXY, XYY). Obviously the XYY is related to the paternal contribution. Also, are these kids at increased risk for having the compound heterozygous MTHFR defect? Spina bifida and occulta spina bifida? I know for a fact that the XYY boys have an increased prevalence of autism and Asperger’s. These conditions are often overlooked by OB’s and pediatricians.

    Also, can you comment on the TMLHE gene defect (deletion) with is found on the X chromosome and affects the production of carnitine from the amino acids methionine and lysine and may also affect glutathione production? I was reading about this on MSGtruth.org — their home page. These individuals respond to low glutamate diets. Supposedly more boys than girls have autism. But then the fact that XYY has a higher rate of autism may indicate something on the Y chromosome itself also contributes — so autism is likely multi-factorial, perhaps several genes, environmentally triggered.

  11. Lindy January 19, 2014 at 1:53 am # Reply

    OH — and one more point. According to research on the Y chromosome, it affects the mitochondria of cells regarding metabolism — so that men and women have different mitochondria production. I can’t remember the specifics. Do you know if this relates to methylation or precisely what the difference is?

  12. Farrah January 21, 2014 at 4:19 pm # Reply

    Hello Dr. Lynch,

    I just ordered quite a few supplements off of Seeking Health. My question pertains to my children. I can’t seem to find a protocol for them on the website anywhere. I have ordered the optimal chewable for my 5 year old son (he has one copy of the A1298C) and the kids optimal for my 10 year old daughter (who has one copy of the C677T) since she can swallow pills.

    Are these the only supplements they need? Do these optimal vitamins contain everything? I do have them on a probiotic called Good Belly as well. If you can’t advise children, I’m wondering if you could just tell me what your children are taking? Thank you in advance for the information.

  13. Amee January 23, 2014 at 2:12 am # Reply

    I have MTHFR C677T T/T (homozygous). I asked my MD to test folate and homocysteine.

    The Serum Folate test result is 19.9. (I also had it tested in 2008 and it was >20).

    My homocysteine (nutritional) was 5.5.

    Should I be worried about this high serum folate? What does it mean if anything? The homocysteine level seems safe.

    I should probably be able to figure this out from your post but I am sorry I am not sure I fully understand it.
    Thank you.

  14. Deb January 23, 2014 at 5:58 pm # Reply

    Hi Dr. Lynch,

    Thank you for all the work you are doing in this area – it is awesome!

    I was just recently diagnosed as homozygous for the C677T after a lifetime of “symptoms” and several years of real problems. I have three children who are all healthier than they should be given the fact that they grew in my body! I plan to get all three tested. My youngest has suffered from seizures – triggered by sleep deprivation, and illness. She also suffered a very bad seizure after our doctor had me start supplementing her with some things that typically help seizure kids – including some B vitamins, magnesium, L-carnitine, etc. I believe that her seizures, if they aren’t caused by bad methylation, they are definitely exacerbated by it. She can’t handle any toxic exposure -( artificial sweetener, chlorine) and her seizure from the supplements occurred right at the point when her body would have been starting to detox.

    Who would you recommend I work with – I will go anywhere in the country -to get support for evaluating her and then putting her on a proper supplement program? I would like it to be someone who has specific experience working with seizures if that person is out there!

    Thank you for your help!

  15. Jan Kent January 24, 2014 at 3:25 pm # Reply

    My 30 year old son had a diagnosis of CHARGE syndrome but he does not fit the diagnosis. (He has some features of Treacher Collins syndrome albiet mild) He has a lot of mid line defects Agenasis of the Corpus Colosum, overlapping bones in his forehead, Choanal Atresia, High Narrow Pallette. He was born from my 5th and last pregnancy, 4 miscarriages (2 blighted ovums) and 2 live births (I lost his twin). My other child has midline defects also (internally). I was pregnant 5 times in 3 years and took Iron and Folic Acid that whole time. All three of us are MTHFR and I have 1 CBS and my son has two and presuming that my other child has CBS also. Am I right in thinking that the excess of Folic Acid would have contributed to my son’s unusual congenital abnormalities ?

  16. Heather Brandt February 4, 2014 at 7:03 pm # Reply

    My husband also has MTHFR (as well as me) so I’m wondering what kinds of supplements he needs to take. We’ve only had one pregnancy that ended in early miscarriage due to blighted ovum so I assume now that I know we both have MTHFR mutations that may have been the cause and would like to prevent it in case we are blessed with another pregnancy.

    • Heather Brandt February 5, 2014 at 12:18 am # Reply

      MTHFR C677T homozygous (both my husband and I). sorry I left that off.

