MTHFR, Hashimoto's And Nutrients Genetic Effects on Nutrient Extraction

Some individuals with Hashimoto’s may have a gene variation that prevents them from properly activating folic acid. This gene variation is present in up to 55% of the European populations, and some have been saying that this variation seems to be more common in those with hypothyroidism.

The gene involved is the MTHFR (Methylenetetrahydrofolate Reductase) gene, and genetic testing is available to show if someone has this gene variation. The MTHFR gene codes for the MTHFR enzyme, the enzyme that converts the amino acid homocysteine to methionine, a building block for proteins.

Individuals with low activity of the MTHFR enzyme may present with elevated homocysteine levels, which have been associated with inflammation and heart disease, birth defects, difficult pregnancies, and potentially an impaired ability to detoxify.  

Nutrient deficiencies in Folate, B6 and B12 have been associated with elevated homocysteine.

Individuals with the MTHFR gene actually have a difficult time processing folic acid that is present in most cheap supplements and added to processed foods. Some professionals claim that this type of folic acid may even cause a build-up in the body leading to toxicity. Studies have been done that showed folic acid supplements increased cancer risk… one more reason to ditch processed foods and your multivitamin!

Folate is present in the activated form in real foods such as asparagus, spinach and beef liver. B6 and B12 are mostly found in meats.

Betaine, (sometimes known as trimethylglycine), also helps with metabolizing homocysteine. This is known as the alternate pathway for homocysteine metabolism. Betaine can be found in whole grains like quinoa (which some individuals may not be able to eat), beets and spinach.

In addition to lifestyle changes, individuals with the MTHFR gene variation and high homocysteine levels may benefit from an activated version of folate, B6 and B12 , such as methylfolate (also known as L-5-MTHF Folate), Pyridoxyl-5-Phosphate (P5P), and methylcobalamin, respectively. This is because we may not be able to get enough of the needed nutrients from food alone. 

Pure Encapsulations makes a supplement called Homocysteine Factors that contains all of the above-mentioned ingredients and may be helpful with reducing homocysteine levels.

Testing for homocysteine and the MTHFR gene variation is available through many labs. offers a test for the MTHFR gene and many individuals can get the tests from their physicians covered by insurance.

However, some may be concerned with this genetic information getting reported on insurance or to employers. A MTHFR variation or elevated homocysteine levels can potentially interfere with future insurance coverage that limits pre-existing conditions.

Patients can order their own confidential tests that will not be reported to insurance by using online lab testing services, like Ulta Labs for Homocysteine or Ulta Labs MTHFR gene variation test.

Many of the lifestyle interventions helpful for Hashimoto’s are also helpful for the MTHFR variation. Additional information about lifestyle interventions for Hashimoto’s can be found in my book, Hashimoto's: The Root Cause.

Does everyone with Hashimoto's have this variation, and does it make Hashimoto's worse? 

Please note, not everyone with Hashimoto's has this variation. A recent study by Arakawa and colleagues of thyroid patients with Hashimoto's and Graves found that polymorphisms were as common in autoimmune thyroid disease as they were in the normal population. 

Additionally, the authors concluded that the disease severity did not correlate with whether one had this gene variation or not. 

Direct quote from the study: 

Genotype and allele frequencies of the MTHFR +677C/T and +1298A/C polymorphisms showed no significant differences between healthy controls and patients with AITD; these genotype and allele frequencies did not influence prognosis of AITD.

I wish you all the best in your healing journey!

Your Thyroid Pharmacist,
Dr. Izabella Wentz, Pharm D.

PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free. You will also receive occasional updates about new research, resources, giveaways and helpful information.  

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  1. Dell'edera, Domenico (08/2013). "Effect of multivitamins on plasma homocysteine in patients with the 5,10 methylenetetrahydrofolate reductase C677T homozygous state". Molecular medicine reports (1791-2997), 8 (2),  609.
  2. McNulty, Helene (10/2012). "Nutrition throughout life: folate". International journal for vitamin and nutrition research (0300-9831), 82 (5),  348.
  3. accessed 6/1/2013
  4. Zappacosta, Bruno, et. al. "Homocysteine lowering by folate-rich diet or pharmacological supplementations in subjects with moderate hyperhomocysteinemia". Nutrients (2072-6643), 5 (5),  1531.
  5. Prinz-Langenohl, R.; Brämswig, S.; Tobolski, O.; Smulders, Y.M.; Smith, D.E.C.; Finglas, P.M.; Pietrzik, K. [6S]-5-methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wildtype  677C→T  polymorphism  of  methylenetetrahydrofolate reductase. Br. J. Pharmacol. 2009, 158, 2014–2021
  6. Prinz-Langenohl, R [6S]-5-methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wild-type 677C-->T polymorphism of methylenetetrahydrofolate reductase. British journal of pharmacology (0007-1188), 158 (8),  2014.
  7.  accessed 6/3/13
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  11. Walsh, Nancy Folic acid caner debate continues, accessed 6/3/13 at
  12. accessed 6/3/13
  13. Arakawa, Y. Association of polymorphisms in DNMT1, DNMT3A, DNMT3B, MTHFR and MTRR genes with global DNA methylation levels and prognosis of autoimmune thyroid disease. Clinical and Experimental Immunology, 170: 194–201   


