The other night we finished a delicious meal of pasta Bolognese and my husband asked what was in the gluten-free pasta. I grabbed the box and, as I scanned it, my face fell. The pasta was fortified with a vitamin and mineral mix, including Thiamin, Riboflavin, Niacin and Folic Acid! If you have MTHFR, consuming Folic Acid is a big no, no. Our bodies can’t process it and the excess ends up being stored as toxins in our organs and tissue. I was so busy looking for a gluten-free product that I didn’t think to check the box for folic acid fortification. This usually wasn’t a problem at the organic supermarkets where I shop.

enriched gluten free pasta

Note that this manufacturer does make non-fortified varieties of gluten-free pasta.

Although the names are often used interchangeably, there is a big difference between naturally occurring folate and folic acid. The linked article explains this really well but basically folic acid is an inactive form, added to food because it is more stable. The human body has to convert that substance into a form of folate that the body can use. But if you have MTHFR defects, your body can’t convert this folic acid and it builds up in your system.  One of the things that likely got me into trouble was my consumption of more than 800 mcg folic acid for over a year when we were trying to conceive. I believe I now have circulating unmetabolized folic acid in my system, which I still haven’t figured out how to get rid of.

Since 1998, the U.S. Food and Drug Administration (FDA) has been requiring food manufacturers to add folic acid to grain products like cereal, bread, flour, pasta and rice. This practice also goes on in countries like Australia, Canada, Costa Rica, Chile, New Zealand and South Africa.

Professional Supplement Center

This is an issue whether you have MTHFR gene mutations or not. Even the Harvard School of Health recommends against the consumption of fortified foods. When I started reading about this issue I was shocked. Granted this knowledge is coming at the same time as my discovery that I have the MTHFR genetic defect, but I think even those who are not affected by MTHFR in their bodies will have the same reaction to the research. The primary reason for forced folic acid ingestion was to lower the incidence of neural tube defects in newborn babies. In the United States, this has resulted in a 30% reduction. But what about those of us who have MTHFR and are trying to conceive? Even one of the most popular pregnancy and conception book series out there didn’t warn me that I might be one of the many women for whom folic acid is completely useless. So here we are taking loads of the stuff, increasing our own toxicity, and we can still end up with birth defects or miscarriages. That’s what they don’t tell you.

white flour

Meanwhile, people who aren’t even pregnant or trying to conceive are receiving a heavy dose of this unnatural folic acid. If 30-40% of the population as estimated does have MTHFR gene defects, then could those people be poisoned by this program? As mentioned in this research article that examines the fortification issue from both sides, potentially yes. The effects have not been studied adequately enough. The article mentions that the addition of folate to established tumors has previously been shown to cause an “acceleration phenomenon” in humans.  But the FDA still defends itself while others have posited this same question.

Unmetabolized folic acid can cause health problems for all people that don’t show up for many years.  It can decrease natural killer cell cytotoxicity and impair the body from responding to arthritis, cancer and anti-malarial drugs. In the elderly, who often have B12 deficiencies, folic acid can cause cognitive impairment and anemia. And while folic acid can have a protective effect against certain cancers, it can accelerate the growth of tumors already present. For me, it’s simply too risky to ingest this substance.  Alternatively, I encourage women to find out their MTHFR status and take the appropriate form of folate for them. If you’re having sex and know that pregnancy might be a risk, do this as a precaution. The information about folic acid while trying to conceive is out there. Until studies can prove that folic acid is safe for everyone else, I don’t believe that other people should be dosed with a substance that could harm them. And especially not at the levels unwitting consumers are being exposed to.

Fortunately you don’t have to be a reluctant victim of this fortification. Let this be a reminder to always check your packaging. If you are buying rice, pasta, oatmeal, cornmeal, products made with flour (crackers, biscuits, cookies, baking mixes, etc.), or even soy milk, ALWAYS check the label. If you see the words “enriched” or “fortified,” the product probably contains folic acid. And don’t forget about dietary supplements. Many multi-vitamins and prenatal vitamins contain the inactive form. Other vitamin or mineral blends may sneak it in there as a supplementary ingredient. While you’re at it, keep an eye out for cyanocobalamin (the inactive form of B12) and B6. If you have MTHFR you want the active forms of these vitamins, which means specific types of methylfolate instead of Folic Acid (see the linked article before purchasing active B9 supplements), methylcobalamin and pyridoxal-5-phosphate (P5P), which is active B6.

