Transcription
MTHFR. We keep hearing about this genetic mutation repetitively. So many people on the internet hawking and pawning supplements to take if you have MTHFR. So I decided to bring the world's leading expert on the topic on the show today. Join me in welcoming Dr. Ben Lynch, the author of the best-selling book "Dirty Jeans."
You unlock this door with the key of compassion. Beyond it is another world—a world of science, a world of common sense, a world of sanity. You're moving into a land of both empathy and ethics, of nutritional knowledge and empowerment. You've just crossed over to Dr. Osborne's Zone. Welcome to Dr. Osborne's Zone! Today we've got Dr. Lynch with us. He's a longtime friend of mine and has influenced me with his great book "Dirty Jeans."
Dr. Lynch, thanks so much for being with us today.
Awesome to be here, and great to see you again, Peter.
What—let's start with your story. What got you into looking at genetic testing, genetic SNPs? What's your background and expertise here?
Yeah, so my undergraduate was cell molecular biology from the University of Washington, which then, through a very roundabout way, got me to Bastyr University and got my degree in naturopathic medicine. I would say that while I was studying at Bastyr, working with patients, despite being in a naturopathic medical school, we were still treating the ICD9 code at that time—now 10 or whatever it is nowadays—versus the patient. In naturopathic medicine, we are taught that you work with the patient, not the condition. If someone walks in with thyroid dysfunction or celiac disease, you don't treat the celiac or the thyroid dysfunction; you support the person because everybody's reason why they got there is different.
I noticed when I was on the environmental medicine shift, people would come in with a plethora of issues. We would test them, find heavy loads of mercury, arsenic, and so on, and we chelated them. We chelated them basically the same; of course, we adjusted dosages of DMSA, EDTA, and DMPS as needed. But I would see people respond very well, and other people not respond at all, and other people would respond very negatively, especially around sulfur compounds. I was wondering, "Is there a co-factor deficiency? Are we pushing so much sulfur, or what's going on here?" The doctors were like, "Ah, I don't really know."
So I just did a quick research on PubMed and found that MUM was a necessary co-factor for sulfation pathways. We started giving patients MUM when they had DMSA reactions, and it really helped them. Then other people were still struggling, and I started thinking, "Okay, phase 2 detoxification is probably slower than phase 1." I was like, "Okay, let's stop pushing phase 1; let's focus more on phase 2."
Then I started thinking, "Well, is there a genetic component to this?" This was back in 2008, you know, when genetics wasn't really a thing. 23andMe wasn't alive back then, and I think Genova had really the only detoxification panel back in the day, and honestly, it wasn't that good.
So I think what got me into genetic testing was working at the individual level, at a deeper level than just biochemical. It's like if you identify someone has a specific genetic variation, then that particular enzyme may not function as fully as someone else who has a typically functioning enzyme. But then you have to take into account co-factors and nutrition and other things as well.
When I started looking at MTHFR, that was the first gene I ever started looking at because someone reached out and said, "Hey, Dr. Lynch, I've struggled with bipolar. What do you have for me?" I started just writing the usual stuff: fish oil, gluten-free, all these things. I was like, "You know, I should revisit the research because I haven't visited in so long." I knew folate was associated with bipolar, but I didn't know how. So I typed in "bipolar folate" in PubMed, National Library of Medicine, and it came back with a research article that said "bipolar" and had this acronym of MTHFR, and it said "folate."
I'm reading the abstract, and I didn't know what the hell MTHFR was. This was like 2009. So I copied and pasted MTHFR back into PubMed, and when the results came back, I was like, "Oh my God! This is significant!" I say that because if you type MTHFR in the National Library of Medicine and just look at the headlines or the research articles, it's associated with basically everything known to man and woman: pregnancy complications, infertility, dementia, cancers of various types, cardiovascular issues, pulmonary issues, mood disorders, and so on.
That was my first take on it, and that led me down a huge rabbit hole, and here I am today. Here we are, how many years later? Still talking about it—15 years?
Yeah.
So you mentioned initially MUM and sulfur with heavy metal detoxification. Can we tackle that in a little bit more detail for the audience and make it make sense for the layman? Because there are plenty of people out there doing metal detoxes, feeling like garbage, wondering why they're struggling. Could you kind of walk us through that and maybe make it simple?
Yeah, so let's just start with detoxification itself. Detoxification is basically the identification of particular compounds that are toxic to your body that you want to remove. Your body has built-in systems in order to remove them. The problem is those systems get overwhelmed, and if they get overwhelmed, then those toxicants build up. As they build up, they start messing up your enzymatic function to the point where you start getting significant symptoms.
That comes to what Peter held up earlier today: the concept of a "dirty gene." A dirty gene is a gene that's not functioning very well. Toxicants play a huge role in that. So you want to detox; you want to remove those toxicants. The best way to detox is actually to not get toxic in the first place. You want air filtration; you want to build a home that doesn't have formaldehyde in the pressboard; you don't want carpets with formaldehyde.
In my office here, I've got real wood, which does leach some formaldehyde, but not nearly as much as pressboard. When individuals detox, they look for supplements or things that they can do. Fasting is all the rage these days, which is great but also potentially dangerous. Sauna is very useful. Then people take various supplements; some people take gallbladder flushes or what have you.
