[MTHFR and FRA are first on the page, then MTHFR info alone]
Written by Sarah (see page that brought you here) August 2015
“Diagnosis and Treatment of MTHFR and FRA (folate receptor antibodies)” (scroll through the page; there’s more at the bottom!)
MTHFR
MTHFR is a mutation that affects the speed of conversion of folic acid to active folate.
There are 2 mutations:
- c677t
- a1298c
C677t is more severe.
There are different combinations of mutations.
In order of worst to “best”: (Sarah is not 100% on the percentages…this page is a work in progress)
- 2 copies of c677t (convert ~10% of folic acid)
- 1 c677t, 1 a1298c (convert ~40% of folic acid)
- 2 copies of a1298c
- 1 copy of c677t, 1 normal copy
- 1 copy of a1298c, 1 normal copy
If you take folic acid when you have the mutation, depending on which mutations you have, the folic acid may not be usable. If it is not converted, you will have a build up of folic acid which can be toxic, and you will have a deficiency of active folate.
Folate deficiency can cause:
- problems making neurotransmitters
- autism
- pregnancy loss,
- birth defects
- cancer
- immune problems
The severity of the results of having folate deficiency depends upon the mutations and nutrient status of the patient/patient’s mother before/during pregnancy.
Testing for MTHFR
You can have the mutation tested by a standard lab through insurance.
Or you can do the 23 and me test for ~$99 and get the results by running genetic data through Genetic Genie, Livewello, etc.
Or you can just treat with the same vitamin doses you would use if you had the worst mutation combo. You will pee out any excees B vitamins.
FRA
FRA are positive in 75% of autistics and cause similar symptoms to MTHFR, but more severe.
For more info visit: http://iliadneuro.com/
The test can be ordered and drawn by any MAPS doc, or a regular doc but go to the website for instructions on how to get it done. Cost is ~$200.
For info on treating your child, see FB group Cerebral Folate Deficiency & Folate Receptor Antibodies https://m.facebook.com/groups/363697893680469?tsid=0.8663348045665771&source=typeahead
If you are not able to get the testing done, you can treat with higher doses of vitamins to cover you in case you are positive.
Treatment
1. Avoid folic acid in supplements and fortified foods.
2. Take B6, B12, and active folate.
It’s preferable to take Active B6 (p5p) and Active B12 (methylB12).
Active folate is folinic acid or methylfolate/quadrafolate/5-mthf.
(If a supplement just says “folate”, do not use as there is no way to know which form it is.)
There are many ways to achieve this.
To get B6 and B12:
- One way is the supplement HomocysteX Plus (one pill with 800mcg methylfolate).
- Or Pure Encapsulations B Complex Plus (one pill with 400mcg of methyfolate.
To get active folate:
- -Kirkman’s folinic acid 800mg pills
- -Rx Leucovorin (folinic acid) comes in different dosages
- -Rx Deplin: methylfolate in 7.5 or 15mg.
- -Rx Cerefolin NAC , contains NAC 600mg, MB12 2mg, methylfolate 6mg
Dr. Rossingol recommends 2.5mg (2500mcg) of folinic acid to treat FRA.
Other strategies for FRA:
Antibody levels are supposed to go down with a dairy free diet. Beware of dairy in supplements. Brand name Deplin has dairy.
Antibodies may be suppressed by steroids. Dr. Quadros reported to me a case study where a FRA+ mom kept having pregnancy losses until she went on steroids.
Low Dose Naltrexone is another option. It may reduce antibody levels, anecdotal reports from my doc (Berger) and patient of it being good for reducing thyroid antibody levels. Also anecdotal reports of LDN treating infertility and recurring pregnancy loss (could this be due to reducing FRA?). I am trying it this pregnancy.
Comments:
Q: ” What dose of folate and what form does Dr R recommend to treat FRA?”
A: “For pregnancy Dr R recommends 2.5 mg of folinic acid (I did 3 kirkman 800mcg). Much higher before pregnancy and after. I did 8mg folinic (leucovorin). As you know this doesn’t treat the FRAs, just works around them by pushing up serum concentration.”
Some More Collected Info about MTHFR:
A mom writes: I’m wondering how much folate to take during pregnancy? Example: some vitamins have 800mcg (Folate [50% as Quatrefolic® ((6S)-5-methyltetrahydrofolate, glucosamine salt) and 50% as folinic acid (calcium folinate)]).
Laurie writes: 800mcg-1000mcg (1mg) is the standard amount in most prenatals/multi’s (if they are really good ones. The decent ones usually have 400mcg. And the lower quality ones often have only 250mcg-200mcg).
Based on the description u wrote, your supplement actually has 400mcg METHYLFOLATE and 400mcg folinic acid. Folinic acid is not bad (folic acid is) and its a good idea to get this supplement too because it has different functions in the body. 400mcg is a small dose but it’s better than nothing because most don’t get any at all. However, 400mcg methylfolate is way too low a dose for pregnancy and especially not enough for pregnancies at risk. 2-5mg methylfolate is a more optimal dose for pregnancy and 7-10mg for pregnancies at risk. This is my personal opinion. I’m compound heterozygous MTHFR, so I was already getting approx 2mg before but when I found out I was pregnant I got on Deplin 7.5mg because I didn’t feel comfortable taking less. Between that and extra in OTC supplements, I was getting a total of 8.7mg folate. (Plus 1.6mg folinic).
infantreflux: would following this ^ be detrimental, neutral or harmful to one who doesn’t know their MTHFR status?
Laurie: In the case of not knowing your MTHFR status, my opinion is that it’s best to supplement assuming u have at least one copy of one mutation bc with 60% of population having it the probability is likely. Having signs/symptoms or kids with signs/symptoms increases that probability. Besides there is virtually no risk to taking a high dose when u don’t need it- it’s in the b vitamin family and all b vits are water soluble so u pee out whatever your body doesn’t use. MTHFR is just one of a bunch of snps involved in folate metabolism and there are autoimmune issues, neurological conditions and mental disorders that are affected by folate levels. So MTHFR status isn’t the only determining factor in supplementation. Some ppl require higher doses than others and knowing how much is best figured out by trial and error. Those that have difficulty tolerating it shouldn’t assume that means they never will or they just can’t handle it. Undesirable side effects occur usually from taking too much too fast. There’s a great post by dr lynch on MTHFR.net called “preventing methylfolate side effects”. Some ppl need to have precursors on board first, for others diff nutrient deficiencies have to be corrected first, and some ppl just need to ramp up extremely slow. Starting low and increasing slowly over time is always a good idea.
Healthy Pregnancy!! How to do your best to have a healthy baby: ‘infantreflux’ but really the page is for Preventing any _____*fill in the blank* ; there are articles & links to information for the healthiest of pregnancies, including, but not limited to: mag, HTMA, folate/folinic acid/methylfolate , mthfr , mother’s micro biome, probiotics, prenatals, recommended blood tests, FRAT, iron, ferritin, k2, zinc, etc
