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.

Who should order this test?

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

What if my doctor won’t order this test for me?
You may order this test directly from Seeking Health. Please note that insurance is not accepted.

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

  1. Kim April 1, 2012 at 1:23 am # Reply

    When you take medications that can be tested by a lab you typically have to test periodically (monthly every six months and so on). I would assume with this test that even once you get to the levels you need your body is every changing and the levels can change? How often would you recommend somone test once they get to the right level?

    thanks

  2. Sofia April 3, 2012 at 6:09 pm # Reply

    Dr. Ben,

    I realize that dosage of methylfolate and methylB12 are individual specific. In trying to maintain the right balance as I titrate up with the methylfolate, is there a ratio I should try to maintain between the two vitamins?

    • Dr Ben April 3, 2012 at 7:24 pm # Reply

      Sofia –

      That is an excellent question which I do not know the answer to – and I don’t think there is any research on that – I have not seen it.

      We do know that these two nutrients are needed together.

      I would titrate up using the Active B12 with Methylfolate. I think the amounts of each nutrient in this tablet are well balanced as one increases the dosage.

      • kam December 14, 2013 at 1:21 am # Reply

        Hi,
        I need to know if I can take doses like 7,5 mg of Quatrefolic a day.
        My doctor tell me that he don’t know very well this story of folic acid.
        I’m in France, and it’s a family doctor, I can’t have better advises, and I don’t come in the US before two months.
        I read on a lot of websites that more than 2mg of vitamin b9 a day can be dangerous.
        I need to know if I can take 5mg or more of Quatrefolic safely.
        I want to take it because I was in contact with methyl alcohol (methanol) but not enough to have a treatment from my doctor (the treatment of methyl alcohol poisoning is folate or folinic acid).
        Since this exposure, I’m tired easily, and I’m tired of this situation, because now it’s very dificult to me to do my job, but I have to earn a living.
        If it can helps you, I’m a man of 27 years old, I have no health problem according my doctor, I take 20mg of paxil (paroxetine) since last january, because my doctor told me that it can helps me to relax.
        But I haven’t seen any great improvement with paxil.
        I have been taking vitamin b9 (800mcg) in folic acid form since last august.
        I have seen a little improvement since I take this vitamin, so I want to take more of this, to try to live and to keep my job.
        Please forward this email to someone who can answer me.
        Thank you very much for your help.

  3. Janis Bell April 10, 2012 at 6:58 pm # Reply

    Dr. Ben,

    Could you comment further (perhaps another blog post) on why niacin helps relieve side effects from too much methyl B12 and methylfolate?

    The side effects I get are stress-like symptoms (insomnia, hyper, sometimes jittery), but I am also COMT++ and MAO+, making me slow to breakdown dopamine and other neurotransmitters.

    This, and your blog on various types of methylfolate are great posts. I’ll be linking to them on my next blog.

    • Janis Bell April 10, 2012 at 8:23 pm # Reply

      Also wanted to ask if you were familiar with the Vitamin diagnostics lab methylation panel.

      It’s the only one I’ve found that looks at RBC folic, serum folic acid, and serum 5-MTHF. I found it interesting that, in my own case with C677R hetero mutation, and several other methylation snps, that taking only 400 mcg of 5-MTHF brought my serum levels up, but my RBC folate remained low. I was, and still am, vigilant about avoiding folic acid since serum levels were quite high.

      My hypothesis is that inflammation from environmental toxins (especially mold) damaged cell membranes. While I work to fix that with diet and supplements, detox and avoidance, I wonder if there is another lab that offers RBC folate levels since VDL has a slow turnaround time and the panel is extremely expensive. I was disappointed that Metametrix didn’t offer this as part of their profile, since it seems to me that serum levels give us only a part of the puzzle.

