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MTHFR and Pregnancy

Having an MTHFR genetic variant (especially being homozygous for the C677T variant), can pose some serious problems. Beyond impaired methylation and detoxification, as well as the many health problems that could occur as a result, women are faced with two major MTHFR-related obstacles:

  1. Conception - Having an MTHFR variant is associated with fertility struggles, including the inability to conceive and recurrent pregnancy loss (RPL).

  2. Healthy Pregnancy - Having an MTHFR variant is also connected to very serious pregnancy complications and birth defects, including preeclampsia and neural tube defects, such as spina bifida and anencephaly.

While these experiences can be devastating, there are steps that can be taken to avoid such outcomes. You are in the right place! To begin, check out The Great Folate Mistake and Detox Like a MTHFR. These two posts will give you a solid foundation to build on. While folic acid can be highly problematic for anyone with an MTHFR variant, the stakes are especially high while pregnant or trying to conceive.

Folate is critical in order to conceive, to have a healthy pregnancy, and for fetal development. It's therefore all-the-more important to use the correct form to accommodate having an MTHFR variant. For the general population, folic acid gets the job done. However, folic acid is not appropriate for everyone.

Folic acid is a synthetic form of folate that does not share the same molecular structure. This slightly different structure requires an extra step of conversion into a form that the body can use. This conversion process relies on MTHFR enzymes. However, those with an MTHFR variant are deficient in this enzyme to varying degrees. The result of supplementing with folic acid is two-fold:

  1. Folic acid is not adequately converted into a bioavailable form of folate that the body can use. This can lead to folate deficiency and the fertility/pregnancy complications described above.

  2. Unconverted folic acid can block folate receptors from doing their job. This means that even dietary folate can be blocked, leading to an even more severe folate deficiency and the consequential problems that follow.

The solution is to supplement with methylfolate. If methylfolate is not tolerated well, then try folinic acid. Both methylfolate and folinic acid are bioavailable forms of folate that the body can use without that extra step of conversion that relies on the MTHFR enzyme. Seeking Health offers prenatal formulas that utilize bioavailable B vitamins that are appropriate for someone with an MTHFR variant. It also contains ginger, which is helpful for morning sickness and general nausea.

The amount that you should supplement with may vary. Depending on the health history of the woman in question, anywhere from 400 mcg to 4-5mg may be recommended. That's a pretty large range! Most women will take somewhere between and low and middle range of the recommendation. However, women who have a history of miscarriage and/or pregnancy complications may be advised to supplement with the higher end of that range under the supervision of their physician.

It's also important to note that homocysteine levels can pose a potential problem for pregnancy health. Homocysteine levels are regulated by vitamins B9 (folate), B12, and B6. It's therefore critical to have adequate amounts of these vitamins in order to keep homocysteine levels in check. If a prenatal formula is not adequate, you could also try an additional B vitamin complex. Certain medications, such as those for ulcers and acid reflux can interfere with the absorption of B vitamins. In such a case, B vitamin shots could be necessary.

A healthy diet that is rich in folate will also help to lay the foundation for a healthy pregnancy. Try to consume lots of leafy greens, asparagus, broccoli, oranges, papaya, nuts and seeds, avocado, Brussels sprouts, beans, peas, and lentils. Minimizing processed and enriched foods, as well as sugar, will also help to create an MTHFR-friendly diet. Try to minimize your toxic load as much as reasonably possible. The less toxins you require your body to process and eliminate, the more energy it can place on a healthy pregnancy. Implementing a lifestyle of gentle detox will be very helpful. However, ask your physician before attempting any detoxifying supplements or teas.

Beyond these tips, there's no underestimating the power of the foundational principles of wellness, such as exercise, sleep, and stress management. Many women who struggle to conceive find that nothing works until they get the stress in their lives under control. And it makes sense...carrying a pregnancy requires a lot of energy and resources. The body must feel "safe" enough to undergo such a major process. For some, a breakthrough in their stress levels is the pregnancy-related breakthrough they needed the most.

There are other more controversial treatments for pregnancy with an MTHFR variant. These include Lovenox and Heparin injections with a daily Aspirin regimen to prevent the formation of blood clots between the placenta and uterine wall. For some women, this may be necessary. However, many find that making some simple but strategic changes to their supplements, diet, and lifestyle is what they needed to carry a healthy pregnancy.


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.


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