MTHFR Protocol – Treatment

MTHFR Protocol I have placed a hard copy of the treatment here due to the website inavailability of the PDFs. The website covers illnesses related to MTHFR. It is a wonderful resource.

Nutritional protocol for MTHFR
Revised 7/21/2010

The Human Genome project has developed a new approach to medical problems. There are several of the B vitamins that require activation before they are useful to the body. By taking the active forms of theses vitamins you are able to bypass metabolic glitches and compensate for genetic and environmental problems. The MTHFR genetic defect is in between 40-60 % of the population. It is associated with problems such as early heart disease, stroke, Blood Clots, Depression, Anxiety, Irritable Bowel syndrome, Fibromyalgia, Chronic Fatigue, Chronic pain, Migraines as well as heavy metal and other environment toxin retention. This protocol is designed to help treat these problems with nutritional therapy. It is not designed to replace your medications however you may be able to over time decrease the medications that you require to manage these problems.

The Supplements should be added one at a time rather than start them all at once.

METHYL FOLATE (Prescription)
Deplin 7.5, 15 mg a day. This is just the Methylfolate and tends to increase energy. Take 7.5 mg at a time. If taking 15 mg take ½ in the am and ½ at noon. Most widely used.
MetaNX 1-2 tablets/day Methylfolate (B9), Vit B6 (Pyridoxyl 5 Phosphate), Methyl B 12 Methylcobalamin. This works well 6 months to 1 year. In a small percent of the population the Vit B6 builds up and creates a tight band type headache. Great for surgical wound healing
CerefolinNAC. One tablet a day. This is for Methylfolate, Methyl B12 and N-acetyl cysteine that helps form Glutathione. Glutathione is important in memory and clearing Heavy Metals.
Neevo Prenatal, Prenate Elite, Thorne Prenatal These prenatals contain Methylfolate

Methylfolate (MTHF). 1mg. also available at Richland Clinic Pharmacy or Prescription pharmacy age 8-12, 1 tab, age 12+, 2 tabs (7.5 tablets are equivalent to 1 Deplin)
Methyl-Guard. Thorne Pharmacuticals Available at Richland Clinic Pharmacy, Prescription pharmacy age 0-3, 1 capsule, age 3-5. 2 capsules, age 6-8. 3 capsules. (6 tablets are approx equal to MetaNX)

You may require additional supplementation to support this pathway.
Options for Methyl B12 :
Methyl B-12 5000mcg. Oral dissolving tablets every day (usually 1 but up to 4x/day)
Methyl B12 oral drops Richland Clinic Pharmacy or Biogenesis (called Methyl Protect) on line. This works well for infants and children.
Methyl B-12 (15 or 25mg/ml) 0.1-0.5ml sub-cutaneous injection every 1-3 days
It can lower blood sugars at about 8 hours. In diabetes it seems to work bests daily.
Your urine may be an orange-red about 4-6 hours after the shot. That is your body clearing the excess. I have found that some people that are very ill have not noticed this till several weeks into treatment. The injection has to be compounded, needs a prescription and be refrigerated. Regular compounding pharmacies do not have the special equipment to do this.

Some pharmacies that do: Richland Clinic Pharmacy 509-943-3030

(local) Hopewell Pharmacy NJ 800-792-6670.
Moses Lake WA Pharmacy 800-476-6505

Other supplements that seem to help with this particular metabolic pathway include::
N Acetyl Cysteine 600 mg Once a day
This helps make glutathione which clears heavy metals, Seems to help with memory
Full Spectrum Minerals Mineral supplement with Amino Acid Chelate (AAC)
Take one a day. NOW brand and others are available.
Vit B6 (Pyridoxyl 5 Phosphate or P5P), 25 mg This is in Meta NX. Can be added to Deplin
This B vitamin can build up in some people and it causes a headache that feels like a tight band.
Vitamin C 1,000-3000 mg up to 3 times a day
This helps with regenerating glutathione as well as helping to have 2-5 BM/ day
Epsom Salt bath Soak feet or body with ½ -1 cup of salts 2/3 times/week
– The magnesium absorbs directly. It helps with improving the mineral balance. It also adds the sulfate that is

critical in clearing toxins. It is not well absorbed orally.
DMG-Dimethylglycine. (another option in TMG) 100-250mg/day Start with one a day
This adds methyl groups to the amino acid that your body uses in the methylation.
Zinc 20 -50 mg/ day Especially important in eye sensitivity which is common.
Omega 3 (Flax seed or Fish oil that has mercury removed) 1-2 tablets per day
Some of the fish oil tablets don’t have the mercury removed. Helpful with brain/nerve healing
Vitamin E 400 IU Once a day
Silymarin (milk weed Thistle) 150 mg 1-2 tabs/day. Boosts glutathione
Glutathione SR (Thorne pharmaceuticals). 1-2 tablets/d This may give symptoms as the toxins come out so it may be useful to do on a 3 days on, 4-11 days off.