      • Dr Ben April 10, 2012 at 8:44 pm # Reply

        Janis –

        I am familiar with the Vitamin Diagnostics lab. I am not that happy with it either. There are no methylation tests that I am happy with at this point.
        - Vitamin Diagnostics is great in that it offers various types of folate but not all of them and also the glutathione is not RBC
        - Doctors Data is not complete enough
        - Metagenics is not complete enough – not nearly

        I hope to work with a lab who will listen to me and look at my research – then make a lab test based on my recommended markers. This would be ideal.

        RBC folate comes from food or conversion from folinic acid in my opinion. Folic acid is not folate. It has to be converted. I need to study all the cofactors from standard crappy folic acid to methylfolate. I know the cofactors for the last step to make 5-MTHF but the other steps – I need to study.

        • Robin April 13, 2012 at 6:02 am # Reply

          Dr Ben, Do you recommend supplementation with folate? We methylate inside the cells? Where does the methyl-folate go?

          All the info out there is very confusing.

          Yasko recommends small amounts of folinic, I think 100mcg a day. I’ve heard of others saying that folinic in addition to FA can block the methyltrahydrofolate from entering cells. So they avoid even folinic. I also understand that Dr Neubrander (last I read) uses folinic and slow release subcutaneous MB12. He has developed a special formula that creates a consistancy allowing the MB12 to slowly release over 3 days. His interest is autism and methylation in the brain.

          I am taking your sublingual metafolin-MB12 and still at least at times feel a need for additional sublingual MB12. My nerves can feel frayed literally, like live wires, gait can go off at times. The MB12 helps. On the other hand, high doses of metafolin up to 24 grams sent me for a loop mentally (extreme aggitation) and physically (balance off, feeling a bit disoriented). So I am holding with your one sublingual and extra MB12 sublingual.

          I’m not sure I need the extra MB12 daily or for those “special occasions.” My red blood cell size across the board (not sure if only MVC is relevant) presented in “normal” range with methylation supps but did seem to increase about the time I started lipo glut daily. I am not sure the glut was a factor.

          • Robin April 13, 2012 at 6:14 am #

            I meant 2.4 grams or 2400 mcg of metafolin….

    • Dr Ben April 10, 2012 at 8:48 pm # Reply

      Janis –

      Yes – good point. This is important to know and understand.

      The bottom line is niacin is metabolized by SAMe. So, this means that SAMe is used up in order to process niacin. This means that excessive precursors to SAMe (such as methylfolate and methylcobalamin) get used up quickly.

      Certain neurotransmitters are also broken down with niacin…

      I will be getting this article up – it’s big.

      • Janis Bell April 11, 2012 at 9:21 pm # Reply

        Thanks, I’m looking forward to it. In the meantime, i ordered niacin in case I ramp up too quickly.
        I think you meant Metametrix, not Metagenics.
        Good luck finding a lab. We really need a panel that can guide those of us with methylation snps into getting the right amounts. I just posted a summary of my story, which, due to the hundreds of opinions based upon inadequate knowledge of this complex issue, is entitled “Bumbling around Methylation.” Hoping now, with your guidance, to get a good ratio as I”m already doing everything you recommend for C677 mutation thru my own trial and error and ND background.

        Also very interesting to me is your idea that RBC folate comes from conversion of folinic acid. When, during 2005 I was taking Folixor in the higher dose they had available (I recall it was 5 mg tablets) and for the first time in years, my MCV came into a good range. I don’t recall why I stopped, perhaps because I did Yasko’s nutrigenomic testing and started to supplement specific forms of B12 and 5MTHF

  4. Dee April 16, 2012 at 9:44 am # Reply

    How will I know if I’m “feeling side effects from taking Active B12 with Methylfolate”, or just detoxing? What are all the possible negative side effects? I have so many symptoms that I’m not sure how to sort some of this out.

    Thanks!

    • crosswind April 22, 2012 at 11:33 pm # Reply

      I am newly diagnosed with one gene just started my methyltetrahydrofolate with B12liquid and feel slight anxious, insomnia, irritable, like i just can’t get comfortable with anything, more tired, lost my appetite, cravings or thirst for anything specific. I want to cry easily. I will call Dr tomorrow and ask if we should reduce. Dr. started me on 1mg right away. I’ve always been physically & energetically very sensitive.

