Recurrent Pregnancy Loss and MTHFR

There is no doubt that MTHFR and recurrent pregnancy loss are linked.

This is especially true if you have:

  • 1 or more copies of the C677T MTHFR mutation or
  • 1 copy of each (1298 and 677) or
  • 2 copies of A1298C or
  • A single copy of A1298C MTHFR mutation may not be related – however, I am still on the fence about this for various reasons.

I recently came across an article regarding a 31 yr old woman who had 3 recurrent pregnancy losses in 12 months. She was tested positive for 1 copy of a MTHFR variant (which form is not clear).

She was inappropriately prescribed high amounts of folic acid.

What should have been done?

In my experience, doctors should prescribe methylfolate and folinic acid to pregnant women.

How much?

It depends on the MTHFR variant, lifestyle, diet and symptoms. There is no set guideline to how much. One must taper up or check their blood levels for various forms of folate.

The point I want to make is there are certain guidelines for recurrent pregnancy loss and MTHFR.

I am not an OB/GYN or a specialist in recurrent miscarriage so in order to provide you the best information, it is best that I find someone who is.

I’ve done that.

1. Edward Ramirez, MD, FACOG
2. Reproductive Immunology Associates

You ask: What is FACOG?

FACOG = The initials FACOG after a physician’s name indicate that he or she has met additional criteria to qualify as a Fellow of The American Congress of Obstetricians and Gynecologists. By choosing an ACOG Fellow as your physician, you can feel confident that you will receive the highest quality health care. Choosing an ACOG Fellow as your physician ensures that your ob-gyn is being kept abreast of the latest medical guidelines, treatments, and techniques in women’s health care today.[1]

To make this as clear as possible, I am going to now provide you the Q and A[2] that occurred between D from Boston and Dr Ramirez:

Dear Dr. Ramirez,

I am 31 years old and have had 3 chemical pregnancies in the past 12 months. They have run a slew of genetic testing and a RPL (recurrent pregnancy loss) workup and all has come back normal with exception to the MTHFR test. I have tested positive for 1 copy of the MTHFR mutation. The nurse told me that because I was considered heterozygous that this was not a big deal. They prescribed me with a high dosage of Folic Acid. She said that it was likely not contributing to the repeat losses. I have been reading online and while the homozygous mutations seem to be more serious, there seem to be mixed reviews on whether this can contribute to early miscarriage.

Do you prescribe Lovenox or Heparin in this type of situation (only 1 copy?) Should I be concerned about this and demand that they treat it somehow? It doesn’t seem like they are planning on doing anything besides the folic acid.

Also, given that this test has come back as it did, is there any other testing that you would reccommend that may be related to this? I am a little frustrated because this test was not originaly included in the work up and I had heard about it from online research and specifically requested it.

I just want to make sure that I am not missing anything.

Thank you,

D. from Boston


Hello D. from the U.S. (Massachusetts),

The treatment for MTHFR (Methylenetetrahydrofolate reductase), is increased Folic acid (for more information But with your history of recurrent pregnancy loss or RPL, I usually will add the following to my patients, although there is not clear research backing it up if you are immunologically negative:

1. Low dose aspirin 81 mg starting with the start of the cycle

2. Low dose heparin 2000 units bid starting with the start of the cycle (you can substitute lovenox but it is more expensive).

3. Medrol 16 mg starting with the beginning of the cycle until ovulation then decrease to 8 mg

4. Increase progesterone supplementation of either Crinone 8% per day or Endometrin 100 mg three times per day starting after ovulation.

This cocktail has been shown to be effective in recurrent miscarriages (see Reproductive Immunology Associates for further information regarding immunological causes of miscarriage). My presumption is that you have had immunological testing, specifically antiphospholipid antibodies?

I hope this helps!

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG


You may have noticed Dr Ramirez stating that the treatment for MTHFR is high dose folic acid. Well – it is – unfortunately. This is the standard of care which physicians are forced to abide by. You notice that Dr Ramirez mentioned to visit for more information. That is all I’ll say about that.

Proactive doctors who are ahead of the standard of care know that high dose folic acid is cause for concern. Not only that, but folic acid is not the active form of folate that is needed for a developing baby. The forms of folate that are needed for a developing baby are folinic acid and methylfolate.

Moving on…

Why would Dr Ramirez provide aspirin and heparin (or lovenox) for a woman with 1 copy of a MTHFR variant?

Because this woman had recurrent miscarriages. Period.

We know that D from Boston had recurrent miscarriages and the ‘only’ thing that showed up in her bloodwork was 1 copy of a MTHFR variant.

What we don’t know is:

  • What other relevant blood tests were not done?
  • What tests should have been done on her partner? It is not only the woman’s genetics that can cause miscarriage. The man may donate genetics which can recurrent pregnancy loss.
  • What is her lifestyle and diet like?
  • What is her occupation?
  • Are her environmental exposures partially at cause here?
Regardless of all of these, if a woman experiences recurrent pregnancy loss, then why not be proactive and assume that there are underlying clotting disorders, unknown MTHFR variants, and/or clotting disorders passed from the partner.

To understand my point in detail, one must read this article on recurrent pregnancy loss and how it is important to identify the genetics of the man also – not just the woman.

If your doctor is not being proactive in addressing the known (and unknown) causes of recurrent pregnancy loss, then it is time to educate them on it and/or find a new doctor.

Resources for Recurrent Pregnancy Loss:

1. Edward Ramirez, MD, FACOG

2. Reproductive Immunology Associates

Please comment below your experiences of recurrent pregnancy loss

  • How your doctor has been either proactive – or – underactive.
  • If your doctor was proactive and you successfully carried to term, please do share who your doctor was.
  • What was done medically and nutritionally for you in order to carry to term?

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53 Responses to “Recurrent Pregnancy Loss and MTHFR”

  1. SaraB June 7, 2012 at 6:20 pm # Reply

    I am 31, and am currently 23 weeks pregant with my third child. I have also had four miscarriages over the course of the last 10 years, the last one being in the second trimester. I was diagnosed with homozygous c677t MTHFR after my last miscarriage. My OBGYN who did the testing recommended Lovenox and Folic Acid, and then a Maternal Fetal Specialist I saw prescibed me Lovenox and Folic Acid. She said that research shows that MTHFR is not actually related to pregnancy loss but gave me the Lovenox “just in case”. I have yet to have a doctor that seems to really know much of anything about MTHFR or take it very seriously.

  2. April I. June 7, 2012 at 6:59 pm # Reply

    I had 2 miscarriages before I found Dr. Dobay. He diagnosed me A1298C Homozygous while pregnant with my daughter. He started me on baby aspirin and 40mg Lovenox. He delivered my 2 1/2 year old daughter at 37 weeks. I’m seeing Dr. Dobay for current pregnancy. I’m 32 weeks and taking 80mg Lovenox twice a day (due to PE last year), baby aspirin and Metanx.

    Thank you so much for this article! There are so many women out there who are losing hope because their doctors think MTHFR has nothing to do with their miscarriages. I will make sure everyone I talk to reads this article.

    • Teresa Nevins December 22, 2012 at 4:07 am # Reply

      I was not aware that the A1298C variant was connected to miscarriages (from blood clots?), that one would should take aspirin. I am concerned because my daughter is homozygous for the A1298C variant and uses the nuva ring. If she is prone to blood clots, she shouldn’t be on this form of birth control. Do you also have the C677T variant too? I need to get facts straight for her health’s sake.

  3. Amy June 7, 2012 at 7:42 pm # Reply

    Does anyone have a history with the medication cocktail listed above? Did it prove successful? I plan on bringing a copy of this article to my next appointment! Thanks so much for the info!

