Methylation briefing
So you have MTHFR, now what?
An MTHFR gene variation makes it harder for your body to convert folate into its active, usable form. The good news is that most of what helps is practical: the right form of folate, supportive foods, and a few changes that ease the load on your methylation and detox pathways.
Where to start
First of all you need to find a health care provider that you can work with. Many professionals are yet to acknowledge the significance of MTHFR, and may explain it away as not being that important. If this is the case, find another GP or health care provider who understands the condition and who will work with you to get the results you deserve.
The many names of folate
Folate is often wrongly labelled on supplements and food packaging, which makes it confusing. Here is a simplified break down of the forms you will come across.
| Form | What it is | Status |
|---|---|---|
| Folate | Naturally occurring folate that exists in food. | Favour |
| Folic acid | Synthesized folate added to processed foods and used in many supplements. It is broken down very slowly by the body, which can cause high amounts of un-metabolised folic acid (UMFA) to build up. This may cause ill-natured consequences. | Avoid |
| Folinic acid | A type of folate important for DNA synthesis, only 3 steps away from being converted into activated folate. Depending on the MTHFR mutation it may be wise to avoid this form. In other instances it may be useful, for example during pregnancy when the need for healthy DNA production increases. Discuss with your health care provider. | It depends |
| 5-methyltetrahydrofolate | Also known as active folate, 5-methylTHF, 5-MTHF or methylfolate. This is the final result of the folate cycle, and is essentially the form of folate that MTHFRs have trouble creating. | Active form |
Diet changes
Remove folic acid
Those with MTHFR have trouble converting folic acid into methylfolate. Folic acid is common in supplements and is added to non-organic white flour, which is used in commercially sold breads. Breakfast cereals and fruit juices may also contain folic acid, so read labels carefully. It is commonly and wrongly labelled as “folate” on packaging.
Incorporate folate
Add lots of raw leafy green vegetables such as spinach, kale, romaine lettuce, mustard and collard greens. Folate is very fragile to heat, so it is best to eat these raw. If adding to cooked meals, add them at the last minute to avoid too much degradation.
Read every label
Because folic acid hides in fortified flour, cereals and juices and is often mislabelled, careful label-reading is one of the most useful habits you can build with an MTHFR variation.
Get tested
Discuss with your health care provider which tests may be helpful to see how your methylation cycle, and your body as a whole, are running.
A good starting panel
RBC folate, active B12, homocysteine, thyroid function, E/LFTs (electrolytes and liver function), and haematology are a good start.
Tests that add insight
Zinc, vitamin B6, neurotransmitter analysis, stool analysis, or hair mineral analysis can also be very insightful, depending on your picture.
Foods to support methylation
Beyond raw leafy greens, these foods supply the nutrients the methylation cycle relies on.
| Nutrient | Food sources |
|---|---|
| Folate | Asparagus, brussel sprouts, green beans, broccoli, peas, legumes like lentils, chickpeas and black beans, and brightly coloured fruit like berries, mangoes, plums and papaya. Nuts and seeds are also a good source. |
| Vitamin B2 | Liver, soybeans, asparagus, spinach, almonds, mushrooms, salmon, eggs. |
| Vitamin B6 | Grass fed beef, veal, chicken, avocado, brewers yeast, oats, rice or wheat bran, legumes, eggplant, and pistachio nuts. |
| Vitamin B12 | Oysters, sardines, tuna, salmon, eggs, beef, lamb. |
| Betaine | Beetroot, spinach, prawns, quinoa. |
Support detoxification
Use these guidelines to help the liver detoxify, increase bile secretion, regenerate liver cells, and produce glutathione.
Avoid
Alcohol, caffeine, and processed sugar.
Cruciferous vegetables
Include cabbage, broccoli, brussel sprouts, and artichokes.
Onions and garlic
Include these, though support may be needed if there is a CBS mutation.
Citrus and supportive foods
Include lemons, oranges, tangerines and grapefruit, plus green tea, avocado, walnuts, and turmeric.
Promote elimination
It is important to have adequate gut function to remove toxins from the body.
- Including fibre like slippery elm or psyllium husks can help remove intestinal toxins.
- Establishing a good microbial environment is essential for proper methylation. Removal of parasites or other dysbiotic microorganisms should be high on the agenda. A comprehensive stool analysis (CSA) is an insightful way to see what is going on in the intestines.
- Re-inoculate the gut with good quality probiotics. Fermented foods like tempeh, kim-chi, kombucha, sauerkraut, and kefir can help. Fibre in carrots, pears and berries also increases beneficial short chain fatty acids in the intestines.
