Folate Blood TestWhen 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.

Update June 25, 2019:

There are many new updates to this article – including a new Folate blood test available 😉

There are a few issues regarding how much methylfolate to take:

  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
  6. Lifestyle is not commonly evaluated
  7. Environment (where you work, where you live, chemical exposures, occupation) is not commonly evaluated

Consider a Folate Blood Test

Folks, it’s not even just about methylfolate – it’s about other types as well.

There is a Folate Blood Test which evaluates levels of:

  • folic acid (which is also known as unmetabolized folic acid)
  • tetrahydrofolate (THF)
  • folinic acid
  • methylfolate

What is not tested is RBC Folate because RBC Folate is not stable. Labs that are testing for RBC folate must be asked how they can accurately measure it as it’s so unstable.

If doctors order this folate lab test, folate dosing may be more targeted.


I’ve had patients with low folate levels on labs (not done by Doctors Data) and the doctor prescribed higher and higher amounts of folate. The lab still showed low folate levels despite higher and higher dosing. The doctor kept increasing folate intake despite the patient becoming manic.

Moral of the story:

Do not use the lab markers over what you see or experience in the person – or yourself.

For those wanting to evaluate their various types of folate vs. just ‘serum folate’ which is almost worthless, I do recommend ordering the Folate Metabolism by Doctors Data

Who should order this Complete Folate Blood Test?

  • Those with MTHFR defects
  • Those who have signs of MTHFR mutations
  • Those who have signs of a Dirty MTHFR (as taken from the quiz section in the book, Dirty Genes.)
  • Those who want to see how their folate levels are truly doing
  • Those who want to experience a baseline in folate levels before switching away from folic acid to methylfolate.
  • Those who are simply curious and want to see the breakdown of their folate levels.

Where do I send my doctor to order this Folate Blood Test for me?
You send them to Doctors Data.

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

Be sure to tell your doctor about this test!

What to do about the lab findings?

I am not a proponent of blindly recommending supplementation even if the lab shows a deficiency is present. On the flip side, I am not a proponent of avoiding supplementation if a lab shows a normal or surplus amount is present.

One must evaluate the entire picture: labs, history, physical exam and desired outcome

A lab is supposed to help you understand what is going on. It is not dictating treatment.

This same thing goes for genetic testing.

Simply because you find out you have MTHFR mutations doesn’t mean you need a bunch of methylfolate. The absence of MTHFR mutations doesn’t mean you do not need methylfolate.

This is simply useful information you need to know and evaluate.

Possible Folate Lab Findings and What to Consider:

  • High Folic Acid:
    • identify sources of folic acid and remove.
      • supplements
      • processed foods
      • drinks
      • energy bars
      • medications
    • as you avoid folic acid, it will leave your body naturally over a period of a few days
  • Low Folic Acid:
    • Celebrate!
    • Your folate receptors and folate binding proteins are happy you’re free of this artificial intruder.
  • High THF, High Folinic Acid, Low MTHF
    • This is the leftovers of methylfolate after the ‘methyl’ from the methylfolate is donated to homocysteine. THF also comes from other sources in your body. If your THF is high and your MTHF is low along with high Folinic Acid, it may be a sign you have some MTHFR sluggishness going on there.
    • You may need vitamin B2 as riboflavin as this is the cofactor for MTHFR
    • You may be taking folinic acid and not methylfolate.
  • High THF, Low Folinic Acid, Low MTHF
    • You may be limiting folate supplementation or intake of liver or leafy greens.
    • You may be eating or supplementing with folic acid.
    • There may be sluggishness in your MTHFD1, SHMT and MTHFR genes. These genes may be dirty.
    • This may be a result of low vitamin B6 and low riboflavin as these nutrients are cofactors for SHMT and MTHFR.
    • It’s best to try and use the cofactors first before supplementing with methylfolate
  • Low THF, Low Folinic Acid, High MTHF
    • This may be a result of supplementing with methylfolate and not eating greens or liver.
    • The methylfolate cannot get through the MTR enzyme and donating the methyl from methylfolate to homocysteine.
    • Consider checking homocysteine.
    • This may be a result of ‘Methyl Trapping’. You may need to open up the MTR gene which may be dirty – and it is easily dirtied. Vitamin B12 may be needed as well as liposomal glutathione or/and PQQ. The reason for liposomal glutathione and PQQ is because the MTR enzyme gets dirty from reactive oxygen species and these supplements remove them.
    • Which B12 to use? That’s a tough question. For a potentially dirty MTR enzyme, I’d consider using Hydroxo-Adeno B12 over Methylcobalamin. Hydroxocobalamin helps clean up reactive oxygen species and adenosylcobalamin supports mitochondria.
    • If you don’t want to support mitochondria right now, and if you don’t do well with mitochondrial supplements, consider only Hydroxo B12
    • It’s best to open up the MTR enzyme and clean up that dirty gene before supplementing with Folinic Acid.
  • Low THF, Low Folinic Acid and Low MTHF
    • Hmm..not eating any leafy greens, liver or supplementing?
    • Consider eating some grass fed beef/lamb/chicken liver
    • Greens can be hard for some people due to oxalates and other plant constituents
    • If you want to try supplementation, consider starting out with Folinic Acid as that is gentler than methylfolate for many people.  By using the Folinic Acid Lozenge, you’re able to break it into smaller amounts and test. You may also place the full lozenge in your mouth. Let it dissolve slowly while tuning into how your head is feeling. If your head is becoming clear and mood improving, let it continue dissolving until you reach the point where ‘That’s enough!” is felt. Typically the improved mood and clarity will transition to anxiety if you’re taking too much. Simply spit out the rest, note how much dissolved and take that much next time you feel the same way.