Archived Comments

Excellent article!! Thank you for all of your work.
Google Dr Neil Rawlins Also, look at this website
Thank you for the important information about Hashimotos!
I am the youngest of 10 and at least 5 of us, plus my mother and grandmother have/had thyroid problems. Is this strong family history indicative of a probable genetic problem?
Hi Gail, According to new research, there are three things that need to be in place for autoimmune conditions like Hashimoto's 1) Genetic susceptibility 2) Triggers 3) Intestinal permeability Everyone with Hashimoto's has the gene for it, but it's our environment that decides how the genes are expressed.
Hi- Thank you for shedding light on Hashimoto's and MTHFR gene variants. I'm a psychologist and am concerned about the prevalence of mental health issues and MTHFR. Nice job here!
Thank you Jennifer!
please let mw know where I can find a psychologist that knows about this near Illinois.
Hi, I had the testing done through 23andme. I would suggest doing it that way as it tests way more snps and is only $99. I am hetero for A1298C and have Hashimotos. They linked more snps to Hashimotos than just MTHFR. 23andme connects PTPN22 gene to Hashimotos (and Diabetes 1 and RA) marker rs2476601. Honestly I think my trigger may have been getting a bunch of amalgams out with no protection, or the Hep B series. I will never be able to know the exact trigger.
Thank you for sharing Renita! Amalgams should be banned! I think my Hep B series was also one of the triggers for me.
I thought 23 and me was no longer able to do that type of testing?
You're right! Just updated the info! I hope they'll start offering this type of testing again.
I'm a psychologist. I'm still referring friends to 23 and me via my website (above) for genetic testing because raw data results are still available. I've found a place that will interpret the raw data for $5 here: I received a 7-page report from them that was helpful.
I did and you still get the raw data... just 23 and me will not interpret the data anymore. But in addition to Jennifer Thomas's reference of a website that will interpret there is also and the sterling app will translate the .txt file raw data for $20. I'm taking my info to a genetics dr and they said the raw data .txt file will give them info they need
My son has a MTHFR mutation, Heterozygous C677T. I have not been tested but am sub clinical hypo and my ultrasound shows heterogeneous echotexture and my TPO antibodies are raised. So based on above, with the folic acid processing, does this mean it correlates to gut problems and could be a potential trigger? So it would be wise for me to be tested?
I am interested in learning about MTHFR gene mutation and fertility issues and whether/how they are dealt with if one wants to get pregnant
Thank you so much for all your information! I just found out my teenage daughter is homozygous for MTHFR C677T and has TSH within range (2.77) but high on freeT4, Reverse T3 and 117 TPO. She has had lifelong neurological, anemia, muscle, metal and gut issues that we have been addressing. If we are able to treat the MTHFR gene now, is it possible the thyroid will normalize before it crashes completely and she can avoid lifelong thyroid meds? We are also trying to rule out Lyme and co-infections but the only lab we were referred to was IGen-X which is very expensive so wondered if there were other options.
Thank you for sharing. It just confirms that all my drs are frustrating as now after being on thyroid meds for a year my labs are what they like to call normal but i'm still feeling awful even after giving up soy and dairy. Already gluten free as i have celiacs. I found out that i have the MTHFR mutation +/+ for C677t & +/- for A1298C and visiting a genetics dr next week... hopefully they can be helpful with this now coming full circle.
any idea if my genes would actually be the same as my identical twin? she has been tested and i can't remember her results, but she does take some treatments for this and has fertility issues.
Thank you for all the info you have already provided. I have a question about Natural Chelotion drops. I got a small bottle from my chiropractor, it was supposed to help remove heavy metals after the immunization. Do you know if this can help? I was diagnosed w/Hashimoto about 20 years ago. I am not getting ANY help from my doctors and I am developing more autoimmune problems. Where do I start? Does anyone know a good, open-minded doctor in Pittsburgh, PA area?
I just got my lab work back and was wondering what it meant. Good timing :) I'm positive for A1298c high cortisol, A-tg 366.10 & A TPO 273.10 and low D. This is all so confusing to me. Thanks for posting this information.
You truly are our Thyroid Polish Angel! Thank you for all of your information and guidance!

