Hey folks! I’ve been getting a lot of questions lately about the MTHFR gene and how it might impact ADHD. So, let’s chat about it! By the way, in case you missed it last week…

NEW RESOURCE: TYPICAL NUTRIENT DEFICIENCIES IN ADHD: WHAT TO TEST, HOW TO TEST, AND OPTIMAL RANGES.

Have you ever wondered what lab tests you should ask your doctor for, what the optimal ranges to look out for are, and why you should ask your doctor for them?

That’s exactly why I made the ADHD Nutrient Testing Masterlist (Adults). I compiled a list of my top eight tests to ask for so that you’ll know if your levels may be exacerbating your symptoms. It’s available for my ADHD Transformation Lab members ($13/mo)! Check it out!

The MTHFR Gene

The MTHFR gene is a gene that helps code for a process called methylation. It mainly helps us do two important things:

• Convert folate (vitamin B9) into methylated folate (B9 that the brain can use). Methylated folate is important in improving something called BH4, which makes sure we can make serotonin and dopamine.

• Reduce homocysteine levels. Too much homocysteine is associated with cardiovascular and neurological risks.

When we have a polymorphism on the MTHFR gene, our ability to convert folate and thereby reduce our homocysteine levels becomes impaired. The more polymorphisms we have, the worse our ability to convert becomes. I’ll chat a little bit more about what this meaningfully means for us near the end.

Thanks to the wonders of modern-day genetic testing, a lot of people have gotten tested over the years and learned they have a genetic variant on the MTHFR gene. Now, also thanks to fear-based messaging online from people selling supplements, we’ve had an influx in people capitalizing on this and telling people that if they have an MTHFR “mutation” (that’s honestly the first red flag…if they truly understood it they would call it a polymorphism) they should be buying their methylated folate supplement.

ANYWAY.

Because of some of these areas listed above, people connect the MTHFR gene with ADHD. After all, we tend to have higher homocysteine levels than the general population, lower folate levels than the general population, and we definitely would benefit from having adequate BH4.

However, we don’t want to listen to theory - we want to investigate reality. That’s exactly why I love research. So, let’s look at some.

The Association of ADHD and MTHFR

When we look at the association of ADHD and MTHFR gene polymorphism rates, ADHDers experience MTHFR polymorphisms at the same exact rate of the general population (~60%).  So, to be clear, having ADHD is not associated with the MTHFR gene. If you see a person online claiming otherwise, you can throw that 2024 research paper into their DMs.

I also want to highlight how more people than not have at least one polymorphism on the MTHFR gene! At this point, it’s weirder for you to not have a polymorphism on your MTHFR gene (which makes all the capitalizing on this fear even more egregious in my personal opinion).

If ADHDers aren’t more likely to have an MTHFR polymorphism then why do we tend to have higher homocysteine levels + lower folate levels?

Often, the simplest answer is the correct one (thanks Occam’s razor): people with ADHD simply do not eat enough folate or folic acid.

Yup. That’s literally it. So, just like nearly every time, here’s the action I want you to focus on this week: eat more green vegetables, beans, and fortified foods.

Disclaimer on folic acid: Some people may worry that folic acid is “bad” since it’s technically a synthetic (man-made) version of vitamin B9; however, let’s think about where we got this messaging from. Was it from research, or was it from people trying to sell us a product or service? After all, when we look at the research, we actually see folic acid being superior in some cases! Really, what I’m trying to get at here is encouraging you to continue to be critical about where you’re getting your information and how it’s presented to you. After all, fear sells, and money corrupts.

If I have an MTHFR polymorphism, is folic acid bad for me?

It’s a common myth that having an MTHFR gene polymorphism means that you can’t process folate or folic acid and should avoid it.

A common reason that is cited against folic acid especially is the claim that synthetic folic acid can build up and block receptor sites, leading to unmetabolized folic acid issues. However, there is absolutely no evidence for this.

In reality, avoiding folic acid (and especially avoiding folate) is one of the last things you want to do. In fact, you actually may need to eat MORE than the general population, potentially supplementing if your levels continue to be abnormal despite dietary interventions. As always, discuss with your physician about that before you do.

I will enter this caveat here, that certain polymorphisms may benefit from l-methylfolate supplements (677CT/1298AC and 677TT/1298AA) according to our research. However, beyond those two, folic acid supplementation does the same exact thing for us. Therefore, no, if you have an MTHFR gene polymorphism, you do NOT need to avoid folic acid!

Is there anything else I can do?

Beyond making sure you’re eating enough folate and folic acid, there are a few more things I recommend for supporting your MTHFR gene’s processes (whether or not you have a polymorphism):

1. Get enough B vitamins. B12, B6, and riboflavin help compensate for reduced enzyme function. Again, some of the best and easiest sources of these are fortified foods along with nutritional yeast, legumes, and your veggies.

2. Support alternative methylation pathways. Our bodies are incredibly amazing and don’t usually just have one way of doing things. There are a few more pathways that can help with B9 and homocysteine. One uses B vitamins and another uses choline and betaine. Good food sources of choline and betaine are beets, quinoa, spinach, whole grains, eggs, liver, and salmon.

3. Reduce stress. Stress increases the demands our body has for methylation. Managing stress through exercise, eliminating excess stressors, being around supportive friends, and practicing nervous system regulation skills is important.

P.S. if you want to know what to test for at the doctor’s office to see if nutrients are impacting your ADHD symptoms, don’t forget to join the Nutrimind Community to get access to the ADHD Nutrient Testing Masterlist! It’s available in the higher tier at this time ($13/month).

Thanks for reading!

If you have any thoughts, questions, or comments, be sure to shoot me a DM on Instagram @Nutrimindcoach or simply reply to this email. I LOVE hearing from you!

This week on the Nutritional Mental Health Podcast, registered sports dietitian Derek Lipton (some of y’all might know him as @nutrition.with.derek) and I chat about how to use nutrition if you’re an ADHD athlete! We talk a little bit about other mental health connections to sports nutrition in it too. It’s available on podcast platforms + YouTube (yes…I’m finally figuring it out haha. It has captions to help!)