Remove toxins
Many everyday exposures interfere with the methylation cycle and the detox pathways it depends on. Reducing them lightens the load.
- Minimize pesticides and herbicides. Eat organic when possible, wash produce before eating, and shop according to the “Dirty Dozen and Clean 15”.
- Avoid processed foods. These processed chemical experiments are not real food. If you do not recognise words on a food label, do not buy it.
- Avoid charcoaled foods, nitrates (found in food additives and cured meats), and sulphites (found in sausages, cordial, dried fruit and most wines). These interfere with detoxification pathways.
- Avoid high fructose corn syrup and trans-fats. They alter glucose metabolism, damage the liver, and affect fat breakdown.
- Stay away from soft plastics that contain Bisphenol-A (BPAs). They disrupt the endocrine system, in particular the thyroid, which is necessary to activate vitamin B2 that acts as a cofactor for the MTHFR enzyme.
- Use the stove instead of the microwave.
- Use natural body care products that do not contain harsh chemicals, and safe natural cleaning products. Try a 1:1 ratio of vinegar and water to clean bathroom and kitchen surfaces.
Reduce inflammation
Manage stress and sleep
Reduce stress levels and get adequate sleep.
Increase antioxidants
Eat brightly coloured foods like berries, papaya, sweet potato, prunes, red kidney beans, or plums. Or try ginger, turmeric, green tea or garlic.
Increase omega 3
Use flaxseeds, hemp seeds, chia seeds, walnuts, soybeans or good quality fish oils, preferably made from small fish like anchovies or sardines, which are heavy metal free.
Lifestyle
So much can be done with ordinary lifestyle choices. Rethinking our current routine quite often reveals unacknowledged harmful habits.
- Open windows for some sunshine and fresh air. Spend some time outside.
- Drink clean water. Use a good quality filter on your rainwater tank to remove microorganisms, or think about a filtration system for your house to remove fluoride and chlorine.
- Establish a good sleeping pattern. Follow the natural rhythm of the day by going to bed early and waking early. Turn off laptops, mobile phones, and bright lights in the evening. Turn the reality show or news program off and talk to those around you, or read a book.
- Exercise each day by riding to work, hitting the gym, taking the dog for a morning walk, going for a walk during lunch, taking up yoga, playing with the kids, or joining an active group like salsa dancing or ultimate frisbee.
- Reduce stress levels. Laugh, be social, listen to music, meditate, and talk things through with those around you. Get out of your head for a while.
The biggest single change for most people with MTHFR is removing folic acid and replacing it with real, food-based folate and the active form, methylfolate. Folic acid is often mislabelled as “folate” on packaging, so read every label carefully and work with a provider who understands the condition.
Further resources
These external sites cover MTHFR, methylation, and genetic testing in more depth.
Frequently asked questions
What does it mean to have an MTHFR gene variation?
An MTHFR gene variation makes it harder for the body to convert folate into its active form, which is part of the methylation process that supports detoxification and many other functions. It does not mean something is broken so much as that the folate pathway needs the right support. The most practical response is to use the right form of folate and to back up the surrounding pathways with food, gut health and lifestyle, ideally guided by a practitioner who understands MTHFR.
Should I avoid folic acid if I have MTHFR?
The single biggest change suggested is to swap synthetic folic acid for real folate. Folic acid is the synthetic form, and with an MTHFR variation it can clear slowly and build up, so favouring food folate or the active methylfolate form (5-MTHF) is preferred, with folinic acid an it-depends option to discuss with your provider. In practice that means reducing folic-acid-fortified breads and cereals and getting folate from foods like raw leafy greens instead.
What foods support methylation with MTHFR?
Helpful foods include folate-rich choices such as raw leafy greens, asparagus, Brussels sprouts, legumes and berries, with leafy greens added at the end of cooking since folate is fragile to heat. The B-vitamin cofactors also matter: B2 from foods like spinach and almonds, B6 from beef and avocado, B12 from eggs, sardines and oysters, and betaine from beetroot and spinach. Cruciferous vegetables, onions, garlic, citrus, green tea and turmeric further support the body's detox pathways.
Reviewed by Rohan Smith, BHSc Nutritional Medicine · Elemental Health & Nutrition, Adelaide. Last reviewed 13 June 2026.
Important: This summary is general information, not personalised medical advice, diagnosis, or a treatment protocol. Speak with a qualified practitioner about your individual situation. Book a consultation →