The bottom line with detoxification is there needs to be a right time for it. Women shouldn't be doing it when they're obviously pregnant or breastfeeding. You shouldn't be doing it when you're trying to conceive. You shouldn't be doing it if you are weak or if you're an athlete competing actively. You probably shouldn't be doing it right around your menses because that's depleting. Chinese medicine has a whole theory on that as well, and probably not even theory but actual evidence behind it—thousands of years of evidence.
I also say when you are properly detoxing, you should feel only better; you should never feel worse. Imagine if you go back to that moment where you had to really go number two—badly—and you barely made it. Your pants were barely at your ankles before stuff happened, and afterwards, you felt great. You relieved that, and you felt amazing. That's how detoxification should be. You should feel all kind of balled up, and then if you detox properly, you should feel lighter, you should feel clearer, you should feel happier.
A lot of people, health professionals included, will say, "Oh, I'm going through a detox reaction; I just need to push through it." No! What you are going through is you have mobilized these stored toxicants, typically from fat. If you're trying to detox, oftentimes, especially if you're doing weight loss or some type of metabolic fasting, you will mobilize these toxicants from your stored fat tissues. You can also mobilize them from bone—elderly women especially from osteopenia and osteoporosis.
But let's talk about just coming from the fat. You've moved these toxicants—pesticides, herbicides—from safely being in your fat. Now they're in your blood, and now that blood is circulating to all your organs, including your brain. So now you're poisoning your brain by circulating these toxicants throughout your body versus actually eliminating them through sweat, fecal matter, bile—which also should go through the fecal route—or, you know, breathing is also another route.
This was my specialty. I had the privilege of working with Dr. Bill Ray in Texas at the Environmental Health Center in Dallas before he passed. I studied with him, learned a ton, and I still practice environmental medicine. I don't see patients actively, but I still study it actively because it's by far the number one thing for dirtying our genes. The amount of chemicals that are in our environment is absurd, and it's not very well regulated. It's everywhere—in your food, in schools, in your home, in your car, in your office. They're everywhere.
Well, let's move into MTHFR. The top question, the top concern I get on a regular basis is: should I supplement because I have an MTHFR mutation, or do I need to take folate for the rest of my life? There's a lot of fear around that. There's also a lot of fear around somebody thinking they should do something vastly different because they have an MTHFR mutation than if they didn't have an MTHFR mutation.
As an example, I have a thyroid condition, and I'm MTHFR. I don't know what to do. In other words, the question is, it's like the MTHFR supersedes whatever the condition is. In their mind, they're actually fixing MTHFR as if it's a disease state that changes how they should behave in every aspect of their life or in any diagnosis that they've had. Can you kind of walk us through MTHFR, explain it a little bit, and explain what people should be concerned about and what action steps they can take with MTHFR?
I just want the audience to really understand that arena.
Yeah, I'm trying to think of an example. Just because you have something doesn't mean you have to do it. There is a lot of fear around the topic of MTHFR. Let's just zoom out for a second. MTHFR is one particular gene in your body out of 18,000, and it's an extremely important gene with a very, very important function. Its job is to produce your body's number one form of folate called methyl folate. That's it. That's its job.
Not only is it really its only job, but it also regulates upstream forms of folate too that people don't talk about. It helps conserve upstream folate for red blood cells, platelets, white blood cells, skin repair, hair growth, and all that. So there are benefits to having a slower MTHFR enzyme that people just don't realize, and it's not talked about. I do talk about it in the book.
Let's zoom out even further. If MTHFR is so prevalent and we go by the concept of survival of the fittest, then there must be some evolutionary benefit to having this MTHFR variation. Well, there actually is because people who had malaria and who had the MTHFR genetic variation survived better than those who did not have the MTHFR variation. Again, why is that? Because if you have an MTHFR genetic variation, you're conserving upstream folate to support blood cell synthesis. If you have malaria, your red blood cells, from my understanding, die and they break and they burst. If you have MTHFR, you're conserving the upstream folate to help produce more healthy red blood cells, platelets, white blood cells, and so on, and you live through malaria.
So that is pretty cool. What I'll also say is that we are indeed seeing an increase of the MTHFR genetic variation in the population across, for the most part, all types of ancestries: Japanese, Chinese, Italians, Americans, Caucasians, and so on. I mean, just all the way across. Why would that be? It would be for various reasons. We are increasing in vitro fertilization, we are increasing folic acid in the foods, and we are increasing nutrient density through food and giving pregnant women—and men, not pregnant men—pregnant women, but men prior to conception, giving them healthier forms of folate. This supports the pregnancy of a woman whose baby has the MTHFR genetic variation, who would have probably otherwise aborted and died.
If you looked, there was a research paper that I recently looked at Japanese people. There was a very, very low incidence of MTHFR in the elderly, there's an increased incidence of MTHFR in the middle-aged population, and there's an even significant increase in the younger population. So MTHFR is indeed increasing in the population because of folic acid, IVF, nutrient density, and so on. I'm not saying that we should stop IVF treatments; I'm not saying that we should stop supporting individuals with MTHFR variations who get pregnant. I'm just saying that we are increasing the frequency of MTHFR variations in the population because of these things, and it's super important to be mindful of, especially as a future parent.
