How Much Methylfolate Do I Need When Trying To Conceive & During Pregnancy?
A question everyone faces after getting their MTHFR mutation diagnosis…
The answer, it’s not so simple. What’s right for one person is not always right for another. The truth is, the dosage can vary greatly and is affected by many factors. Unfortunately, it can take some trial and error, but there are factors that you and your doctor can take into consideration when targeting your goal dosage.
So what can you do?
Bloodwork-
Always start with bloodwork. You should already be running bloodwork at your annual checkup, but if you have a vitamin deficiency it will have to be run every couple of weeks, to every couple of months (depending on the severity), until it’s resolved. Vitamin deficiencies are going to drastically change dosage needs.
Homocysteine Level-
High Homocysteine will increase your methylfolate, B12, and B6 dosage. Treatment typically ranges from 5–15mg methylfolate for a short duration. Depending on how your body responds to treatment, this could take a few weeks or a few months. Since B12 deficiency commonly occurs alongside elevated homocysteine, higher doses are utilized for treatment as well (you’ll have this verified with your bloodwork as discussed above). Homocysteine should be brought down into the ideal goal range, which is 5–7 umol/L. You do not want your homocysteine below 5 umol/L as this can create other health issues and decrease your body’s ability to produce glutathione, the master antioxidant. There is a necessary balance. For more information, you’ll want to learn about methylation.
Bloodwork should be done to keep an eye on your progress and confirm when you can reduce the dosage of these B vitamins.
The Number Of Mutations You Carry-
Most medical professionals agree 1mg-4mg is the folate range needed during pregnancy for those with MTHFR mutations (those with a good healthy diet will only require the minimum 800mcg).Some doctors will start high, prescribing 5mg or more, but this isn’t necessarily the right approach. What does your bloodwork say? How many mutations do you have? Are you experiencing recurrent loss? These are just a few of the questions that should be taken into consideration.
- It’s important to keep in mind that methylfolate should never be taken alone, and needs other B vitamins such as B6 and B12 to be processed efficiently in the body for methylation. Taking high doses of methylfolate alone can actually be dangerous. Still, many doctors make the mistake of recommending folate alone.
- When taking methylfolate, the dose should always be slowly increased. The standard recommendation with any medication or supplement is to increase the dose by 1/4 the goal dosage every two weeks until reaching the full desired dose. This method allows for easier monitoring during the trial-and-error process, to find the right dosage for your unique body, and limits side effects, while allowing your body time to adjust. You may find you don’t need near as much as was initially suggested, so this process is important to tailor vitamin supplementing to your unique body.
Gene Expression -
Genetics are a funny thing. Two people can carry the same mutation yet experience completely different effects. MTHFR has been connected to a laundry list of health concerns. Your sister may carry the same mutation and experience little to no negative effects, yet you’re experiencing more health issues than you can count.
And there’s this fun effect of genes “turning on” where you wake up one day and suddenly develop an allergy you’ve never had or a food intolerance. Fun right?
Many women wonder why they’ve had successful, uneventful pregnancies, and then suddenly begin experiencing recurrent pregnancy loss, neural tube defects, etc. The answer, it’s all in your genes. Genes are affected by your diet, toxins, age, and environment. The good news is, the more you know, the more counteractive, preventative steps you can take. Modifying diet, detoxing the body, and taking the right supplements are just some of the steps that are going to help you counter the effects of your mutation and prepare your body for pregnancy.
But What About Dad’s Mutations?
- It’s important to know your spouse’s mutation status as well. MTHFR mutations affect male fertility too! If your spouse has mutations, it’s important to get him on a good multivitamin for men with the active forms.
My personal favorite is Naturelo for Men. This is the multivitamin I have my own husband on. Linked here… https://amzn.to/3vKWtJW
- Baby’s needs will increase with inherited mutations, which means mom’s intake needs increase as well. Knowing both parent’s status will help you and your doctor to gauge what dose of methylfolate will be the best fit for you.
