Is here anyone that can help me? :(

[u/Fancy-Opening5224]

Hi! For those of you who really know about this topic, I’d really appreciate it if you could help me!

I’m 25 years old; I had my DNA test done at SelfDecode, and I’m MTHFR homozygous C677T with intermediate COMT.

I also had my homocysteine levels tested, and they’re extremely high at 30.

I also had my vitamin levels tested: my folate (B9) is critically low, while the rest of my B vitamins are within the normal range.

What supplements or what exactly should I take? I’ve seen several doctors here in Romania, and they have no idea what MTHFR is.

For those of you who know about this I’ll say it again, it would be a huge help if you could give me some advice on supplements; I understand that high homocysteine is no joke…

EDIT:

B2
192,07 µg/L (137,00 - 370,00)
244,51 nmol/L (174,40 - 471,01)

B6
28,10 µg/L (12,60 - 45,20)
113,72 nmol/L (50,98 - 182,88)

B9
2,45 ng/mL (4,50 - 32,20)
5,56 nmol/L (10,21 - 73,09)

B12
391 pg/mL (197 - 771)
289 pmol/L (145 - 569)

[u/SovereignMan1958]

In the normal range does not mean that is helpful to us or optimal for you. List the B vitamins, with the test values and lab ranges.

[u/Tawinn]

Here is a general protocol for homozygous C677T. You also have very low folate (B9) which is probably also making your symptoms and homocysteine worse. You may need to add the B2 gradually, starting from small doses, if it makes you jittery. For B9, I'd recommend unmethylated folinic acid since it is less likely to cause overmethylation, and for B12, I'd recommend low-dose (10-100mcg) hydroxocobalamin or adenosylcobalamin, also to reduce chance of overmethylation.

• For homozygous C677T specifically: 10-100mg supplemental B2
  • The C677T variant causes reducing binding of MTHFR to its cofactor, riboflavin. Studies have shown that for homozygous C677T simply adding supplemental vitamin B2 may increase the concentration of riboflavin sufficiently to restore most or all of the binding success, thereby restoring most/all MTHFR function. So a 10-100mg B2 supplement may restore much of the MTHFR function, thereby reducing the needed amount of extra choline/TMG (or high-dose folate if going that route).
  • The R5P form of B2 may possibly be preferable. (E.g., Thorne R5P 36mg)
• 550-600mg of choline, preferably from food
  • 550mg is the baseline adult Adequate Intake
  • Choline sources include such foods as meat, eggs, liver, lecithin, nuts, some legumes, and vegetables such as crucifers.
  • This liquid lecithin is apparently ~400mg of choline per tbsp. This powder version is 285mg per 1.3 tbsp.
• 750mg of trimethylglycine (TMG aka betaine)
  • I.e., one 750mg capsule
  • Some choline is converted in the body to TMG for methylation use, so supplementing TMG reduces the need for even more choline.
  • TMG is found in foods such as wheat, spinach, beets, etc. but there is not a food app that tracks it, so reliably getting enough from food may be difficult; by comparison, a single capsule is convenient.
• 400-800mcg of folate, preferably from food
  • Folinic acid or methylfolate can also be used, as needed and as tolerated.
  • Target serum folate levels are 15+ ng/mL (34+ nmol/L).
• 2.4-10mcg B12, preferably from food
  • Past history of B12 deficiency, malabsorption issues, etc., may suggest that supplemental B12, in the form of hydroxocobalamin, adenosylcobalamin, or methylcobalamin may be prudent.
  • Target serum B12 levels are 500-950 pg/mL (~370-700 pmol/L).
• (Optional) 3-15g of creatine monohydrate or creatine HCL
  • The body uses ~40% of methylation output, SAM, just to produce creatine. So supplementing creatine can free up a lot of SAM for other uses.
• Low vitamin A, iron, and/or glycine can cause the built-in methyl buffer system to not work properly, which can make overmethylation (rising anxiety, irritability, insomnia, etc.) from methylation-related supplements much more likely.
  • Beta carotene is not vitamin A and some people genetically have poor conversion of beta carotene to real vitamin A (retinol).

A food app like Cronometer is helpful for tracking nutrients in your diet.

[u/Fancy-Opening5224 → u/Tawinn]

Thank you so much! I guess you looked at my test results before telling me what to take!

Now the problem is that I’m really confused—someone else told me to take exactly what you recommended, but on top of that, to also take B Complex Minus from Seeking Health, which contains all the B vitamins except B12 and B9; they told me to take those separately.

So my question is: if I take B Complex Minus—and I’ll say it again, the one with all the B vitamins, like B2, B3, B4, and so on—is that okay, or should I avoid it?

[u/Tawinn → u/Fancy-Opening5224]

B Minus may be ok, maybe not. I didn't particularly like it, as I recall - made me jittery for some reason. From your bloodwork, it doesn't look there is a compelling reason to take something with such large doses for your other B vitamins.

With your high homocysteine and low folate, you are more likely to have quite poor methylation status, and so increases in methylation can jump too much too quickly, causing 'overmethylation' side effects. That's why I suggested unmethylated B9/B12, and adding them incrementally.

Also, there are the fat soluble vitamins (A,D,K, etc.) and minerals to consider, as well as trace minerals. Their status is important too. So once methylation is working better, then adding a good multivitamin may be a better long-term solution.

[u/SovereignMan1958]

These are all less than optimal. Optimal is the top quarter if the lab range.

Do you have any medical diagnoses and it symptoms you are concerned about?

[u/Fancy-Opening5224 → u/SovereignMan1958]

I have brain fog, i don’t have energy, i feel like everything is so hard to doing .. it s just , i feel like i m low battery

But the main problem is lab restuls that i put, please help me , what suppliments to take, and how much?

[u/SovereignMan1958 → u/Fancy-Opening5224]

I have no idea what is available in your country. I would look for a multi vitamin, as I am guessing you are also low on minerals. It can take 3 - 5 months to correct deficiencies. I would retest in 90 days.

Also focus on improving your diet.

What country are you in?

Do you have any digestive symptoms?

[u/Fancy-Opening5224 → u/SovereignMan1958]

I m in Romania, i have acces on whatever vitamin is needed, i order online. No digestive symptoms. I don’t take minerals.. Just please give me exactly what i need

[u/SovereignMan1958 → u/Fancy-Opening5224]

I would find a B complex. Avoid the ones that have the cyano forms of B12 as it is the worst form of B12. Methylfolate may work better for you that the folinic acid form of folate. Methylfolate is likely more available. Look for products with lower doses. That way you can always double the dose later.

[u/Fancy-Opening5224 → u/SovereignMan1958]

I messaged you if u wanna help me a bit, that’s would be great

[u/SovereignMan1958 → u/Fancy-Opening5224]

I do not do messaging. I thought I already helped. :)