If you are struggling to have a baby—and I'll get into this MTHFR thing here in a second—but I want to hit this point. If you're struggling to get pregnant, you're infertile, or your husband's infertile, or what have you, and you work on your fertility, you become fertile, you have a baby, but in order to have that baby, you are on steroids, you're taking heaps amounts of methylfolate and folic acid. Sometimes your doctor prescribes you four to five milligrams of folic acid, which does help babies come to fruition. However, it is the worst form of folate you can use, and there are consequences of that.
When you do succeed in having a baby, you all celebrate. It's like, "Wow! I had multiple miscarriages; I was infertile for so long." Then you're holding this beautiful baby in your hands, and you celebrate, and then you kind of stop thinking about it because now you have a healthy baby. Well, you have a healthy baby that came into the world only because you did so many things and intervened in so many ways to have that baby born into this toxic world. You've only started supporting that baby for nine months. Now they have a lifetime to make sure that most likely genetically inferior baby needs support, and it's partly why we're seeing autism skyrocket.
It's because we're seeing genetically inferior babies being born into the world, and they need more and more support. Again, that is not something that is bad; it's something that we need to be very mindful of as parents and health professionals to make sure that nourishing the mother, the father, and the baby in utero does not stop once it's born.
Going back to the original question of if somebody is diagnosed with MTHFR, it sounds like a disease state. There is—let me actually look this up because it bugs me. I always mess it up. The American College of Medical Genetics and Genomics (ACMG) doesn't like me very much, and they don't like me because they say that—and I'm paraphrasing—they say that I promote misinformation around MTHFR. Their guidelines are if you have been diagnosed—again, diagnosed meaning it's a disease state—with an MTHFR variant, that their statement says it doesn't matter; it's super common, there's no real consequences, just take folic acid and go through your life as normal.
My statement is you are correct in that MTHFR, if you have a genetic variation of it, is not a disease state at all. If you have an MTHFR genetic variation, it does not equal that you have a disease state. Peter, how many genetic variations are associated with celiac? If you have them, you are indeed a celiac patient—just a handful, not very many, right? But if you have any of those genetic variations, are you indeed diagnosed with celiac?
Not at all.
Not at all. You have to have the genes—or not even in all cases—but the genes are predisposition factors. They're not guaranteed outcomes of the development of the illness. There are predispositions that if a person has them and they are exposed to gluten and the right circumstances exist, that will lead to villous atrophy of the small intestine, causing what we would consider to be celiac.
But they're born, as long as they avoid all forms of gluten 110% of the time, despite having those genetic variations of celiac, they're fine.
Correct.
Yes, right. So with MTHFR, if you have a genetic variation, it does not equal that you're going to have any problems. It just shows that you are vulnerable to various things. Just like with the celiac genetic variations, if you have them, you damn well better be gluten-free, and if you're not, there are going to be consequences.
If you have the MTHFR genetic variation, then you should be mindful about laughing gas, nitrous oxide. You shouldn't touch that stuff. You should be mindful about methotrexate. You should talk to your doctor about methotrexate because if you have MTHFR and you're taking methotrexate, it could really, really cause some problems. A lot of doctors will prescribe folic acid if you are taking methotrexate, but it's really pretty stupid because methotrexate blocks an enzyme called dihydrofolate reductase, and that enzyme also is required to process folic acid.
So you're taking an inhibitor of a particular enzyme, and you're giving a nutrient that has to go through that same inhibited enzyme in order to do something very stupid. You can bypass that problem by using folinic acid.
MTHFR, just because you have a genetic variation for the common ones—for the most common genetic variations surrounding MTHFR—they are reducing its functional capacity, meaning its ability to perform and do work for you anywhere from 20% to 70% to 80%. This means that you have a functional MTHFR enzyme from a range of 80% functional to about 20% to 30% function, which means that it's still functioning. It may not be functioning as well as if you did not have an MTHFR variant, but it's still functioning.
If you're in your vehicle and you have a 20% full gas tank, you can still drive and get somewhere, and you're going to have to stop more frequently or within 20% and fill up again. If you know you have an MTHFR genetic variation and your capacity for your MTHFR enzyme is around 20% to 30%—like mine—then I'm mindful that I have a set amount of capacity for my enzyme to perform. So I need to do things that don't overwhelm it or dirty it, meaning I don't consume very much alcohol, hardly at all. I basically don't drink.
I'm mindful about laughing gas. I'm mindful about my kids going to the dentist. We have it on their chart in the contraindications and medical allergies: no nitrous oxide. I share that with the dentist. Years and years ago, when I walked into the dentist's office, I told him I had that charge for my kids. I said, "No laughing gas." He said, "That's interesting." He said, "They're allergic to it." I basically said, "Yes," but then I explained what MTHFR was and how laughing gas is a big issue for those with MTHFR.
There's lots of research behind it, which I shared with him, and then I said the potential consequences if someone gets laughing gas and they're in the chair—especially kids or the elderly population. His nurse turned to him and said, "Oh, that explains so much." She saw all these patients, some of them really struggling post-laughing gas, and a light bulb went on. She was like, "Ah, that makes sense."
MTHFR variations increase your susceptibility to things, but it's still functioning. It is nowhere near the amount of fear that you are internally having about it. That is actually way worse than the variation itself, and the fear that you're having is dirtying the performance of your MTHFR enzyme even more.
