There is a reason why patients coming up against MTHFR for the first time will probably hear about Deplin. It’s classified as a “medical food” by the FDA and approved for use by people with suboptimal L-methylfolate levels. Now, for most people, the dosage of methylfolate found in Deplin (7.5 or 15mg strength) will be way too high, even for people with multiple MTHFR gene mutations. But this prescription dosage exists because it is often prescribed for patients suffering from mental illness, including depression.
Is there an aspect of our health and biochemistry that folate deficiency does not touch? Having the proper amount can determine whether homocysteine benefits us or poisons us, and whether we have the right balance of serotonin, dopamine and norepinephrine. The latter three are neurotransmitters and crucial to mental health. Unaddressed MTHFR gene mutations can become a contributing factor to a variety of mental illnesses. These range from serious and debilitating conditions like Alzheimer’s disease, bipolar disorder, depression, Parkinson’s disease, schizophrenia and schizophrenia-like syndromes and vascular dementia, to those that, while not life-threatening, still reduce a person’s quality of life. Some examples are forgetfulness, insomnia, irritability, myelopathy, organic psychosis, peripheral neuropathy, prenatal depression and restless leg syndrome. I’ve also discussed the somewhat related conditions of autism and attention deficit hyperactivity disorder (ADHD) on this blog.
A review of the literature demonstrates that MTHFR is just one factor in the development of most of these conditions. Most mental illnesses are multifactorial in cause with multiple genetic determinants. Major depressive disorder (MDD), for example, has six significant genes of susceptibility: APOE, DRD4, GNB3, MTHFR, SLC6A3 and SLC6A4. Many genes influence schizophrenia, bipolar disorder, Alzheimer’s and autism. Environment also plays a significant role. A new study, for example, found that epigenetic markers related to methylation can determine which trauma survivors develop post-traumatic stress disorder (PTSD). Stress can be inherited and affect later generations. Patients with MTHFR 677CT who experienced traumatizing childhood events may have a more difficult time recovering from depression. As always, our genes tell one story while our environment and lifestyle can heavily influence the outcomes in our own personal journey.
It is also important to remember that, despite getting the most attention, MTHFR 677CT and 1298AC are just two alleles influencing the methylation pathway and other associated processes. Scientists are looking closely, for example, at the catechol-O-methyltransferase (COMT) gene, which affects dopamine levels. Investigations into the combination of MTHFR and COMT may be even more critical in improving therapies for schizophrenia, among other disorders. Knowing, however, that you have MTHFR gene mutations makes it critical to address them if they are expressing and to be vigilant about your homocysteine levels and methylation cycle functioning. Additionally, if you experience the symptoms of mental illness, even the minor ones, it is essential to explore natural therapies such as increased folate consumption and the correction of methylation cycle impairments. Look for a doctor who is aware of MTHFR and related genetic conditions that may be affecting your mood and health. Deplin used in conjunction with common antidepressants has been found to significantly improve treatment outcomes. Some patients may not even need antidepressants and may instead find relief of symptoms by optimizing methylation alone. Prescription drugs have side effects and ideally a person should not be taking them unnecessarily. As with any MTHFR-related illness, it’s important to explore the non-prescription treatment alternatives that may be available to heal you.