How Much Methylfolate Should I Take? Find Out

When one is diagnosed with a MTHFR mutation, the first thing typically prescribed is methylfolate – or, incorrectly, folic acid in high amounts.

There is no standard of care prescribing methylfolate for MTHFR mutations. Thus, the variation in prescriptions is vast – anywhere from nothing done upwards to Deplin 15 mg or Folic Acid 4 mg.

There are a few issues here:

  1. Doctors are guessing how much methylfolate to give you
  2. Doctors are giving high doses of methylfolate
  3. Doctors should not prescribe high dose folic acid
  4. Diet is commonly not evaluated
  5. Supplements are commonly not evaluated

Even with all these issues, doctors – and you – can know how much methylfolate you should take.

There is a lab test which evaluates blood levels of:

  • unmetabolized folic acid
  • methylfolate

If doctors order this lab test, methylfolate dosing will be more accurate.

There are a couple potential issues with the lab test.

  1. Is methylfolate stable or does it readily break down thus making the lab results inaccurate?
  2. Where did the lab get the normal ranges for methylfolate? Since the general population has a 50% to 60% chance of having one MTHFR mutation, the potential for methylfolate ‘normal’ ranges being off exists.

These are two questions that need to be asked – and will be followed up here.

In the meantime, for those wanting to evaluate their unmetabolized folic acid levels and methylfolate levels, I do recommend ordering the Unmetabolized Folic Acid Test by Metametrix. [Please note: Metametrix (now Genova Diagnostics) has discontinued the Unmetabolized Folic Acid Test as of January 16, 2015.]

Who should order this test?

Where do I send my doctor to order this test for me?
You send them to Metametrix.

Stop guessing and identify if your methylfolate levels are where they should be.

Be sure to tell your doctor about this test!

Don’t Want to Pay for a Lab Test? Rather experiment to see how much Methylfolate you need?
If you have been diagnosed with a MTHFR defect, and you want to try taking some methylfolate, what I recommend trying to do is this:

  1. Take small amounts of methylfolate along with methylcobalalmin and work up.
  2. Consider taking 1/2 tablet of Active B12 with Methylfolate. This amount is typically well-tolerated by many.
  3. Increase to a full tablet after 1 week.
  4. Continue to increase the amount taken by 1/2 tablet every 7 days until you feel really good.
  5. If you feel side effects from taking Active B12 with Methylfolate, take 1/10th tablet of Niacin.
  6. Work with your doctor on this and inform them what you are doing.

Comments and thoughts? Please leave a comment below.

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127 Responses to “How Much Methylfolate Should I Take? Find Out”

  1. Robert January 5, 2014 at 7:41 pm #

    I am new to the MTHFR.net website. What a great resource! I have had many of the symptoms of the MTHFR gene mutations for my entire life. I am taking several prescriptions medications to treat individual symptoms, but I have continue to search for the root cause because I felt something was missed in the diagnoses and treatments. I first ran across information about pyrolurea and many of the symptoms were similar. In a recent search on pyrolurea, I found a posted reference to the MTHFR gene mutation as possible explanation for symptoms similar to pyrolurea. After reading information on this website, I decided to experiment with small amounts of methylfolate and methyl B12. I started taking 400mcg of methylfolate and 500 mcg of methyl B12 daily and the results are amazing! I am definitely going to be tested for the MTHFR gene mutation and seek treatment from a qualified physician. I am looking for a local naturopathic physician because it sounds like they are more versed in treating conditions involving supplements; however, I have the following question. Should I order the MTHFR test myself to confirm the MTHFR gene mutation and then find a local naturopathic physician or should I find the physician first and have them order the test?.

    Thanks to Dr. Ben for establishing and sharing this wonderful information and everyone for supporting the site!

  2. Carolyn Friesz February 6, 2014 at 6:46 am #

    I read your article about pre-natal vitamins and autism, etc. I’m curious, would you encourage a nursing mother to get off the prenatal vitamins and switch to the Active with methylfolate? I am very close to someone that is nursing and still taking the vitamins – I want to say something, but don’t want to alarm her. I’ve heard of so many that have children with Autism and it wasn’t diagnosed until they were a bit older; several mentioned an overt change in behavior – which is why I’m wondering if nursing and taking prenatal vitamins could be a problem.

  3. Jen February 26, 2014 at 5:57 pm #

    How do you take 1/10 of a tablet? And what brand or where do you get these vitamins? I went to a natural store today and was overwhelmed. Most of the products with methyl folate also contained folic acid.

  4. jacki kurtz March 19, 2014 at 8:02 pm #

    Any recommendations for child dosage? Specifically a 9 yr old w/ 2 copies of c677t mutation.

    thanks!

  5. Summer April 7, 2014 at 2:22 pm #

    you say start low dose but what is a low dose? My doc wants me to start with 7.5 Deplin is this a low dose? How much is ½ tab of b12?

    • Dr Lynch April 7, 2014 at 8:22 pm #

      Deplin is NOT a low dose.

      1/2 tab of B12 depends on where you obtain the B12. Look at the supplement facts on the bottles.

      • Summer April 7, 2014 at 9:09 pm #

        I don’t understand why it’s so hard to just get a straight answer. How many mg should someone start with and how do I know when I’ve reached optimum dose? What’s so scary about taking 7.5 mg? Since your saying my MD is prescribing something dangerous, what kind of doctor should I listen to? I’m really sick of not getting a clear answer from anyone.

        • Lynn_M April 7, 2014 at 9:49 pm #

          Summer,

          Dosing can be very individual, so hard to give a straight answer. It’s more like – it depends. Many people have reported severe reactions on this forum to starting at 7.5 mg, with symptoms such as great irritability, anxiety, aggressiveness, headaches, violence, and rashes. But then we probably wouldn’t hear from the people who didn’t have any reactions. It’s not that your doctor is prescribing something dangerous, it’s just that 7.5 mg is a much higher dose than some people can tolerate starting out.

          I started at 500 mcg 5-MTHF and went up to 1000mcg after a few days with no problems. I’m +/+ for A1298C, and I now take 1/4 of a 5,000 mcg dose a day, plus 800 mcg folinic acid in a complex by PureZen called DMG Complete. I think many people might take something in that range as a starting dose. I would call 200 mcg a low dose. But some people need to start taking crumbs and very slowly build up from there.

          And what is enough? The best way to tell is to take Metametrix’s UMFA test, which measures unmetabolized folic acid plus 5-MTHF. Or you could do a NutraEval test or SpectraCell micronutrient analysis, or some other measure of nutritional adequacy. Some people have particular symptoms associated with folate deficiency, and when those symptoms go away, they figure they have enough 5-MTHF.

          • Summer April 7, 2014 at 10:51 pm #

            Is there a different protocol if you are taking Deplin for depression?

  6. chris April 7, 2014 at 3:27 pm #

    I am homozygous for C677T and my homocysteine level is 12.

    I started with the methylated B-12 patch and then added Deplin (started with 1/2 pill, now taking 15 mg). I didn’t notice any outward effect of taking the methyl B-12 and Deplin seems to be going ok, however I have a metallic taste in my mouth (but also have a cold), and my tongue has a white color.

    Any thoughts on what is going on? Thank you.

    • Ella May 1, 2014 at 12:21 pm #

      Chris–I left you a note re white tongue and metallic taste on http://mthfr.net/how-much-methylfolate-should-i-take/2012/03/22. Cheers! Ella

    • Rachel Jarrett March 11, 2017 at 1:11 pm #

      Hi, I know this post is 3 years old so you probably won’t see this. But I am curious why you were put on Deplin with a “normal” homocysteine level? Thanks!!

      • Dr Lynch March 16, 2017 at 6:01 am #

        That’s a good question, Rachel.

        Many health professionals put people on high dose methylfolate simply because they see their patient tests ‘positive’ for MTHFR even though their homocysteine levels are healthy (around 7). This is a big problem – and one of the main reasons why we see such high readership of the article ‘Methylfolate side effects‘ unfortunately.

        • Rachel Jarrett March 16, 2017 at 12:26 pm #

          Thank you so much for responding! I am homozygous for C677t and have homocysteine of 11.. Would you suggest a small dose of methylfolate for me, something else, or nothing? I would be happy to pay for a consultation if needed.

        • Rachel Jarrett March 16, 2017 at 12:28 pm #

          Thank you for responding! I am homozygous for C677T and have homocysteine of 11. Would you suggest any treatment for me? Is that high enough to require a small dose of methylfolate or just something to monitor? I so appreciate your reply!!