In my next post I’ll talk about where you can get the nutrients a MTHFR body needs from natural foods. Supplements are fine if you need them, but it’s always better to get your vitamins and minerals naturally from food. Unfortunately, many of us have issues with poor absorption because of leaky gut and other issues, so this is not always possible. But you should be armed with the knowledge of what foods are best for you to eat and what supplements you should and should not ingest.

Seeking Health, Inc

If you have a comment that is related to your own health or have questions that require an answer, please leave these in the community discussion forums and not in the comments below. Thanks! =)

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32 thoughts on “Have MTHFR? How To Avoid Folic Acid In Food

  1. Pingback: Supplement Savvy Sunday #1: Shakeology – Why Am I Not Feeling the Benefits? | Diary of a Mutant 30-Something: Living with MTHFR

  2. Michael B

    Andrea, Cysteine (Cranberries) is the answer for leaky gut, gluten intolerance, low Taurine (heart/muscle control), and inhibited synapses.

    -Cysteine is used in high doses by hospitals to cure leaky gut.
    -Cysteine is used by chef’s to break down gluten in preparing meals (for mixing purposes).
    -Cysteine is 1 of 3 amino acids required to make Glutathione, the cheif anti-oxidant (low Glutahione means high leaky gut). The other 2 chemicals are Glutamate and Glycine, both typically high. Glycine encourages inhibited synapses, glutamate strong synapses as well as muscle building/repairing.

    Lack of information out there on cranberries is a conspiracy theory…

    Reply

  3. theresa

    curious if you have a list of premade items that you have found not to have the folic acid. I spent hours at the store today looking at gluten/dairy/soy free milks and I found lots but they all had folic acid but did not say enriched or fortified. could the folic acid be from natural sources? I can’t see myself making my own almond milk daily. Also I love cereal. but again couldn’t find anything that didn’t say folic acid. :( I eat everything else pretty much fresh but there are just some snack foods I enjoy. glutino pretzels, potato chips, cookies here and there. do you know of a site that have researched all this if you haven’t? I am almost afraid to eat anything. everything has folic acid or b12 natural or added.

    Reply

    1. Andrea Post author

      Unfortunately I don’t have a list, Theresa. I’m a dedicated label reader. If it is a processed food then most likely it’s synthetic folic acid. I haven’t seen any websites that have researched this either…there are just too many products. In general, however, I don’t find it too difficult to find alternatives if I’m shopping at places like Whole Foods.

      Reply

      1. Mila

        Thank you thank you thank you! I was dx last week and have found folic acid added to everything from Emergen-C to my iron supplements, which are now in the trash bin. I’m wondering how many people who assume they have a gluten intolerance, really just need to avoid folic acid. It is disheartening that Pfizer, who now owns Emergen-C also produces medicines purchased for health issues those with MTHFR gene mutations can develop.

        Reply

  4. Pingback: The MTHFR Gene | Jody McComas

  5. Sarah

    I was wondering–if the govt requires all these bread products to be fortified, is it possible to find products that are unfortified? I mean I can grind my own flour to make bread, but I don’t see myself learning how to make pasta… but I will really miss it!! Thanks. Sarah in Austin TX

    Reply

    1. Andrea Post author

      The gluten-free flours usually aren’t fortified and I’ve also found unenriched flour at Whole Foods (and I assume you could find it at similar stores). Good luck!

      Reply

    2. Christine

      I hear you- I LOVE pasta, and am now having to find non- enriched products too…

      BUT-

      Actually, Pasta is SUPER easy to make… a bit time consuming, but you can do up a big batch with the help of some friends, and then freeze it for later!

      Recipe: 4 eggs, 2 cups of flour. That’s it!
      Lots of mixing and kneading… add flour as needed until not sticky.
      Roll out thin. ( a pasta machine is a fabulous invention that is worth the price!! )
      Keep pieces of dough moist in a bowl with a damp cloth on top til you use them.
      Cut into squares for ravioli, or thin strips for fetuccini. ( don’t worry if they dry out at this stage )
      ( for this stage, I hang a string across some cupboard handles to hang the noodles on so I don’t use
      up too much space)
      Then boil as you would normally- they may take less time though.
      Add a bit of oil once the noodles are drained, and toss, so they don’t stick together.