  4. Julia June 9, 2012 at 6:03 am # Reply

    I have one healthy daughter. After her birth been unable to fall pregnant for 3 years. After that had 2 MCs (at 10wks pregnant) within the 2 years following. 1 year after the first MC I was diagnosed homocygous for C667T mutation, my husband heterocygous for A1298.

    Husband was prescribed nothing, but did take FertilAid for Men supplements which contain 500mcg Folate (probably not methylfolate?) and 500mcg B12 (methylcobalamin). His sperm ananlysis showed all normal ranges.

    Myself was prescribed 10x the daily dose of Folic Acid and normal daily dose of B12 (both non-methylated versions), and told with these “I’ll be fine”. Especially since my blood levels showed well within normal ranges of homocysteine, Folate and B12. Sadly I miscarried again at almost 10wks, but fetus had not even developed past 5-6wk this time. Drs still don’t think it has much to do with MTHFR.

    Reading these articles makes it obvious to me though that taking 10x the amount of “wrong” type of Folate, and wrong type of B12 (cyanocobalamin), clearly does not help. Wonder & hope that with help of “right” supplementation in line with the recommendations on this website will help! Thank You for making all your research & findings public here, Dr Ben!

  5. HelenH June 14, 2012 at 7:44 am # Reply

    I am homozygous for the C677T variation, as well as having v high Natural Killer cells and hypothyroidism. These three things were discovered during tests following three miscarriages last year. I am being treated for the NKCs and my thyroid levels are now good, but my consultant insists that only baby aspirin (and 5mg folic acid – but I substitute l-methylfolate for this, and take methylcobalamin as well) is needed for my MTHFR. He dismisses the idea of needing Lovenox (Clexane here in the UK) totally. I have since had 2 more miscarriages, and desperately need to find some medical ‘proof’ to show him that Lovenox is needed, but can’t find anything anywhere. Does anyone know of any medical articles that I could print out and show him, to get prescribed Lovenox please?

  6. Lisa June 21, 2012 at 12:38 pm # Reply

    I am 25 years old. 15 months ago when I was 24, I experienced my first miscarraige. A positive test then my period started 5 days later. I fell pregnant 3 months later only to miscarry this time 6 days after my positive test. I insisted on being tested and the “only” thing that showed up was MTHFR. A copy of the A mutations AND a copy of the C mutation. I saw a genetic specialist and they said back in the day MTHFR patients were considered high risk and that now they don’t even think twice about it. I was prescribed NeevoDHA but decided to take my own version so that I knew EXACALLY how much I was getting. I started this MTHFR cocktail {new chapter prenatal, baby asprin, L-methylfolate, b6 in the p-5-p version, sublingual b12, DHA, probitotic} and I already take a few other things like D3 etc. anyhow I fell pregnant again 8.5 months later. This time I was put on progesterone saposatories for a “just in case”. I made it to 10 weeks. We saw our baby moving around on the ultrasound screen with a very strong heart beat. I was told everything looked perfect. 12 hours later I started spotting. 2 days later I had an ultrasound done due to the spotting and my little baby had no heart beat. I had the baby 4 days afte that, at home.
    I had a phone consultation with a fertility specialist in New York. He was very firm in saying my MTHFR is NOT the cause of our losses.
    My midwife called me just a few days ago and said the next time I’m pregnant they are going to check my homosyt. levels right away. WHY THEY DID NOT DO THAT BEFORE I DON’T KNOW!! I’m tired of hearing it’s not the cause. I have a strong feeling there were tiny blot clots in my babies cord or placenta. Something just isn’t adding.up. I have been checked for an insane amount of blood clotting disorder, thyroid, you name it I’ve been checked for it. Sorry this is long :(

    • Dr Ben June 21, 2012 at 6:21 pm # Reply

      Lisa –

      I am sorry to hear about this.

      MTHFR may be playing a role here – but so may your partner’s genetics. Doctors only test the woman and not the man – yet there are some paternal genetics that cause recurrent miscarriage.

      Below is an excerpt from another article I wrote on recurrent pregnancy loss:

      If you have recurrent pregnancy loss or are considering becoming pregnant, then I highly recommend you ask your doctor to test you AND your partner for the genes:

      FVL – FVL2
      The research by Ozdemir proves the point that genetics from the father and mother must be considered in recurrent pregnancy loss.

      Whether heterozygous MTHFR by itself causes recurrent pregnancy loss is still to be debated; however, when combined with the above mutations, the effect is clear.”

      The supplements and program you were on did not appear to contain any anti-clotting meds such as baby aspirin, Lovenox or Heparin. I highly recommend you mention to your doctors about using these during your next pregnancy.

      There are also other factors that need to be looked at:
      – hormone levels
      – gluten issues
      – chemicals – BPA especially

      Keep me posted what your homocysteine came back with and also update us on your progress.

  7. Rach June 27, 2012 at 8:35 am # Reply

    Hi dr Ben
    I have the heterozygous c1677t mutation and have just experienced my 5th chemical preg in a row (ivf)
    I had no trouble falling preg with my first 2 kids via ivf, but since trying for #3, i have started the miscarriage work up, and also uncovered ACA, mild endo removed, MTHFR and high natural killer cells ( I know I’m a walking fertility disaster)
    Anyway I am on steroids lovenox aspirin etc as well.
    Anyway my question is about supplementation – my acupuncturist put me on activated b tablets which contain calcium folinate. I also bought some methyl folate (5mthr).
    When I last had my blood tested (when i was taking regular folic acid)my rbc folate was 1945
    S active b12 was 113 (high for range) and s total b12 was 630.
    So I know that my levels can be high because my body hasnt been absorbing it properly, but how am I supposed to interpet retests? If it comes back in adequate range do I say then it must be ok because now I am taking absorbable folate? I’m just trying to decide how much methyl folate to take.

    Also my sons biomed dr was saying that the studies show that folic acid has been proven to reduce the incidence of spina bifida and cleft palate etc, but no studies have been done showing folinic acid and methyl folate will do the same- she wasn’t saying it wouldn’t, but just saying the studies are not there. What do u think of that too?

  8. Teri July 18, 2012 at 12:41 am # Reply

    Hi Dr. Ben,

    Thank you so much for your invaluable website. It’s helped me to really feel like I have an idea of what I should be doing. I’m a bit lost in one thing though that I can’t seem to find answers for specifically. Here’s a bit of backstory on me: I’m 36 and my husband is 30. I’ve tested to have the homozygous mutation of the C677T, but have not been tested for the A1298C (this is something that I’m working on getting tested). My husband has not been tested. I have lost 2 babies very very early while trying for our first child. Both were miscarried before I hit my 5th week. I’ve now been to an RE and sadly he didn’t seem to know much about MTHFR. His only comment was that since my homocysteine levels were normal, that I didn’t have a need for anything other then maybe baby aspirin.

    All the stories that I’ve read about have ended with the MTHFR patient being given lovenox/herapin as soon as a positive pregnancy test is known, but my RE won’t do it unless I insist on it. Is this something that I should insist on? I’ve had my homocysteine levels taken a few times (I had no idea what they were for until I started delving into MTHFR) and every time they have been in the normal range. The most current number was 8 where the cut off for being ‘at risk’ was 12. Should I be insisting on either having my homocysteine level recorded after I get pregnant the next time, or just simply insisting on getting the lovenox/herapin? Or is my RE right about not having to worry since my levels are currently normal?

    Any help you can give would be much appreciated.

    • Dr Ben July 25, 2012 at 7:42 am # Reply

      Hi Teri –

      You should absolutely INSIST on lovenox and baby aspirin for recurrent pregnancy loss – and also to consider progesterone support as well.