While that statement might not be helpful, because when I got my genetic test back in 2011 and I found out that I had an MTHFR genetic variation—a special combination called 677 and 1298, which reduces my MTHFR function by about 70% to 80% or so—I flipped out. Then I realized, "Oh, it's just a functional consequence."
Then I studied MTHFR, and I was like, "Okay, what's it do? It makes an enzyme. What's the enzyme do? The enzyme makes methylfolate. Is methylfolate found somewhere? Yes, it's found in liver and leafy green vegetables." Oh, I can't stand liver, but I eat my leafy greens.
What happens if methylfolate levels are low? Well, there's a backup pathway in your body called choline. If your folate levels are low, then choline steps in and takes over for you. Well, where does choline come from? It comes from eggs and meat. Oh, I chow on eggs and meat; that's good.
How do I know if my MTHFR enzyme is working very well? All you can test is homocysteine. What's that? Oh, it's a simple, very inexpensive lab marker. What should a healthy homocysteine be? Labs say greater than or equal to less than or equal to 15 micromoles per liter is healthy.
Well, not so fast. All-cause mortality research shows that homocysteine levels by itself, if elevated, increase your risk of dying of various different types of things. You really want your homocysteine levels to be between 7 and 8 micromoles per liter. So you can just check your homocysteine levels. If your homocysteine levels are healthy, then your MTHFR enzyme is functioning pretty well.
If you're consuming leafy green vegetables, you're consuming organic, grass-fed beef liver, or chicken livers or what have you, great. If you're eating meats and you're getting choline from meat and eggs, that's great. Now, if you're chowing on meat heavily—let's say you've been reading Paul's book, "The Carnivore Code," and you're watching him on Instagram. Back in the early days, all that guy ate was meat, and now he's adapted; he's changed it.
If you just ate tons of meat, you could become nutrient deficient in other things, and your homocysteine levels could be elevated. There's something called the meat sweats, and the meat sweats are basically increasing your homocysteine. The meat sweats are caused by increases of homocysteine, which is caused by huge amounts of protein.
So those of you who are bodybuilding, trying to increase your lean body mass, or following carnivore or paleo or what have you, and you're just maybe eating two grams of protein per pound of your body weight, you're overdoing it, and you're going to have high homocysteine, especially if you have an MTHFR genetic variation because there are consequences of that.
But the bottom line with the MTHFR enzyme is it's a frayed rope. You should know where the fray is in that rope. You should tend to it, identify where in that rope it is, and be mindful not to be pulling on that certain section and to clean it up. There are many things you can do to clean it up.
I am 50 years old now. I am healthier than I was when I was 18 or 19 years old, and I can say that with utmost confidence because when I was joining the University of Washington rowing team at 18 years old, they took my blood pressure, and my blood pressure was like 150 over 90. They were like, "What the hell? What's wrong with you?" I was like, "I don't know."
I don't know what I did, and they retook my blood pressure, and it became like 140 over 80. I barely made the cutoff, and they didn't cut me from the team, which was great. But rowing is extremely high-end endurance. Endurance sports increase your homocysteine levels dramatically, and I didn't know that at all during that time.
If I had known that, if I had known what I know now as an athlete, I would have been supporting with methylfolate. Those of you who are athletes, if you look at yourself in the mirror when you're done exercising, or somebody looks at you while you're exercising, and you're like, "Oh yeah, that's my beet red face." I just get a bright red face when I exercise, and breathing is a little bit more labored. That could be an MTHFR thing because as you exercise, your homocysteine levels increase, and your MTHFR enzyme is overwhelmed.
If you supplement with methylfolate or methylcobalamin prior to exercise, then that red face will go away. I shared that comment years ago on a Facebook post, and this lady said, "Oh yeah, that's me! I'm going to try that." So she took methylfolate and methyl B12 prior to exercising. Nowadays, she goes, "I don't get a red face anymore."
So MTHFR is a mutation that some people have. It's becoming more and more increasingly common from the last three generations. It's not something we should be scared about; it's just something we should take conservative, preventative steps to make sure that we don't overload it or make it too dirty.
Basically, if you're doing things that lead a typical healthy lifestyle, you're fine. Not many people get exposed to laughing gas, but the older we get, the more likely we are going to get exposed to laughing gas because we're more prone to having surgeries or what have you. If you are elderly and you do have to go through surgery and they say, "Oh yeah, we're going to give you some nitrous oxide or laughing gas," you just say, "No, I'm good."
You're like, "Well, do I need it?" Well, laughing gas's primary function is called anxiolytic; it reduces your anxiety. That's it. There are many different types of things that you can do to reduce your anxiety. You could use homeopathics, you can use herbs, you could use CBD. Obviously, you need to look for things that don't affect your blood thickness prior to surgeries.
But there are many things that you can do. Parents with kids that you don't want—get your kids with autism or even kids without autism having laughing gas—find a dentist who has a TV on the ceiling, and the kids will watch movies while they're getting their teeth worked on.
That's important. If you're elderly and you do get laughing gas, then you need to supplement prior to and immediately after. You use methylfolate and methylcobalamin and some glutathione as well. Those are very, very important compounds to be using pre- and post-laughing gas.
