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:
- Doctors are guessing how much methylfolate to give you
- Doctors are giving high doses of methylfolate
- Doctors should not prescribe high dose folic acid
- Diet is commonly not evaluated
- 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
If doctors order this lab test, methylfolate dosing will be more accurate.
There are a couple potential issues with the lab test.
- Is methylfolate stable or does it readily break down thus making the lab results inaccurate?
- 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?
- Those with MTHFR defects
- Those who have any signs of MTHFR mutations
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:
- Take small amounts of methylfolate along with methylcobalalmin and work up.
- Consider taking 1/2 tablet of Active B12 with Methylfolate. This amount is typically well-tolerated by many.
- Increase to a full tablet after 1 week.
- Continue to increase the amount taken by 1/2 tablet every 7 days until you feel really good.
- If you feel side effects from taking Active B12 with Methylfolate, take 1/10th tablet of Niacin.
- Work with your doctor on this and inform them what you are doing.
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