  5. Jessica Scott May 17, 2012 at 10:31 am # Reply

    Hi- Im taking 50 mg p-5-p and 1 mg methylcobalamin a day along with a 81 mg aspirin. I have been looking for L-methylfolate in my town and cannot find it. I did find Metafolin though. Would that be a safe alternative to get my folic acid? Thanks!

    • Sofia May 17, 2012 at 7:16 pm # Reply

      Hi Jessica, Metafolin is the registered trademark name for l-methyl folate.
      Regards,
      Sofia

    • Dr Ben May 17, 2012 at 7:47 pm # Reply

      Jessica –

      Metafolin = L-5-MTHF = ‘methylfolate’

      It may be less expensive for you along with being easier to take HomocysteX by Seeking Health.

      HomocysteX provides:
      Vitamin B6 (from 41 mg pyridoxal 5’-phosphate) 25mg
      Folate (as Metafolin L-5-methyltetrahydrofolate) 800 mcg
      Vitamin B12 (as methylcobalamin 1000 mcg

      Best taken first thing in the morning before breakfast.

      • Jessica Scott May 18, 2012 at 8:50 am # Reply

        Thanks so much Sofia and Dr. Ben!!

  6. Robin June 2, 2012 at 2:26 pm # Reply

    Hi Dr Ben
    I learned so much from your information! The MTHFR video was very well done.

    Could you help me with a reference for the percentage of the population that can’t metabolize folic acid?
    It sounded like 50 percent of the population was effected. Is this correct?

    Thank you.

    • Dr Ben June 3, 2012 at 9:33 pm # Reply

      Robin –

      I will rephrase your question and state:
      “How much of the population has difficulty with metabolizing folic acid?”

      I venture to guess that 1 in 3 have issues. New mutations are being found all the time which increase the prevalence of folic acid metabolism.

      We have to keep in mind that some of these mutations are not even identified yet – or if they are – we do not yet know their prevalence or clinical significance.

      Upwards of 50% is found in certain populations – such as Italians and Mexicans.

  7. Andrew Roberts June 6, 2012 at 12:10 pm # Reply

    Hi

    Is the methyl-folate in this product going to be of benefit? It does not say that it is Metafolin.
    http://www.methyl-life.com/purchase-methyl-life.html

    Thanks

    • Dr Ben June 6, 2012 at 4:28 pm # Reply

      Hi Andrew –

      Great question.

      Please send her an email and ask. Do comment again and let us know what you find out. I’ve been wanting to ask her about it – but haven’t done so yet.

      From my understanding, no supplement can contain more than 800 mcg of L-5-MTHF when in a formulation. A single nutrient supplement may contain 1,000 mcg of L-5-MTHF. These are guidelines may be Merck (maker of Metafolin) and I also believe Gnosis (maker of Quatrefolic) has restrictions as well.

      So I am not sure if Methyl Life contains 800 mcg of L-5-MTHF and the rest as the racemic form of MTHF which is not absorbed and may in fact block absorption of L-5-MTHF.

      Some supplement companies are somehow getting around this requirement which, in my opinion, may be dangerous. L-5-MTHF is a nutrient that must be respected and not simply taken in high amounts by all.

      For more information on this subject of which form of methylfolate is useful, please read this article.

      The Methyl Support product contains a fair amount of copper. I find many need to be cautious with copper as well – especially those with pyroluria or mood imbalances.

      • Andrew Roberts June 6, 2012 at 10:50 pm # Reply

        Hi Ben

        Thanks for that.
        I have asked Jamie and will comment here later.
        Do you know of a good Methyl Support product? Most support products contain the non-active form of folate.

        Thanks
        Andrew

        • Andrew Roberts June 7, 2012 at 11:02 pm # Reply

          Jamie from Methyl-Life says “I do not use Metafolin(R) in my product, the L-Methylfolate I use is a generic racemic mixture”

          • Dr Ben June 8, 2012 at 12:09 am #

            Ok – good to know. Thanks for sharing. That’s critical to know.

