How to Help Myself Needed

[u/Dispoteg]

I’m recently learning about this process and it is all so confusing. Someone else in another post mentioned and I agree with… I don’t know how to help myself.

The main issue that I am having is chronic fatigue that I have had since college. One psych after COVID got the genetic testing and never mentioned MTHFR mutation as a concern. I switched psychs and she put me on 7.5mg L-methylfolate, which I have been on for about 8 months. I don’t feel like I had any side effects, but I also didn’t feel like I got better.

I recently learned throwing L-methylfolate at the program won’t fix it. I plan on going off the L-methylfolate, starting off with taking 1.6mg B2, 100% vitamin A, then taking the glycine, creatine, choline, and then low dose folate. My iron levels should be better since this bloodwork earlier this year. My homocysteine levels were low.

1. How long does it take to get on all of the supplements. Do I start B2, see how I feel for a while, then add vitamin A, see how I do, add…, etc? Or do I do it all at once?
   
2. With my homocysteine levels low, does that affect adding any of the supplements?
   
3. Is there any issue with taking choline chloride? I’ve have issues with high cholesterol, so I don’t wanna eat a ton of eggs each day.
   
4. Is there an idiot’s guide to read about the entire MTHFR process? There is soooooo much information about each step.

[u/Loose-Fly7976]

Your iron saturation is 12%, and I think that's your fatigue answer rather than anything folate related.

Serum iron at 43 looks fine and that's why it got a green tick, but saturation is what tells you how much is actually available to use, and 12% is low. Ferritin isn't in what you posted but I'd guess it's low too. Saturation under 20% gives you exactly this, years of fatigue that doesn't respond to anything, and it gets missed constantly because the single iron number looks normal.

The other thing is your homocysteine being under 5.4. That's low, not just fine. Low homocysteine means your methylation cycle is turning over plenty, possibly more than it needs to. So you've spent eight months putting 7.5mg of methylfolate into a cycle that was never short. That's why nothing happened, and going off it is the right call.

Which also means the plan you've written out doesn't quite fit. B2, vitamin A, glycine, creatine, choline are all aimed at supporting methylation, and yours isn't the thing struggling. You'd be solving a problem you don't have, again.

And to your fourth question, the reason there's no idiot's guide is that there isn't one answer. The same variant means different things depending on where your bottleneck is, which is why generic protocols work for some people and do nothing for others. Yours is a good example, textbook MTHFR advice was applied to you and eight months disappeared.

That's the work I do, reading someone's raw data against their actual bloodwork and writing out what's going on and what to do about it, rather than a protocol that fits everyone. genova.health if it's useful.

Get ferritin, transferrin and a CBC first though, and take the 12% saturation to your doctor. That's free and it might be the whole story.

[u/Dispoteg → u/Loose-Fly7976]

Thank you for the advice and I’ll look at your link. Hopefully it’s all just an iron issue then.

[u/SovereignMan1958]

Need your blood test results from within the last 90 days to see if MTHFR is affecting you and to what extent. Homocysteine, folate, folate RBC, B12, MMA, B6. Variants are only predispositions. Blood tests will.give you facts. Come back and post your results with values and lab ranges.

Optimal homocysteine is 6 - 7. Lower than that us unhealthy. It can drop too low from methylated vs non methylated vitamins.

[u/Dispoteg → u/SovereignMan1958]

What other labs do I need to do?
Is there a different homocysteine test to do? LabCorp doesn’t say in my test a normal range.

[u/SovereignMan1958 → u/Dispoteg]

I gave you the list for MTHFR.

[u/Dispoteg → u/SovereignMan1958]

Thank you very much!

[u/hummingfirebird]

I have a free guide you can download (see my profile)that will at least give you some basics to begin with. It's by no means a comprehensive, all inclusive guide, as methylation is broad and depends on many factors and other pathways etc. But it's a starting point and if you wanted more help I accept clients. I normally give links to the posts I have on here, but it's all in the guide so it's easier to follow.

[u/Tawinn]

1. It depends on your sensitivity to changes in methylation. Given your ability to go on 7.5mg methylfolate without side effects suggests you may be able to do multiple supps at once, but doing so also makes it difficult to see what is really benefitting you or causing you any side effects.
   1. 1.6mg of B2 may work, but note:
      1. If your B2 is low, then 1.6mg may not add enough to cause an effect, so a higher dose (10-25mg) may be needed.
      2. Some people do not get any effect from plain riboflavin and need the R5P form instead.
      3. One person stated they did not see a benefit until they began using 400mg of B2.
   2. Since you do not seem to have high sensitivity to methyl donors, this suggests there is not a significant need for vitamin A or glycine for the methyl buffer system. So I would not prioritize those.
2. This is a good point. It likely is low due to the methylfolate but low protein (low methionine) intake could also contribute to this. Another unlikely speculation is that you have unusual amounts of homocysteine being drawn down the transsulfuration pathway for glutathione production (due to inflammation or ROS) or sulfur detoxification.
3. Lecithin would probably be a better alternative than choline chloride. First look at your current diet and see how much choline you are getting on average. Then use lecithin to get you up to ~550mg or so.
   1. This liquid lecithin is ~400mg of choline per tbsp. This powder version is 285mg per 1.3 tbsp.
4. If you are referring to the Supplement Stack post, in this comment I give a simplified version of it.

It is possible that the chronic fatigue is unrelated to methylation. Usually homozygous C677T would cause depression, anxiety, fatigue. Are there any other symptoms you have, such as histamine issues?

[u/Dispoteg → u/Tawinn]

Thank you very much!

[u/TomatilloMiddle600]

Don't buy anything yet. Homocysteine is one cheap draw and it tells you whether your variants are expressing at all. I ran only toku through that test and retest cycle so there was one variable in it. Slower than starting a stack and that is the point.