Generally speaking, measure your homocysteine. If your homocysteine levels are good, then you're good. If your homocysteine levels are stubborn and you take methylcobalamin and methylfolate and they go back down and you get them to where they're healthy at 7 to 8 micromoles per liter, great. If you check your homocysteine levels and they are still being stubborn, even though you're supplementing with, say, a milligram of methylfolate and 100 micrograms or so of methylcobalamin, and they're still elevated, they're not budging, then there's an intersection of another gene called MTR, which is called methionine synthase.
MTHFR sends its methylfolate with methylcobalamin, and methionine synthase is called a redox sensor. It will not function in high oxidative stress environments, which is why homocysteine levels increase from exercise. Exercise itself is high oxidative stress. Infections, prolonged infections, high oxidative stress, mental emotional stress can lead to oxidative stress.
Even if you have sufficient B12 and methylfolate levels, and you have oxidative stress, they're not going to work. So you need sufficient glutathione, and glutathione is your body's number one form of antioxidant. It works amazingly well; it basically neutralizes hydrogen peroxide, arsenic, mercury, and so on.
Going back to summarizing kind of what you said: so again, MTHFR, you shouldn't fear it. If you're going to the dentist, you should be aware if you have it; you know, pass on the nitrous oxide or laughing gas. If you're a heavy exerciser, you can elevate your homocysteine and have an increased risk for problems from that elevation in homocysteine.
So it's not a bad idea to either take 5-MTHF, like a methylated folate, or methylcobalamin pre-exercise or even post-exercise to help with that recovery of transient homocysteine elevation. Or if you've been sick with a cold or flu and you've had a high oxidative, you know, cytokine storm type of response from it, you might have a transient elevation in that homocysteine as well.
If you have MTHFR, you're at greater risk for all of these types of things, and so you can use supplementation during those times as a means to support yourself. You can follow up with your doctor periodically and have your homocysteine checked with your annual exams to make sure that it's not becoming problematic over time.
Are there other things that people with MTHFR should be concerned about in terms of risks, behaviors, environmental exposures to things? What else should they be thinking about if they're just trying to take a preventative mindset with that gene marker?
Yeah, another big one is folic acid. Folic acid is the garbage form of folate; it's not found in nature. So let's back up on the word folate for a second. Folate comes from, I think it's a Greek or Latin word, as most words are. It comes from "folium," which means foliage or leaves. That's interesting, and folic acid does not come from leaves; it doesn't come from anywhere. It comes from a lab, and it is not recognized by the human body at all.
I will say that supplements that utilize calcium folinate or, you know, calcium methylfolate or glucosamine methylfolate are also synthesized in a lab, but they are also bioidentical to the human body. They work immediately. Folic acid does not work immediately in the human body; it actually leads to what's called unmetabolized folic acid, which can actually lead to the blocking of your natural forms of folate from working.
So what do I mean by that? If you are consuming more than 200 micrograms of folic acid, that folic acid has to go through the enzyme called dihydrofolate reductase in order to be turned into a recognizable form of folate by your body. If you're consuming—and it can do that at 200 micrograms, at more than 200 micrograms—so women who are taking four to five milligrams of folic acid are definitely saturating their DHFR enzyme, and now they're having what's labeled as unmetabolized folic acid, meaning it's not broken down into usable forms.
What happens is that folic acid binds to folate transport proteins. Your body actually will literally carry folate through your blood, and then it will deliver it to a folate receptor. There, at the folate receptor, an action will take place. Just because you consume a supplement does not mean it's going to perform a particular function. It actually has to be transported. Oftentimes, well, first it has to be absorbed, then it has to be transported, then it has to be bound to a receptor—most commonly, not always, but commonly.
Unless those three things happen, there's no physiological effect. What happens in people who take a lot of folic acid is they could have lots of methylfolate in their blood, but it's actually not being utilized because the folic acid is blocking the transport proteins. The folic acid is blocking the receptors, and there's not a lot of research on this, but there are research papers on breastfeeding mothers. It's also a big deal because what happens is if a woman is taking folic acid and she's breastfeeding her baby, the baby is getting the folate through the milk, but the baby's getting folic acid through the milk, which is then clogging up the baby's folate receptors and folate transport proteins, which is then leading to the baby's functional folate deficiency.
So a functional folate deficiency means that there is sufficient folate in the body, but it is not functioning; it's not performing its job. There's a condition out there called cerebral folate deficiency. It's actually a condition, and this is very interesting to me. If you are diagnosed with cerebral folate deficiency, what do you think is contraindicated?
Folic acid.
Yeah, folic acid. It's clearly stated if you are struggling with cerebral folate deficiency, folic acid is contraindicated. You must use folinic acid or methylfolate. I'm thinking, "Are you kidding me? Of course that makes sense!" How many people are struggling from an undiagnosed degree of cerebral folate deficiency?
Now, you could be crazy fully deficient in your brain and really struggling, but a lot of us are on the spectrum. I swear I'm somewhere on the autistic spectrum personally. With autism, there's a spectrum. There are people that are high-functioning autistic, and there are people that are not functioning very well at all with autism. There are people walking around on this planet that have some degree of cerebral folate deficiency—someone on that spectrum.