      I also highly recommend that you support your MTHFR mutation regardless of homocysteine levels. Doctors typically do not understand all the nuances of biochemistry – they used to – but daily medicine has pulled them away from it.

      There are many ways to lower homocysteine – and even if one has MTHFR, homocysteine can be normal but this doesn’t mean that your methylfolate levels are fine – they in fact can still be quite low.

      Please read this article on prenatal supplementation and MTHFR. It should shed some light for you.

      If you really want to get informed, I do highly recommend you watch this MTHFR video presentation I did for a group of doctors.

  9. Kris August 12, 2012 at 8:48 pm # Reply

    Hello Dr. Ben,

    I am so happy to have stumbled upon this website. I’ve taken the whole weekend just reading and soaking up the information. I have a daughter that is 8 years old and I had absolutely no problems with that pregnancy. I’m now 34 and have had 2 miscarriages and a chemical pregnancy due to IVF. I found out that I had MTHFR mutation after the second miscarriage only because I had to push really hard for some type of testing. My OB came back and said I was positive for MTHFR Mutation with Factor II and protein S, protein C. I’ve never heard of this before and couldn’t get much out of her about what exactly it all meant except that I would need to take baby aspirin and lovenox during my next pregnancy to prevent blood clots. What is protein C and protein S? I was able to find information about Factor II and that scard me half to death.

    Last year my husband became ill with cancer and we had to do sperm banking for IVF. He’s cancer free now but his sperm did not return, so we used the sperm from the sperm bank to do IVF in May of this year. My fertility Doc gave me the same explanation as my OB about MTHFR. He said my regiment would be 4mg of folic acid per day, 81mg aspirin per day, lovenox shots daily, (I started the lovenox 3 days before the transfer) and of course prenatal vitamins. Even though I went through the entire IVF process with flying clolors, the embryo’s did not attach to the utereus after the transfer. They took so many viles of blood from me before we started IVF. They tested for everything. Due to my husband’s cancer, we completely changed our diet so we eat alot of fish/chicken and vegetables. I work out 5 days a week 30 minutes a day and drink and insane amount of water. So I feel like I’ve made great changes in my diet and exercise. I’ve never smoke or drank so I consider myself to be pretty healthly. I’ve had tingling in my feet and hands and night sweats off and on for a while. So, I asked about the MTHFR and if I had the correct amount of Folic acid and/or Lovenox but was quickly dismissed and told that the embryos not attaching had nothing to do with MTHFR. I don’t knwo what to beleive or think. We were devastated and felt helpless. We feel like we are at the mercy of the doctors and they don’t seem to take the MTHFR seriously. It’s extremely stressful to us because we know that we only have a certain amount of sperm to work it. Once it’s gone that’s it for us. And because of the cancer situation we have to do IVF to become pregnant which is an expensive procedure. We are desperate to find doctors that will take this seriously and not just brush us off. After reading through this website and all of the other ladies comments I feel like I need to find a new fertility doctor as I have already found a new OB who is much more understanding and willing to work with me. Can you tell me if I should be taking a different type of folic acid? Should I take more supplements? Is there anything I can bring with me to my new fertitlity doctor to help him understand MTHFR? Before we try again I’d like to get more testing if need be. We just want to do all that we can to optomize our chances of becoming pregnant and going to term with his baby. If you can provide any insight or direct me in the right place, it would be greatly appreciated. We have no where else to turn.

  10. Jennifer August 14, 2012 at 2:29 am # Reply

    Hi Dr. Ben – I want to thank you again for your helpful comments to previous questions I have asked. I’ve been investigating this topic since our most recent miscarriage when I discovered I tested positive for one copy of C677T.

    I just came across a previous lab test, in which I tested high for folate (20, where the upper range was stated to be 17). What does this mean, and how does it relate to how my body processes folic acid? Would this result mean that I do not need higher methylfolate fortification? Or would it mean the opposite?

    Thanks again for your insight,

  11. Jen from Ohio August 20, 2012 at 4:45 pm # Reply

    Hi Dr. Ben,
    Boy, am I glad to have found this website…though I wish I’d have found it sooner.
    My husband and I have a 4-year-old son and have been trying for 3 1/2 years to have another child. We have suffered two first-trimester losses (10 weeks in 2010, and 14 weeks this past April, though the baby measured 12.5 wks). I have been through a slough of tests, all showing normal, except I am heterzygous for Factor V Leiden. However, since I had miscarried in 2010, the doctors had me on 80 mg of Lovenox daily, and we still lost the baby. (I will add that both babies were tested following the miscarriage and their genetic makeup was completely normal).
    My mom referred me to her ob in St. Louis, who has been studying MTHFR, and though I’m negative for it, he wanted to have my husband tested. We did that, and I just found out today that he is homozygous for MTHFR, though I don’t yet have all the info on which variation. Dr. Gosser is convinced that the MTHFR gene was passed on to the two babies we lost, and has prescribed me Folgard, B6, and baby aspirin. He told me that he has worked with couples dealing with recurrent miscarriage, and while 99% of the time, it’s the mom with the mthfr, the other 1 % (20-30 couples he’s dealt with) , it’s been the father (he, himself has 2 copies of the mthfr gene and his wife experienced two miscarriages before going on the folgard…they now have 8 kids). He’s seen excellent results in treating the mother with the above “cocktail”.
    What are your thoughts on this? I am excited to possibly have an answer.
    Thank you!
    Jen in Cincinnati

    • Lynn_M August 22, 2012 at 7:02 am # Reply

      If you were the one with the MTHFR gene, the advice is to take methylfolate and methylcobalamin and not folgard, which is folic acid, cyanocobalamin, and B6. Maybe your body can use folic acid, but if the fetus had MTHFR, I would think it would do better if you were taking methylfolate and methylcobalamin, the active forms of folic acid and B12..

      Your husband should be taking methylfolate, methylcobalamin, and other cofactors.