There are likely other scenarios as well but this gives you a great place to start.

Don’t Want to Pay for a Lab Test?

Rather experiment to see how much Folate you need?
If you have been diagnosed with a MTHFR mutation, or even if not, and you want to try taking some folate, 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. Once you feel good, stop taking it.
  6. If you stop long enough and start feeling your old sluggish self coming back, then you know you need more methylfolate.
  7. If you experience methylfolate side effects from taking Active B12 with Methylfolate, consider a lozenge of 50 mg Niacin. The niacin typically works really fast to neutralize the side effects.
  8. I highly recommend getting both of these supplements at the same time in the event you need the niacin.
  9. Work with your doctor on this and inform them what you are doing.

If you don’t want to use Methylfolate, consider using Folinic Acid instead.

You may use the Folinic Acid Lozenge without vitamin B12 or you may want to use a combination of Folinic Acid with Hydroxocobalamin

Use the folinic acid as I described above. The same guidelines apply.

If you cannot tolerate any folate, consider reading this article on Preventing Methylfolate Side Effects

Long Term Solution for your MTHFR Mutation

Now that you realize you have to be careful with methylfolate, I’d really like to see you get on a full program vs just supplementing – and possibly making yourself worse.

Reading my book, Dirty Genes, will help you immensely.

You’ll learn about MTHFR and how to use methylfolate in depth, yes, but you’ll learn WAY more than that.

Empower yourself and take action the right way.

Dirty Genes is the guide you’ve been looking for.

It continues to be a bestseller month after month for good reason.

Dirty Genes book by Dr. Ben Lynch

You’ll see why once you pick it up and start reading 😉

Don’t like reading books? Want to get more in depth and see how it all ties together?
Get access to the Dirty Genes Course where I discuss how food, lifestyle, environment, mindset and genetics are influencing how you’re feeling – and how to deal with it all.

The Dirty Genes Course is where I bring in a lot of published research, translate it and make it actionable for you. It’s an extension of the book, Dirty Genes. There is a lot of science, biochemistry and actual examples of how to use this stuff in your daily life.

Is it going to be over your head in terms of difficulty?

Absolutely not.

You’ll learn a ton and you’ll be amazed how easy it is to implement what you learn.

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10 years ago

I am new to the 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!

Carolyn Friesz
10 years ago

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.

10 years ago

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.

jacki kurtz
10 years ago

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


10 years ago

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?

10 years ago
Reply to  Dr. Ben Lynch

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.

10 years ago
Reply to  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.

10 years ago
Reply to  Lynn_M

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

Holly Kay
4 years ago
Reply to  Summer

Obviously this company is trying to get you to buy their products, which are not FDA regulated, nor supported by clinical trials, because they are SCAMMERS. I’m a Pharmacist. Mthfr mutation? You need Deplin 15mg. FDA backs that product up. Signed, Pharmacist Holly

10 years ago

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.

10 years ago
Reply to  chris

Chris–I left you a note re white tongue and metallic taste on Cheers! Ella

Rachel Jarrett
7 years ago
Reply to  chris

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

Rachel Jarrett
7 years ago
Reply to  Dr. Ben Lynch

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

Rachel Jarrett
7 years ago
Reply to  Dr. Ben Lynch

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

Rachel Jarrett
7 years ago
Reply to  Rachel Jarrett

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

Holly Kay
4 years ago
Reply to  Dr. Ben Lynch

I do not agree. It’s because the 15mg is backed by clinical trials and FDA backs them, unlike your products.