Available at Richland Clinic Pharmacy

5-9 serving’s of fruits and vegetables are key to getting many of the minor but essential nutrients.

Laboratory evaluation may be useful. This allows testing for the genetic predisposition and looks for toxicity in the B6. It helps identify people who would benefit from long term therapy.
MTHFR (methytetrahydrofolate Reductase) This is an initial test for gene defect.
Homocysteine This seems to be optimal if under 6.3. Do baseline and follow if over 7.5.
HbA1C. This is a estimate of glucose intolerance. If in the 5.5 to 8 range you can have more problems with dosing the Methyl B12 and it should be given every day.

MTHFR tests only two of the common genetic variants. There are as many as 50+ variants to this gene alone.

You get one from each parent. Possible combinations of these two are:
Normal/Normal It doesn’t test for the environmental toxicity or the minor defects.
Normal/ 677 More susceptible to environmental damage, depression, addiction
Normal/ 1298 More susceptible to environmental damage, depression, addiction
677/677 This means exposure to Lead, Mercury, and Pesticides may not clear well
1298/1298 This means exposure to Lead, Mercury, and Pesticides may not clear well
677/1298 As noted above this genetic defect has increases in strokes/heart disease/ blood clots.

Nutritionally bypassing these defective Genes with the above protocol is very important. It may also be important to take an aspirin daily. All of the defective MTHFR genes are associated with Depression, Irritable Bowel, Fibromyalgia, Migraines and Chronic Fatigue and may make you more susceptible to viral infections especially Mononucleosis. Avoiding environmental toxins like BPA (plastic stuff), Mercury, Lead and by drinking filtered water in a stainless steel or BPA free plastic helps treat with getting better and avoiding future problems.

Changing the course of Autism, The scientific approach for parents and physicians. Bryan Jepson, MD. This book talks about the importance of these supplements. Magnificent Mind at any Age, by Daniel Amen. An excellent resource on treating the effects of this gene

An old version of my MTHFR presentation was put on a web site by my niece.

***To view the vitamins and supplements I am taking click here.




4 Comments (+add yours?)

  1. ralph and me
    Jan 13, 2012 @ 01:01:35

    This is the same protocol that I have and am using but I cant remember what website i found it on. I would like to give that information to my doctor. Do you have a link that goes with the protocol?



    • Libby
      Feb 10, 2012 @ 16:37:46

      Hello Anne, The link to the protocal is; Be aware that sometimes the links works and other times it doesn’t. So when the page come up be sure to print it all so you have a hard copy. Also, you can click on the link in my menu bar for the full protocal and the link is their as well. Sorry for the delay. Good luck!


    Feb 19, 2016 @ 21:41:17

    I was told I have this mutation, was given methfolate and told need nothing else, not to take B12 shots as too much in my blood? and sent on my way. I DO NOT fwel any better, also just diagnosed with CEBV, CFS, FM. ostopenia. Extreme pain in bone and muscles…all over but muscles and bones the worst.


    • Libby
      Apr 19, 2017 @ 11:49:42

      So sorry for the delay. Normally having mthfr you should be required to have b12. I take methyl-b12 everyday but recently started a multivitamin which is called smarty pants womens vitamins … I had no side effects to it which I normally have side effects to most. But the form above does have the activated forms of methyl-b12 and methylfolate which I would highly recommend. If you do become deficient in b12 it can cause many symptoms. You can find the book on amazon called “Could it be b12”. It is a very good read. Also, recently I began vaping cbd oil from hemp and it has helped with some of the pains and helps me sleep a lot better. I got it from or you could see a pain management doc. I know how you feel with all the pains you are stating … literally everything hurts and all you can do is treat each symptom. That is what I do. If you have the chronic active form of ebv it is more difficult to treat. I know the docs only treat the symptoms for me so I only go in if I have no other choose (not recommended). I know many who take valtrax to treat the ebv but I have not yet tried it. I try to take various vitamins that are activated forms or chelated forms to help rid my body of the toxins/waste the ebv releases. Now I am taking (which I will update my vitamins page in the next few days) vitamin c, l-lysine, zinc, magnesium chelated form, smarty pants multivitamin, curcumin, d3. I have noticed they have helped. The magnesium helps with some of the heavy feeling and makes me feel more awake. I also take the following meds (some as needed to treat various pains): gabapentin, valium, klonopin, tramadol, mobic and percocets. Also taking epsom salt and baking soda baths help a bit. Big hugs and I know how you feel … stay strong.


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