          • Rachel Jarrett March 16, 2017 at 12:35 pm #

            I also forgot to mention that my folate levels are high (>24) and my b-12 is normal

  7. Dia April 10, 2014 at 12:30 am #

    Hi

    My doctor had me do the Health Diagnostic Laboratory testing for MTHFR due to my symptoms associated with an allergic reaction to levothyroxin and synthroid six years ago. I have never been the same since that reaction and struggle to get through each day. I have the heterozygous genotype for the C677T (CT) and A1298C (A/C) polymorphism Compound heterozygot. After being directed you by Susy Cohen (Headache Free), I am realizing that my doctor does not know how to properly dose. She prescribed Douglas Labs Bcomplex, 500mg niacin, and Douglas Labs sublingual Methyl Plus 1-2 daily. I am so glad I found your site, thanks Susy Cohen, because due to my sensitivities, I knew I could not start with so much at once. I am going to send my doctor your website

  8. Dianey April 10, 2014 at 12:36 am #

    Because they need to be educated on dosages, etc. If you have any suggestions for me, please let me know. I purchased your Niacin 50 mg for moderating symptoms. I just received it and have not used it yet. I have had symptoms, bad headache after bcomplex, also some muscle soreness and other weirdness. Thanks for your information. Diane

  9. douglas smith May 13, 2014 at 10:49 pm #

    Do you mean B12 for item 4 on the list or methylfolate?
    Thanks,
    Doug

  10. Terry May 22, 2014 at 12:52 pm #

    Dr. Ben,
    What a busy guy you are! Listen, a friend of mine (a woman of 35 years) in Puerto Rico is doing the 23ANDME gene testing to check especially for the MTHFR gene mutation. She will have her results interpreted by MTHFR support. (By the way I purchased & read your book on my Kindle PC). Do you ever do phone consultations long distance with someone? If so, what would the cost be? Would it be possible if she were to get her results to you? Or…I’ve looked at the “find a MTHFR doctor” and did not see any doctor listed in Puerto Rico who has taken your training or seminar. However, might you know of a doctor in the San Juan, Puerto Rico, area that might by a MTHFR doctor? Sorry for all the questions but I do want this friend to get well!

  11. Sarah Joy June 13, 2014 at 12:17 pm #

    Hey Dr. Lynch! I did the 23andme.com test after my friend was diagnosed with MTHFR defects and recognized symptoms in me.

    I am hetero C667T, and my other mutations that seem to be important (according to geneticgenie.com) include: homo VDR Taq, MAO-A R297R, MTRR A66G, CBS C699T; hetero MTRR A664A, BHMT-02, BHMT-08 (although I’m still struggling to learn how all of this affects me).

    I have had severe depression and anxiety since I was 12. As of 2011 I have been able to live well without medication, but found I needed fish oil, magnesium and b-complex or I would get depressed again. I am certain I have a very leaky gut and have been developing more and more food sensitivities, especially over the last year. I have also had trouble sleeping for more than a decade, sensitive skin (excema and rashes) inflammation in my fingers and wrists and off and on intense addiction to alcohol. I stay away from alcohol now because I never know when it will cause binge drinking.

    After getting my test results and reading your basic MTHFR protocol I ordered the Seeking Health multi-vitamin and within a week I was sleeping through the night without melatonin! Woo hoo! I read about the side effects people experience with methylfolate and am thinking I didn’t experience them because I was already taking 1500 mg Niacinimide. I am assuming this is ok but could use some reassurance! Soon after I switched vitamins I had a strange binge episode after using alcohol extracts in our almond muffins (which we make all the time), so someone recommended I try molybdenum. I’ve added that in and seem to tolerate the extracts much better.

    I’ve removed processed foods from my diet and eat very low-carb/sugar. I’ve lost 100 lbs and feel much better. BUT my inflammation seems to be increasing! I’ve just removed nightshades two weeks ago because I was reacting to them very strongly. My next step I’m considering is adding in Tumeric to my supplements, hoping it will help with my inflammation. It has spread to other parts, my knee is so inflamed that I’m limping today.

    Just curious if you have any thoughts or recommendations for me. I have no money for tests and such so I focus on healing through food and whatever supplements I can afford. I am still taking my Garden of Life B-complex, but will switch to the Seeking Health one when it runs out. I also take fish oil, magnesium, potassium, D3, Garden of Life raw probiotic (will switch this out to SH as well). Oh, and I have histamine issues. I react to fermented foods in particular.

    Thanks so much for your time! I appreciate all the info you put out there. I appreciate any input you (or anyone who has experience with these matters) can give me.

  12. Jamie July 27, 2014 at 12:29 am #

    Hi Dr. Lynch,

    I have had several miscarriages/ectopic pregnancies. After my third my body started reacting to everything. I went though allergy testing, food intolerance testing and finally through an elimination diet confirmed I had a histamine intolerance as well. I was also tested for MTHFR and I am heterozygous A1298C. I have done the genetic testing through 23andMe and with the help of my dietician, my symptoms are now manageable. I recently became pregnant and I am trying to figure out how much of the optimal prenatal vitamin I should start with since it contains methylfolate. What dose would you suggest I start with since my body is extremely sensitive.

    I am currently taking:
    Liposomal Vitamin C
    Micellized D3 1200 IU
    L-tyrosine
    Probiotics HLC Mindlinx
    5-HTP
    Gaba (Fennel Buterate Gaba)/Biotics GABA
    Butyric-Cal-Mag

    Considering:
    Optimal Prenatal
    Optimal Iron Plus Cofactors
    Optimal Fish Oil
    Optimal Prenatal Powder

    What are you suggestions and any recommended reading that would help me understand this better?

    Thank you. I appreciate any input you (or anyone who has experience with these matters) can give me.

    Jamie

  13. Lisa P in NC August 7, 2014 at 6:48 pm #

    Please help me understand: If I have side effects after increasing the dose of methylfolate, then I can try taking niacin to counteract the side effects. The Optimal multivitamins which contain methylfolate, also contain niacin. Is this to allow the body to find its own balance? Is the niacin working against the methylfolate?

  14. April Wortman August 20, 2014 at 1:27 pm #

    Dr. Ben, my daughtee has mthfr tt mutation. She was normal sized ten year old. Good at school work. She hit ten and a half. We had CO exposure.er said fine. She began gaining weight. Shes hypthroid with twenty small nodules. She has hyperinsulenemia gerd and gastroporesis. Her thyroid number are supposedly therapeutic. Last summer she was five fett and 138 up from beginni g weight of 95. This wss over a year plus. Dr wanted her diwn twebty pounds changed low carb diet to all protein no carbs. She followed this eight weeks while her dr was out if the country shed gained thirty mort pounds in eight weeks i insisted she see endocrinology out if town at childrens hospital. They said they didnt belueve she had cushings as sge had grown 1/2 inch in height in a year. I was worried about brain tumor. They said diet change again to mediteranean and she needed 800-1000 cal a day and exercise three hours a day joined gtm calculate everything. She has gone since october at 169 to190. Her weight gain had stalled for a few weejs byt atarted climbing agaun. November last year dr prescribed 15 l methylfilate…deplin…and vitamin d. We had her on multivitamin following mediterranean diet. Took awau aspartane…any products with synthetic sugars then too gluten and webt completely organic wuth her food. She swims cylcles and does five ks…she akso has personal trainer works out three times a week curves…. shes now up to 190.she had work up at medical genetics in may. A couple amino acidswere one out of nirmal range bone scans etc fine. They said her pth was off so endocrnologisy doubked ger vutamin d supp and added b12. She alsi tajes c as sge gets sick often even though homeschooled. We have chemucal free environment as i have mcs. No chemicals on her body in soaps eyc all sunscreen bugspray lipbalm etc all irganic. Shes still gaining. We are desperate. She is so depressed at cobtinued weight gain although relugiousky we follow organic gluten free sugar free diet she sees medical genetics this thursday. Anything else that we could suggest testing?

  15. Vlad September 7, 2014 at 1:47 am #

    I have a question about the use of methylfolate when it relates to someone that has a heart condition as well as iron overabsorbtion issues. My mom has been diagnosed with arrhythmia and on top of that she has a mild form of hemochromatosis. She has been perscribed Methyl Protect 120 C by Xymogen. She has had most of the side effects icluding headaches, palpitations, mood disturbances, muscle soreness and cognition issues after having taken Methyl Protect. What concerns me the most are the palpitations since she already has arrhythmia. Also the mood alterations have been very hard for her to deal with. My main question is is should she continue to take methylfolate? If so what would be some alterations to the way she takes it as well as some adjunct supplements that can be used in combination with the methylfolate taking into consideration her unique condition?