If they are supplementing with folic acid—or even if they're not supplementing with folic acid, but they're eating heavy amounts of processed foods or processed drinks or enriched foods—then they're getting it. I actually want to say, Peter, that I think part of the reason why this carnivore movement is becoming so popular—and I commend Paul for this big time and everyone else around it, Shae Baker and so on—is because they are avoiding folic acid to such a huge degree. They're avoiding processed foods to such a huge degree. They're eating actually whole foods, nutritious foods, and that is why they feel so much better.
I think that's great. For more specific details, there are some more nuances with MTHFR that I cover in the book "Dirty Jeans." Another big one is vitamin B2. Riboflavin is actually a commonly deficient nutrient, surprisingly—probably because it's in such high demand by the body. It's used for glutathione recycling; it's used for clearing out neurotransmitters in your brain; it's used for breaking down histamine. It's used for countless different things, and if you are deficient in riboflavin, your MTHFR enzyme does not function.
Now, let's pause on that for a second. What did I just say? If you are deficient in riboflavin, your MTHFR enzyme does not function. I didn't say that if you have a deficiency in riboflavin and you have the MTHFR variant, it doesn't function. You can have no variation at all in your MTHFR gene, and it can not be functioning because you have a riboflavin deficiency.
That's the concept of a dirty gene. You can be born with an MTHFR genetic variation, which is a dirty MTHFR enzyme because it's already reduced in function, and then you can enhance that potential vulnerability—I didn't say problem, vulnerability—by being deficient in riboflavin, by consuming folic acid, by being exposed to methotrexate and laughing gas, and drinking alcohol, and so on.
Some of the sickest people that I've met, Peter, are those people I've done genetic testing on. They don't have MTHFR genetic variations. In fact, most of the genes that I've looked at didn't have any genetic variations at all. It's just when I asked them about what they were exposed to or what was going on in their life—mold is a big one; their diet was a huge one; there were some significant stressors in their family.
Some of the recommendations I've made were, "I think you need to divorce your partner. I think you need to move from the city to the country." I think you need to move from this polluted zip code in your area to an area that has better air. You can have a dysfunctional MTHFR enzyme regardless of whether you have an MTHFR genetic variation or not, and that is a very, very important point for a multitude of reasons.
Let's say you do genetic testing; you swear you've got the MTHFR variation. You have a high homocysteine; you've been struggling; you have recurrent miscarriages your whole life; you've been struggling with mood disorders and so on. You get that red face after exercise, and you're like, "I'm going to do this genetic test," and it comes back, "No variation found." You're like, "What the hell? I swore I had the MTHFR variation."
Then you go to a doctor who runs organic acid testing, and they're like, "Oh, well, yeah, you're deficient in riboflavin. Oh, and by the way, you're hypothyroid, and it's pretty significant. So we're going to support your thyroid." You've been probably struggling with hypothyroidism for a long period of time because your hair's been coming out, and you're tired, and dry skin, and all these different things were happening throughout your life.
You finally had that supported properly, and you went gluten-free, and now you're feeling great again, and now you're good, and you get pregnant, and you have a beautiful baby. That is a perfect example of why MTHFR should not be the focus because you can dirty your MTHFR enzyme just as easily—not just as easy, but quite easily—regardless of whether you have a genetic variation or not.
Very, very well put. So I think maybe if I paraphrase the takeaway there, it's whether or not you have an MTHFR mutation, you can still put your MTHFR at risk with the wrong behaviors, the wrong environment, the right amount of malnutrition or lack of nutrients—using vitamin B2 in that case as the example, riboflavin.
Exactly.
Yeah. And let's give an example to that. You've got a four-wheel drive vehicle or all-wheel drive vehicle, and you drive it across the mountains. There's a sign that says "Chains required." You know, it's like you don't have chains; you can maybe make it over the pass; you may not. Another person has four-wheel drive, and they have chains, and they make it over the pass.
But if you're driving over the pass and you're like, "Oh, I got four-wheel drive, and I've got chains, and now I'm just going to mob because I feel like I can," and you see them pass you, and you drive another 10 minutes, and you see them flipped over in the ditch, right? Just because you have the right equipment—meaning a healthy MTHFR enzyme, you know, or functional—well, you have no MTHFR variation, does not mean that you can go through life dirtying it up.
Just because you've inherited an MTHFR genetic variation from your mom or your dad or both does not mean that you're screwed up. It means that you are more vulnerable to slipping on the ice. You better drive more carefully; that's it. It's really that simple. To me, it's a blessing that if you've had genetic testing and you've identified an MTHFR genetic variation, you should be smiling because now you know that you have to drive more carefully.
You are in the driver's seat for your body. You are in the driver's seat for what you put in your mouth. You are the driver; you see what you're exposed to, and you say, "Oh, my doctor told me to do that." You're in charge of your doctor. Your doctor is an employee of yours; you are paying them; they are not paying you.
So if you are not happy with your doctor, you fire them. "I don't like any doctor in my area." Well, then you go online and look for a health professional. You read more books; you listen to more podcasts; you go on YouTube. The people who ridicule those who become "Dr. Google"—first of all, shame on you—because a lot of those people who are put in that position to become "Dr. Google" is because they are not getting what they need from the health professional's office. They're not being listened to; they're not being helped; they're not achieving whatever they're trying to achieve.