  12. Jennifer Hansen August 31, 2012 at 7:31 pm # Reply

    Hello Dr. Ben,

    I was diagnosed after 3 recurrent miscarriages with Heterozygous MTHfR C677T and also heterozygous for Prothombin Gene mutation G20210A. We wanted to try again so my Dr. put me on a daily dose of baby asprin and told me to take prenatals vitamins and extra folic acid, but not the right kind of folic acid as I am now learning. He said the baby asprin was all that was needed because I have not had any blood clots yet or altleast didn’t know if I had one. We got pregnant again a forth time and I lost that one at 10 wks. .The first 3 I lost at about 7-8 weeks. We did have the 4th fetus checked for chromosome abnormalities after the DNC was perfomed to try to give us some answers on if there were other reasons for the 4 miscarriages than just my two gene mutations. The labs came back and the fetus showed miscarriage due to chromosome abnormalits on chromosome 17 p.13. So, my doctor had me and my husband checked for chromosome abnormalities in us. He was worried we may have a translocation gene in one of us. The tests came back and we both were normal. So lots of money spent, just to really find out that this was not the issue. It was worth it though, as we atleast know we are fine in that department and also have no family history of other disorders. So now my thought is maybe it is just the genetic mutations I carry that are causing blood clots in the tiny vessels and the babies can’t make it. I started studying up in depth on your website recently and it has helped me a bunch. I got blood work done because of my concern with homocysteine levels. My test came back and my homocysteine level is just below the normal range. I know that normally your homocysteine levels should be high or atleast a little high due to MTHFR. I read your article about if your levels come out normal to get an additonal few tests done to see if the homocysteine is causing plasma issues within vessels. And how also people with MTHFR that have lower homocysteine levels could also be more likely to have oxidative stress where their bodies cannot rid toxins and chemicals or metals. Both of these worry me since my homocysteine levels were low. I want to get the additional tests taken. The S-Adensylhomocysteine test and the MMA test ( not sure if this is to test for toxins in the body?) And an estrogen test to see how high it may be. I know high estrogen is bad for both my genetic mutations is why I should never get on birth control. And a fibrin test. Do you think all these tests are needed at this point?? I want to try to get pregnant again but won’t until I know if I am safe and in good shape. I am 39 and pushing the envelope as I feel time is not on my side. I am trying to figure it all out before I get pregant so I don’t miscarry again and am on all the RIGHT medications for the two gene mutations I carry. I also worry that because I carry the Prothombin Gene Mutation G20210A that my chances of my S-adensylhomocysteine test could come out not in my favor. I think you said something about the prombem of the build up homocysteine that causes plasma build up in the vessels can lead to recurrent miscarraige due to the tine little vessels getting clogged. That scares me for me and the baby next time if I had that plasma vessel problem along with my Prothombin Gene Mutation on top of the MTHFR. Am i atleast on the right path with the tests I am taking??? Is it too risky at 39 to try again. i am blessed to have my two boys that are 6 and 12. i only had 1 miscarraige in between them and was on no baby asprin then or the right kind of folic acid. So confusing. I also wonder if my MTHFR just isn’t that bad and that my normal intake of folic acid up till now has gone through the mythalation process is why my homocysteine level is a little below normal range. Could I be that lucky? I am currently taking baby asprin daily ( ! tablet at night) Thyroid medication ( Armour ) in the morning by itself. 2 hours later taking vessel care( contains Riboflavin 5mg, B6 as pyridoxine HCI 25mg, Folate as calcium L-5 methyltetrahydrofolate 800mcg, B12 as methylocobalamin 1mg, zinc as zinc citrate 5mg, Trimethylglyine 500mg, Choline as choline bitartrate 100mg and Intrinsic Factor 20mg. i also take another liquid dose of B12 at 1000mcg’s a day, vitamin C and vitamin D3-5. I feel like I am taking soooo much but see that you have other vitamins like the Flow FX, neurtralizer, optimal turmeric, Probiota 12, Liquid Vitamin D360, Krill oil ect. I don’t know if I take more meds if it will be too much or if I should substitute meds. Should I have my S-adensylhomcysteine test done first and the toxin and fibrin tests before I keep adding meds? Such a long message I know, my apologies. I just feel that I have only one more chance of having a baby with my new hubby and want to get it ALL right this time. Thanks Dr. Ben !!!

  13. Jennifer Hansen August 31, 2012 at 8:05 pm # Reply

    Hello again Dr. Ben,

    i forgot to tell you what tests I have already had done in my previous message. My CBC panel all came out normal range. My thyroid is off but was in range during all 4 previous lost pregnancies at that time. My B12 is within range. My DHEA Sulfate is within range. My cortisol AM is within range. My homocysteine was lower than range at 4.6. I have no Natural killer cells. Vitamin D was in range, I am still awaiting results for my B6 test and cortisol PM. And I have had the all the tests done for blood mutations showing heterozygous for Prothombin Gene Mutation G20210A and heterozygous for MTHFR C677T. Thanks so much again…so need advice on where to go from here….all details in my previous messsage. Thanks Dr. Ben

  14. Jennifer Hansen August 31, 2012 at 10:09 pm # Reply

    Hi Dr. Ben,

    Ok, now after reading more of your posts I see that I had the wrong B12 test taken and probably the wrong B6 and folic acid tests I assume as well?? What is the name of of all these tests in the form for people with MTHFR. Makes sense now why my Dr. said ” well your miscarriages don’t look to be from low folic acid according to your test.” Am I wrong on this? Can baby have mythlation problems in your belly if you or you and your husband have this problem? Which gene mutation has the risk of mythlation the most and should we get tested on this before we try to get pregnant again?

  15. Jennifer Hansen September 1, 2012 at 6:26 pm # Reply

    Hello Dr. Ben,

    I have sent you 3 previous messages and they are all related to each other. I forgot to mention that my husband had 5 previous miscarriages with his x wife before their 3 daughters were born consecutively after the miscarriages. Then when we got married we had 4 recurrent pregnancy losses. In my other messages I explained that I have MTHFR heterozygous C667T combined with Prothombin Gene Mutation for Thrombosis. My husband is going to have blood work done to see if he has a genetic mutation, but the three daughters born concecutively after the 5 miscarraiges with his ex doesn’t seem to match up. I would love to know your opinion on this. I am so thankful to have your website. I understand so much more than i did before.

  16. Jennifer September 3, 2012 at 6:06 pm # Reply

    Hi Dr. Ben – I want to thank you again for your helpful comments to previous questions I have asked. I’ve been investigating this topic since our most recent miscarriage when I discovered I tested positive for one copy of C677T.

    I just came across a previous lab test, in which I tested high for folate (20, where the upper range was stated to be 17). What does this mean, and how does it relate to how my body processes folic acid? Would this result mean that I do not need higher methylfolate fortification? Or would it mean the opposite?

    Thanks again for your insight,

    • Lynn_M September 4, 2012 at 2:29 am # Reply

      Being heterozygous C677T, you have an impaired ability to metabolize folic acid to the active form of methylfolate. The usual folate test actually measures the folic acid level, and unless you’ve been consuming high levels of folic acid or folate, your high result means the folic acid is building up in your blood and not being metabolized. You need to avoid all sources of folic acid, both supplements and food, and take the active form of methylfolate.

  17. Amber September 14, 2012 at 12:14 am # Reply

    Dr. Ben,

    I’m 33 and have one healthy son who just turned 3. I have had 2 miscarriages this year after which by OBGYN sent me to an IVF specialist. I received the results from my blood work today which revealed that I am compound heterozygous for the mutations, C677T and A1298C. My doctor has directed me to begin taking 4mg of folic acid daily. After reading through the information on your site and many others, I do not feel confident that this is the best treatment. My doctor said that because my homosystine levels are normal, along with all of the other tests, I have had a successful pregnancy along with being a healthy woman, that this is all that I should need. I inquired about heprin, lovenex or even a baby aspirin, but he said there is nothing in my history and test results that warrant those treatments. Like I said, I am healthy, a runner and I eat a balanced diet, always getting my fruits, vegetables, protein, calcium, etc. My concerns now are:

    1. Having another miscarriage
    2. Other potential health problems I am at higher risk for in the future
    3. The health of a future child

    I would like to know what you would suggest as a next step. My IVF doctor did give me the name of a hemotologist. Is this an appropriate next step? I want more information and I want to take a proactive approach with my lifestyle and find out what I can do to stay healthy and active. I live in western NY and am unaware of anyone local who I can go to for more in depth information and a second opinion.

    Thank you for helping educate me on this genetic defect and its seriousness.

    • Lynn_M September 14, 2012 at 7:44 pm # Reply

      Read Dr. Ben’s protocol for the C677T mutation. It’s in the Articles section. He also has an article about why it’s not enough to just have a normal homocysteine level.

      Do not take folic acid or anything, including foods or supplements, with folic acid in it. Take methylfolate instead. And the methylfolate needs methylcobalamin as a cofactor, so you need both of those. Plus other supporting supplements and avoidance of toxicity.

      Most doctors seem to be ignorant about proper treatment of MTHFR mutations. If you do seem a hematologist, you just about need to go in there knowing more than the doctor, so you can recognize any crap advice he/she might give you, and you can better know what you want the doctor to do for you. Read or listen through everything in the Articles section – the audio presentations are excellent- and then start on the Forum posts.

