MTHFR and the Genetic Mutation That Could Be Affecting Your Migraine Treatment
MTHFR is the official symbol for a gene called methylenetetrahydrofolate reductase (NAD(P)H). This gene instructs the body to make an enzyme, methylenetetrahydrofolate reductase, which is involved in converting certain B-vitamins into a form the body can use. The body then uses the converted vitamins in a multi-step process that eventually leads to the formulation of proteins and other vital compounds, including the neurotransmitters dopamine, serotonin, and norepinephrine.
A genetic mutation on this gene makes it difficult for a person to metabolize and use the B-vitamin Folate normally, especially the form of Folate most commonly added to foods: Folic Acid. The mutation also has been linked to a number of chronic and acute health conditions (though it is worth noting that not everyone with the mutation will experience any or all of these conditions):
- myocardial infarction,
- venous thrombosis,
- certain cancers,
- congenital defects, especially neural tube defects and congenital heart defects,
- inflammatory bowel disease,
- Crohn’s disease,
- Ulcerative colitis,
- Parkinson’s disease,
- Alzheimer’s disease,
- Bipolar disorder,
- Epilepsy, and
- Migraine with aura.
Estimates vary, but many researchers believe about 50% of the population has some form of this mutation. I’m one of that 50%, though I had no idea the mutation even existed until my current neurologist asked if I had ever been tested for it.
When my results came back positive, several things changed. I started reading up on the mutation and realizing how significant the MTHFR enzyme is to our overall health. I started talking about the mutation with my family members and urging them to get tested. I started taking a very specific supplement that includes large doses of already methylated versions of Folate (5-MTHF) and Vitamin B-12 (methylcobalamin), and I started getting weekly methylcobalamin injections from my neurologist. I also started feeling better.
Though my neurologist warned me that supplementing with methylated versions of Folate and B-12 wouldn’t necessarily have a direct impact on my migraine, it seems to have had exactly that. This could be happening in a number of ways.
First, our bodies use methylated Folate to create the neurotransmitters that many of our migraine preventatives rely on to make us feel better. An antidepressant like amitriptyline, for example, which affects mood and migraine by preventing the reabsorption of serotonin in the brain isn’t going to have a strong effect on us if we aren’t creating enough serotonin in the first place. By giving our bodies the methylated version of the key vitamins we need to make serotonin and other vital compounds, those of us with the mutation are actively treating a very real deficit that is affecting our overall health. (Side note: My anxiety and depression, both of which are correlated with abnormal levels of serotonin and other neurotransmitters AND with the MTHFR mutation, have gotten significantly better since beginning this supplemental treatment.)
It might also be that by taking the supplements I am avoiding a chemical that was a secret trigger for me. Prior to supplementing with the methylated versions of these chemicals, I craved bread, cereal, and other foods fortified with folic acid. This may have been my body’s attempt at getting the Folate it needed for optimum health. Unfortunately, because of the particular version of the MTHFR mutation that I have, I cannot process Folic Acid very well. Attempting to do so may have been setting off a chemical process that triggered my migraines. Now that I’m taking the supplements, my appetite has significantly decreased and my cravings for these foods have all but disappeared completely.
Regardless of the exact mechanism, since beginning the treatment two months ago, I’ve noticed a sharp reduction in both the intensity and the frequency of my migraine attacks. I’ve also noticed that my aura and vertigo – often two of the most debilitating aspects of my illness – have significantly diminished. This improvement also went away (and my migraines returned with a vengeance) when I temporarily stopped the B-12 injections. Taken together, this makes me believe that these supplements are having a direct, preventative effect on my migraine disease. Whether or not this is actually true, I’m going to keep taking them.
If a look at your symptoms or family history makes you suspect you may have a version of the MTHFR mutation, ask your doctor about getting tested. It’s a simple blood test that most labs can preform, and the results don’t take long to come back. Mine was also covered by insurance, as are my B-12 injections (which are now considered medically necessary).
Those of us with migraine are constantly searching for something, anything we can do to feel better. I’ve stumbled, happily, on this. I hope at least some of you find the same relief from it as I have.
How much has your migraine disease changed or evolved over time?