I was told I have a MTHFR gene mutation. Do I need to take methylated forms of B vitamins, such as methylfolate and methylcobalamin?

Written by Tod Cooperman, M.D.

Updated April 28, 2022 ⓘ

Answer:

The most common MTHFR gene mutation, the C677T mutation, may make your body less efficient at converting folic acid and folate into L-methylfolate, the active, methylated form of folate in the body. Forms of folate such as methylfolate or folinic acid may be more efficient at raising folate levels in the body than folic acid (the common form in supplements) in affected people, although it is not entirely clear that these special forms are necessary.

People with this mutation may also be more likely to be deficient in vitamin B-12 and may need additional B-12 either as its methylated form, methylcobalamin, or the more common form, cyanocobalamin.

Taking vitamin B2 (riboflavin) may also be helpful for people with C677T mutation who also have high blood pressure.

On the other hand, people with another MTHFR gene mutation (the A1298C mutation) do not appear to be at increased risk for any health conditions, including vitamin B-12 deficiency or elevated homocysteine concentrations, compared to those without this mutation.

For more about this, see the What to Consider When Using section of the B Vitamin Supplements Review.

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8 Comments

GerneyLee7309

April 24, 2022

Thank you for sharing.
I do similar.

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frances7304

January 06, 2022

Thank you for your input.

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Karen7291

August 28, 2016

I was taking the cyanocobolamin form of B12 regularly, low dose. I had, across several years, severe lower leg and ankle pain, so bad at times that my ankles felt as if there was something very wrong physically. I spoke with doctors (MD) several times about this, with absolutely no help (interesting how different doctors approached it, I will say). Then my older daughter, having recently been tested for an MTHFR mutation, suggested I try the methylcobalamin type of B12, not for my leg pain specifically, just because it made her feel better. My chronic leg pain went away within an hour of taking 1000 mcg of methyl B12. I have difficulty finding words to express the change in the quality of my life this tiny supplement made. That event led me to look through the genetic testing of my younger daughter, who had been tested while pregnant; she has 2 MTHFR mutations. I have not spent the money to get tested. I take 1000 mcg of methylcobalamin each morning.
I will note that I went to a nurse practitioner for medical care, and told her about this. She ran blood tests, and told me to quit taking the B12, as my blood levels were high. I did not follow medical advice, nor did I try to explain that the test results did not necessarily mean I did not need the B12 (methylation and B vitamins is brain-warpingly complicated).
For awhile, I also supplemented with 25 mg P5P (methyl form of pyridoxin, or B6) and a methyl form of folate; the lowest dose I could find is 400 mcg, which I concluded is too much. Now I take a tablespoon of brewer's yeast and one 1000 mcg tablet of B12.
I also use a variety of supplements for vein, eye, bone, and joint health.
I check out the research, and make educated choices.
Obviously, I believe there is a place for the judicious use of supplements. Otherwise, why would I belong to Consumer Lab?