      • Lynn_M September 15, 2012 at 3:57 am # Reply

        I don’t think Dr. Ben mentioned this in his article about MTHFR needing to be treated even if a person had normal homocysteine levels. But CBS C699T and CBS A360A are two of over 33 genes that also impact methylation. These two genes upregulate, that is, speed processes up, and one of the effects is low homocysteine levels. CBS mutations increase ammonia and sulfite/sulfate levels and need to be treated before MTHFR mutations, otherwise methylfolate and methylcobalamin go down the drain and wind up producing toxic metabolites.

        A 23andMe genome test will tell you if you have the CBS genes, as well as about 25 other methylation genes. You can also buy urine sulfate test strips for around $40 and test your sulfate levels yourself. There’s been discussion in the forum about CBS and the sulfate test strips.

        So if you had a CBS mutation in addition to being compound hetero, it’s possible your homocysteine levels could be normal because of CBS tending to decrease homocysteine from the level it would be due to being compound hetero C677T/A1298C.

        Also keep in mind that, depending on age, the ideal homocysteine level is 6.3, but what doctors consider a normal value can go much higher than that.

        For more about CBS and other methylation genes, see

    • Kristina November 11, 2014 at 3:03 am # Reply

      Hi amber…..I know this is an old post but I am in the exact same situation and also live in western ny….would love to follow up with you privately…..especially because we’ve probably seen the same dr. If you happen to see this please emAil me at


  18. Angie September 20, 2012 at 11:54 pm # Reply

    I had my first child in 1999 but I had many complication caring him he was born @ 36wks and healthy thank God. But after that I got pregnant in 2000 and miscarried at 12wks and had a few more after that no testing ever done so we quit trying for a while. We decided to try again in 2007 and then again miscarried at 6wks but this time I had a great Dr who tested me and my husband to find out what was going on. My husband was fine but I carried the C677T and something else don’t remember but he gave me 4mg of folate and Heprin injection twice a day as soon as I became pregnant. Dr. Smith was my doctor in Northport Alabama.

  19. ickle October 15, 2012 at 1:48 pm # Reply

    i am in my first and last cycle of ivf (i will not repeat it) and my dr. has suggested heparin too.
    i would like to ask, whether taking higher doses of fish oil, garlic, ginger, bromelain could be used instead of heparin. im not comfortable taking many drugs
    thank you!

  20. Diana October 27, 2012 at 9:16 pm # Reply

    I’m 29 yrs old. I have experienced two miscarriages in 4 yrs one in 2008 ( 8-9 weeks) and in January this year 2012 ( appx 10 weeks ). After the last miscarriage, The OB /GYN doctor ordered some test to detect blood clotting disorders. the following was tested and came back negative. Fibrionogen, Homocys, ANA, Anticardio, Leiden, CHRMBLD, APC-R, – except -MTHFR. This last one the results came back as noted : ” Heterozygous , the word negative ( don’t know what it means ) then, the interpretation reads : ” This patient was determined to have both a MTHFR C677T allele and a wild type allele .” I need help in interpreting this statement. Do I have the mutation that has been discussed here by Dr. Ben ?? the OB/ GYN did not look very concerned when she went over these results with me. she just mentioned I might need to take extra folic acid.. Now, I have been reading several articles here by Dr. Ben and I could see my ob / GYN doctor is not really taking this result with MTHFR seriously. I really want to know for sure I have this mutation and If I need to make eating habits & lifestyle changes that Dr. Ben suggests in this website. Any comments , suggestions, any post would be really appreciated. I’m just starting to learn all this terminology and vitamins and I’m starting to feel very confused on which direction I should take. I want to become a mother, but also a mother to healthy child. Thank you!!

  21. becca November 30, 2012 at 4:18 am # Reply

    I had 2 healthy full term babies, one girl, one boy. Then I got pregnant with Vivian and on a routine ultra sound at 17 weeks she did not have a heartbeat and she had always been 2 weeks 2 small. I was found to have Homozygote C677T and they put me on high doses of folic acid, fish oil and when I got pregnant again I was to be on a baby aspirin.

    Got pregnant and it ended in a 1st trimester loss at about 7 weeks. They told me 1st trimester losses were normal and as long as I was taking my folic acid that I should be able to have a healthy baby.

    Got pregnant again and Ethan looked great and my high risk doctor gave him a 96% survival rate and I woke up with night sweat at 17 weeks and my husband and I wondered if something was wrong. I asked to be seen and the doctor did not seem worried. After an ultrasound my baby did not have a heartbeat.

    Currently I have seen several doctors and they disagree how to treat me some even saying they do not know the cause of my losses. But the more I research the more I know I clotted my babies off. One of the Doctors we are seeing encouraged us to take methlyolated folate, and B12 sublingual and tested my husband who also has the homonzygote for C677t. This same Doctor encouraged my to read this site.

    I guess I am unsure about the research behind methylfolate. My high risk who put me on a ton of folic acid said there is no reseach for methylfolate and the one who pointed me here said to get off the folic acid and take the methylfolate.

    I am tired of holding my dead babies and I need to make sure I get it right this next time. Thinking about visiting the Mayo Clinic.


  22. MandyS December 7, 2012 at 1:09 am # Reply

    I miscarried at 20 weeks. I bled throughout the entire pregnancy, passing massive clots. Every doctor appt. would be the same: “Baby is fine, baby is doing good, can’t tell you why you’re bleeding”…my last appt. I was diagnosed with a placenta abruption. They say this is rare for this to happen during the second trimester, that only 20% of placental abruptions can be detected thru ultrasound, but when they happen it’s usually within the third trimester and the pregnancy is far enough along that they just take the baby early. I was so determined to find a “why” to this whole nightmare, my doctor has been proactive and started some of the testing right away, some tests I am waiting to be 12-weeks post pregnancy before I test. I was given the results of the first round of tests today and I was told I have a MTHFR A1298C mutation (double). My homocysteine levels were tested as well, but they were normal. My doctor says this “could” have been a contributing factor to the placenta abruption, but, of course, there is no definite on that. She told me today that I should start taking prenatal vitamins now (b/c of the folic acid) and get a “build up” before I start trying to get pregnant again. Once I am pregnant, she would prescribe a baby aspirin and then a prescription for a higher dose of folic acid (higher than what you get from the OTC). I have been sitting in front of this computer since I arrived home from the doctor’s office, I am officially confused! Do I need this “build up” of folic acid prior to pregnancy? Could this gene mutation be the reason for the placenta abruption? I don’t know what my next steps should be. In January I will complete the final blood work – I believe she is wanting to test my proteins – maybe?? She said this particular test can be affected by the pregnancy hormones in my body and wanted me to be at least 8 weeks post-prego, but it would be better to be 12-weeks post prego to get a true reading of what my blood is like when NOT pregnant. I want to do the right thing, I thought this information would help me to understand why thishappened to me, but now I’m even more terrified. Can someone give me any advice?

    • Teresa Nevins December 22, 2012 at 4:31 am # Reply


      If you find out any more information about the A1298C being a factor in blood clots or miscarriages I would like the information. Myself, son and daughter all have two copies of the A1298C variant. My husband has one or two (not tested yet). I had two normal pregnancies, but I suffered a great deal from morning sickness throughout both pregnancies. I am concerned for my daughter as she is using the nuva ring (hormones) and that increases risks of blood clots. She should not be on it if the A1298C increases chances of blood clots like the 677 variant does. This is confusing and I need to know for sure as soon as I can.