Pregnancy vs General Health-
Providing your body with the right vitamins and nutrients doesn’t begin and end with pregnancy. Adequate folate and B vitamins in general, are crucial for so many roles and functions in your body. You should already be taking care of your health and trying to meet the minimum daily suggested dose of 400mcg of folate, through diet and when needed, supplements such as a good multivitamin with active or natural forms. During pregnancy, your body’s needs increase, and new concerns arise such as lowering the risk of Neural Tube Defects (a risk that’s already increased by the MTHFR mutation). These risks are countered and decreased with sufficient folate. This is why studies, medical professionals, and fertility specialists recommend starting your prenatal and additional supplements for pregnancy a minimum of 3 months before trying to conceive. I highly recommend checking out the book “It Starts With the Egg.” The book does a fantastic job covering these supplements for fertility, egg health, and how to reduce risks while covering these great studies.
Find the Book “It Starts With The Egg” here… https://amzn.to/3dCvBVp
Pregnancy History-
If you have any children living or who have passed with a neural tube defect (NTD), your methylfolate dosage will be increased to lower the risks of this occurring again. You should also be eliminating synthetic folic acid from your diet.
There are also many supplements that can help improve egg health. These supplements are covered in the book “It Starts With The Egg.”
Many doctors who are unfamiliar with MTHFR mutations make the mistake of prescribing high doses of folic acid. However, we have found this actually increases risks for those with MTHFR mutations. We already carry an increased risk due to the defect in our ability to convert forms of folate into methylfolate. All forms of folate MUST be converted by the MTHFR enzymatic process into methylfolate for the body to make use of it. Otherwise, it’s useless to the body.
So why do risks of NTD increase? We fail to convert folic acid into methylfolate, therefore rendering much of it useless and harmful, left to build up in the body. As a result, our bodies are flooded with synthetic folic acid, which binds to the cell's folate receptor site, blocking the absorption of other forms of folate or even the active form (methylfolate) from your supplements. This creates a hidden folate deficiency in the body, and as we know, folate deficiency is specifically what increases risks of Neural tube defects. This is why it is so important to remove synthetic folic acid from your diet as well. Many processed foods such as bread, pasta, and cereal are enriched with synthetic folic acid. There are folic-free options out there so be sure to read the ingredients label.
Absorbency Issues-
If you suffer from Crohn’s or Celiac disease, or other digestive issues like IBS, your ability to absorb crucial vitamins and nutrients is affected. Working with your doctor is important if you suffer from any of these health issues, in order to adjust your dosage accordingly to make up for these absorption issues. Some doctors may prescribe intravenous multivitamins to help bypass the digestive system. (You’ll have to request methylfolate and the active forms of B vitamins).
- Be aware that folate absorption is also affected by Tylenol, antacids, antibiotics, anticonvulsants, and even alcohol. If you are currently on any medications, take a second to look into the effects on Folate and vitamin absorption.
- A commonly prescribed medication for fertility and PCOS, Metformin, affects absorption. Taking your vitamins before taking medications that affect absorption, and giving them sufficient time to absorb can help.
Can You Take Too Much Methylfolate?
Yes. Though methylfolate doesn't come with the same risks of too much folic acid (which are very concerning), there can be some side effects and issues of concern.
Low Homocysteine- This is a concern because when your homocysteine level drops too low, it leads to low production of glutathione (the body's master antioxidant), which many with MTHFR mutations are already low in. This leads to side effects as well, including sore muscles and achy joints. Low homocysteine comes with other health issues which we’ll cover in more detail in another blog.
Side Effects- Anxiety, irritability, insomnia, headaches and migraines (from increased nitric oxide production), nausea, palpitations, and even rashes.
Create Vitamin Deficiencies- Too much methylfolate can exacerbate B6 and B12 deficiencies, along with magnesium, zinc, copper, manganese and other mineral deficiencies.
Methylfolate works hand in hand with B12 and B6 for methylation. Folate pulls on B12 stores as a result, so if you’re not taking enough in balance alongside it, you can create a B12 deficiency you didn't even have to begin with. This is another reason why Folate should never be taken alone.
For more information and community support regarding MTHFR mutations, TTC, pregnancy, and loss, join our Facebook group here…https://www.facebook.com/groups/409258566180772