    • Dr Lynch September 9, 2014 at 6:22 pm #

      Vlad –

      I think many people who have these symptoms are deficient in various nutrients – such as magnesium, zinc, selenium, other key B vitamins and also may be stressed and/or adrenal fatigued.

      Because of the common symptoms, I have just designed and formulated a supplement to help replenish key biochemical pathways. If this occurs prior to taking things like Methyl Protect, the side effects should be much less or gone.

      The product is called Optimal Start. Take as directed on the label.

      I also recommend starting low and working up. Using a lozenge which contains B12 and methylfolate is much easier than opening a capsule and regulating dosage. I recommend Active B12 with L-5-MTHF and starting low – say 1/4 of a lozenge. BUT – prior to that, consider using Optimal Start for 1 month and then adding in the Active B12 with L-5-MTHF.

      Be sure to get some Niacin on board now to counter the side effects.

      • Vlad September 14, 2014 at 12:16 am #

        Thank you very much for the information I grately appreciate it! I had another question to follow up. Since my mom is currently on many supplements I was wondering which ones should she discontinue while doing a course of the Optimal Start for the month period? Also the type of arrhythmia she has is called paroxysmal tachyarhhythmia, figured I’d clarify that for the previous post as well. I look forward to hearing from you. Thak you!

        Her supplements:

        1) InterPlexus Inc., Seriphos, Phosphorylated Serine, 100 Capsules – 2 caps. in the evening
        Proprietary Blend Phosphorylated Serine/Ethanolamine 1000 mg
        (to help with sleep)

        2) Jarrow Formulas, N-A-C Sustain, N-Acetyl-L-Cysteine, 600 mg – 1 tab. in the evening (to help with muscle cramps)

        3) Jarrow Formulas, Acetyl L-Carnitine 500, 500 mg – 3 caps. a day (to help with heart support)
        Acetyl-L-Carnitine (as acetyl-L-carnitine hydrochloride) 500 mg

        4) Doctor’s Best, Best Nattokinase, 2,000 FU – 1 cap. X 2 times a day (to help with post-traumatic inflammation)
        Nattokinase (fibrinolytic units) enzyme activity 2,000 FU

        5) Doctor’s Best, Best Fisetin, Featuring Cognisetin, 100 mg – 1 cap. X 2 times a day (to help with memory)

        6) Vitacost Hyaluronic Acid with BioCell Collagen II® — 100 mg per serving. Serving Size: 2 Capsules – 2 caps. a day (joints)
        BioCell Collagen II – 1000 mg*
        Hydrolyzed Collagen Type II – 600 mg*
        Chondroitin Sulfate – 200 mg*
        Hyaluronic Acid (HA) – 100 mg*

        7) Biotics Research Corporation, Ca/Mg-Zyme. Serving Size: 3 capsules – 2 caps. a day (bone density support)
        Calcium (as calcium citrate) 350 mg
        Magnesium (as magnesium citrate) 70 mg

        8) CoQ-10 by Premier Research Labs – 1 cap. X 2 times a day (to help the heart & cognition)
        It has 100 mg or CoQ10 Enzyme (Ubiquinol)

        9) Vitacost 5-HTP 100 mg – 1 cap. X 2 times a day (for mood support)

        10) Xymogen Methyl Protect™ – 1 cap. X 2 times a day (for hemochromatosis)
        Riboflavin (as riboflavin 5’-phosphate sodium) 25 mg
        Vitamin B6 (as pyridoxal 5’-phosphate) 10 mg
        Folate (1000 mcg as calcium folinate and 1000 mcg as 6(S)-5-methyltetrahydrofolic acid, glucosamine salt†) 2000 mcg
        Vitamin B12 (as methylcobalamin) 1000 mcg
        Betaine Anhydrous (trimethylglycine) 500 mg

        11) i-cool for Menopause Relief featuring geniVida® genistein 30 mg. – 1 tab. X 2 times a day

        12) Standard Process Red Clover 1:2 extract – 45 drops X 2 times a day for menopause relief

        13) Singular 10 mg a day for allergies

  16. Linda September 11, 2014 at 10:19 pm #

    I’m heterozygous C677T. I consume dark leafy greens 3x per day. I add them to my morning smoothie. I have a large salad for lunch (including protein), and typically a salad with my evening meal. I’m taking your Optimal Multivitamin. Am having symptoms that I may be over methylating – particularly achy hip joints during night which disturb my sleep. I’m not sure if it’s due to methylation or osteoarthritis, a condition I have as well. Also experiencing some irritability and slight headaches, neither of which are normal for me. Since I’m getting so much methylfolate in my food, maybe I should not even be taking Optimal Multivitamin but only Methylcobalamin. I’ve never heard this discussed in any of the posts. If anybody has any feedback regarding this, I’d love to hear from you. Meanwhile, I’ll try tapering down my dosage (6 per day currently) to see if my symptoms disappear. Thanks to Dr. Ben for this wonderful forum.

  17. Vanessa September 15, 2014 at 10:56 pm #

    I suspected, and then found out from 23&me recently that I have many methylation defects, including homozygous A1298C. I keep reading that the A1298C is not supposed to lead to high homocysteine, that the other defect is, which I don’t actually have. But my homocysteine is 29. I’m still reading about all of this and have not found a doctor (who accepts my insurance) yet who knows anything about this, but sounds like some of the other homozygous defects I have, the BHMT or COMT? or some of the many hetero ones, could be causing this. My main question is this: I have taken up to 8 pills a day of the 800mcg methylfolate/1000 mcg methylcobalamin, and feel nothing. That’s 6.4 mg of methylfolate. I’ve finished the bottle in well under a month. Where do I go from here?

    I was diagnosed in childhood with ashtma, allergies (foods, plants, chemicals, pretty much everything), major depressive disorder, anxiety, and Crohn’s disease, and then hypertension in my early 30s. I’m 42. I have other symptoms that no doctor has been able to explain. I still struggle with all of these issues, except, perhaps due to diet changes and probiotics or luck, I have not had a flare of the Crohn’s for about 4 years. I still have digestive pain, discomfort, bloating etc. daily as I had to have half of my colon and the majority of my small intestine removed when medicines failed to work for the Crohn’s when I was 18. This has caused scar tissue and IBS type symptoms. I am desperate to feel better. Antidepressants do not work for me, I have tried pretty much all of the newer ones and some of the older class. My health problems disrupt my life to the point where I have been hospitalized multiple times for the depression and have been trying to survive on disability supplemented with work when I can, for the past 9 years. I don’t want this to continue to be my reality. I have seen tons of doctors, and I feel they have failed me and at times made me worse. I found some naturopaths in my area who supposedly are familiar with MTHFR, but it will take me about 6 months to save up to see one of them as they don’t take insurance. And then paying for more labs and more supplements.. I can’t wait that long, I want to do what I can right now.

    I used Nutrahacker to help decipher some of my tests, and sounds like hydroxycobalamin is better for me than methyl, so that’s one thing I will try. I also ordered a 10mg methylfolate and took 1 pill yesterday. It doesn’t have B12 in it, so I gave myself a 1000mcg cyanocobalamin shot (I know this is the worst kind, but I have a prescription for it due to not being able to absord B12 in my intestines, and I cannot afford another supplement until next month). I actually felt something, but it wasn’t good. A weird, anxious feeling in my chest. Today I dumped out a small amount of the capsule, and I have the same feeling in my chest but not so bad, so maybe it’s still too much, or I’m not taking the right kind of B12 with it, I don’t know.

    If the Dr or anyone else has suggestions on where I should go from here, and where is most important for me start (keeping in mind that I do not have the money to buy every supplement I probably need at once), I would be extremely grateful.

  18. Vanessa September 15, 2014 at 11:10 pm #

    Sorry, forgot something that may be helpful: I actually did feel better one day when I took 4 methylfolate/methlyB12 tabs (3.2 grams methylfolate). Unfortunately it only lasted about an hour, but I suddenly felt, while in public, at that, completely unselfconscious. I felt relaxed and alert. It is hard to describe, but it reminded me of how abnormal my “normal” has been for years. But when I took the same amount for the next week, and slowly increased after that, I did not get that feeling back. It was my usual depression, anxiety, and hyper self-consciousness, leading me to be more focused on all of my physical problems. Maybe it was the placebo affect, but one of my gene mutations supposedly means that the placebo effect is less likely to affect me, and that’s probably true, as lots of medicines do not work for me at all, including SSRIs, codeine, and vicodin (but somehow I still get side effects from them). They have no positive effect for my mother either. She hasn’t been tested, but as some of my mutations are homozygous, she must be at least heterozygous.