      • MandyS December 29, 2012 at 5:56 am # Reply

        I do not have any new information YET…I went to my General MD with my blood results and he has referred me to a Hematologist. I am waiting on an appointment date. When I go, I plan to take all this information with me and really try to get some major info from this doctor…my problem is, I am finding contradicting information, which worries me. I am reading different things as far as treatment too, all of this is so confusing! Has your daughter had her homocystine levels checked? If so, were they normal? This plays a factor in all this as well. I will let you know any new information I get from the Hematologist.

  23. Myrto Ashe January 2, 2013 at 7:08 am # Reply

    I went looking for any conventional medicine research that people could bring to their doctors. There is definitely a little out there about 5-methylfolate, though not much yet. This is the best article I could find. You can print it and bring it to your regular doctor or Ob-Gyn or hematologist:

  24. Kristi April 2, 2013 at 6:09 pm # Reply

    Dr Ben,
    Can you recommend any OB who has some knowledge of MTHFR in the St. Petersburg/Tampa, Florida area? I have homozygous C677T and am 8 weeks pregnant (I have had 3 miscarriages before knowing about this test). My current OB knows nothing about MTHFR and was originally going to put me on Lovenox, but decided to only do baby aspirin because I have had no history of clotting issues. I am also taking methylfolate. Those are the ONLY things I am doing differently this pregnancy and have to wait 4 more weeks for an appointment with a high risk doctor to see if they will even accept me as a patient. Even just knowing what else I should be taking (methyl B’s?) or avoiding would be great.
    Thank you!

    • Sophie May 23, 2013 at 3:48 pm # Reply

      Hi Dr. Ben
      We have been thru 7 IVF’s in a little over a years time. one failed due to implantation issues (surgery corrected the issue) two mc and two chemical pregnancies. The last two were the chemical pregnancies which genetic testing was done on them. Before the last two tries I had NK cell and APA done which came back ok. My karyotype was tested and it was normal. Since we are coming to the end of our IVF journey( for financial reasons) we have two more tries. My RE finally sent me for more labs and I’m not sure what to make of the results. I`m concerned about recent lab results: 2 months ago my TSH was 2.63 5/16 TSH is 3.79T4 14.2 Antithyrogobulin 6.0Antithyroperoxidasae pending and MTHFR pending. I took what was suggested by my acupuncturist since my RE wouldn’t test me for MTHFR at the time and I’m concerned if it was adequate should I have MTHFR. It’s made by APEX and its called Methyl SP (K14) she had me take 2 capsules a day. I was also taking Lovenox, prednisone, baby aspirin along with estrogen and progesterone that remained in adequate levels when I was tested twice after embryo transfer. My RE has told me that there isn’t anything else that can be done for us. My husband is Azoospermatic so we have to use a donor. I don’t think they test for things like MTHFR but I can tell you that pregnancies were reported from other women who used this same donor. Is this Methyl SP adequate to treat MTHFR with 2 capsules per day? Is it true that no other preventatives can be taken? I know that I will be put on thyroid meds, he did indicate that he wanted that less then 2.
      Thank you for your time and suggestions!!

      • Sophie May 24, 2013 at 1:11 pm # Reply

        Hi Dr. Ben
        Since I posted the message yesterdayI found that I do in fact have both gene mutations relating to MTHFR. I now have SO many pregnancy loss. My duty know is to find acceptable treatments for these issues in hopes of one day having a full term pregnancy.
        Thank you

  25. Summer Jarvis May 27, 2013 at 7:10 pm # Reply

    I am heterozygous for the A1298C, and looking for supplementation. I am highly sensitive, although I have learned to deal with it well. Do you have a post that would recommend a supplement? What about Pure Encapsulations b-complex plus?

    I have had four early miscarriages, all before four weeks, and I have two living children. Do you think my one copy affected my miscarriages?

    My sister is hetero for the C677T, and sadly she had a stillborn son at 37 weeks, possible due to clotting issues.

    • Summer Jarvis May 27, 2013 at 7:11 pm # Reply

      Sorry, my miscarriages were before 6 weeks not 4.

  26. Bobbie July 1, 2013 at 6:22 pm # Reply

    I am 33 and I have had 6 total pregnancies. My first was carried to 41 weeks with no complications and is currently 9 years old with no health concerns. 2nd I miscarried around 10 weeks (fetus with heartbeat). 3rd Clomid U/S revealed bad pregnancy and D&C was done for testing, trisomy 16. 4th IVF, Chemical pregnancy miscarried both embryos. This prompted the fertilty DR to order genetics testing which revealed that I had a heterozygous MTHFR mutation. Which we were told was not the reason for our recurrent pregnancy losses or our fertility issues. Prior to the IVF we had the typical work up for infertiltiy. I also had laproscopic surgery and ovarion aspiration done. They diagnosed me with PCOS, said I had some endemetriosis, and a slightly underactive thyroid. After the IVF failure we decided not to pursue anymore children and I decided to stop taking my tyroid medicine and the PCOS meds. (My PCP tests my thryoid every year and it has been normal.)

    Fast forward 5 years to now I have been pregnant twice with no fertiltiy help but still miscarrying. 5th, Blighted Ovum. 6th miscarried at 10 weeks (hearbeat & fetus) pregnancy stopped growing around 6 weeks.

    I have been through 5 different doctors with these 2 pregnancies and they all say my mutation had nothing to do with the losses. I was told by one DR when I miscarried #5 that if I was to get pregnant again they would do lovenox. When I called with my postive test I had to see a different DR who refused to treat me with lovenox or even test my homocysteine levels because he felt and said multiple studies reveal my heterozygous mutation doesn’t matter. I have now refused to see the DR who will not do anything and have been seeing the one who said he would treat me with the Lovenox. He tested my homocysteine level and it came back at 11. He said I needed to be on vitamin therapy which consisted of b6, b12, and 6mg of folic acid just for precautionary reasons. But he also reminded me that he didn’t think that the mutation was my problem. I miscarried the day after I seen him for my results.

    I have been hounding these DR’s since pregnancy 5 about this mutation. I found this web-site with #6 and I am so aggravated that they just fluff off this mutation when it sounds like it really could be a vital part of what is wrong with my pregnancies. I wrote this to answer your question about whether the doctor is being proactive or underactive. It is quite obvious that they are being underactive. I live in Indiana and I’ve been told by the maternal fetal medicine doc that they just aren’t as aggresive as they are in the northeast where she stuided. My homocysteine level should have been tested with pregnancy #5 and after that loss they should have tested thrombosis. I have an appointment in 8 weeks to test that. Why didn’t it get done after #5 to eliminate any possible causes? Why didn’t they test to see if my body was absorbing folc acid? Because these doctors are not proactive at all!

    I’ve been trying to go through the web-site and learn as much as I can. I listened to one of DR Ben’s radio interviews and I am becoming increasingly convinced that my MTHFR mutation has everything to do with my losses as well as some of my health concerns. I had to have my Gallbladder taken out a few years ago. I am not the typical Gallbladder patient, 5’5 120lbs. I am healthy overall but I feel tired most of the time. My PCP has told me that I need to consider taking gluten out of my diet. It seems to be all adding up to the mutation to me!

    I am waiting to get my files out of storage from the fertility doctor to make sure in the genetic work-up that they tested my husband for MTHFR, verify that my copy is C677T, and see what they tested. I also don’t think I should be taking 6mg of folic acid but rather taking the methylfolate & methylcobalamin. I am currently trying to change my diet to elminate processed foods and reduce/elimate gluten. I am pushing to find out if this mutation is my cause because I want to help other women that are in my shoes and are being told that their MTHFR mutation has nothing to do with their recurrent pregnancy loss. Does anyone have any other suggestions on how to get to the bottom of this?

