While Western medicine and those in the holistic health community don't see eye-to-eye on many things, there is one complication related to having an MTHFR variant that everyone seems to be able to agree on - a higher likelihood for elevated homocysteine levels and an increased risk for cardiovascular events. This is especially true if you are homozygous for the C677T variant.
Is this a death sentence? Absolutely not! In fact, although I am homozygous for the C677T variant, my homocysteine levels have never been in a dangerous range. I believe this is likely due to discovering my condition at a young age, after developing other health complications that pointed to it. Many people, however, find that they have elevated homocysteine levels after years or decades of poor MTHFR-related choices. Thankfully, this issue can be managed very well once you understand what is causing it.
Homocysteine is an amino acid that is mostly obtained through eating meat. It is then broken down by vitamins B12, B6, and B9 (folate) into other substances your body needs. In a typical healthy person, homocysteine won't be a problem unless they're not getting enough B vitamins in their diet and/or they don't take a multivitamin.
However, when you have an MTHFR variant, you are more likely to be deficient in these B vitamins that your body needs to safely convert homocysteine. To make matters worse, folic acid (the synthetic form of folate often found in fortified foods and supplements) can not be converted properly into a form that your body can use. This can lead to both a deficiency in folate and a buildup of toxic and unusable folic acid.
Consequently, homocysteine levels may rise out of control. This can lead to artery damage, blood clots, and ultimately cardiac arrest. High levels of homocysteine are also connected to osteoporosis, stroke, dementia, and Alzheimer's disease. When homocysteine is excessively high, it is known as hyperhomocysteinemia. Anything above 15 mcmol/L is generally flagged as risky. However, the ideal is right around 7 mcmol/L and you don't want to stray too far from that.
So what's a MTHFR to do? It's really all about B vitamins and getting them in the form you need. Below are some steps to take to manage homocysteine levels.
Eliminate sources of folic acid from supplements and enriched foods.
Consume lots of folate-rich foods, such as leafy greens, asparagus, broccoli, papaya, oranges, avocados, seeds, nuts, Brussels sprouts, and cauliflower.
Supplement with bioavailable B vitamins. In this case, vitamins B9, B12, and B6 are of critical importance.
Some people resort to a plant-based diet to further manage homocysteine, since it's primarily acquired through animal products. However, it's important to note that even plant-based foods can indirectly provide homocysteine through methionine, which converts into this compound. For those who try this type of diet, it's important to supplement with more B12 than normal.
It's also important to note that certain medications can inhibit B vitamin absorption, leading to elevated homocysteine levels. Examples include acid reflux and ulcer medications. In such a situation, B vitamin shots may be necessary.
To take a deeper, guided dive into how to thrive with an MTHFR variant, check out Hey MTHFR Academy. This 16-week online course will give you the tools you need to harness the power of epigenetics and befriend your MTHFR gene.