  19. Billie September 22, 2014 at 4:17 pm #

    Dr. Ben,
    I am one of the lucky people who got immediate results from taking methylfolate, active B12 and active B6. I am homozygous c677T. I was diagnosed in my 30’s but did not experience severe symptoms until after 50. After reading the comments and your answers I am wondering if I may be taking too much mFolate. I am currently taking 2 to 4 800mcg per day. If I do not need that much I would like to cut back. I also take 5000 to 10000 units (not sure what they are) of active B12. Should I cut back? I guess I do have some muscle pain but nothing like before the vitamins. Thank you for this forum and your tireless work, it has changed my life.

  20. Koerner October 1, 2014 at 3:41 am #

    Hey Dr. Lynch, I am compound heterozygous for 677 and 1298. My Psychiatrist put me on 6mg l-methyfolate in the form of Cerefolin NAC.

    I felt extremely happy, positive, and energetic for about a week, and then my mood started to drop and I began to feel anxious, irritable, and with headaches.

    I’m very glad to have found your website. From what I gather, you say that I was taking too much, which caused these side effects.

    I stopped taking it for one day (and I felt great that day!) and the next day I took 800mcg of your l-methylfolate (with methylcobalamin). After a few days of that, I have started feeling the same side effects again! I thought that surely 800mcg would be low enough. Do you think I should take 400mcg? What if that gives me the same side effects?

    You wrote somewhere about “pulsing” the dose. Could you explain how that works (both practically and biologically)?

    Thank you so much for the information! Really!

    Koerner

  21. Alicia October 2, 2014 at 12:52 pm #

    I was recently diagnosed with a homozygous c677t mutation after having 4 early miscarriages and an ectopic pregnancy. It is the only thing that seems to be wrong. I began taking Seeking Health Optimal Prenatals and can already feel a difference! I just ordered the Seeking Health Vegan DHA liquid and Probiotics. Are these a good combo to add in? We are going to be trying to conceive shortly. I am probably going to be taking baby aspirin and progesterone as well. I have read a lot about Metanx and was wondering if this product should be used or if the Optimal Prenatal is already doing what that would? Is there anything else you recommend taking to help my body get exactly what it needs (for pregnancy and for normal every day life)? Any feedback would be helpful!! Thanks!

  22. Michael R. October 24, 2014 at 5:24 pm #

    Hey guys i have had anxiety and depression that came from nowhere 3 years ago and have been searching for why this is the case. im 20 years old college athlete and find it hard to function between the anxiety depression and fatigue. i found out i have MTHFR and am heterozygous c667t. this makes sense that this may be the cause of my ailments. i have been take 1mg of methylfolate and 1 mg of methyl b12 and its not helping. ive read that i should be taking 15mg of methylfolate? any suggestions or comments would be much appreciated, thanks.

    • Molly Malone October 30, 2014 at 9:04 pm #

      Hello, I found this site and the one I will link to below to be very helpful. From what I understand, everyone is unique so everyone has their own unique protocol. There is:
      Timing (when to take),
      Amount (how much to take), and
      Cofactors (all the other stuff you will need. Most people seem to need to correct some things first, such as mineral deficiencies).
      You also need to take a brand that works, so please take a look here: http://forums.phoenixrising.me/index.php?threads/b-12-the-hidden-story.142/

      Dr Lynch’s site and the Phoenix Rising site are extremely helpful, Dr. Amy Yasko is another though I’ve only read a couple of papers by her. While I’m at it, I want to say that I agree with Dr. Lynch that it’s best to start with small doses of methylcobalamin, adenosylcobalamin and methylfolate and work your way up so that you minimize negative effects. Best Wishes to you.

    • Linda H. October 30, 2014 at 11:15 pm #

      Michael R., I am also Heterozygous C667T. Good news is … there is HOPE! It’s important you get your information from very reliable resources. Dr. Ben Lynch is one of those. Scroll up to the top of this page and look in the right hand column where you will see MTHFR C677T Mutation: Basic Protocol. Go there to read Dr. Lynch’s recommendations. I am working down the list and it’s been very helpful. I also take Dr. Ben’s Optimal Multivitamin to get the proper balance of methylfolate and methylcobalamin (a form of B-12). Check it out here: http://www.seekinghealth.com/optimal-multivitamin-240-vegetarian-capsules.html
      I really notice a difference when I take those. I take 4 in morning and 4 with lunch. But I would start out taking much less and working your way up. The ingredients in these are impressive and Dr. Ben goes to painstaking efforts to ensure the quality of his products. Not cheap. But your health and well-being are worth every penny. I hope you start feeling better soon, Michael.

  23. Oskar November 25, 2014 at 10:06 am #

    I haven’t taken any genetics tests but concluded based on symptoms that I needed to rev up methylation

    And indeed, I did fare very well on methylcobalamin and methylfolate. The latter felt almost miraculous when I hit the right dosage, but could also cause overmethylation and overstimulation the first few months, even at minuscule doses

    However, this tendency faded. In only about three months my threshold for overmethylation/overstimulation went up from about 400 mcg methylfolate/day to a whopping 3×15 mg/day, and even at that dose I rarely hit the overmethylation rooftop but feel rather balanced. If I decrease the dose I tend to go into undermethylation

    So, I ”started low and went slow” and yet I ended up at these monster doses.

    Problem is, 45 mg methylfolate/day is a huge expense which I can’t afford long-term. I do take a low dose B complex and—as I know that B3 quenches methylation—I have tried to omit it to see if my methyfolate need decreases, but it doesn’t. Any suggestions to get the same nice buzz going without these ridiculous doses? Anyone had similar experiences?Very grateful for input.

    • Cathi November 26, 2014 at 8:16 pm #

      Oskar,

      I’m curious, how much Methylcobalamin (M-B12) do you take with such a high dose of methylfolate? We are trying to figure out the B12 component of all of this. I would love to know.

      Also, this gives us hope in increasing our sons methylfolate dose beyond what he seems to be able to tolerate (2 mg). He initially tried 7.5 mg of methylfolate, and felt great, but in a matter of days he was completely overmethylated (extreme soreness and agitation), so he took some niacin and went back to a low dose. I guess my question is, did you just keep adding more to your dose no matter how overmethylated you felt? And, did you just keep taking niacin for symptoms of overmethylation, but ignore them and keep going up? We just figured our son had hit a ceiling with 2mg. I would love to hear your thoughts on all of these questions.

      Thanks!

      • Dr Lynch November 26, 2014 at 8:46 pm #

        Cathi – read this latest post – it may help:
        http://mthfr.net/preventing-methylfolate-side-effects/2014/11/26/

      • Cathi November 26, 2014 at 9:14 pm #

        I should add (to my previous comment) that my son is currently also on an antidepressant. He began taking methylfolate (and also methylcobalamin) as an adjunctive treatment to his antidepressant, because he has had treatment resistant depression and has had little success with anti-depressants.

      • Oskar November 27, 2014 at 8:42 am #

        Hi Cathy,

        Since I have been treating downright B12 deficiency symptoms, I have been on a 10 mg injection once a day for some time (or the equivalent in B12 patches—drdavidspatches.com—which work very well).

        My way to the methylfolate megadoses was not straightforward. Initially I had my socks blown off by 100 mcg! What I did was I stayed on the lowest ”energizing” dose I could tolerate. After a while I started sliding into undermethylation on that inital dose. It’s like the body wanted to shift gears. So then I upped the dose slightly until I felt energized again. If SEVERE overmethylation symptoms arose I quenched them with B3, but mostly I just pushed through and the symptoms would disappear within a few hours or overnight. The need for methylfolate seemed to increase almost exponentially—that is, when I had reached the higher doses a minuscule increase didn’t make any difference at all. So now I’m sifting between 10—15 mg doses 3 times a day. 10 if I feel good, 15 if undermethylation symptoms return.

        So, to sum up, the ”ceiling” was not fixed for me. It crept upwards when I had stayed just below it for a while. But this is only my personal experience and I have no clue as to your child would react.

        And for me, the MB12/methylfolate ratio doesn’t seem to matter much for me as long as they are both sufficiently supplied. MB12 has never caused overstimulation for me, just a sense of balanced well being. Methylfolate, however, have caused and can still cause agitation at times.

        Best of luck!