    • Kris July 1, 2013 at 11:35 pm # Reply

      Hi Bobbie,

      You are on the right track. I also believe that MTHFR has everything to do with the miscarriages you have been having. I am so sorry for your loss. I too have experienced miscarriages, but I found this website after 2 miscarriages and a failed IVF. I read all I could from the website then, I contacted Dr. Ben for a consultation and was able to get the information I needed to take the right vitamin supplements, then I changed my doctors to doctors that were willing to listen to the new information I found. The new Doctors are still not 100% convinced that MTHFR was the cause of my miscarriages, but I was very firm with them that I believed it was and I was armed with information from the website. I pretty much had to convince them that MTHFR was the problem. When I was done, they approved the regiment that Dr. Ben recommended. Those changes made a big difference in how I have felt physically from day to day and I am happy to say that I’m now 12 weeks pregnant. We did IVF in April 2013 and the embryos attached with no problems. All of my testing have come back good. Currently I am taking Prenatal Essentials, Low dose Aspirin daily, Lovenox injection daily, Active Co Q H, Probiotic 12, 1/2 B12 Lozenge. It’s amazing how something as simple as vitamins could change your life.

      You have to be persistent. Don’t stop your research on this website. Read and find as much documentation as you can to make your case to your doctors. I am so grateful the and to Dr. Ben. It’s been a long road for you, and I pray that it all works out for you. Good Luck!!!!

      • Bobbie July 3, 2013 at 7:28 pm # Reply

        Thanks for your reply and advice! Today on the web-site I found the podcast of suggested supplements for women trying to get pregnant. I am going to get started on these as soon as I can get them.
        Congratulations, I will be adding you to my prayers!

  27. Sunshine August 20, 2013 at 2:10 pm # Reply

    I have been given conflicting info from my RE and another Dr. from the same practice. I am hetero c677t and A1298C. The Dr. who told me about my mutation (after 5 losses) said his protocol would be baby aspirin, low does heparin, and 4 mg. folic acid. He said he did not think the folic acid would matter though and I needed to have folate through greens. The second Dr. said I should not have heparin, as I have anemia and I should take folic acid (4 mg) and scoffed at my Thorne prenatals, said it was not enough folate and that folic acid would be processed by me, though he could not even prounouce MTHFR. I currently 5 weeks pregnant and just taking 81mg baby aspirin, Thorne prenatals, and seeking life l-methylfolate 1000 mcg. also dairy free (goats milk) and trying really hard to be gluten free. lots of leafy greens. Is heparin a good idea or not? I don’t have any options where I live for a Dr. who is knowledgeable about MTHFR. I would be so grateful for a reply and thank you for all the information.

  28. Pamela D September 11, 2013 at 2:25 am # Reply

    You asked our experience. Below is my story and answers to your questions.

    I am a 38y/o female, this is my first pregnancy and I am pregnant with a singleton survivor of a twin pregnancy achived via IVF. After being diagnosed with Sjogren’s syndrome, I asked that I be tested for clotting disorders upon successful implantation. My RE obliged and sent me to a Hematologist for testing. In the meantime, I was placed on daily heparin (Lovenox was too expensive for me) and a high dose of folic acid. My RE told me that the extra folic acid was needed to support the twin pregnancy.

    My clotting factor testing came back normal with only a heterozygous A1298C mutation. The hematologist told me to stay on the heparin (as she was afraid of liability if she took me off and the pregnancy ended) and that having this MTHFR mutation was of no consequence and to ignore it.

    I was released to my high risk OB who agreed with keeping the high dose folic acid, but referred me to a MFM doctor regarding the heparin (as she also wanted no liability for taking me off). In the meantime, she did some routine blood work showing b12 deficiency, a Vit D dificiency and low HBG and HMT (indicating iron deficiency). She told me my prenatal vitamins (which I had been on for a few months already) should resolve this.

    The MFM doctor removed me from the heparin right away stating that it would do more harm that good. She recommended a Vit D supplement and a Vit B12 supplement.
    She agreed with the continuation of the high dose folic acid.

    After 3 sonograms showing two to developing embryos and two heartbeats, a fourth sonogram at 12 weeks showed demise of twin A with no heartbeat. This twin had gradually fallen further and further behind on growth measurements until demise. I was told at that time by my OB that I could discontinue the high level folic acid as it was no longer needed.

    Needless to say, I’ve been researching a lot during this pregnancy. Although I continue to see by OB and MFM doctor, I was recently able to get in with a doctor who treats MTHFR in Austin, Texas. His name is Dr. Kenall Stewart. He has recently performed addtional blood tests which came back this week. Below are what showed up as “abnormal lab values” according to LabCorp:

    % CD 8 Pos. Lymph. 37.6 (High)
    Hemoglobin 9.8 (Low)
    Hematocrit 31.4 (Low)
    MCV 74 (Low)
    MCH 23.2 (Low)
    MCHC 31.2 (Low)
    RDW 17.1 (High)
    Pregnenolone, MS 550 (High)
    Folate (Folic Acid), Serum >19.9 (High)
    Homocyst(e)ine, Plasma 4.2 (NORMAL – but I thought I would add this information)
    Ferritin, Serum 6 (Low)

    I have not spoken with Dr. Kendall Stewart since these results came in. However, he stated he would contact me shortly after the results were received in his office. I am expecting further instructions shortly.

    •How your doctor has been either proactive – or – underactive.
    In my opinion, all of my doctors have been underactive. They did appear to be proactive when I pushed (testing, extra folic acid etc) when pushed, but it appears that treatment wasn’t correct.

    •If your doctor was proactive and you successfully carried to term, please do share who your doctor was.
    I am currently 35 weeks pregnant with a plan to induce in 4 weeks.

    •What was done medically and nutritionally for you in order to carry to term?
    I feel that my treatment was not correct, so I don’t think this would help. I am still taking my Rx Fe (which by my serum iron doesn’t seem adequate), after meeting with Dr. Stewart I have stopped taking my sublingual B12 (it was the wrong kind), stopped taking my Vit D3 and have had my OB switch my prenatal to a brad with Quadrafolic instead of Folic Acid (as per the recommendation). I am also using Dr. Stewart’s “Neuro-Immune Stabilizer” which states on the lable contains: 5-Methyltetrahydrofolate (5-MTHF), Hydroxycobalamin (Hydroxy B 12), Methylcobalamin (Methyl B 12), 1.75mg Pyridoxal 5-Phosphate (B 6) and Approximately 1,000 IU Natural Vitamin D Per Pump. After contacting the manufacturer, they resp;onded that the 5-MTHF is as follows: “The current formula uses 6(S)-5-Methyltetrahydrofolate. Due to new FDA regulation our label will reflect that so that documentation will be provided to everyone. Thank you for your inquiry.”

    I’m still BRAND NEW to the world of MTHFR research. We had my husband tested today and will have our daughter tested at birth. Dr. Stewart has recommended that we NOT vaccinate our daughter until her MTHFR status has been evaluated and her methelation reviewed. He suggested possibly starting vaccines at 6-9 months if all is well and recommended a personalized protocol to treat any issues. We shall see how this goes.

    We have been interviewing pediatricians and have not found one that acknowedges (and very few that have ever heard of) MTHFR. We are looking for waomeone who will agree to work with Dr. Stewart in preventing any issues in our daughter should she be shown to have an MTHFR mutation.

  29. Merle December 2, 2013 at 9:28 pm # Reply

    After 2 miscarriages and lots of testing, I was found to be compound hetero MTHFR.