    • Ika staf October 4, 2014 at 2:16 pm # Reply

      I feel very confused , I have been diagnosed with MTHFR after 3rd miscarriage and my Doctor prescribed me folic acid high dose of 5mg per day. I have been taking since April and have been told that with future pregnancy I should not have any problem .
      I had another 2x miscarriages , in July 2014 and one in Sept. 2014, also I was taking penicillin and Heparin from day one , when we found out I was pregnant.
      I was reading in more than one article , to avoid folic acid and use folate…
      Shall I stop taking folic acid and start folate only ,or could i take both?
      is there anyone in similar situation , I would love to hear their opinion / story.
      Also , I have 2 yearl old girl already and had absolutely fantastic pregnancy with her, got pregnant 1st time and carry full term without any conplications.

  17. Kim February 5, 2014 at 8:08 pm # Reply

    Dr. Lynch thank you so much for all you do!

    I am homozygous A1298C & have had 5 miscarriages. All my tests come back normal? The doctors don’t know how to help me and I can’t find anyone educated about MTHFR. I found your supplements and started them 2 days ago. I know that you can’t prescribe with limited data, but if you could make some medical protocol suggestions I would be grateful. There is less data available for A1298C and I am finding it difficult. I have also tested positive for ACE although I am not sure which SNP I should be reviewing.

    Keep fighting for us and our babies! Thank you!

  18. Trev February 15, 2014 at 7:16 am # Reply

    This is so similar to the reverse T3 using up the T3 receptors.. Thanks Doc, you rock.

  19. Kelly February 21, 2014 at 12:30 am # Reply

    Dr. Lynch,

    You mentioned in your response to someone that her husband should also take prenatals. I’m planning on starting the optimal prenatal vitamin, am I understanding correctly that it’s okay for my husband to take them as well?

    • Dr Lynch February 21, 2014 at 6:07 am # Reply

      Hello Kelly –

      Yes, that is correct.

      We also have the Optimal Prenatal Protein Powder – vanilla or chocolate. I personally use the vanilla flavor about 3 times a week mixed with frozen blueberries, fish oil, chia seeds, hemp seeds and almond and/or rice milk.

  20. Laila March 16, 2014 at 5:12 pm # Reply

    Hello Dr Lynch,

    Great read! Very, very interesting. I am histamine intolerant and appear to have my diet under control since the last few weeks. But I wanted to take pre-natal folic acid and indeed my gynecologist prescribed me a box. But now I see I should be taking active methylfolate. Could you recommend a brand that will not interfere with my low histamine diet, low gluten diet? I am based in Eurpe and want to start trying for a healthy baby soon.

    Thanks in advance.

    Laila

  21. Robert March 24, 2014 at 8:31 am # Reply

    Thank you Dr Lynch,

    One question: on the 23andme site I just read about general genetic testing to find out about your ancestry. Does that standard kit include the testing of the folate pathway blocks?

    Thanks
    Rob

  22. Jenny March 26, 2014 at 8:59 pm # Reply

    Dr. Lynch,

    Thank you so much for this information! We lost our first child to a chromosomal defect (T13) and are trying to conceive #2. I have been researching prenatals for days, and looked up some of the ones you recommend (although it’s interesting that some of the brands that have folate in their multi put folic acid in the prenatal – like Pure Encapsulations!). What do you think of the New Chapter Prenatal (very popular, carried at grocers etc). It has folate on the label, and when I called to inquire, they told me that they start with folic acid and have some probiotic process that turns it into folate. Does this sound false to you? I like that it is a whole foods vitamin unlike some of the others discussed here.

    Thank you!!!!
    Jenny

  23. Jenny March 26, 2014 at 9:07 pm # Reply

    ps. The Seeking Health Prenatal one looks great but it’s $70 for a one month supply. Very expensive!

  24. Rachael April 3, 2014 at 11:56 pm # Reply

    I am 1298 homozygous. I receive monthly b12 shots from my doctor. Could you list specific supplements I should be taking? I get overwhelmed by all of the choices. My Dr. Just toldme to take a sublingual B12, folic acid, and a baby aspirin.

  25. Breann July 15, 2014 at 4:48 am # Reply

    If my child (5 years old) is showing symptoms of an MTHFR mutation, should I test myself or the child first?

  26. Sylvie July 16, 2014 at 1:56 pm # Reply

    When should you start consuming folate before getting pregnant… is there a big difference if you don’t consume folate before getting pregnant… I have the Thorne Research 5-MTHF and Thorne Research Basic Prenatal….. I have done 2 miscarriges is the last year

  27. Rachel August 2, 2014 at 10:19 am # Reply

    Hi Dr Ben,

    I found out I was compound heterozygous after a miscarriage and concieved quickly again the next month but had only just started taking methylguard and a prenatal with folinic acid. I’m currently 10.5 weeks and am so worried about birth defects as I wasn’t/ didn’t have folate in my body. Does this give me a higher chance now of having a baby with birth defects? I’ve got my 12 weeks scan booked but am so worried.

