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The MTHFR ride is in true swing!!

Weeeeeee!!!!

 

Supplement companies are offering practitioners seminars and bringing out supplements left right and center; there are websites springing up everywhere; there are MTHFR facebook groups till the cows come home; multiple services offering genetic interpretation; software recommending supplements based on genetic SNPs; and it seems everyone is an expert!!

Recently the TGA has allowed the sale of methylcobalamin (activated B12) and 5-methytetrahydrofolate (activated folate) in Australia, so the days of visiting a qualified practitioner to discuss how MTHFR may be affecting a person are falling short.  It’s human nature…. we like to try things.

I remember when a certain article came out about a lady with MTHFR who conquered anxiety with folinic acid and B12.  It was a Saturday, and I was consulting with a patient about various health issues, one of which included MTHFR.  The patient had her sister with her, who was scrolling through her phone while we were chatting.  She interrupted all of a sudden like she had struck gold!  “Have you seen this article!!?” she said.  She was so excited!  That’s when everything went MTHFR bonkers!!  The following Monday my appointments booked up weeks in advance, to the extent that I was turning people away!  All because of a single persons story.

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MTHFR affects 54-56% of the Australian population  (fig.1) – it’s more common than drinking coconut milk lattes, and eating Paleo!  If you don’t have it, the person sitting next to you does!!

So understandably, when the MTHFR tidal wave crashed upon us, and people realized they had a “genetic mutation” (sounds so X-Men doesn’t it?), what followed was a surgent increase in people wanting the right supplement for their disastrous mutation!

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MTHFR Occurence

Figure 1.

 

The common approach for MTHFR seems to be using activated B vitamins.  This is a strategy self-administered by many people, and also by many practitioners who perhaps don’t have the full understanding of genetics, and how this one little, tiny, weeny, enzyme works.

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MTHFR Basics

We really need to put this enzyme into perspective.  Let’s simplify it as much as possible (full names are in parenthesis for those that are interested).  MTHFR (methyltetrahydrofolatereductase) is an enzyme in the body that is responsible for converting one form of folate (5,10-methylene tetrahydrofolate), into activated folate (5-methyltetrahydrofolate).  That’s it.  MTHFR activates folate. That’s all!  The MTHFR enzyme requires vitamin B2 and B3 for it to function properly; they act like bike pedals to help it work more efficiently.

This all happens in the folate cycle.  The folate cycle then connects to the methionine cycle (also called the methylation cycle).  The methionine cycle needs a variety of other enzymes and nutrients to work properly, which includes B12, zinc, choline, vitamin B2, vitamin B3, magnesium, ATP (energy), B6, and SAMe (S-adenosylmethionine).  The methionine cycle then connects to the transulfuration cycle, which requires another whole gamut of enzymes and nutrients.  The folate cycle connects to the biopterin cycle, which needs more enzymes and nutrients.  And all of these enzymes are inhibited by various substances, whether they be inflammatory molecules, hormones, high levels of vitamins, low levels of vitamins, heavy metals, yeasts or a whole bunch of other possible substances.

The purpose of this confusing paragraph, is to illustrate that the whole system is quite complex and operates in a very unique balance, and that MTHFR is only 1 single part of a larger machine.

It’s really important to appreciate, that nutrients work with, and against, each other. Click on figure 2 to see the extent of this. Can’t be bothered?  Hear me out.  Let’s take B12 for example…. High B12 in the body can inhibit zinc, potassium, magnesium, and manganese.  If Magnesium becomes low, it can elevate calcium, sodium, and even lead! Plus all of the other imbalances that can result from the other nutrients mentioned.

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Pushing one enzyme can inhibit another, and high dose nutrients can cause a negative feedback loop to REDUCE the function of nutrients & enzymes! 

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Figure 2

Figure 2

Activated B vitamins commonly prescribed for MTHFR generally contain everything that the supplement companies think we need for MTHFR and methylation.  They will always have;

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  • Activated folate
  • Activated B12
  • Activated B2 (or at least straight riboflavin)
  • Activated B6
  • Vitamin B3
  • Sometimes choline
  • Sometimes even serine. 

But what about zinc?  What about magnesium?  What about nutrients to help make ATP? What about antioxidants to lower inflammation?  What about things to reduce yeasts or heavy metals in the body.

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These supplements are not always nurturing and supportive of our bodies, but instead keep push push pushing processes to FORCE enzymes to function.  How long can you whip a horse for?

Activated B’s  are a blanket approach to methylation as whole, but when we really look at it, one of the main functions of methylation is to create SAMe (S-Adenosylmethionine).  All of these nutrients will push processes to help make SAMe, but guess what…..  SAMe inhibits the function of the MTHFR enzyme!  I’m not even joking!!  So all of these people taking activated B’s for their MTHFR SNP, may just be shutting down the enzyme further, and then they’re just relying on a supplement!!  Thats not a natural way to go about things!

.MTHFR Inhibition by SAMe

Don’t let me distract your from the importance of the MTHFR enzyme, and the need for treatment.  Of course it’s very important, as are all of our enzymes.  But they all need to assessed in context of the person, and what their body is expressing.  I see a lot of 23andMe results and wade through SNPs all the time, and what I have found is that a few select SNPs are often the main ones that are implicated in a person’s case.  Often there are more important SNPs than MTHFR.  And this whole genetic aspect is only taken into consideration when looked at in conjunction with their actual symptoms, and also the persons diet and lifestyle.

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We don’t treat genes.  We treat people.  

If symptoms correlate, THEN we move forward with genetic based strategies.

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What we should do, is think about our health on a larger scale, and then zoom in.  If we have digestive issues, lets settle that down; if we experience migraines, lets address that; are there thyroid issues? my god this HAS to come before MTHFR; do we have poor sleep? this even comes before thyroid; are we stressed? stress trumps sleep!!  You see where I’m going here.  We’re too reductionist these days!  “I have a SNP, this MUST be the reason why I’m unwell”.  Perhaps it is, perhaps it’s not; but lets slow it down a bit and really understand how the person is feeling, and what specific nutrients they need.

We are not a perfect species.  On average, each of us has 10 million genetic “mutations”.[1]  Hands up who would take 10 million supplements….

These afternoon musings may be surprising to many of you who know me, and even those who I treat for MTHFR.  Of course my business has a strong emphasis on MTHFR, methylation, and genetics, and that’s because I dig it!! I find it fascinating, I have a very solid grasp on the various pathways involved, and i’m good at it.  But the most dominant aspect of my business is getting patients well.  I have seen a countless number of patients for MTHFR, who I have not even treated for it, because it’s not the driver of their health issues!

We are people; a collective sum of genes, enzymes, nutrients, bacteria, gooey bits, hollow bits, hard bits, and these are all made up of minerals created by exploding stars!!  An amazing, vibrating, energetic soup!  To take supplements based on such singular reductionism, really makes no sense at all, and it’s not sustainable.

I love this picture below.  The MTHFR enzyme is a speck within the methylation cycle, which is highlighted. I went to the SHEICON conference in 2015 to hear Dr. Ben Lynch and other amazing minds speak. Dr. Neil Nathan held a huge poster of this up, and said we can’t keep thinking linearly.  We’re not that simple.  He then screwed it up, and said THAT’S how we need to think!  Not in a straight line, but in complex, multi dimensional ways.  The use of 1 supplement for 1 gene is the perfect example of a straight line.
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MTHFR Perspective

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[1] https://ghr.nlm.nih.gov/primer/genomicresearch/snp