MTHFR gene

If you follow a lot of health blogs and podcasts, you’ve probably heard of the MTHFR gene.

People with mutations in this gene have problems with methylation and folate metabolism, which can translate into a wide variety of signs and symptoms including:

  • Fatigue
  • Brain fog
  • Anxiety or depression
  • Infertility or miscarriage
  • High homocysteine levels

(I won’t go into detail on methylation here, since it gets complicated fast, but if you want a primer, see my podcast called Methylation 101.)

The typical approach to addressing MTHFR mutations has been to take high doses of folate—and sometimes other methyl donors like B12 and B6.

But, some recent research suggests that taking super-high doses of B12 and folate for a long period of time may not be ideal. I discussed this in an interview I did with Dr. Kara Fitzgerald.

That’s why I was really interested to come across research done by Alex Leaf, a researcher for Examine.com. He found some studies suggesting that people with MTHFR mutations may simply need a little extra riboflavin (vitamin B2) in order to make the enzyme work properly.

For example, one study he reviewed showed that in MTHFR carriers, homocysteine levels are only high when riboflavin levels are low—regardless of folate status.

Another study found that taking just 1.6 mg of riboflavin a day reduced homocysteine levels by a whopping 40 percent in people with two copies (homozygous) of the MTHFR C677T mutation.

We’ve been testing riboflavin levels in people with MTHFR mutations in my clinical practice for some time, and it’s not unusual for them to be low.

We’ve also recently started prescribing riboflavin to MTHFR carriers—with good results. Higher doses than 1.6 mg/d may be more beneficial. We tend to use around 25 to 50 mg/d as a starting point, but we will sometimes go higher. The good news is there is no known upper limit for riboflavin supplementation.

Or, we just have them eat more liver, which is very rich in riboflavin. But not everyone will do that. 🙂

If you have an MTHFR mutation, attending to your riboflavin status is probably worthwhile. If you do that, you may not need high doses of folate or other methyl donors.

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Chris Kresser LLC, a Nevada LLC / Kresser Institute | 810 E. Sahara Ave | Suite 402 | Las Vegas | NV | 89104 | USA