So they're putting it into their own hands to actually become better, and I salute those people. You are driven; you're trying to find out what's wrong with you or your family members. Kudos! Now, you might be doing it incorrectly in Facebook groups, but you're making an effort.
I don't like it when health professionals joke that, "Oh yeah, I had a Dr. Google come in my clinic today." They could be frustrating to work with sometimes because they might be giving you information that is, you know, not quite accurate. What's happening with Peter is a perfect example. "Dr. Osborne, I've got MTHFR. What do I do with that now?"
They're going all over the internet hearing it, and they're hearing it on podcasts and so on. I've been talking about this thing since 2011, and I honestly thought I was done. Here we are. When I wrote my book in 2018, I was like, "Okay, now I don't have to talk about it anymore." But no, we're back.
I'm glad that it's increased in awareness. I just wish it was increased in awareness from a positive, empowering standpoint than a fear-based one; that's all.
Yeah, couldn't agree more. Let me ask you a follow-up question to a lot of what you've said today, and one of them has to do with taking folic acid. What is your opinion, or what has your research shown you, as to why in the heck we're fortifying everything with folic acid instead of methylfolate? Is somebody making money? Is there a patent on that synthetic version that is just enriching certain people? Why would we put something as a staple in the food supply under the guise of health when, in actuality, a huge chunk of our population can't really even properly metabolize that form of folate?
That's a very good question. The short answer is, I don't know. Your question of, "Is someone making money off of it?" That's a very good question. You know, you look at sucralose, Splenda—that was a Dick Cheney thing during the Reagan era. There's a documentary called "Sweet Misery" on sucralose. Very interesting.
Splenda is gnarly. What they'll defend is they will say that folic acid has a very high absorption rate. What did I say earlier? There are multiple factors at play. Absorption is just one of them; transport and binding is another. I also said that you can have a functional folate deficiency. Unmetabolized folic acid is not functional.
All they do is they look at absorption and they say, "Folic acid is well absorbed; therefore, we've done our job." And they're wrong. Are they afraid of massive class action lawsuits? I don't know. Stability—folic acid is very stable. Methylfolate is not very stable at all, which is why at Seeking Health, we don't offer liquid methylfolate anymore. We used to, and then we did stability testing on it, and it just wasn't stable, so we stopped selling it.
I don't know. It's very frustrating. It's very frustrating when you know ACMG, the American Council of Medical Genetics, says that, "Oh, even if you have MTHFR, you can take folic acid." They're just wrong.
We used to get around by foot, then we used to get around by horse-drawn wagons, then we got around by bicycles, and then there were some old cars, and then there were airplanes, and now there are jets. Just because you used to get around by one form of transportation doesn't mean that you have to continue using it.
I equate folic acid as horse and buggy. It had utility back in the day when they discovered that people who were eating processed grains early in the industrialized revolution—when they were wanting to make a lot of bread and have it shelf-stable—they stripped all the bran and all the nutrients out of the flour, and then all the nutrients were gone with it. They started seeing a massive increase in infertility, pregnancy problems, and spina bifida, and they were like, "Oh crap! We can't do that anymore."
What they should have done is said, "You know what? We're just going to have to make fresh bread. Sorry, people, we can't have it sitting on the shelf for months." But no, what they did is, "Well, let's go to the lab and make a compound, and we'll call it folic acid, and we'll process it, and then we'll stick it in the flour, and then we'll tell everybody to swallow that too instead of eating the whole grain."
Bizarre thinking. What they're also working on is folic acid-enriched corn because the Hispanic population does not eat wheat. The Hispanic population has a pretty high prevalence of MTHFR, and they also have a high prevalence of living in pretty toxic areas. Farmland communities are very toxic, and you find a lot of Hispanics living in these communities, and they're exposed to lots of pesticides, lots of herbicides, and lots of nitrates in the soils and water, and their foods. These cause all sorts of problems, and so they are more likely to have problems with spina bifida and so on.
So their solution is, "Well, they're exposed to all these things; they need more folic acid." Instead of saying, "Well, let's stop using all these chemicals and artificial fertilizers increasing nitrates in the water supply," no, they just enrich corn.
I would love them to at least switch to folinic acid. Folinic acid is more stable than methylfolate is. What I did not say is methylfolate comprises 80% of the type of folate in your body—in your blood, at least it should. So in summary, methylfolate should account for 80% or more of the circulating type of folate in your blood.
Folic acid, if you are consuming folic acid, it has to be transformed through like five different genetic genes or enzymes in order to become methylfolate. In every one of those steps, in every one of those five genes, there are genetic variations that are present. MTHFR is the main one talked about; it's very common. It definitely has a very significant functional change, and so that's the one most talked about.
There's also MTHFD1. MTHFD1 is a very significant genetic variation as well that reduces its functional capacity by 70%. Why isn't that one talked about? I don't know. That leads to fatty liver, gallbladder dysfunction, cholestasis of pregnancy, and all sorts of problems.
And that's before you even get to MTHFR. When people say, "I have MTHFR, and therefore I can't take folic acid," that's an incorrect statement. It should be, "I am human; therefore, I can't take folic acid." The reason why I say that is because when they were doing the research way back in the day—in the 70s or 80s—on folic acid, what did they use? They used mice. Mice are the quintessential research animal utilized because it has similarities, I guess, with human biochemistry and so on.