  8. Janis Bell June 7, 2012 at 12:45 am # Reply

    Metabolic maintenance introduced a new high dose Quatrefolic product, 10 mg. They say it does not contain any of the racemic forms.

    I won’t be taking it in any case.

    • Dr Ben June 7, 2012 at 5:22 pm # Reply

      Janis –

      You are right about the new Metabolic Maintenance product. I am actually shocked to see that this is offered; however, I do not think it is available over the counter – doctors much prescribe it – I hope!

  9. Andrew Roberts June 7, 2012 at 11:15 pm # Reply

    Hi Ben,

    Here you say to take 1/2 tablet of Active B12 with Methylfolate. Increase to a full tablet after 1 week.

    In the comments for Active B12 with Methylfolate product you say “Optimal Multivitamin is recommended alongside Sublingual Active B12 with Methylfolate because of all the complementary B vitamins, minerals and antioxidants. Consider taking 2 to 3 capsules of Optimal Multivitamin with breakfast and with lunch”

    If I take 6 Optimal Multivitamin a day, it means that I am getting:

    Folate (as L-methylfolate, Metafolin) 400 mcg x 6 = 2400 mcg
    Vitamin B-12 (methylcobalamin) 125 mcg x6 = 750 mcg

    as well as 1/2 tablet of Sublingual Active B12 with Methylfolate giving:
    Folate (as Metafolin®* L-5-methyltetrahydrofolate) 800 mcg x 0.5 = 400 mcg
    Vitamin B12 (as methylcobalamin) 1,000 mcg x 0.5 = 500 mcg

    If I am taking both products at recommended starting dosage level, I end up with 2800 mcg a day of Metafolin, which is 7 times as much 5-MTHF a day that you recommend starting off with on this page?

    Or are the Metafolin ingredients in the 2 products not the same? Have I missed something?

    Please clarify?

    • Dr Ben June 8, 2012 at 12:16 am # Reply

      Andrew –

      You start with one supplement at a time – and in this case – you start with the Active B12 with Methylfolate – and a small amount of that first.

      If you do well with the Active B12 with Metafolin, then you begin the Optimal Multivitamin and introduce the amount taken slowly as well – one capsule at a time.

      This is for those who are sensitive.

      The amounts taken vary from individual to individual.

      You are not reading the amount of Metafolin properly in the Optimal Multivitamin. There is only 400 mcg of L-5-MTHF as Metafolin in 8 capsules. There is also only 125 mcg of methylcobalamin as well – per 8 capsules.

      Seeking Health supplements use Metafolin.

      Hope this helps it make it more clear.

      • Andrew Roberts June 8, 2012 at 12:22 am # Reply

        Thanks for the clarification. It was not clear to me that the amounts specified in the supplement facts are for 8 tablets. But now that I read the serving size is 8 tablets, I guess that makes sense.

  10. Nadette September 12, 2012 at 2:51 am # Reply

    Dr Ben , I recently found out that I am compound hetero. I have no idea where to begin with vitamins and supplements I should be taking. Please give me any advice possible!!! Thank you SO much! I am learning so much from your site everyday, thank you!

    Nadette

    • Lynn_M September 12, 2012 at 10:40 pm # Reply

      My advice is look in the Articles tab and read and/or listen to what Dr. Ben has there. The C677T protocol really applies to any of the MTHFR mutations. There’s a lot of information in the forums, too, some of it written by Dr. Ben, but mostly posted by the members here.

      • Nadette September 12, 2012 at 11:36 pm # Reply

        Thank you, found an article to help get me started! I will be ordering the sublingual B12 with L-5-MTHF so I can start right away! I’m hoping to notice a difference. Thank you for the info!

        • Nadette September 14, 2012 at 12:48 am # Reply

          Another question, you say to keep upping the dose by 1/2 tab per week til you feel good, so what’s the max allowed? Just want to be sure there’s not a limit I should watch out for.

          Thanks!