  24. Jennifer December 8, 2014 at 6:28 pm #

    Hi Dr. Lynch,
    I have 4 children. One of our children, age 24, has been experiencing major depression, and we recently discovered that he is homozygous 1298. He is now taking methylfolate and methylcobalamin and doing pretty well. Because of this, we had our other three children tested just to know what their status was. All three of our other children are healthy and completely functional without any mental illness issues. However, we discovered that out of our other three kids, one is heterozygous 1298, and the other two are homozygous 1298. My husband and I are each heterozygous 1298 and are completely fine and have never had any health issues, so we aren’t worried about our lone heterozygous 1298. We are mainly looking ahead for our other two homozygous 1298’s. They are still quite young. One is 17 and one is 12. We have started to give them the optimal multivitamin (chewable) (400 mcg’s of mthf). Do you think this is sufficient, at this point, in the absence of any symptoms? We don’t really want to wait until there ARE symptoms. We just want to help keep them healthy.

    • Dr Lynch December 9, 2014 at 6:54 am #

      Jennifer –

      Great comment and you’re right – point is to stay healthy. Do the dietary and lifestyle recommendations as recommended here – along with just basic supplemental support as you are doing and that will go a long way.

      Here is a good article also to keep healthy with – http://mthfr.net/toxic/2014/12/09/

      • Oskar December 10, 2014 at 9:53 am #

        Hi Dr Lynch,

        When I posted my initial question above, I didn’t expect you to answer it, so I addressed it more publicly. You did surprisingly dive in, though, to comment on another poster’s concerns. I still haven’t come up with a solution to my issue, so this time I’ll try and address it directly to you, if you do have a minute (I totally understand if you don’t). Maybe my post was too long for you to browse through. Here is the short version:

        • Felt AWESOME on very low dose (200 mcg) methylfolate initially, but often hit overmethylation rooftop.

        • I started low and went slow only to see a kind of ”tolerance” developing after a few months: larger doses were needed to achieve the same sense of brightening and vitality. Overmethylation less common.

        • Today overmethylation just doesn’t happen, and even on 3×15 mg/day of methylfolate I can feel undermethylated.

        My methylcobalamin dose has stayed the same through the process: 10 mg SC/day. Other than that there are no confounding factors to take into account.

        Can a tolerance develop—a ”methylfolate resistance”, like insulin resistance? Can it be reversed? Or do I need another cofactor?

        Very grateful for any suggestions. Thank you for your efforts.

        • Oskar December 10, 2014 at 11:06 am #

          I should add that initially I even had a serotonin syndrome—yes, full blown—going on for a night or two. This happened on just a few grams of methylfolate. And now I’m struggling to get even a normal buzz going, even though I’ve titrated up to megadoses.

  25. Gloria Schaefer December 14, 2014 at 5:09 pm #

    I am trying to determine a safe dose of L-Methylfolate during pregnancy. I had a doctor recommend a high dosage and I am looking for confirmation on the safety.

  26. Caleb January 30, 2015 at 6:26 pm #

    Dr. Lynch,

    Can you provide any guidance on supplementing a 6 month old who is confirmed heterozygous 677? I cannot find any information anywhere. Thank you.

  27. Elisa January 30, 2015 at 9:54 pm #

    Dear Drs, I have elevated Folate levels – 24 ng/ml, and lowish B12 (around 400). I’m 40 and homozygous for A1298C.

    I also am having a terrible time with memory lately. my neurologist wants to put me on Cerefolin NAC for memory – but it has over 5mg of l-methylfolate! Shouldn’t I be REDUCING my folate intake? Or does l-methylfolate help me process the other folate? Is there any other way to reduce folate levels?

    Any insight is super appreciated. Thanks!

    • Dr Lynch January 31, 2015 at 5:05 pm #

      Elisa –

      Elevated folate levels may mean that you are not able to get it into the cell. If it doesn’t get into the cell, it doesn’t get used up. If not used up, it builds up.

      Could be due to many reasons – one being B12 deficiency – specially methylcobalamin.

      I get into BIG detail on this in the Part 1 and Part 2 courses available at http://www.seekinghealth.org

      • Elisa January 31, 2015 at 6:19 pm #

        Thanks so much! I am going to sign up for these courses this weekend. But can you please tell me if it is unwise to take the Cerefolin while already having elevated folate levels or because it’s a better processed form, it’s ok?

  28. Tammy February 9, 2015 at 6:49 pm #

    I’m having headaches with Methyl B12. I’m homo1298. Can I take adeno B12 or hydroxy B12 instead? Thank you.

  29. Nicole February 15, 2015 at 4:47 am #

    Hi Dr Lynch
    I am homozygous for 1298. I wondered how much riboflavin and P5P you would reccommend daily? Also is it fine to take phosphatidyl choline in you struggle with anxiety?

    Thanks for your help.

  30. Marwa El-sayad March 1, 2015 at 10:02 pm #

    im hetero mthfr c677t…i was on folic acid high dose …now i shifted to metafolin and methylb12 …i wonder wt is the recommended dose …knowing that i try to get pregnant

  31. Nohora Groce March 17, 2015 at 2:51 am #

    I just got Methylfolate and is 1000 mcg microlingual. Is that a good dose to start?

  32. Bella March 20, 2015 at 2:14 pm #

    So, I know you advise 1/10th dosage of Niacin if there are reactions but I already take a high dose niacin for cholesterol issues. Is that ok? I take 2500-5000mcg of B12 , Vit K2, D3, CoQ10, ALA, Inositol, Chromium Piconolate, Fish Oil, Turmeric and Magnesium, all of these daily.

    I haven’t found any info on if Methylfolate (1000mcg sublingual) is ok to take with high doses of Niacin for cholesterol.

    Ideas?

    Thanks in advance!

    • Dr Lynch March 21, 2015 at 4:52 am #

      Bella –

      High cholesterol can be issues with mitochondria, diet or methylation.

      It is fine to take methylfolate with niacin.

      Just keep in mind that your serotonin levels may increase – and as a result – anxiety or irritability – or histamine.

      Just keep that in mind…and adjust as needed with your doctor.

      Remember – supplements are merely that – a supplement to your health – not intended for a daily thing – take when needed and as directed by your doc.

  33. Carla April 6, 2015 at 2:31 pm #

    I saw the Unmetabolized Folic Acid Test by Metametrix is no longer available. Is there another test that I could take or have my doctor order? I have been taking 4mg of folate and I’m wondering if it’s a good level because I’m trying to conceive.

  34. Brenda April 9, 2015 at 2:52 pm #

    Hello Dr. Lynch,
    I am new to all this and trying to fully understand it. Last November my doctor tested me for many things through the HealthDiagnosticsLaboratoryInc. Several tests were done including MTHFR. MY C677T was in the optimal range , but the A1298C was in the high risk range. (C/C -7-12/ A/C–30%/ A/A -58-63%). He Rx’d Deplin 15 mg and Niacin. I have not refilled the Deplin because it is so expensive. I really didn’t notice a difference in how I felt. I also received a BIOTE implant (bioidentical hormones) at the same time and felt that it was too high in testosterone. I have had side effects- unwanted facial and body hair, acne -and maybetoo much estrogen. I also take an oral progesterone. So, all of this is confusing. I want to know what to do to keep my folate levels in correct balance but don’t know what to do now. I clearly do not understand everything related to MTHFR and so far haven’t read an explanation that makes complete sense to me, so I hope you can direct me to that information.

  35. Lynn May 7, 2015 at 6:15 pm #

    Can I take both of your products: Active B12 with L-5-MTHF and HomocysteX?

  36. Tammy May 10, 2015 at 2:30 am #

    My doctor just prescribed 400-600 mg methylfolate for my homozygous MTHFR a1298c mutation. After trying to purchase it at my favorite pharmacy, they and I think that was WAY too much and should have been mcg. What do you say?
    Thanks!

    • Aron May 11, 2015 at 11:17 pm #

      Hi Tammy – This was likely a typo on your doctor’s part. 400-600 mg (milligrams) would be an astronomical dose. Micrograms (mcg) is probably what your doctor meant. 🙂

  37. Kate May 31, 2015 at 1:58 am #

    I have to go very slowly with supplements, and one at a time. Does it matter which I start with – methylfolate or B12? And do I increase A to optimal dose, then add B, or should I increase A then B, more A then more B, etc. increasing them in tandem. ~Thanks!

  38. Jennifer July 17, 2015 at 8:44 pm #

    Im really anxious to know if I can take:

    Seeking Heath’s Active B-12 with L-MTHF while breastfeeding.

    It has 800mcg of folate (5-methylterahydrofolate, glucosamine salt)
    and
    1000mcg of B-12 (methylcobatamin and adenosylcobalmin)

    I read of LIVESTRONG that breastfeeding mothers should dose at 2.5mcg of b-12…its SOOOOO much lower of a dose of what I have…Im so confused.

