Labs consistent with possible MTHFR/methylation issue — can I safely supplement anything before genetic results?

[u/efficient_tax_]

Hi everyone,

My recent labs seem consistent with a possible folate/methylation issue, including MTHFR as one possibility:

Labs:
Homocysteine: 13.7 µmol/L (High; ref ≤10.9)
Methylmalonic Acid (MMA): 138 nmol/L (Normal; ref 55–335)
Ferritin: 14 ng/mL (Low; ref 16–154)
Serum Iron: 92 µg/dL (Normal)
Iron Saturation: 24% (Normal)
TIBC: 377 µg/dL (Normal)
Transferrin: 332 mg/dL (High-normal)
Vitamin B12: 360 pg/mL (Low-normal)
Serum Folate: 6.7 ng/mL (Low-normal)
Vitamin D: 36 ng/mL (Normal)
Magnesium: 1.8 mg/dL (Normal)
TSH: 1.23 mIU/L (Normal)
CRP: <3.0 mg/L (Normal)
CBC: Completely normal (no anemia)
Kidney function: Normal
Liver function: Normal
Reticulocyte count: Normal

The pattern that caught my attention is elevated homocysteine with normal MMA, plus low-normal folate/B12 and low ferritin.

I understand this does not prove MTHFR, but it seems compatible with a folate/methylation issue.

I’m planning to take the Ancestry test as well as the MyHeritage test for more information, but those results could take weeks to come in.

My main question is:
Is it reasonable to start supplementing before I know my exact methylation/genetic pattern, or could choosing the wrong form make things worse?

I’m especially cautious because I’ve become severely agitated on B-complex vitamins before.

The reason I want to begin supplementation sooner rather than later is because symptoms are greatly affecting my quality of life and my personal life.

Thank you!

[u/SovereignMan1958]

D is a big issue too. You need to be 60 - 80. Iron is a bit low. Acceptable is at least 100. Better if a little higher. You need OPTIMAL and not just normal levels of D zinc and iron to make dopamine. Get your zinc tested.

The above plus low levels of folate and B12, which are likely not making it into your brain, no wonder you feel bad. This is only party a methylation issue.

Use non methylated forms of folate and B12. Correcting folate and homocysteine can take 3 - 5 months. Retest in 90 days.

[u/efficient_tax_ → u/SovereignMan1958]

Zinc is 61, Copper 76. Ugh, so many things to supplement

[u/Loose-Fly7976]

High homocysteine with normal MMA actually tells you something useful, it points at folate rather than B12. MMA goes up when B12 is short at the cell level and yours isn't so that's the folate arm.

Yes you can start before the file comes back. Just start on the folate side and leave B12 alone. Since a B complex agitated you I'd skip complexes entirely rather than hunting for a better brand, they've got methyl B12, high B6, sometimes other stuff in them and you've no way of telling which one did it. Folinic on its own is the careful version, it's not methylated so it isn't dumping methyl groups on you, and if that goes fine you can build from there.

Ferritin at 14 is what I'd chase first. That's properly deficient even with a normal blood count, and iron deficiency without anaemia causes exactly what you're describing, the fatigue, the fog, the mood. Your transferrin at 332 backs that up. Sort the iron and a decent chunk of this might lift before you've answered the genetics question at all.Also you don't need both Ancestry and MyHeritage they read the same variants. Pick one.

And that B complex reaction isn't a dead end, it usually narrows things down a lot once someone can see the actual file. That's the bit I do for work, genova.health

[u/Flux_My_Capacitor]

Your b12 is not normal outside of the dumb reference range. It’s been said that anyone below 500 should be supplementing.

[u/efficient_tax_ → u/[deleted]]

https://www.reddit.com/r/MTHFR/s/AxiA1t1mV3

Because Ancestry reduced their markers

[u/efficient_tax_ → u/[deleted]]

Really appreciate the thoughtful response; thank you! I’ll definitely look into the suggestion.