          Nadette

          • Lynn_M September 14, 2012 at 7:48 pm #

            Hard to give a max. Depends on what other genetic mutations you other. The prescription Metanx comes in 7.5 and 15 mg doses, if that’s any guideline. Most people don’t need that much, but there is one person and his family who needs lots more.

  11. Sarah September 18, 2012 at 11:18 pm # Reply

    Dr. Ben,
    I compound heterozygous for mthfr mutation. I have had 2 repeated miscarriages. I have started taking metanx 1 month ago and had my rbc folate done a week ago. It was a little high i.e, 523. Does that mean that I don’t need metanx any more? Is RBC folate same as l methylfolate or does that test detect folic acid? One more thing, if RBC folate is normal does that mean that there is another cause of repeated miscarriages besides mthfr?
    Thank you so much.

  12. Karen November 10, 2012 at 1:17 pm # Reply

    Dr. Ben,
    I am homozygous A1298C. I began titrating your B12 sublingual tablet – 1/4 for four days, then 1/2 tablet for a week. I immediately noticed a lift in energy and spirit. My urine was noticeably potent but is now normal. After 8 days on the 1/2 tablet my headaches and fatigue returned so yesterday I added another 1/4 at lunch time. Today I feel lousy with a continued headache that may well need migraine medication (injectable Imitrex) to stop. I don’t seem to have any other other symptoms listed like irritability, anxiety, insomnia – although I have not slept as soundly the last three nights.

    Do I increase to a whole tablet or just stop for a period? I am basically gluten and dairy free and have not eaten processed foods in years.

    I was feeling so good at the beginning and thought I had a new lease on life!

    Hope you can suggest where I go from here. I have a new order for the Optimal Multivitamin and more B12 sublingual tablets backordered – wonder if I should cancel it.

    Thank you for any ideas.

    -Karen

    • Dr Ben November 10, 2012 at 7:28 pm # Reply

      Karen –

      Appears you have taken too much B12.

      The rule I go by typically is this:
      - if you are feeling improvement with a nutrient, continue using it.
      - once you feel really good with this nutrient, stay on the amount that works well – stop increasing the amount taken.
      - if you begin to feel lousy while taking same nutrient, then stop it – you’ve enough in circulation and may be overdoing it.

      In your case, consider taking 50 mg of Niacin every 30 minutes until symptoms abate. If using Niacin by Seeking Health, use only 1/10th a tablet every 30 minutes as needed.

      Consider switching your order from just the Active B12 to the combination of Active B12 with L-5-MTHF. Take only a 1/4 tablet to start and consider taking it every 3 days or so.

      Please call Jatone at 800 547 9812 to alter your order.

      Remember the rules above.

  13. Donna December 27, 2012 at 11:19 pm # Reply

    I noticed that while I was taking 1/4 of a Metanx 3 times a day I was feeling very good. Then, I decided to take 1/2 tablet twice a day and have started experiencing joint and muscle pain in my shoulders. I am also taking a very low dosage of niacin in addition to Carvedilol as I had a heart attack back in 2010. I have the 1298 mutation from both father and mother. I now understand why I had a heart attack. My doctor did test me because she suspected I had this mutation. I do not know how much I should be taking. Maybe 3/4 tablet is all I need. Is this possible? Thanks for your website and information. I have learned so much and understand why I now have heart disease and diabetes. I’ve probably had this all my life and never knew it. Thanks for any help you can give me.

    • Sarah February 23, 2013 at 2:12 am # Reply

      I started taking 2 tablets a day and my serum potassium fell. High dose of b 12 and b 6 can cause low serum potassium. This should be the cause of muscle aches and pain. Reduce the dosage to where u feel comfortable,

      • Dr Ben February 27, 2013 at 4:55 pm # Reply

        Sarah –

        How do you know your serum potassium fell? Your doc test it? I know the connection between the two but I would like to know if you for sure know it fell by lab analysis. Thank you

  14. Tiffany February 23, 2013 at 2:01 am # Reply

    How do you feel a out 23andme testing?