But they found that mice turned out that they could take the folic acid, and it turned the folic acid into methylfolate—no problem. No issues with the mouse. The mouse's dihydrofolate reductase enzyme (DHFR) is very fast-acting—no problems. The human DHFR enzyme is 700 times slower than that of the rat or the mouse—700 times.
So they did all this research on mice: folic acid becomes methylfolate—no problem. Now let's introduce it to humans. Oh, wait a minute! The DHFR enzyme is 700 times slower in humans. Ah, it still works. They say, "But it works for 200 micrograms only at a time." Well, that's fine; it'll just sit there, and it'll eventually become more active forms of folate.
Well, yeah, it sits there and blocks your transport proteins and your receptors, thereby leaving us all with cerebral folate deficiency.
I know just in rheumatology alone that when they put people on— you mentioned methotrexate earlier—it's the milligram dosage, not the microgram dosage daily, as an antidote to the poison of methotrexate.
That's right. And they're using multi-milligram doses of folic acid when I bet you could use 400 micrograms of folinic acid to get probably the same effect without having any folate binding protein or receptor blockages from the unmetabolized folic acid.
Well, I could speak from experience. We use 800 micrograms of methylfolate and monitor those patients, and they do fantastically well without having to take folic acid.
Yeah, for sure. One thing I will say—this is an interesting point. I used to do a lot of conferences for health professionals, and I stopped doing that. But when I was at a conference years ago, I convinced health professionals not to use folic acid and to use methylfolate and guided them on when to use which form of folate when.
This doctor shot me an email, and they were like, "Hey, Ben, I got this patient going through chemo, and they're on methotrexate as well. Their platelets are rock bottom, and their hair is falling out. I think they were post-chemo and maybe cancer-free now at this point. I don't remember the exact context, but she goes, 'I've been giving methylfolate because I know not to use folic acid, but the platelets aren't going up, and the hair isn't regrowing.'"
I was like, "Well, most likely the chemo caused a lot of oxidative stress, so the methionine synthase enzyme is probably inhibited. The methylfolate has to be converted to tetrahydrofolate and then get back to folinic acid for the hair growth and the platelets. If that's not happening, then apparently it's not because they're still not performing well. Your patient's not doing well; they're still low platelets, and their hair is still not growing."
So switch to folinic acid. That way, you don't need to go through the methionine synthase enzymes. She goes, "Oh, okay." A couple of months later, she followed up and said, "Oh yeah, it worked! Thank you!" I was like, "Phew!"
That said, if your patients are doing well with methylfolate, great. If they're not, back up the folate pathway and use folinic acid, or you could use a combination of folinic and methylfolate. I enjoy using a combination in our prenatals and our multivitamins for the most part. The only time I do not use methylfolate at all is when some people are very sensitive to methylfolate, and they don't do well with it.
There's a theory out there from Joe Cohen of Self Decode. He feels that if some people are very sensitive to methylfolate, they are low in serotonin. I was like, "That's an interesting concept." He walked me through the biochemistry of it and physiology, and I forget how it worked, but it kind of made sense.
I haven't really tried it. I've been wanting to take heaps of methylfolate and make myself have a side effect and at the same time take some serotonin-supportive supplements to see if I can pull myself out, and I haven't been brave enough to do it because I don't like the side effects.
On that same note, I've seen people that I have seen that don't do well with methylfolate or methylcobalamin either are the ones that are being exposed to high levels of mold.
Yeah, I theorize that just the elevation in methylation and detoxification just helps to mobilize their fat-stored mycotoxins into their circulation and just makes them not feel very well. We always, when we have somebody in mold, try to be careful about any kind of high-dose methylation.
That's true, isn't it? It's been a while since I've looked at phase one and phase two, but I believe B12 and folate are both phase one, aren't they?
MTHFR, yeah.
Yeah, interesting. Methylfolate—that stuff is like jet fuel. It's amazing.
Well, this has been a great conversation. I really appreciate you coming on and sharing your experience and expertise with us. Those looking to learn more, where can we send them?
I think the best way to go is you can go to your local library and snag a copy of "Dirty Jeans." A lot of libraries have it, or you can go to Amazon. I think it's even like $10 or something on Amazon right now. I think the best place to start is the book itself. It's a very empowering book. My agent and publisher—I don't know if I told you this, Peter—but they wanted me to call it "Seven Deadly Genes." I was like, "No, I'm not doing that." They're not deadly.
We came up with "Dirty Jeans," and that was a game-winning title. I was very happy with that; still am. It's not a scary book; it's a very empowering book, and I think that's the best place to start. You can find me on Instagram, but honestly, I'm less on social media than I used to be for various reasons. I'm trying to post more on YouTube, and then we have a membership program at Seeking Health now where I am doing webinars and live Q&As once a month.
You can go to seekinghealth.com and type in "membership," and that way you get hundreds of hours of courses from me from the past or just whatever concept that you're interested in. If I do a live webinar and it resonates with you, then you can access it. So that's where people can find me.
Fantastic! Well, thanks again. I appreciate you being on. It was good to talk with you today.
Likewise!
Thanks for tuning in to the Dr. Osborne Zone. Don't forget to share, like, and subscribe for more content like this, and make sure you come back next Tuesday at 6:00 p.m. Central Standard Time and Thursday at 7:30 for more episodes.