  28. Concerned September 1, 2014 at 4:39 am # Reply

    Dr Lynch,

    Any comments on this study?

    Homocysteine Lowering by Folate-Rich Diet or Pharmacological Supplementations in Subjects with Moderate Hyperhomocysteinemia: http://www.mdpi.com/2072-6643/5/5/1531/pdf

    Abstract: To compare the efficacy of a diet rich in natural folate and of two different folic acid supplementation protocols in subjects with “moderate” hyperhomocysteinemia, also taking into account C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene. Subjects/Methods: We performed a 13 week open, randomized, double blind clinical trial on 149 free living persons with mild hyperhomocyteinemia, with daily 200 μg from a natural folate-rich diet, 200 μg [6S]5-methyltetrahydrofolate (5-MTHF), 200 μg folic acid or placebo. Participants were stratified according to their MTHFR genotype. Results: Homocysteine (Hcy) levels were reduced after folate enriched diet, 5-MTHF or folic acid supplementation respectively by 20.1% (p < 0.002), 19.4% (p < 0.001) and 21.9% (p < 0.001), as compared to baseline levels and significantly as compared to placebo (p < 0.001, p < 0.002 and p < 0.001, respectively for enriched diet, 5-MTHF and folic acid). After this enriched diet and the folic acid supplementation, Hcy in both genotype groups decreased approximately to the same level, with higher percentage decreases observed for the TT group because of their higher pre-treatment value. Similar results were not seen by genotype for 5-MTHF. A significant increase in RBC folate concentration was observed after folic acid and natural folate-rich food supplementations, as compared to placebo. Conclusions: Supplementation with natural folate-rich foods, folic acid and 5-MTHF reached a similar reduction in Hcy concentrations.

    Thanks.

    • Dr Lynch September 3, 2014 at 7:35 pm # Reply

      They did not look at intracellular homocysteine – only extracellular. The good researchers are looking at what happens to intracellular homocysteine post-folate or folic acid supplementation. Folic acid lowers homocysteine outside the cell – in the blood – but not inside the cell – which is where it really matters. There are studies which back this up – and I discuss them in this course: Methylation and Clinical Nutrigenomics Part 1

  29. Nicole September 3, 2014 at 10:59 pm # Reply

    Is it ever possible to rid the body of the synthetic folate floating around in it? If so, what helps with that? We feel a great benefit from using liposomal vitamin C, but I know it may be completely irrelevant to this problem.

  30. Ika staf October 4, 2014 at 2:25 pm # Reply

    I feel very confused , I have been diagnosed with MTHFR after 3rd miscarriage and my Doctor prescribed me folic acid high dose of 5mg per day. I have been taking since April and have been told that with future pregnancy I should not have any problem .
    I had another 2x miscarriages , in July 2014 and one in Sept. 2014, also I was taking penicillin and Heparin from day one , when we found out I was pregnant.
    I was reading in more than one article , to avoid folic acid and use folate…
    Shall I stop taking folic acid and start folate only ,or could i take both?
    is there anyone in similar situation , I would love to hear their opinion / story.
    Also , I have 2 yearl old girl already and had absolutely fantastic pregnancy with her, got pregnant 1st time and carry full term without any conplications.

Trackbacks/Pingbacks

  1. Preparing For Pregnancy With MTHFR Mutations • MTHFR Living - January 8, 2014

    […] It is especially important to avoid folic acid, which is the synthetic form of folate, if you and/or your baby has MTHFR gene mutations. This does not mean that you shouldn’t consume folate. Synthetic folic acid cannot be converted properly to methylfolate and blocks the folate receptors in people with MTHFR. Try taking methylfolate instead, as recommended by Dr. Ben Lynch in this article. […]

  2. Nutrients for Pre-Conception, Pregnancy and Breastfeeding | NZ Health - April 21, 2014

    […] http://mthfr.net/folic-acid-awareness-week-2014-want-awareness-here-you-go/2014/01/08/ NTD prevention with bioactive folate forms […]

  3. The Epigenetic Epidemic | Michael Chad (Stay-at-Home Dad) - October 26, 2014

    […] can you do fix the epigenetic epidemic? That’s another blog post, but to start, eat folate, not folic acid. If you’re a woman on hormonal birth control, stop taking it. Don’t use antacids. Go […]

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