    • Dr Ben February 27, 2013 at 4:56 pm # Reply

      I think it is a wise thing to do personally – if you are ready for the data it can present.

  15. Meg Travis March 22, 2013 at 9:17 pm # Reply

    I am A1298C positive and my adult daughter went in for testing to determine if she has the factor also. Before her getting her test results back she was immediately put on a multivitamin and 2 pills a day of methyl-guard plus. She felt good for a couple of days and then went into full panic anxiety and almost suicidal mode. She is teary and basically unable to function. She quit taking the methyl-guard two days ago, but is not getting back to a normal feeling. What do you recommend? We thought the treating Dr. was well versed in this, but after finding your site I am beginning to believe the treatment was way off base and wrong.

  16. Lucy March 30, 2013 at 8:21 pm # Reply

    I could use some help figuring out dosage even after reading your article. I am homozygous for 677t. I have not tested for anything else. I did the methlyation panel by Health Diagnostics (Vitamin Diagnostics) and came back low in Folic Acid. The Genova Metabolic Analysis also came back borderline in folic acid and other B vitamins including B12. It recommended supplementing at 800 mcg. After a year of supplementing with the Modified Lasko Protocol, including 1 mg. MTHFR and various B vitamins, my MAP test came back still deficient in folic acid and B12, even slightly lower. My doctors suggested that my digestion/absorption needs to be cleaned up, which I a working on. In the meantime they recommended a high dose of MTHFR to compensate for poor absorption. I have been taking 10 mg MTHFR without apparent improvements or exacerbations.
    I had most of the symptoms of side effects before I started any of this so it is hard to track via symptoms. I started this whole adventure on Deplin before i knew anything about all of this. I took 7 – 15 mg for a week and felt like myself again. Then it stopped. No exacerbation of symptoms, just a loss of the “I feel like myself again” sensation.
    I am going to take the MetaMetrix test for unmetabolized folic acid.
    Do you have any other recommendations for how to track this and how to know if I am getting the right dose?

  17. EV April 12, 2013 at 6:43 pm # Reply

    Hi Dr Ben,

    I started taking the Thorne Prenatal just in case I became pregnant (I’m not yet) bc I have had 2 second trimester losses. I felt good at first, then my ND wanted me to increase by 2 mg for 7 days, another 2 mg for 7 days and then again a third time for a total of 7 mg.

    I am still breastfeeding a 2 year old, 4x/day. So I was nervous and I thought he meant 1 mg, so I only added 1 mg. For 2 days when I took it I had severe anxiety, headaches and nausea, so I stopped. Ever since that experience I struggle with the prenatal. I’m on GAPS and my anger/mood swings have gotten worse as well since this trial.

    Now the Thorne prenatal gives me relief 30 min after taking. So I divide the 3 daily capsules so I can take one get relief and still have more to take the rest of the day. IT’s almost like I am going through withdrawal and I need a steady dose. I feel more a mess since starting 5-MTHF in the prenatal then without vitamins. I have one copy each of C677 and A1298 (I think I got those right, but one of each is right)

    Thanks,
    EV

  18. Abeer April 20, 2013 at 2:34 pm # Reply

    what is the different between Folic Acid and methylfolate because my 16 month daughter only take 1 tablet of Tri-B and 1 tablet of Folic Acid daily ?

  19. Joshua May 21, 2013 at 1:55 am # Reply

    So. My Dr. believes I “may” have a problem metabolizing folic acid. The first time I took 5mg of 5-mthf and a methylated b-vitamin with tons of b-12 and most the other b vitamins. Right away I had more energy – later on I acted like I was high and kept laughing at ridiculous things that werent really all that funny. Later I couldnt afford the supplament and ran out. I had insomnia and was depressed. Now I am back on it again but on the 10 mg instead of the five. I started taking three at a time and I feel tired a lot. I wonder if I am taking too much all at once or what?