    • Dr. Aron July 22, 2015 at 9:18 pm #

      Hi Jennifer – 2.5 mcg of B12 seems to be the recommendation in line with the recommended daily allowance (RDA) which is the amount deemed sufficient for most people. There is no upper limit to B12 because it’s been deemed safe with no adverse effects even in higher doses (https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/#h8). During nursing, it is often more detrimental for the child if the mother is deficient in B12. If you have concerns specific to your situation, please double check with your doctor. Hope this helps!

  39. Elaine July 30, 2015 at 6:37 pm #

    I think I recently saw a list of medical food supplements in addition to Deplin. I recently took Deplin for a month with every worsening horrendous side effects. I will never take Deplin again but might consider something else in a tiny dose.
    Feeling hopeless, EG

  40. Lori August 4, 2015 at 3:59 am #

    I have both C677T & A1298C MTHFR mutations and just lost a baby due to a neural tube defect. My doctor has me on Folinic Plus which has 4mg folinic acid, 2 mg methycobalmin, and 50 mg pyridoxal 5 phosphate. He told me to take 2 of these a day but after a few days and serious abdominal cramps I have been taking one a day and feel much better. Should I be taking methyl folate also or is the folinic plus sufficient? Should I take a separate multi vitamin or just get one with all of that as well (like Optimal Prenatal)? Can I take something like the Optimal Powder and the Folinic Plus together?

    • Dr. Aron August 30, 2015 at 5:28 am #

      Lori – It’s tough to answer this question for your specific situation. However, if you are trying to conceive, please take a look at Dr. Ben’s article on prenatal supplemenation. You can discuss this with your doctor and hopefully you can decide on the next steps that are right for you.

      • Lori September 1, 2015 at 2:14 am #

        Hi, I did that and talked to my doctor. He just doesn’t understand mthfr, I feel like no one does except you guys. I now am taking the Optimal Multivitamin plus 2000mcg methylfolate (metafolin) and 1000mcg methylcobalamin. (Also Vitamin D & Probiotics). My doctor told me that was probably good but that I should also take 4000mcg folic acid with it because they know the high dose of folic acid helps prevent ntds but there is no evidence that methylfolate does. Really? I argued with him that if I have this mutation then I can’t process folic acid or maybe a little will get through the metabolizing process with that high amount and the rest will just build up in my bloodstream like a toxin. I argued that what is the point of that, why not go straight to the “body ready” active form. I even suggested that maybe there was no proof of methylfolate being more beneficial because doctors never tell their patients to try it because they don’t know enough about mthfr and the methylation process. I have been doing a lot of research on this and I think what I’m doing is the right thing but I don’t really know! I know I feel better, I know I’m having a bowel movement every day after suffering with constipation my whole life, I know that before I was taking 1200mcg folic acid and my unborn baby had to die because of a fatal neural tube defect. My doctor recommended I take both the 2000mcg of methylfolate AND 4000mcg folic acid. Don’t you think this is ridiculous and counter active? Or do you agree? I thought I should be avoiding folic acid. I just wish someone would help me. I just want to do the right thing, I’m so scared that this will happen again when I get pregnant again, or that my child will have a lot of health or neurological problems (my husband is compound hetero too) if I don’t get on the right plan.
        P.S. I’m really liking the Optimal Multi (and the detoxing effect I’m feeling) so I thought I would stay on it for a few months then maybe switch to the Optimal Prenatal.

        • Dr. Aron October 12, 2015 at 9:17 pm #

          I hear you that it can be scary. It sounds like you are being proactive taking care of your own health, which directly effects the health of your children. I don’t agree with taking folic acid in addition. There’s no biochemical need if you are taking methylfolate and eating your leafy greens. If anything, folic acid is counter-productive. Consulting a doctor from the Physician Directory would be a good next step to get some reassurance that you are on the right track.

  41. Lindsay Piedra August 4, 2015 at 7:54 pm #

    Dr. Ben,

    I recently started taking your optimal prenatal vitamins but I can tell that I need more methylfolate (I’m compound heterozygous MTHFR). What would you recommend taking in addition to the prenatals? I’ve taken your active B12 and methylfolate lozenge as well as your homosystex before and have done well on both I just don’t want to overdo it because I know I am getting a lot of B vitamins already from the prenatal. I’m not pregnant yet but hope to be soon.

    Thank you!

    Lindsay

    • Dr. Aron August 15, 2015 at 12:52 am #

      Hi Lindsay – It’s hard to say whether you need to take more or just based on this information. This article on prenatal supplementation should give you an idea of Dr. Ben’s general guidelines for women preparing for pregnancy. You can then discuss with your doctor to make any necessary adjustments. I hope this help. Please keep us updated!

  42. VICKIE harter August 12, 2015 at 12:55 pm #

    My daughter in law has both copies of the 677/1298 gene mutation. She had a baby boy three months ago and we are trying to put him on natural goats milk. In order for him to receive methyl folate and b-12, how do we determine how much a little baby should have added to his milk. I see 65 mcg on most places I have looked, but could you give us any information on what a reasonable and safe amount would be and any details on what else he should have. We are avoiding all folic acid products and we know he needs the folate and b-12 and we are about out of her breast milk. Can you help us with this dosage? Thank you so much. My email is: [removed]

  43. Betsy August 16, 2015 at 12:41 am #

    Hello,
    I have the genetic mutation C. I started with the B12 and MTHFR at 800 mg. I felt so much better after day # 2. At day 10. I developed an intense skin rash and swollen, red and itchy ears. I am now at day 3 and it is getting a bit better. MD ordered 40mg prednisone and benadryl. I used benadryl topical on my ears which helped a bit. I’ve taken 100mg Niacin x 2 days now with intense flushing.
    I am 63 and just found out about the genetic mutation. Could the MTHFR and 12 be releasing too much long standing toxin?
    I’ve stopped taking the B12 and MTFHR for now but do want to continue becuse it did make me feel better. Thoughts? Thank you.

    • Dr. Aron August 30, 2015 at 5:36 am #

      Betsy – you may be experiencing methylfolate side effects, which you can read about here and here. It’s possible that B12 and methylfolate may not be the right place to start for your specific situation. You may want to discuss these articles with your doctor before continuing.

  44. Dan August 22, 2015 at 12:30 am #

    hello group, i’m about to start L-methylfolate, i’m 45 yr old healthy male but suffer anxiety symptoms at times and mild depression at times…., when anxiety surfaces it is panic attacks and problems falling asleep (fast heart rate starts as falling asleep, anxiety triggers me back awake – anyone who has this knows it is bad and the only way i can sleep is using a benzo, which i dont like to do)… i’ve been on SSRIs a handful of times (short term for anxiety) since I was 30… at younger ages, i stressed more than my friends….. anyway, recently just having a lot of preventative labs done….. i found my MTHR genes 677 are perfect but my A1298C is heterozygous mutated – so not the worst combo but still affected 30-40% in processing folate eventually into all 3 vital brain chemicals – my homocysteine is about 1/3rd higher than it should be which of course is due to the hindered methylation

    so obviously, i think using methylfolate will help me with the homocysteine, and more mental chemical balance of course – i realize there is some things to avoid , like synthetic folic acid –

    i have no clue how much methyfolate i should eventually use, etc – and i’m aware i should use methyl b-12 with it for sure – anyone with my gene variation (see above) have any suggestions or links? i’m going to consult again with an NP somewhat versed in this but as I have read a lot of it comes down to the individual and gene combination MTHFR. Thanks for reading! I hope for all of us as a society, this type of therapy will continue to be fine tuned and further implemented.

    PS

    can i use TMG along with L-methylfolate or is that a bad idea? I read one source that said I could, some may know TMG also breaks down homocysteine and turns into the 3 brain chemicals we need.

    last but not least, i recently went on paxil 3 weeks ago due to my most recent anxiety flare up and it’s worked pretty well but i eventually want to get off it especially if the methylfolate starts balancing me out – anyone have any experience in doing this? I know they use methyfolate with SSRIs – but i would imagine as they taper off the SSRIs you may increase the methylfolate , at least in some cases…

    thanks for reading and offering info on anything i’ve presented.