      Give it a try- even if you don’t have the energy ever to do this more than once, it’s definately fun (and a little messy) to try, and the fresh pasta is amazing!!!

      Christine

      Reply

      1. Andrea Post author

        Thanks so much for suggesting this, Christine! I actually have a pasta roller attachment for my Kitchen Aid so I have been wanting to try it…nothing like fresh pasta…

        Reply

    3. Dyana

      Making pasta is not that hard just the rising time can be a bit much depending on your recipe…if you need or want a quick option look for Tinkyada rice pasta…it is gluten free and not fortified …it also seems -to my family- to be the closest in texture to traditional pasta and it comes in macaroni, spaghetti, and linguine …some box stores carry it but most health food stores carry it

      Reply

  6. Dawn @ Prickly Mom

    Hi Andrea! I hope you’re well. I was Googling “can the body rid itself of unmetabolized folic acid” and this was one of the top results. Do you know the answer to my query? :)

    Also, I just posted this on the new FB page my sister and I have started, called I Hate Folic Acid (I also bought the domain and we will be starting a blog).

    Sidebar: you mentioned the 800 mcg of folic acid you have taken in the past as a prenatal. I’m just curious: did it make you nauseous? I took 1 gram a day, as advised, throughout both of my pregnancies, and never got over “morning sickness.” (Of course this was before MTHFR was on anyone’s radar). It was so bad during my second pregnancy that my OB put me on Zofran for nausea. Looking back, it just makes me angry that my little boy had to be exposed to that extra junk in my body.

    Reply

    1. Andrea Post author

      Hi Dawn! Just liked your new FB page – thanks for sharing this post there =)

      It didn’t make me nauseous…in fact, I didn’t know what was going on until I had a miscarriage and then my body started crashing shortly after that. It’s hard to describe. I just went through some really strong hormonal changes but then also could not recover from the m/c. When I had a lot of bloodwork done by a specialist, I noticed the high folate and then tested positive for comp hetero MTHFR a couple of months later. My homocysteine was also high at 9.4

      Let me know what you find on how the body gets rid of unmetabolized folic acid! I am curious about how long it takes and what we can do to help it along…

      Reply

  7. Kaela

    So happy to find your blog! I was recently diagnosed with Compound Heterozygous MTHFR Deficiency (almost two weeks ago) and I was diagnosed with Hypothyroid disease four years ago, and I’m TTC. So, we seem to have a lot in common! I was prescribed MetanX, and baby Aspirin by my fertility doctor. I’ve started trying to avoid folic acid as much as possible, and increasing folate from natural sources. I’ve been slowly trying methods of detox (I feel like I’m one who really has problems with detox…). My next step is to have my homocysteine levels checked, and find a doctor who can help me manage my MTHFR Deficiency. In your experience, what type of doctor should I see? I am a little clueless about what type of doctor may be knowledgeable enough about MTHFR. Thanks for sharing your story. It helps to feel like I’m not alone! As I continue to learn more and more, I may have more questions for you! Thanks in advance. ;-)

    Reply

  8. Dawn

    Just diagnosed with MTHFR and my Dr prescribed 1 mg of folic acid. It seems that folic acid is a big no no. I am I correct in this. I’m confused. Please help.

    Reply

    1. Andrea Post author

      You are correct. Please do not take any folic acid or consume foods fortified with it. You want the active forms of folate (methylfolate, for example) or food folate. I also highly recommend that you find a new doctor right away. There’s a list on the Resources page (see main menu of this site).

      Reply

  9. Janill

    I have been diagnosed for 2 weeks and prescribed Deplin, not a settling in my stomache. Any suggestions or thoughts, how to’s and what not to’s. Thank you!!!!

    Reply

    1. Andrea Post author

      Hi Janill – It’s really impossible for me to make recommendations to you as I am not a doctor and have no information on your personal health situation. Deplin could be too high a dose for you. I’m opening up an online community here in the next week or so and I’ll send you an invite when it’s live. Perhaps you can chat with others about their treatment protocols. There’s often a lot more to it than just taking methylfolate. Please visit our resources page and see the links under methylation for some treatment protocols and explanations. Drs Yasko and Lynch will be particularly helpful. Good luck!

