Why you might not want to start out with addressing the MTHFR SNP.
Many people are quick to jump on the MTHFR bandwagon and give Methylfolate, Methyl B12 and SAMe thinking they are fixing the problem and treating a SNP (read what a SNP is HERE). Taking this approach can cause some major issue and patients end up worse off than they were before while others do just fine. Well, what exactly is the problem to begin with? There might be other things you need to do before you try pushing the Methyl cycle with methylated B’s. So, lets talk.
First off, MTHFR, MTR, MTRR, SHMT, etc gene mutations/SNPS are nothing new. They have been in our genome for quite some time, but why are they just now becoming a problem? First we need to clear the water and say we are still in the very early stages of understanding how our genes function and work together. Each gene influences others and each SNP can be aggravated or helped by another SNP. Our genome is amazing and some mutations are not necessarily bad. Take FUT2 mutations for example, there are some negative consequences on B12 absorption but there is an interesting benefit to it as well. Individuals who have mutations on FUT2 are also Immune to Noravirus infection, you know that stomach bug that is famous for ruining cruise ship vacations? Yeah, you may be one of the few on board who can still enjoy the trip while everyone else is sick as dogs. No line at the bar! Just take a little extra Methyl-cobalamin with your margarita. So that being said, are there other mutations that might make up for some of these issues we see, sure! And maybe we just haven’t found them yet but the pictures is becoming clearer as we continue learn.
Many people will leave my office saying, “But, we aren’t doing anything for my MTHFR mutation.” Well, actually we are. Remember when I said MTHFR mutations have been around for a long time? It’s certain things we are changing in our diet and lifestyles that are causing some of these mutations to show up and be expressed. Wonder why autism rates are spiking? Not going down that rabbit hole….. but you get the picture. Certain people are at a slight genetic disadvantage to others, that’s why one might get sick while the other doesn’t as our environments become more toxic and we continue to put crap into our food/ bodies some of us are inevitably going to get sick.
I don’t even know how many people I have seen that have come in to see me with MTHFR and Anxiety and they just can’t figure out why they feel the way they do. Themselves or a practitioner had haphazardly put them on SAMe and methylated B’s, including methylfolate, because of the MTHFR mutation. Well, there is more to the methylation cycle than just MTHFR. Let me say that again, MTHFR is just one part of a bigger picture given it is a very important part. There can be downstream mutations in many other enzymes too. As you push MTHFR you can flood neurotransmitter pathways and if the neurotransmitter breakdown pathways are not the greatest due to other SNPs or other factors you can cause some anxiety and maybe even an panic attack. I had a patient last week that came in after having a panic attack from taking methylated B’s and the practitioner had ignored her downstream mutations in COMT, VDR, and GAD. I have new patients weekly that this has happened to! More on COMT below!
So what’s first? Synthetic Folic Acid must go (Read more on Avoiding Folic Acid). It’s in everything! Bread, cereal, protein shakes, multivitamins, random supplements, crackers, you name it we have this desire to shove it into everything processed. So evaluate what supplements and dietary items you eat weekly and see what’s in it. And replace it with something with naturally occurring Folate. Raw, green leafy vegetables are packed with folate. So eat more salad. Yes, it’s that simple. There is quite a bit of negative research out on unmetabolized folic acid, and some countries have stopped fortifying foods with it already. Keep in mind the half-life of folic acid is around 12-14 days, and Methylfolate is about 4 hours. Of course, America will be about 10 years behind on it. So once again, this is another example of where a Paleolithic lifestyle or even a lifestyle that was only 100 years ago might be beneficial.
Second is we must try and lower our immune system activation. We live in an age where autoimmune diseases are rampant and we are so immune dis-regulated that many of us can no longer deal with seasonal allergies without getting a bacterial infection once or twice a year. So where do we start? Well, where is most of your immune system? Hint… It has to do with your food. It’s in your gut! We have to take care of our gut flora and gut lining integrity. Once again this kind of goes back to diet. Are there genetic mutations that make one more prone to gut issues? You bet! See how this is kind of a viscous cycle? Everything effects the next and then it compounds the previous issue. As The immune system up-regulates we can see hormonal issues, in fact there is quite a bit of research on multiple chemicals that come from bad bacteria in the gut that will screw up our hormones. Many times I’ll look at immune system SNPS or order advanced cytokine panels to see how we might be able to calm the immune system down naturally. Immune system is king.
Nitric Oxide is another immune chemical known to cause issues for people with MTHFR when they try and start supplementing with methylated B’s. We have to calm the immune system down or give other nutrients to help calm nitric oxide before pushing methylated B’s. This is where hydroxocobalamin comes into play. H-B12 can help lower excessive nitric oxide in the body and is a much safer form of b12 than methyl when dealing with someone with anxiety or anger issues.
COMT, Catechol-O-methyltransferase, is an enzyme that breaks down Norepinephrine, Epinephrine, and Dopamine. With these SNPs you may have issues breaking adrenalin down. This means you are prone to anxiety and anger issues. So if someone has an MTHFR mutation and simply takes methylfolate and it pushes neurotransmitter production someone can have an anxiety attack. So you can see how haphazardly giving methylation support too soon without looking here, you may get angry with the results and punch a hole in the wall. Seriously.
People with MTR and MTRR SNPS really need Methylcobalamin, but when COMT is present it’s a sticky situation and we have to use the hydroxocobalamin form again. If you see COMT +- on your reports and you think you’re ok, you MUST MUST MUST look at your VDR status and if its –, you need to treat this situation like its COMT ++ and be careful. But once again, if you suffer from anxiety it’s probably a good thing to take it slow with methylfolate support COMT or not.
So when you find out you have MTHFR, it is important and it means you need to really watch your epigenetic factors and what you put into your body if it is folic acid(BAD), methylated B’s, Methylfolate or something else. It does give you reason as to why you may be more sensitive to certain things than someone else or other symptoms. But, there is no one size fits all protocol for anyone with MTHFR, or any condition for that matter, and if you need help there are practitioners out there to help you traverse this MTHFR/epigenetic/ circadian biology Jungle that is unfortunately but amazingly life as we know it today.