Just wondering what your thoughts are about methylfolate. I know your general stance on supplements seems to be that they shouldn’t be taken unless directed to by a physician due to a known deficiency. I saw a podcast advocating supplementation for someone with a Mthfr gene mutation. I have no idea if i have that issue, but the supplement is really cheap so I gave it a try. Wow! For about 3 days I felt so good that I could barely get to sleep at the end of the day and then it leveled off and i just don’t get that run down feeling I used to get anymore. I dont know if it was just due to a lowering of homocysteine or I was deficient in something. I mentioned it to my PCP, but I dont think he was really familiar with the issue. But he thought taking it was fine. If someone has such a positive reaction to methylfolate, would you think that indicates they should continue with it and that they probably do have a mthfr gene mutation? Thanks.
Methylfolate (vitamin b9) is used in many physiologic processes such as making DNA, neurotransmitters, and methylation pathways.
The enzyme, methylenetetrahydrofolate reductase (MTHFR), converts folic acid to to L-methylfolate. Many have a variant of the MTHFR gene that alters its activity, sometimes leading to an increase in homocysteine levels. It has shown that some variants of these genes are associated with increased risk of things like heart disease, major depressive disorder, some cancers, blood clots, and so on. While the associations are established, causality from either MTHFR variants and/or homocysteine levels hasn’t really been established. In fact, we have many ways to reduce homocysteine levels, but generally these have little to no effect on the disease or health outcome of interest.
I don’t think people should be routinely tested for methylenetetrahydrofolate reductase (MTHFR) variants. While b-complex vitamins may lower homocysteine levels, existing evidence generally shows little benefit to doing this. Additionally, I don’t think people should supplement with methylfolate (vitamin b9). Folic acid is likely beneficial in pregnant women, which is the extent of my folic acid recommendations. I don’t think you are likely to benefit from taking the supplement. Coupled with the risk of contamination and the cost, I’d skip it.