Silvia Price
8 months ago
Reply to  Holly Kay

Giving everybody the same high dose is like giving everybody size 12 shoes and expecting them to fit.

10 years ago


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

10 years ago

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

10 years ago

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

10 years ago

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

Sarah Joy
10 years ago

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

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

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

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

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

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

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

9 years ago

Hi Dr. Lynch,

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

I am currently taking:
Liposomal Vitamin C
Micellized D3 1200 IU
Probiotics HLC Mindlinx
Gaba (Fennel Buterate Gaba)/Biotics GABA

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

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

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


Lisa P in NC
9 years ago

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

April Wortman
9 years ago

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

Molly Malone
9 years ago
Reply to  April Wortman

Hello April, I can suggest another site in addition to this one that might provide some insight and help: the phoenixrising site. I will include Chris Kresser’s 2 articles as well; you may know more than these but I found them helpful. Sometimes it gets very complicated as Dr. Lynch has said in some of his articles. Sometimes also, there are other complications such as heavy metal toxins that need to be removed (check out the Cutler Protocol if you think this is an issue) or other deficiencies such as vitamin D, potassium, magnesium, sulfur and others.
Here are a few links to get you started, blessings to you and your daughter! Rich’s Page P.4 of the active B-12 protocol. MethylTrap, Paradoxical and/or Donut Hole Folate insufficiency, Low B12, Low Potassium

Molly Malone
9 years ago
Reply to  April Wortman

Also, check out this article by Dr. Lynch, it’s very helpful:

[…] How Much Methylfolate Should I Take? Find Out […]

9 years ago

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

9 years ago
Reply to  Dr. Ben Lynch

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

Her supplements:

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

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

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

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

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

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

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

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

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

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

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

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

13) Singular 10 mg a day for allergies

9 years ago

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

9 years ago

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

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

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

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

9 years ago

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

9 years ago

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

9 years ago

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

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

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

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

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

Thank you so much for the information! Really!


9 years ago

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

Michael R.
9 years ago

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

Molly Malone
9 years ago
Reply to  Michael R.

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

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

Molly Malone
9 years ago
Reply to  Molly Malone

I forgot to mention Chris Kresser’s site, it’s helpful too, especially the numerous comments.

Linda H.
9 years ago
Reply to  Michael R.

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

9 years ago

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

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

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

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

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

9 years ago
Reply to  Oskar


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

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


9 years ago
Reply to  Cathi

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

9 years ago
Reply to  Cathi

Hi Cathy,

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

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

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

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

Best of luck!

9 years ago

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

9 years ago
Reply to  Dr. Ben Lynch

Hi Dr Lynch,

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

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

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

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

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

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

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

9 years ago
Reply to  Oskar

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

Gloria Schaefer
9 years ago

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

9 years ago

Dr. Lynch,

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

9 years ago

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

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

Any insight is super appreciated. Thanks!

9 years ago
Reply to  Dr. Ben Lynch

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

9 years ago

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

9 years ago

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

Thanks for your help.

Marwa El-sayad
9 years ago

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

Nohora Groce
9 years ago

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

9 years ago

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

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


Thanks in advance!

9 years ago

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

9 years ago

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

9 years ago

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

9 years ago

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

9 years ago
Reply to  Tammy

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

9 years ago

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

8 years ago

Im really anxious to know if I can take:

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

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

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

Dr. Aron
8 years ago
Reply to  Jennifer

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

8 years ago

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

8 years ago

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

Dr. Aron
8 years ago
Reply to  Lori

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

8 years ago
Reply to  Dr. Aron

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

Dr. Aron
8 years ago
Reply to  Lori

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

Lindsay Piedra
8 years ago

Dr. Ben,

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

Thank you!


Dr. Aron
8 years ago
Reply to  Lindsay Piedra

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

VICKIE harter
8 years ago

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

8 years ago

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

Dr. Aron
8 years ago
Reply to  Betsy

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

8 years ago

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

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

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


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

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

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

8 years ago

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

8 years ago

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

Lynne Clement
8 years ago

Dr. Ben,

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

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

8 years ago


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

Thank you!!

8 years ago

Hi Dr. Ben,

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

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

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

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

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

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

Thanks in advance,


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MTHFR? This Course is For You

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