      Reply

  10. Iva

    Hi Andrea,
    I am so glad I found your site. Things are so much clearer for me now. I also have MTHFR, and I lost two babies because of it, and I also cannot get pregnant easily, we are trying for 5 years now. After I read your site I completely changed my diet. My doctor only gave me baby aspirin to take every day, and when I asked him about folates and B vitamins he agreed with everything you described here on your site. But I have a problem, I live in a small country Bosnia and Hercegovina and I searched for these vitamins everywhere but unfortunatelly they are not selling here. So I decided to buy them online but there are so many of them and I really do not know which to choose. Can you please name some of the vitamins that you think are good so that I can search and order them online.
    Thank you so much for everything that you write here, I was lost without it :)

    Reply

    1. Andrea Post author

      Hi Iva – I am so happy to hear that my website has helped you!

      I purchase my supplements from two specific providers, both shipping internationally through third-party shipping companies. Just go to their websites and look for “International Orders.”

      Professional Supplement Center

      and Seeking Health, developed by Dr. Ben Lynch, the leading MTHFR expert

      I’ve also heard some international people say they order from iHerb but I don’t have any experience with them.

      I wish you a lot of luck on your conception journey – I’m in the same boat as you are…still trying. All the best, baby dust… Andrea

      Reply

  11. Someone with Asperger's and CFS/ME

    Since 1998, the U.S. Food and Drug Administration (FDA) has been requiring food manufacturers to add folic acid to grain products like cereal, bread, flour, pasta and rice. The U.S. Government under the Obama Administration is all about change. Isn’t it time for a change as far as the FDA policy regarding adding folic acid to food products is concerned, as this is a counterproductive health-ruining policy affecting around 40% of the U.S. population. As of January 10, 2014, the United States has a total resident population of 317,440,000. So how many people does this FDA policy affect? Yes, perhaps something like 126,976,000 people in the USA alone.

    Reply

    1. Andrea Post author

      I couldn’t agree more! I think something that those of us who are MTHFR aware need to do is push awareness and work at raising money for studies to prove the negative effects. This is something I hope to get more involved in this year.

      Reply

  12. Joelle Connors

    Just found your site. I have MTHFR and my doctor recently told me to take folic acid, B complex, and baby aspirin. Every day. For the rest of my life. After reading your article and I am totally confused. Thoughts?

    Reply

    1. Andrea Post author

      Hi Joelle, The old way of addressing MTHFR was to advise patients to take lots of extra folic acid, seemingly in the hopes that the body would just process some of it and in this way one could overcome the enzyme deficiency. What we’re learning now from Dr. Ben Lynch and others is that folic acid (which is synthetic and not the same as methylfolate) may linger unprocessed in the body, especially with the homozygous mutations. This can lead to adverse health effects including cancer (please refer to published studies and resources linked in the article). The advised course of treatment is to take methylfolate instead, which completely bypasses the enzyme deficiency (the body doesn’t have to convert it to anything, it just uses it). At least that is my understanding. And for the B-complex, you want to make sure that you’re taking the active forms of the B vitamins (B12=methylcobalamin, B6 = P5P, B5 = Pantethine, etc.) The baby aspirin recommendation is correct. Watch out for folic acid in your B complex, even if it has some of the other active B’s); if you want to take a mix of folate vitamins you can do folinic acid (again, not the same as folic acid) + methylfolate.

      References:
      http://mthfr.net/l-methylfolate-methylfolate-5-mthf/2012/04/05/
      http://mthfr.net/l-methylfolate-not-needed-come-on/2011/09/26/
      http://mthfr.net/comparison-of-homocysteine-support-products/2011/09/13/
      http://mthfr.net/absolutely-no-folic-acid-question/2011/10/04/

      Your doctor is simply not up to date on the latest protocols for MTHFR. Happens all the time.

      Please note that this is not intended to be medical advice. I am merely passing along the information from leading doctors in the field like Dr Amy Yasko and Dr Ben Lynch. Please refer to the article for links to these sources.

      Reply

  13. Dawn @ PricklyMom

    My sister and I are new to the MTHFR club (we are both in our early 40s), and were just talking today about how absolutely sick we both were on prenatal vitamins. With my younger son, I was nauseous and had to take Zofran for my entire pregnancy. I bet it was too much folic acid!

    Thank you for writing about fortified foods! I would have never given that a second thought; it’s something that’s so ingrained in our food consciousness. Wow.