  20. Dave H May 23, 2013 at 11:44 pm # Reply

    Hi Doctor:

    I have stumbled across this methylfolate concept recently and I’m very intrigued by it. I am also VERY INTERESTED in your opinion. I am a lifelong sufferer of depression, anxiety, etc…(you name it, I’ve had it). Over the years my strength, self-esteem and just about everything have improved greatly due largely to vigorous exercise, better nutrition and just the learning experience of life.

    BUT, I have never been able to fully get over occasional feelings of depression, certain situational anxiety attacks and lifelong fatigue. About 2 years ago, I had neurotransmitter testing done. The test covered 12 of the (I’m assuming) most important neurotransmitters (which I won’t bother listing). The results showed that just about every one of them was below the established minimum healthy level. It was a surprise to the doctor (she called it the worst case she’s ever seen). I was also diagnosed separately by a psychologist as having Adult ADD.

    Despite it all, today, I am much better but definitely not healed. The fatigue and the ADD have held me back in life and career. I have been prescribed Adderall and have noticed a significant improvement. But as fatigue and concentration have not been fully resolved, I just bought “Seeking Health” Active B12 lozenge with 800mcg methylfolate and 1000mcg methylcobalamin. Naturally, I forgot to first consult lab results from last year which show a “Folate RBC” of about 900 nG/mL (apparently a good score). My homocysteine levels were also normal but my IL-8 (interleukin-8) was off the charts (also the highest the doctor has ever seen). But as I read about MTHF mutuation, I wonder whether I could have good RBC Folate and yet deficient active folate for proper neurotransmitter production.

    I am now hesitant to delve into this sublingual lozenge I was hoping was a strong step in the right direction. The test results suggest I don’t need more folate but it may not take into account a MTHF mutation that I ‘may’ have. I don’t think taking some low dosages will hurt me in the short term, but I don’t know what to think here. I haven’t found many substances that can account for such vast neurotransmitter deficiencies.

    Do you think I could have an active folate problem even though the “Folate, RBC” was normal? Can you think of anything else that I might be missing?

    Thank for taking the time to read. I appreciate any guidance you can give.

  21. Nancy Barnidge October 3, 2013 at 1:46 pm # Reply

    I am new to your program, so I will start by telling you that I have the heterozygous 1298 and 677. I have been experiencing life changing symptoms for 3 1/2 years and have been on a very long journey to find the cause of the sudden onset of these symptoms, which began after a chelation treatment and after a dehydration experience while hiking and biking in hot climate.
    I was a very active 59 years old (now 62). I am a pilates an fitness instructor, so it has been devastating for me to not be able to live the life that I once knew.
    As for the conditions that you list that are caused by the MTHFR gene, I only have IBS (currently under control), meningioma (discovered with tests to determine the cause of my symptoms and removed in 12/10), and what doctors have suggested might be chronic fatigue).
    In 2010, just a week after my dehydration and one day after a chelation treatment, I experienced a three day spell of fatigue, headaches and intermittent weakness. A month later I had vertigo that was diagnosed as dysfunction in the right inner ear, unknown cause. I continued with a variety of symptoms that included constant head pressure which to this day varies in intensity and location, periods of floating head (type of dizziness), ambient vision dysfunction (1 year of therapy for that), spells of severe weakness, spells of severe tremors lasting from a few minutes to a few hours, along with other symptoms. So none of these symptoms match any of the symptoms for the MTHFR gene and that has puzzled me.
    I worked with a doctor for two years who started me on injections of methycobalmine, folinic acid, and B6. I took that for a year and then switched to his cream version of these supplements. When my symptoms did not significantly improve, I switched doctors, who ran far more extensive testing, which included the test for the MTHFR gene That was in April of this year, at which time I started on her program. She practices functional medicine, so diet was first addressed. It did not change drastically since I was already eating healthy foods and had been tested in 2009 for food sensitivities and therefore avoid gluten, dairy, soy, yeast and eggs. I have been treated for overgrowth of good bacteria and yeast found both in my large and small intestine. I cleared the yeast in my large intestine but not my small, so I continue to work on that. I have gotten on all of her supplements which include NAC and liver support to begin detoxing.
    This doctor has identified “the players” involved in my condition, but is finding my case to be complicated for her. Besides the above findings, tests indicated oxidative stress, mitochondrial stress, malabsorption of vitamins and minerals, including the B vitamins that I have taking for 2 years, amino acid deficiencies, neurotransmitter imbalances and overload of toxins.
    Recently I discovered that folinic acid is NOT the correct form of folate, so my research lead me to your product line. I started taking your L-5-methyfolate with metafolin several weeks ago, adding it 1 mg at a time while reducing the folinic acid at the same time. I did fine on 1 mg, but starting experiencing symptoms when I went to 2 mg, so I backed down to 1 mg for about a weak. My symptoms were increased head pressure, floating head, fatigue and sleep disturbance. After a week on 1 mg with my symptoms stabilizing, I again went to 2 mg for 3 days then 3 mg for three days. When still doing ok, I went to 4 mg but within a day started experiencing the same symptoms for 2 days. I seem to be stabilizing now. My next step will be to get off the remaining 5 mg of folinic acid, now that I have read your material about what increased amounts of synthetic folic acid can do to the body. Like everyone else, I don’t really know how much methyfolate to take. I currently am on injections of 2 mg of methycobolamin and 25 mg of B6 daily. I am doing the injections since my digestive tract was had so many issues. Eventually, I will switch to oral supplementation of these vitamins. I purposely asked the doctor to back out the folinic acid from my injection so that I can experiment on my own and orally with the methyfolate amounts.
    I have recently done Dr. Yasko’s methylation genetics testing to determine if I have other genetic defects, however, I will not get those results until December.
    Have you ever had anyone with my symptoms?

