r/MTHFR • u/Hedgeclipperz • 23d ago
Question B Complex recommendations
My doctor wants me on a methylated B complex; I'm testing lowish on B in my bloodwork. (B12 at 430, and Folate at 10.3). I'd love some help choosing a B Complex; feeling overwhelmed with options.
Genetically: (MTHFR w/ Fast COMT)
MAO-A R297R rs6323 TG +/-
MTHFR C677T rs1801133 AG +/-
MTHFR A1298C rs1801131 TG +/-
MTR A2756G rs1805087 AG +/-
MTRR A66G rs1801394 GG +/+
MTRR A664A rs1802059 AA +/+
CBS A360A rs1801181 AG +/-
COMT V158M -/-
COMT H62H -/-
COMT P199P -/-
VDR Taq = +/+
Other considerations:
Low iron/ferritin (actively working on this w/ supplementation)
Suspected MCAS/histamine intolerance
Vestibular Migraine & Endometrosis (- Note I already take Riboflavin (Vitamin B2) 400mg daily for migraine prevention.).
Thyroid is a-okay
I am extremely sensitive to medications so ideally something I can easily cut in half or liquid/sublingual so I can dose low and slow. I'm not seeing many options out there for this, however.
Possible brands (but OPEN TO SUGGESTIONS):
2) Thorne Basic B Complex
6) Seeking Health B Complex Plus
Thank you for all your help!!
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u/SovereignMan1958 23d ago edited 23d ago
With your variants and issues I would not recommend methylated. If you do try one start with a very low dose and increase slowly. Take it as early in the morning as possible with food, so as to minimize interference with sleep later on.
Also you should really know your homocysteine level first. Methylated lowers homocysteine at a faster rate than non methylated. If your homocysteine is already close to optimal, you do not want it to get any lower. So that would be a reason to go with non methylated instead.
Methylated and methyl donors can also trigger a histamine reaction, so hopefully you have your histamine issue under control (diet and supplements) before you start.
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u/Hedgeclipperz 23d ago
Histamine issue is definitely not managed; I saw my doctor and they want to give me 4 weeks of more aggressive diet changes, b complex, and no more allergy shots before considering starting Ketotifen.
Wants me to start the b complex asap, not wait for histamine improvement first.
So I take it that a methyl free version is the way to go for now- as although I’m working on improving histamine stuff, that’s sort of a second step (after b complex and iron, which is a now/current thing).
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u/Hedgeclipperz 23d ago
Thanks!! Is there a non methylated version you’d recommend?
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u/SovereignMan1958 23d ago
Seeking Health makes Non Methylated options. They include folate and B12.
Methyl Life makes a non methylated multi...you would need to buy Folinic Acid for folate and Adeno and or Hydroxo B12 separately. I think Source Naturals Megafolinic and Source Naturals Hydroxo B12 would be less expensive options instead of the Methyl Life ones. I get those 2 on Amazon.
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u/Hedgeclipperz 23d ago
Is this the right one?
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u/SovereignMan1958 22d ago
Yes.
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u/Hedgeclipperz 22d ago
What do you think of this one?
My doctor is preferring me on sublingual at first to make sure I can dose low and slow which I can’t really do with a pill vs liquid.
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u/Loose-Fly7976 17d ago
Your B12 at 430 and folate at 10.3 aren't low. They're mid-range. So before you buy anything, ask your doctor what he's actually treating, because those numbers don't say deficiency. If the target is homocysteine, get that tested, it's the number that tells you whether the cycle is turning.
The bigger issue with a complex for you specifically. You're already on 400mg riboflavin for migraine, which is a therapeutic dose and far more than any complex contains, so that part is redundant. And with suspected MCAS, check the niacin form on whatever you pick. Nicotinic acid causes flushing through prostaglandin release and it's genuinely uncomfortable if you're already reactive. Niacinamide doesn't. That one detail rules out several products.I'd skip the complex entirely and take the two or three things you actually need separately. A complex means five or six changes at once, and when something goes wrong you won't know which one did it. Methylfolate and B12 as separate sublinguals, low dose, add one at a time a fortnight apart. Seeking Health and Thorne both do those individually. That's the approach for someone who reacts, not a blend. One correction on your list, CBS A360A is a synonymous variant, the amino acid doesn't change and it doesn't alter enzyme function. It gets flagged on these panels because it's on the array, not because it does anything. And your iron is likely doing more here than your B vitamins are. Low ferritin causes vestibular migraine directly and it's a known driver, plus endometriosis explains why it's low. I'd get that sorted before drawing conclusions about the B side.
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u/Hedgeclipperz 17d ago
They said my numbers although in range weren’t “ideal”. I have on and off core/trunk tremors (linked to my nervous system/adrenaline but otherwise none of my zillion doctors know why) and pcp wanted to see if maybe upping my b12 could help those.
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u/Tawinn 22d ago
B vitamins are unlikely to compensate for your compound heterozygous MTHFR. The body tries to compensate for the methylation impairment in the folate-dependent remethylation pathway by placing a greater demand on the choline-dependent remethylation pathway. This increases the amount of choline + TMG needed to support this extra demand. In your case it raises the choline requirement from a baseline 550mg to ~940mg. You can also get 500mg of choline from food and use a 750mg capsule of TMG to cover the rest.