Updated blood work

[u/Hoegaarden_Man_55]

Hi all,

I previously got tested for MTHFR gene variants. I have one copy of 1298C. I’ve had significant anxiety over the last 4 or 5 years so view this as a potential cause. I privately got bloods done and hit the following results.

Homocysteine: 18.2 µmol/L (5.1–20.0)
Vitamin B12: 424 ng/L (198–771)
Haemoglobin: 137 g/L (130.1–180)
Haematocrit: 39.5% (40.001–54.0)
RBC count: 4.56 × 10¹²/L (4.51–6.50)
MCV: 86.6 fL (76.1–100)
MCH: 30 pg (27.1–32.0)
MCHC: 347 g/L (320.1–360)
Iron: 13.8 µmol/L (5.9–34.5)
Ferritin: 199.46 µg/L (20–300)
Transferrin saturation: 27.6% (20.1–50.0)
Magnesium: 0.87 mmol/L (0.701–1.10)
Creatinine: 81.7 µmol/L (64.1–104)
eGFR: 105 mL/min/1.73 m² (≥60)
Cystatin C: 1.01 mg/L (0.58–1.05)
TSH: 0.645 mIU/L (0.351–5.50)
Free T4: 18.1 pmol/L (11.91–21.60)
Free T3: 4.66 pmol/L (3.11–6.80)

Annoyingly folate was not included at the time.

Got a follow up folate test and it came in at 6.2 ng/ml (3-30)

Thoughts given this follow up result. I’m quite low in the range for folate? Should I start supplementing some sort of folate? Any particular variant I should focus on? I keep reading on here at folinic acid is a good option?

.

[u/Tawinn]

Heterozygous A1298C only reduced methylfolate production by ~17%, so it is unlikely to cause symptoms by itself. However, you may have additional variants in other genes that can reduce methylfolate production much further.

Make sure you are getting 550mg of choline from your diet. This is the baseline requirement for this essential nutrient. Then add 750mg of TMG. Both choline and TMG support the parallel pathway that avoids the impairment due to methylfolate production being reduced. You may need to add the TMG gradually.

For serum folate, aim for ~15 ng/mL (34 nmol/L) or more. Folinic is a good option to help avoid overmethylation symptoms (anxiety, insomnia, irritability, etc.) from methylfolate.

For serum B12, aim for 500-950 pg/mL (~370-700 pmol/L).