  22. Julie November 26, 2013 at 3:25 am # Reply

    I am almost 5 weeks pregnant and just found out about all of this a few days ago. I have spina bifida occulta (lowest lumbar vertebra didn’t close all the way, but nothing other than that).

    I bought some methylated folate a few days ago. It looks like I have been taking too much of it, but I am concerned I am at a crucial time in my pregnancy (my first ever).

    If you don’t mind answering, how many milligrams of the folate would you suggest I take each day? I would rather risk unpleasant symptoms for myself and give my baby the best chance of normal development.

    Thank you so much for your help!

    Julie

    • jean December 3, 2013 at 2:59 am # Reply

      Hi Dr Ben,

      I am in Australia and just tested for MTHFR homozygous A1298C, i also have a borderline hyperthyroid (not autoimmune), long term zinc deficiency despite 3 months of supplementation, low iron, (despite a good diet and am studying to be a naturopath), i have also had dysthymia, and severe anxiety, 3 months ago i started having lots of heart palpitations which after a 24 hour ecg shows an ectopic heart beat, and regular fevers, sore muscles, headaches, sore throat, restless legs at night, sleep goes up and down, and high blood pressure the last couple of times it was measured. I am only 31, and my doctor wasn’t familiar with the MTHFR polymorphism, although has suggested i take folic acid (which i wont do).. There have also been suicides on both maternal and paternal sides of my family history. From what i can gather active folate is not available in Australia which i am curious about, and i have also been taking kava for anxiety and vitex to try to reduce premenstrual dysphoric disorder.. both of which work on the HPA axis.. So much to it all, but do you have any thoughts on how taking activated Bs will further effecr the HPA axis ? I worried about having so many things altering it as when i tried to come off the vitex recently i had severe PMS and mood disturbances and it is all affecting my ability to continue studying and life in general.. any thoughts would be greatly appreciated and if you know of any doctors here in Australia that you recommend i would be much obliged.
      Kind regards,
      Jean

  23. Michael Dowdy December 30, 2013 at 4:36 am # Reply

    I know that some drugs and supplements are impacted by the patients weight or BMI. Is this a factor with determining dosage of methylfolate?

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

    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!

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

    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.

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

    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.

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

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

    thanks!

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

    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 # Reply

      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 # Reply

        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 # Reply

          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?

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

    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.

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

    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

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

    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

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