  45. Nichole August 31, 2015 at 6:53 am #

    Hello!
    I have a question about folate and pregnancy. I have the heterozygous c677t mutation. I am currently nursing my 9 month old and plan to get pregnant soon (or at least try). I take 400 mcg of methyl folate (plus 1000mcg b12) in one tablet and then I take 800 mcg of folate((not folic acid )vitamin code raw prenatal)) in my other supplements…which =1200 mcg of folate. My question is…is this enough folate to support my nursing baby, a pregnancy and myself? My husband has also been tested and was also positive for c677t but homozygous. I have him taking the 400 mcg tablet with b12 for the last 3 months so that we can try again for another baby soon. I am extra concerned about this because my 9 month old has a sacral dimple (thank God it’s ok and not connected to his spinal cord) and I’m thinking it was caused by the fact we didn’t know we had the mutations and I wasn’t taking folate supplements at the time and vitamin code prenatal I was taking hadn’t switched from folic acid to folate yet at that point , PLUS I was nursing my oldest still and I think my baby wasn’t obviously getting enough folate when he needed it. So to sum it up… My questions are 1) how much folate should a nursing mother that plans to get pregnant soon take before pregnancy and during? 2) is my husband taking enough folate as well? If not how much should he be taking?
    Thanks so much for your help, I’ve been searching for an answer for months and haven’t found it yet .

  46. Kristin January 6, 2016 at 3:41 pm #

    I found out last week that I am positive for two copies of the c677t mutation. The nutritionist who tested this seemed not very well versed on the subject of MTHFR and told me to start taking folinic acid. I went to The Vitamin Shoppe and purchased Source Naturals MegaFolinic, 800 Mcg. I’ve been taking one 800mcg tablet a day for a week now. After reading some replies on here, I am now afraid that I started too quickly. Should I stop? I am very nervous now that I started the dosage too high. Thank you.

  47. Lynne Clement January 12, 2016 at 3:46 pm #

    Dr. Ben,

    Would you be willing to rally the troops to help us try to get Deplin covered by our health insurers? Even a 50% coverage would have a huge financial impact for many of us. Can the case be made that insurers could financially benefit from this decision?

    I just got off the phone with my health insurer (Highmark). I wanted to find out the most cost-effective way to purchase Deplin. What I learned is that since Deplin is considered a supplement, it is not covered by my health insurance. I asked what we can collectively do to effect change here. It makes financial sense to me that insurers would want to cover Deplin in order to prevent the costs of treating the diseases, miscarriages and birth defects (i.e., costs of treating) that NOT taking the supplement can cause.
    HERE IS WHAT I LEARNED and CAN DO:
    1) Make sure your pharmacy runs your prescription through your insurance and it is rejected. Any time my insurer rejects coverage of a prescription, there is learning — insurers can keep track and monitor this data. Big numbers of rejections and our voices will call attention to the data. I learned that my pharmacy did not even run my prescription, so my insurer did not even know they rejected it. I need to change that.
    2) Appeal the rejection and even though the insurer may not change its mind immediately, this is an opportunity for us to educate insurers. Put your feedback in writing to your insurer. Tell them you need Deplin to keep your family healthy and ask them to provide coverage for Deplin. Tell them why. We need to educate.

  48. Sarah February 4, 2016 at 9:03 pm #

    Hi,

    I recently discovered that I have the MTHFR mutation. My doctor prescribed Heplin. My paternal grandmother and my father have pernicious anemia. Can you recommend what steps/tests to take next to help determine where I should go from here? I haven’t started the Deplin yet, as I am afraid this may not be the right step without further tests.

    Thank you!!

  49. Jenn February 17, 2016 at 9:22 pm #

    Hi Dr. Ben,

    I recently did the most comprehensive blood work from True Health diagnostics that I have ever done. For past 6 years, have had extreme cervical issues. The two things that came back in the bloodwork and various inflammatory cancer screenings, was a red flag marker in the cervical/uterine area (which I knew of) and then the mutated gene MTHFR C6777T showing at intermediate risk on test results.
    I like to assimilate facts, esp. before taking things…but Dr. Doni (on her website) discusses the link between this mutation and cervical dysplasia and cancers.
    However, my doctor is prescribing me a whopping 15 mg of L-Methylfolate based on these results and wants me to order from methyplpro.com

    I really wanted your opinion on that because I feel it is a bit high of a dosage, based on what I have read….but then again, I have a red flag on the endometrial/uterinie/cervical tumor marker screening for CA125+ (U/mL) — should be below 36, mine is at 38

    This doctor wants me to order the product from methylpro.com and take 1 in the morning of the 15 mg
    Also the vitamin b 12 she is recommending at 2500 mg in morning and 250 mg of niacin at bedtime, the flus-free/ extended release

    I am petrified to buy anything at this point because I’m not sure of the correct dosage for me. It seems such a far gap between the 1000 mcg and the 15 mg….but based on results of my bloodwork not sure why the high dosage

    Also, I take Dr. Schulze’s Super Food Plus (have taken it for 5 months) but it does contain folic acid at 267 mcg daily. Recently, have gotten headaches and have had terrible insomnia. Not sure if it is the folic acid that is the culprit.

    Any suggestions or advice you may have would be greatly appreciated and also maybe any insight you may have on that methylpro.com website that she mentioned.

    Thanks in advance,

    Jenn

  50. Sarica February 23, 2016 at 3:12 pm #

    Hi Dr. Ben, I’m just wondering your opinion of the MTHFR testing from Cell Science Systems? Thank you!

  51. Suzy March 22, 2016 at 7:57 pm #

    If I am understanding correctly, you raise B12 and keep the folate the same? I take 400mcg methyl folate and 1mg methyl cobalamin and don’t feel any side effects from this. I can then add 1/2 tab more of the b12?

    Sincerely thanking you for answers.

    • Dr. Aron March 28, 2016 at 9:57 pm #

      Suzy – Dr. Lynch’s example references a specific Active B12 with L-5-MTHF lozenge from SeekingHealth.com. So in this example the 1/2 tab more would be 400 mcg additional methylfolate and 500 mcg additional B12.

  52. J Rolli April 14, 2016 at 7:25 pm #

    I am homozygous CT677 MTHFR and was started on liposomal MTHF 3 pumps daily plus supplements. Doing well, but could you please give some guidance for transition dosing to HomocystineX/ tablets a for a place to start? The specification approximates per pump are:
    4mg – 5-MTHF
    1mg – Hydroxycobalamin (B12)
    1mg – Methylcobolamin (B12)
    1mg – P5P (B6)
    1,000 IUs – Vitamin D3
    Obviously big absorption differences from liposomal and GI, because I doubt I am taking 12mg of 5-MTHF! Thank you.

  53. Jessica April 18, 2016 at 9:18 pm #

    I was recently diagnosed as homozygous C677T two mutations. An ND put me on 2.5 MG of methylfolate and in a week I increased to 5 MG. I’m feeling great. My anxiety levels have dropped and I had no pms symptoms prior to the start of my cycle. I’m tolerating things which used to easily irritate me much better. My girls are heterozygous, one of each gene. I started them on 2.5 MG of Metabolic Maintenance 5-MTHF

    After about 1.5 weeks I uped the girls doses to 3.75. On day 2 my 7 year old is melting down and saying she is tired all day. I’m going to drop her back to 2.5 MG. My 10 year old is much calmer, and handling situations much better tgat would normally make her flip her lid.

  54. Mel May 18, 2016 at 1:21 pm #

    Hi Dr Ben, I tested positive for Heterozygous C677TT & A1298C. For the past 8yrs I’ve suffered from rapid heart rate, chronic low grade fever, fatigue, muscle aches/weakness, brain fog, eye floaters, and headaches. I felt great until about 8yrs ago and my symptoms came on very suddenly and grew progressively worse. I believe there’s a very good chance I was exposed to mold where I worked and/or where I was going to college; my symptoms suddenly appeared when I started that job and going to college. I’ve also been tested for and shown to have a genetic defect that makes it difficult for my body to remove mold toxins. For past two weeks I’ve been taking 7-10mg of Chlorella and for the past few days have been taking 5-7mg of Methylfolate & 10,000mcg of B12 & B6. I haven’t seen any improvement yet, but have felt more achy and my heart rate is all over the place. Also last few days I have not been sleeping well. I’m not at all sure on how much I should be taking of everything or how long it should take to start feeling better and seeing improvement. Any input would be greatly appreciated. thank you!

  55. Debra June 11, 2016 at 8:20 pm #

    I found several products online that contains the elements necessary to processes methylfolate in small to moderate doses, noted as Quatrefolic. Country Life coenzyme B-complex contains the above. The jury is still ou

  56. tristan June 13, 2016 at 1:04 pm #

    Dr Ben,
    I have an 18 month old with hetero Kruger on the a strand. He is slightly anemic and his teeth are wrecked even being breastfed which I believe are all linked to his gene mutation. How much methylfolate and b12 should I give him and where do I find it? Thank you! Tristan

  57. Julie Conger July 16, 2016 at 8:17 pm #

    Should you start off with the Active B12 Lozenge With L-5-MTHF as the first step once you find out you have MTHFR? I am 677C>T: Heterozygous mutant, 1298A>C Normal.