Could a shingles vax set off thyroid malfunction? Im 64 , had vax 2 years ago. Having problems , tried synthroid, levothhyoxine, double dose, now doctor has me taking Armour. Gaining weight, itchy bumps on legs, top of feet, cant stay asleep.

I am also a psychologist and I am trying to spread the word about MTHFR and mental health issues and problems. Please check out Dr. Ben Lynch's websites. He is brilliant! Mos conventional doctors are still unaware of the consequences of this genetic polymorphism. They do not know how to test for it. Thank you Isabella!

I was recently diagnosed as Heterozygous MTHFR, discovered a blood clotting disorder during high-risk & complicated pregnancy. I have struggled with many hypothyroidism symptoms for several years, but no physician took me seriously when tests kept coming back "within normal range". I am still having major issues and medicating the thyroid doesn't seem to be alleviating much. I'm seeing a psychiatrist who has tested & adjusted many times over, trying to find what works for me. I want to find out mode info from Ben Lynch's sight and take it to my dr. bcuz he is willing to listen to me. Apparently, i need to get the above mentioned book, as well. I feel like there is hope, after all. I have felt so alone in that I dont k ow of anyone elae who has the problems that I have, which are debilitating at times. Maybe there is a ligbt at the wnd of my tunnel after all. Crossing my fingers!

They still do the testing, just not the interpretations.

23andme is still available if you can get a DNA relative to share there genomes with you, that have been grandfathered in before the cut off. I share mine with my DNA relatives, also found 1, 2, 3,4, and 5th cousins.

Hi there! I am also from the PGH area :) and was wondering if you have found a doctor yet who is knowledgeable in MTHFR yet?

Hi Amanda, I have a great doctor in Hudson, Ohio who knows all about MTHFR. Her name is Dr. Shelley Bluett and Dr. Ben Lynch has a listing of doctors who have taken his training, as I think Dr. Amy Yasko does as well. Hope this helps! Best in health!

My family has had success with a Dr. Aldino Pierotti MD in Pittsburgh Pa

My family has had success with a Dr Aldino Pierotti in Pittsburgh, Pa

Thank you for such interesting and useful information! What are the physical symptoms of having the MTHFR gene? I will be getting copies of the information you share to my next endo appointment.

Thank you for your most helpful book and your continuous participation in the forums on Facebook. I have just received results of MTHFR testing. I have 2 positive copies of the A1298C, my homocysteine is 7.3, and TPO is 159. Is the mutation the root cause of Hashimoto's/hypothyroid?

this is so me as I have such a difficult time gaining and keeping muscle mass, though I eat good proteins and a balanced diet. I was told just a few years ago by a chiropractor that I obviously have an issue with protein due to my spinal issues. it got me researching and now this is just another confirmation. since adding some supplements and upping my digestive enzyme intake I am getting more energy from my foods and beginning to grow some hair and my nails are a bit more sturdy. I hope to begin to see improvement on skin and underlying tissue as collagen is almost non existent.

My daughter is unable to take B vitamins or L5MTHF as they give her migraines. What would be the reason? Her Dr. does not understand it.

Lynn, I read recently that migraines indicate low magnesium. You may want to research that. My son gets migraine auras without the pain and it goes away as soon as he takes Mg.

What have you found about the relation of histamine resistance to MTHFR / Hashimotoes?

I am homozygous for MTHFR C766t and have Hashimoto's. Thanks for information on how to get your homocysteine down. I have been asking doctors for YEARS and taking supplements with two of those ingredients but not much of B6. I have your book and it is still the best one. Do you know a doctor in Los Angeles who can knowledgeably treat MTHFR? Thanks

My folic acid is 0. I had a baby with spina bifida. I am now 58 and my folic acid level is still 0. I have Hashimoto. I was diagnosed about 12 years ago but always ran borderline values low. I think even back then i had hypothyoidism. I take supplemental folic acid but does not bring my level up.

Billie, do some reading about MTHFR. People with that mutation do not use folic acid and should not eat enriched foods. Instead of folic acid, which is stable and cheap, you may benefit from methylfolate which is the usable form and available from leafy green veggies.

I love Homocysteine Factors but big bummer in that it requires refrigeration, so I can't travel with them or carry them out for the day to take with meals. Happily, Thorne makes an equivalent called Methyl Guard - and also Methyl Guard Plus, which also adds riboflavin. These have been lifesavers for me. @Billie, if you have spinal bifida, you have MTHFR and should probably check B12 levels, avoid folic acid and take methylfolate instead.