    I am now pregnant again — almost at 12 weeks. I’m on Thorne Prenatals PLUS specially compounded active forms of folate, b6 and b12 in the same ratio as Folgard. I’m also on Baby Aspirin.

    I was told to stop the baby aspirin after 12 weeks — should I? Or should I continue through the pregnancy?


    • Myra May 13, 2014 at 7:15 pm # Reply

      Hi there, just wanted to check to see how your pregnancy was progressing. I am currently 23 weeks pregnant and on the a very similar regimen – Thorne Prenatals, methylfolate, b6 and b12 and baby aspirin. My RE also put me on lovenox at 6 weeks just as a “finger in the wind” precaution. So far, so good except my MFM has been wanting me to come off the lovenox for weeks but I refused to do so. She says it’s not doing anything for me or the baby; that the BA is what’s helping with blood flow to the baby. I feel that with the lovenox along with the BA and vitamin cocktail has kept my baby alive. Did you continue with the baby aspirin? Did your doctor mention using lovenox or hepirin as well? Is it really not necessary if you are taking the active form of folate and B vitamins? It would be great to get some insight from Dr. Ben here.

  30. helen March 6, 2014 at 12:54 pm # Reply

    Hello, I am just recently 36 and after suffering my 4th miscarriage I have been diagnosed with Heterozygous MTHFR (unsure which one yet) and High protein C.
    My fertility doctor has put me on baby aspirin and 5mg Folic Acid. Also my last pregnancy he had me on shots of Clexane ( a heparin derivative) – I still lost at 8 weeks.
    After doing some googling I am wondering if I should be taking methylfolate instead of Folic Acid but unsure in what dose. I know that I must be converting some of the folic acid I am taking but if I swap it for methylfolate would I still need to take 5mg… seems a lot and because I am so close to beginning my next and final round of ivf ( emotionally and financially we are unable to do more…) I need some advice so not to over methylate.
    Also what dosage of methylcobalamin should I take along side with the methylfolate???
    I raised all of this with my doctor but he just said that Folic Acid is the only thing I needed for my MTHFR, and looked at me like I had 5 heads when bringing you methylfolate and methylcobalamin. Now I feel unsure if I should question him at all. He is one of the top specialists here in Australia and I am very lucky to be seeing him.
    Please can anyone out there help me. I need to do all I can to avoid another miscarriage and feel like no one understands..

  31. Claudia June 30, 2014 at 7:07 pm # Reply

    Hello. I have recently been diagnosed with two copies of the c677t mutation, after experiencing my third consecutive miscarriage. Two different REs in my area are adamant that MTHFR is not contributing to my losses and refuse to advise anything other than upping the folic acid in my supplements. I have since started taking a prenatal vitamin with methylfolate and increased B12 instead, along with altering my diet as per the recommendations on your website. My question: aside from following the diet and supplement advice is there anything else I should be doing? Will I need lovenox shots in the event I conceive again? My homocysteine levels tested as “normal.” There are no MTHFR doctors listed in my area on your website unfortunately and I feel very much on my own. Like Helen above, I desperately need help to ensure I am doing everything I can to avoid another miscarriage.

  32. Katye July 12, 2014 at 9:13 pm # Reply

    Can you recommend any specific articles to help convince my OBGYN about the necessity of starting heparin? I had a 2nd trimester miscarriage last year and my doctor sent me to a maternal-fetal medicine specialist who literally knew nothing about the MTHFR gene mutation and when I pointed out to her that I was not only compound heterozygous for that mutation but the prothrombin mutation as well, she admitted she wasn’t aware it increased the risk and after looking it up on “Up to Date” in front of me told me just to take baby aspirin. After the miscarriage (and my almost dying) the doctor told me that “next time” I would have to take blood thinners as it was most likely caused by a clot. How frustrating when I tried to tell them to begin with. Anyhow, it seems that the recommendation is to start heparin when trying to conceive, but that isn’t something she seemed open to.

  33. a September 9, 2014 at 11:43 am # Reply


    I am exactly in the same situation as D. from Boston. What do you recommend doing in such a case?


  34. Jennifer November 11, 2014 at 3:19 pm # Reply

    I am new to all of this… just found out that I am heterozygous for both C677T and A1298C. I am curious about the idea of my miscarriages being related to this…. I have had 5 miscarriages, but I have also had 8 live births… All of my miscarriages, except the last one were while I was nursing a toddler, and I have always believed that it was low progesterone that caused each one. I used progesterone cream, without the doctor’s knowledge (because I did not believe they would agree) with my last four full term pregnancies, including one pregnancy that occurred while I was nursing a toddler. I did not have any clotting issues, however, during my last 5 pregnancies, I did develop mild idiopathic thrombocytopenia. It did not cause any problems for me.

    I had four pregnancies without difficulty, then 2 m/c’s, then a full term pregnancy, then a m/c, then two full term pregnancies, then a m/c, then a full term pregnancy, then a m/c.

    From what I experienced, I very much think that if my MTHFR was related to my losses, then it was related to my inability to have a high enough progesterone level while lactating…. My losses were all early, and unlikely to have been clotting problems. I am now getting ready to enter into menopause, and I am struggling with continual hormonal problems. I am very curious about how this all fits together.

    Also, I have 8 kids who most likely, do have some expression of MTHFR ( none tested at this time.) I am a little overwhelmed with how to proceed to ensure that they are able to have good health in the future, and would not like to see them have to go through pregnancy loss. I haven’t seen anyone on any of these posts who has a large family. It would be nice to connect with someone who understands, not only the health implications, but also the financial implications of trying to keep one’s family healthy.

  35. Kate March 2, 2015 at 9:55 pm # Reply

    Hi Dr. Ben,

    I’ve had two pregnancy losses (10 weeks with heart tones and then again at 9 weeks with heart tones). My partner and I went ahead and went to a reproductive endocrinologist and got the full work up. Everything on his end came back normal/negative.

    I had some strange things come back, but an important one is that I’m compound heterozygous MTHFR (homocysteine levels looked great luckily). I also tested positive for anti-nuclear anti-bodies at an extremely low number with a very sensitive titer (no history of autoimmune issues in my family and no signs/symptoms in me). I also tested positive for an unidentifiable RBC antibody in my blood typing/Coombs test (they were unable to determine what it is after multiple draws and suspect that I could potentially have these because I have a lot of tattoos, weird eh?). I’m Rh positive, no history of transfusions, no hemolytic disease of newborn, no major surgeries, nothing like that.

    Our doc determined the course of action (for the next time we get pregnant) to be the following:

    1) Baby aspirin (81mg once per day)
    2) Prometrium suppositories 1-2x daily depending on levels
    3) MetanX
    4) Frequent blood tests and close monitoring

    I’m making a running list of questions for the next time we do conceive and I’m wondering these things:

    – Should I ask about Nattokinase since I won’t be on Lovenox? It seems minimally invasive.

    – Will I have any negative effects on the MTHFR end of the spectrum if my ANA levels go up and I get put on prednisone and antihistamines?

    – Should I ask about Lovenox since it seems other doctors are prescribing it as part of the “standard” catch-all protocol?

    Thanks a bunch, Dr. Ben! Your website is wonderful!


  1. Preparing For Pregnancy With MTHFR Mutations • MTHFR Living - November 13, 2013

    […] Complications. Initial scientific research for homozygous C677T cases supports this opinion. Dr. Lynch explores this subject more on his website as well. In the next section I’ll discuss some additional situations where […]

  2. I'm Looking for Answers and Why I'm Now Gluten Free | Simple Life Abundant LifeSimple Life Abundant Life - March 17, 2014

    […]  However, according to a lot of research I have read, this is not always the case.  Read here for more […]

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