I’ve been wanting to write a blog about methylfolate for a while since the genetic variation in how we process folic acid can sometimes have a huge impact on heart, mood, and overall health. I’ve been delaying because it is not a simple topic, but here is a basic introduction to it.
Our bodies use several active forms of folic acid, one of these being methylfolate, or more scientifically 5-methyltetrahydrofolate. Methylfolate is necessary to activate B12 and make SAMe, which in turn is necessary for some detoxification processes, neurotransmitter production, and proper genetic expression. Methylfolate is also used to neutralize of homocysteine, an amino acid derivative that is possibly implicated in heart disease. B12 is also needed for this last process.
Between 10-20% of the population has a genetic variation in their ability to make methylfolate. Most people with this genetic variation will still have one gene that is functional and probably make adequate methylfolate. Other people have two bad copies of the genes and will be deficient in this active form of folate.
Especially with this last case, these genetic variations can lead to very serious health conditions. These can range from common mood issues like depression to serious mental health disorders like schizophrenia and bipolar disorder. I also see these genetic differences more commonly in my patients with ADD and autism. Because of the reduced ability to neutralize toxins, people with these genetic issues can have increased rates of autoimmune disease, Alzheimer’s, and Parkinson’s disease. Another variant in this gene can lead to an increase in conditions that are caused by blood clots like heart attacks and strokes. Finally, this genetic variation can cause an increase in birth defects and miscarriages.
So the solution to this genetic issue can be simple sometimes and more complex for others. Since the eventual end product of this gene is methylfolate (or more precisely 5-methyltetrahydrofolate), we can take this as a supplement and bypass the problem. The dosage can depend on the person so I start low unless there has been adequate testing. Where this gets challenge is that this genetic variation isn’t always the only one. Taking methylfolate can help us make epinephrine, an excitatory brain chemical. For some types of depression, this can be very useful, but others have trouble breaking down epinephrine due to other genetic mutations. For these people, they can build up too much of this stimulating epinephrine and experience anxiety.
For people who are really curious about these possible genetic variations, the good news is that genetic testing in now really inexpensive. For $119, you can get a full panel from 23andme.com, which is then translated by the Sterling App. This approach can help you and your doctor better understand how to balance your supplements for your genes.