    Reply

    1. Andrea Post author

      Hi Dawn – So glad you found my site! I was loading up on folic acid and cyanocobalamin last year when we were trying to get pregnant. By April I was completely ill – and I had a miscarriage in February. Folic Acid strikes again! Once I got on the right supplements I felt so much better – and I’ll be reporting on some amazing results from switching to methylfolate in tomorrows post =)

      Reply

      1. Laura

        Hi Andrea,

        I am so glad I found your site. I recently found out that I have MTHFR and was prescribed 4 mg of folic acid daily by my RE! Now I am freaked out because I realize I shouldn’t be taking that but folate. What is a good folate supplement? I know that growing babies need lots of folate in order to reduce the risk of birth defects. I have been TTC for almost 3 years, have done 3 IVFs, have had 2 chemical pregnancies and I am convinced now that I am not staying pregnant because of these autoimmune issues. I also have elevated levels of natural killer cells. I am pretty sure that between the MTHFR and the killer cells that is why I cannot stay pregnant. Now I just need to find a doctor who will treat me for those instead of the typical RE who really doesn’t know much about either.

        Thanks for all that you share on this blog.
        Laura

        Reply

        1. Andrea Post author

          Hi Laura – so glad you found my site too! I am shaking my head at your RE because prescribing high dose folic acid for MTHFR is an outdated (but sadly very common) response to a MTHFR diagnosis. What you want is methylfolate, which can luckily be found in many over the counter supplements. I take the Seeking Health Optimal prenatal and you can order it online. Please also see my post about methylated vitamins because you’ll want to be getting enough B12 (as methylcobalamin) and checking those levels before starting (watch the video I link to there for all the info). I have to mention also that there are many other methylation SNPs that could be important for you. Examining these requires further genetic testing so it’s something you may want to look into, especially if you don’t feel good on the methylated vitamins. All of the information I am telling you here comes from MTHFR.net, which I highly recommend visiting to explore these issues in further detail. I also recommend Dr. Amy Yasko’s work (see resources page). I’ve been doing this regimen from the first of July and am now starting to see many improvements (it can take four months to improve egg quality and see the effects of supplementation at the cellular level, so I recommend patience here).

          Regarding the elevated Natural Killer Cells, I refer to the book ‘Is Your Body Baby-Friendly?’ by Dr. Alan Beer. Treatment is available for this and may differ depending on what type of NK cells you are having issues with. What you want is a good reproductive immunologist – perhaps check out the INCIID website and use the discussion forums there to find a doctor in your local area?

          Good luck and all the best!

          Reply

  14. Lynn_M

    For people with MTHFR, I certainly agree with you about the need to avoid folic acid in supplements, because those are big doses of folic acid. I think the situation is more equivocal when we’re talking about the amount of folic acid added to enriched foods. People with MTHFR don’t have a total inability to convert folic acid to active forms of folate. Even people homozygous for C677T still have about 30% of the normal conversion ability, so very small doses of folic acid will get converted.

    When a food is enriched, I don’t know what quantities of folic acid are added. But I suspect the quantities are miniscule enough that a MTHFRer could convert them to active folate, so it may not be necessary to worry about 100% avoidance of the folic acid in them. Of course if a person ate a lot of enriched foods, then the total amount consumed of folic acid might be a concern.

    Reply

    1. Andrea

      Thank you very much for your input, Lynn. The studies I was researching for this post mentioned that there is an overall concern by many that even people without MTHFR are consuming way too much Folic Acid daily because so many products are fortified, especially in the older population who may be more susceptible to cancers. The Folic Acid is allegedly not good for anyone in very large quantities. The problem, I believe, lies in how much enriched and processed food we eat as a society, especially in the United States. Plus many people take daily multivitamins that also contain this substance so they could be unknowingly getting too much. So that is why I am cautioning against it as my understanding is that the synthetic Folic Acid can also become inhibiting against the active form. Please do let me know if that is incorrect though!

      According to the Spina Bifida Association, the “FDA requires that 40 mcg of folic acid be added per 100 grams (3.5 ounces) of bread and other grain products…breakfast cereals do have the full recommended amount of 400 mcg in a single serving.” In Australia, they add 0.135 mg of folate per 100g of bread according to Wikipedia. The Harvard article also mentions that many nutrition bars contain the full daily recommendation. So I am really advocating that people check their labels.

      Reply

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