Hi Friends,
If you’ve been doing everything right but still feel tired, anxious, or foggy, the real issue might lie in your genetics.
I see this all the time in my practice, and in many cases, the missing link is a hidden genetic mutation called MTHFR.
This gene controls an enzyme that plays a critical role in your body’s ability to activate B vitamins, specifically folate (B9) and B12. It regulates a process called methylation, which affects everything from:
- 🧠 Brain neurotransmitters (like serotonin and dopamine)
- 🔄 Detoxification in the liver
- 💥 Hormone metabolism
- 🧬 DNA repair and inflammation
Unfortunately, nearly 50% of people carry one or more mutations in the MTHFR gene that may interfere with this process.
But here’s the good news:
You don’t need expensive genetic testing to find out if this is affecting you.
In my practice, I start by checking homocysteine: a simple blood test available through most standard labs. I like to think of it as an "inverse marker" of your B vitamins, so lower the better.
🔬 If your homocysteine is elevated (9 µmol/L or higher), it can indicate your body is struggling to clear this inflammatory amino acid.
🧠 High homocysteine has been linked to heart disease, stroke, dementia, and more.
✅ If your homocysteine is around 6, you're likely methylating well, even if you do have a genetic variant.
Symptoms Tied to Poor Methylation:
Chronic Fatigue Syndrome
Fibromyalgia
Depression 😔
Anxiety 😰
ADHD
Migraine Headaches 🤕
High Blood Pressure
Infertility
Dementia 🧠
Cancers 🦀
Autoimmune Diseases
Autism
Diabetes
Obesity
Chemical Sensitivities ⚠️
✨ Support Healthy Methylation:
🥬 Eat more dark leafy greens like arugula, spinach, kale, and chard
✅ Methylated B Vitamins
💊The Problem with Most Standard Vitamins
Most over-the-counter vitamins use the cheapest and least bioavailable forms of B vitamins: namely folic acid (for B9) and cyanocobalamin (for B12). These forms require full MTHFR function to be converted into their active forms.
For someone with an MTHFR mutation, synthetic forms like folic acid and cyanocobalamin may not be efficiently converted into their active forms.
That’s why I always recommend the Methylated Forms:
✅ Methylfolate (active B9)
✅ Methylcobalamin (active B12)
These forms are already active and bypass the MTHFR enzyme, giving your body exactly what it needs.
👩🏻⚕️ My Clinical Algorithm for
Lowering Homocysteine
In patients with elevated homocysteine, I typically begin with either:
👉 Methyl B Complex: for broad-spectrum support
👉 Methyl B12 Tablet: very well tolerated even by those sensitive to B vitamins
If we don’t see homocysteine come down to optimal levels (around 6 µmol/L), I switch to:
👉 Methylation Support – which includes additional cofactors like trimethylglycine to more aggressively support methylation pathways.
Most people can also benefit from additional detoxification support, and that’s where Glutathione can make a big difference. As the body’s master antioxidant, it helps reduce oxidative stress and supports your liver’s detox pathways.
💉 B12 Shots?
For current patients, we also offer Methylcobalamin (B12) and Glutathione injections for even greater bioavailability, especially beneficial for those with gut issues or impaired absorption of oral supplements.
If you're still wondering what MTHFR stands for (and no, it’s not a swear word 😅)... watch my video to find out! I also cover:
- What the MTHFR gene actually does
- How it affects your symptoms
-
The simplest ways to test and support your body
Have you tried red chard before? It's probably one of my favorite vegetables.
Dark leafy green vegetables are a natural source of folate to promote methylation. They also have magnesium, calcium, iron, vitamin A, vitamin K and potassium.
Sautéed Chard:
Ingredients:
2 bunches of organic red chard, washed, and chopped
1/2 yellow onion, diced
2 cloves of garlic, minced
1/4 cup chicken or vegetable broth
2 tablespoons olive oil
1 tsp organic ghee (optional)
1/2 tsp salt
1/4 tsp black pepper
In a large pan on low-medium heat, heat the olive oil and add in the onions and garlic. Sauté for a few minutes until fragrant. Add the chopped chard, salt, pepper, and broth. Cover and lower the heat to low. Cook for 5 minutes. Optional: finish off the dish by stirring in 1 tsp of organic ghee.
Thank you for taking the time to learn about the MTHFR gene. Over the past 15 years in practice, I have seen methylated B vitamins transform the health of numerous patients. Some were able to wean off antidepressants. Others noticed improvements in their ADHD symptoms and ability to focus, while others experienced fewer migraine headaches.
I also know firsthand what a difference Methyl B Complex can make in my own energy and focus. If only I had known about it back in medical school!
Enjoy these last sunny weeks of summer, and have a joyful, energized week!
Rajsree Nambudripad, MD
