Now What? MTHFR Mutations

 So you’re a mutant too? You’re in good company. It’s currently estimated that up to 40% of the population has some variation of an MTHFR mutation (and the estimate keeps climbing as more data is analyzed). So if so many people are affected, and folic acid is a big NO for someone with an MTHFR mutation, why is our food fortified with this synthetic vitamin, and why are so many of us told we need folic acid?

Well first, folic acid is cheaper than folate. And second, by fortifying our food with folic acid and by suggesting we take supplemental folic acid, many doctors believe they are encouraging us to access a nutrient critical for our well being. But there’s mounting evidence that this line of thinking is misguided. Why? Because, simply put folic acid and folate are NOT the same thing. 

“Medical professionals, nutrition experts, and health practitioners frequently mix up the two, simply because the terms are often used interchangeably.

Many health professionals would even argue that folate and folic acid are essentially the same nutrient. While folic acid is often considered to be a supplemental form of folate, there is an important distinction between these two different compounds.” – Chris Kresser

No one needs folic acid, but everyone needs folate.

Folic acid is synthetic and man-made. It’s structure is completely different from the usable form of tetrahydrofolate derivatives naturally found in food. To make folic acid usable, it has to be converted by the MTHFR enzyme. The more mutations you have, the lower your ability to convert folic acid and the more likely it is to build up as a toxin (unmetabolized folic acid) in your blood stream. (1) Additionally, by consuming folic acid, you won’t be getting the critical folate that you really do need in your diet!

Picture it this way, I ask for an apple and you hand me a banana. They’re both fruits, but they’re in no way the same. That’s folic acid and folate.

So, what do you do if you have an MTHFR mutation? 

  1. Avoid folic acid. Yes, that means that you have to avoid enriched flour and processed food products containing folic acid. Yes, that means most store bought bread, tortillas, crackers… even goldfish. And, unfortunately, it sometimes even means coconut milk. Learn to read labels. Your health may depend on it.
  2. Consume folate in it’s natural form. Spinach, liver, garbanzo beans, pinto beans, brussel sprouts and broccoli are just a few great sources of folate. (Here’s a more exhaustive list.)
  3. Consider supplementation with methylfolate. Supplementation should ALWAYS be done under the care of a doctor. Simply adding a methylfolate supplement to your regimen alone will not solve all of your methylation problems as you may also need B12, B6, Vit D to name a few. (Seriously, methylation can’t happen without the right combination of nutrients.) Plus, your needs for folate may vary dramatically from your neighbors. But the good news is that your functional medicine doctor should be able to run diagnostic labs to determine your own personal needs.
  4. Explore ways to further boost your body’s ability to methylate and detox. Sometimes this means additional supplementation (again, lab tests). Often times it means avoiding toxins and cleaning up your diet and environment. If your methylation is impaired due to an MTHFR mutation, then your body may struggle to rid itself of toxins. Help it out and lighten the load. Consider eating organic when possible, drinking mineral spring water, using an air purifier, and switching to safer cosmetics and beauty products.
  5. Run away from any doctor who tells you that you need folic acid. Not to be redundant, but… you don’t. You need folate. They are not the same.


Additional Reading:

Folic Acid vs Folate | Paleo for Women

The Little Known Difference Between Folic Acid and Folate | Chris Kresser

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