    I have been taking your Optimal Multivitamin but I believe I need to be taking a B12 and more L-Methyfolate? I’ve seen many naturopaths who aren’t sure what to give me.

  58. Julie Conger July 16, 2016 at 10:48 pm #

    Do you have to take a Pyridoxal 5-Phosphate (P-5-P) with your Active B12 Lozenge With L-5-MTHF in order for them all to work?

  59. Fata July 23, 2016 at 1:04 am #

    I need to know what doses of Methylfolate and b12 should I start with? And is there anything else that I need to add? I am newly diagnosed with Mthfr Mutation C.665C>T and Mthfr Mutation C.1286A>C heterozygous. My doctor prescribed me folgard which I don’t want to take since I find out that I have this gene defect and because I start swelling every time when I take any prenatal vitamins or b-complex. Now, I think that is because of folic acid. I had 2 miscarriages and I plan to get pregnant again. I also have antiphospolid syndrome (Phosphatidylserine IgM 44 units/mL range is 0- 24 units/mL) and I take aspirin 81 mg a day for that. I also want to know once when I get pregnant should I continue taking the same doses or more?

  60. Rachel R. July 28, 2016 at 12:01 am #

    I tried 200 mcg of 5-methyltetrahydrafolic acid, after having been on B12 for several weeks, and it kicked my butt. I’m wondering, though, as I re-read this page, if my B12 might not have been adequate.

    What about those of us who, due to other mutations, can’t take the methyl form of B12? According to Dr. Yasko, based on other genetic markers (COMT and others), I should stick to the hydroxy and/or adenosyl forms, because I won’t tolerate methylcobalamin. Does this (the form of B12) have an impact on how methylfolate is metabolized?

  61. Judy forccino September 10, 2016 at 10:56 pm #

    Hi Dr Ben,

    I have been taking Deplin 15mg, and Thorne Methyl-Guard Plus 2 capsules 1 daily, I was getting sick, so we cut the Deplin in half. Still getting nausea and foggy head after eating, am I taking too much B’s as well or the wrong combo? Need B12 instead? I also have Chronic Lyme. I am wait for my Niacin and curcumin to arrive! Thank you for this website!

    • Dr Lynch September 15, 2016 at 4:03 pm #

      sounds like TOO much to me. Need to talk with your health professional about these symptoms.

  62. Darla Mullen October 20, 2016 at 11:38 pm #

    You mention 1/2 tab of B12 as well as a partial tab of niacin but don’t mention how many mg the tab is to begin with. Could you clarify please?

  63. Suppsforlife December 27, 2016 at 8:14 pm #

    My daughter has bipolar disorder. She takes wellbutrin and lamotrigine for the bipolar. Her homocysteine is normal but her Vit B-12 in blood tests is always high, highest was 1600. She was tested for MTHFR mutation and it came back homozygous A1298C. She started taking the L-5-MTHF 5mg but after reading we decided to stop and figure out the right way to do it. Because she has the mutation does the high B-12 mean her body is not using it? For some reason they didn’t check folate. Should we check that also? We were going to try the product you suggested to restart and slowly increase. Is it okay to take the methyl B-12 if her B-12 in the blood is high? Also what is the precaution with bipolar disorder for taking these supplements?

  64. Melissa December 31, 2016 at 1:31 am #

    I am having severe anxiety with methylcobalamin and methylfolate. I am homozygous C677T. My B12 level is very low and my doctor started me on a very high dose of methylcobalamin. The anxiety I got from it was crippling. Can I bypass the methyl’s all together and take folnic and hydroxocobalamin? Or will these not give my body something that only the methyl’s can?

  65. Mary O'Donnell March 1, 2017 at 2:48 pm #

    Could you please clarify when you say on the summits that folate is foliage and people aren’t eating their greens, it implies that folate from diet is fine instead of supplements? I also saw someone quote a study that used ‘folate’, not activated, and got results in improving methylation but yet the person said MTHFR means folate cannot be used from the diet.

    It seems you are saying it actually can be got from the diet but people aren’t eating their greens.

    • Dr Lynch March 8, 2017 at 5:39 am #

      If people are eating greens- they are getting methylfolate. If they are not eating greens, then yes – they need to supplement as needed.

  66. Jenn March 6, 2017 at 8:16 pm #

    I use Daily Essential Nutrients (worked up to 12 veggie capsules a day) after reading this article because it has methylfolate along with methylcobalalmin and has completely changed my life, my mood swings and anger rushes are gone.

  67. Siobhan Beaney March 9, 2017 at 6:53 am #

    I have been diagnosed with MTHFR A1298C mutation (heterozygous) and in May 2016 my levels of Plasma Homocysteine was 10.3. I recently did another test and the result was 11.8 umol/L which is concerning. I’m a 49 year old female and have an extremely healthy diet (lots of wild tin salmon, don’t drink coffee or smoke, lots of water & vegetables etc, not overweight). I ordered Seeking Health Homocystex Plus which I received today and just want to confirm this will be ok – especially after reading the side effects some have experienced! Am I best to take 1 a day or go slowly starting with only a couple of days per week? Many thanks
    Siobhan

    • Dr Lynch March 18, 2017 at 1:25 am #

      Hi Siobhan –

      I highly recommend reading this article to help prevent methylfolate side effects.

      HomocysteX Plus is quite effective at supporting healthy homocysteine levels.

      Consider for now starting with one capsule every other day with breakfast. Best to take it slow.

      Following some of the suggestions in the article is also helpful.

      Keep us posted how you are doing 🙂

  68. Jayne Mossop May 5, 2017 at 11:28 am #

    Hi Dr Lynch

    Hoping you can point me in the right direction please.

    My 7 and a half year old daughter is homozygous for MTHFT (C677T). She suffers from low mood, learning difficulties, low core muscle tone and has been found to have spina bifita oculta.

    I recently started her on a children’s multi/omega 3 supp (Smarty Pants Kids complete) that contains L-methylfolate 267 mcg and Vit B12 as methylcobalamin 67 mcg.

    She seemed to do well on it for a short time, her alertness in the classroom improved and her reading ability took a significant jump however a couple of weeks in we are seeing extreme mood swings, anger that she doesn’t know where its coming from and suicidal comments (I wish I was dead, I wish I had never been born etc.) which are incredibly disturbing as a parent particularly as she is only 7!

    I live in Australia and I am not under any guidance from a doctor at the moment on this.

    Can you please help. I obviously don’t have the balance right. I have not been able to find correct dosage information for children.

    • Dr Lynch May 10, 2017 at 1:58 am #

      Hi Jayne – this is a common issue. Do well – then tank and do horribly. MTHF is a powerful nutrient and I use it when they need it, then stop. Wait till they show signs of needing it again – then they do well – then stop. I typically stop when they start showing signs of aggression, anxiety, insomnia.

      At this point – definitely stop.

      Please read this Preventing Methylfolate side effects – thoroughly – and also how to neutralize them in ‘Methylfolate Side Effects’ – niacin 50 mg should help her immensely.

      • Jayne Mossop May 10, 2017 at 2:15 am #

        Hi Dr Lynch
        Thank you for your reply. Can you please advise children’s dosage for the niacin. Is one a day ok? How long do I supplement with this for? Same question with the glutathione and methyl folate.
        Many thanks

  69. Kevin Ryan May 31, 2017 at 1:46 pm #

    What is the difference between Active B12 and HydroxB12?

  70. Traci Veno June 9, 2017 at 9:17 am #

    Hi!
    I just received this information from plugging my raw dna report into this web site that said I have the Mthfr mutation.
    Where should I start?
    Should I be taking a supplement?
    Do I need lab tests done?
    It is all very overwhelming.
    Any advice would be much appreciated
    Kind Regards
    Traci Veno

    Gs192

    Gs192
    Magnitude 2.9
    Repute Bad
    Summary MTHFR polymorphisms affecting homocysteine
    Criteria Gs192/criteria

    You have a combination of 2 SNP variations in MTHFR which influence homocysteine levels. This is found in ~20% of people. 0.08% of people had a double copy of a mutation in one of the SNPs, and a single mutation in the other. [PMID 15834246] .

    gs193 indicates double mutations in both snps, and people with this are believed to be critically impacted, however several promethease users have self reported this genotype with no apparent consequences.

    rs1801131 is at position 1298
    rs1801133 is at position 677

  71. KEN June 21, 2017 at 12:48 am #

    HI just started taking half of 400 mgs tablet of metholfolate and 500 mgs of b12 been on a week no side effects when can we increase and by how much hetro gene thanks mr and mrs crabb adselaide australia

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