Diet/Supplement Where to start¶
General Diet & Supplement Recommendations¶
Genetic polymorphisms that affect mineral and vitamin requirements are extremely common in Dr. Powers patients. The information here can help to give a solid start for improving what we may fail to meet with diet, tailored around those with these common methylation polymorphisms - like MTHFR, MTRR, MTR, COMT, MAO, and so on.
Disclaimer: Always discuss changes to your diet or supplement regimen with your doctor, this is not intended to be a substitute for medical advice.
Step 1: Fixing Mineral Deficiencies¶
Start with the foundation of making sure you are getting enough of all the macrominerals in your diet, i.e. calcium, potassium, magnesium, sodium, etc. Meeting the RDA of these to start is a good first target.
https://ods.od.nih.gov/HealthInformation/nutrientrecommendations.aspx#dri
If you are unable to meet these RDAs through diet, supplementing these is an easier first step. Many with these genetic polymorphisms can have an increased daily requirement of certain vitamins and minerals. For example, those with MTHFR gene polymorphisms have a higher dietary folate requirement:
"homozygous individuals with the TT genotype (resulting from the 677C>T polymorphism) have 20% lower folate levels compared to individuals without the polymorphism, despite having the same folate intake"
https://pmc.ncbi.nlm.nih.gov/articles/PMC12027316/
Also, as deficiencies in potassium and magnesium are common and both are important cofactors for the other following minerals and vitamins. For example, even with a healthy diet, many are still deficient in several of these, such as magnesium:
"Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less."
https://pmc.ncbi.nlm.nih.gov/articles/PMC5105038/
Or for potassium where ~98% aren't meeting the RDA: "Overall, \<2% of US adults and ~5% of US men consumed ≥4700 mg K/d (ie, met recommendations for potassium)."
https://pmc.ncbi.nlm.nih.gov/articles/PMC3417219/
Step 2: Adding A Multivitamin¶
Once the above macrominerals are corrected, then moving onto supplementing the rest of the vitamins and minerals your body needs is the next step. There are two strategies, the first is trying a methylated multivitamin, such as the ones listed below to see if any of these work for you. If you find these don't help, or you react negatively, see the section directly below titled "Step 3 - Troubleshooting." The multivitamins listed below are ones with methylated forms of all the B vitamins, which those with MTHFR, COMT, MTRR polymorphisms will most often do better on.
Pure Thera Methylmulti Without Iron
Seeking Health Methyl Multi
Thorne Basic Nutrients 2/Day
MethylLife Methylated Multi
Step 3: Troubleshooting¶
If you reacted poorly to the above multivitamins, and if you are sure you're getting enough of the macrominerals above, the most likely culprit is one of the B-vitamins. Some of these combinations of genetic polymorphisms can create more unique requirements for the B vitamins in different amounts and type. If this is the case, start with a multi that leaves out the components some may be more sensitive to like Folate and B12. Something like this:
Seeking Health Multivitamin One Sensitive
From there add in individual types and amounts of the Bs the multi lacks (Folate and B12) until you find a combination that works for you. For example, someone who is -/- COMT and +/- VDR Taq might not tolerate the methylcobalamin form of B12 that is common in the multis in the section above and instead will react better to the hydroxocobalamin form of B12.
For info on what B12 may work better for you: https://www.balancingbrainchemistry.co.uk/peter-smith/148/How-to-Choose-the-Right-type-of-B12-for-the-MTHFR-Gene-Mutation.html
If Methylcobalamin is poorly tolerated: try Hydroxocobalamin and/or Adenosylcobalamin.
If Methylfolate is poorly tolerated: try folinic acid.
Repeat and experiment until you find a stack and dosage that works well for you. For example, some find they need large amounts of methylfolate (15mg+) and some find they can barely tolerate the RDA's worth. Avoid changing everything at once. Avoid starting with high dosages of any of these. Start low, and titrate up with each until you find what works for you.
Step 4: Other supplements that may help support methylation:¶
All of the additional supplements below are a part of or support the methylation cycle and you may find additional effect from adding some of the below.
1. Betaine
"The link between choline, betaine, and energy metabolism in humans indicates novel functions for these nutrients. This function appears to go beyond the role of the nutrients in gene methylation and epigenetic control." "Betaine is a significant determinant of plasma tHcy, particularly in case of folate deficiency, methionine load, or alcohol consumption. Betaine supplementation has a lowering effect on post-methionine load tHcy. Hypomethylation and tHcy elevation can be attenuated when choline or betaine is available.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3798916/https://pmc.ncbi.nlm.nih.gov/articles/PMC8224793/
2. Additional Choline
You may have a higher dietary requirement depending on your genetics: https://cmj.documentkit.io/cmj/
For info on choline form: https://pmc.ncbi.nlm.nih.gov/articles/PMC10025538/
3. Creatine
Creatine is one of the largest consumers of methyl groups in the methylation cycle, approx 40-45%, so it may be worth experimenting with supplementing this.
"S-adenosylmethionine, formed by the adenylation of methionine via S-adenosylmethionine synthase, is the methyl donor in virtually all known biological methylations. These methylation reactions produce a methylated substrate and S-adenosylhomocysteine, which is subsequently metabolized to homocysteine. The methylation of guanidinoacetate to form creatine consumes more methyl groups than all other methylation reactions combined"
https://pubmed.ncbi.nlm.nih.gov/11595668/
4. Additional B12
Especially if you're vegan: "Inadequate intake, due to low consumption of animal-source foods, is the main cause of low serum vitamin B-12 in younger adults and likely the main cause in poor populations worldwide;"
https://www.sciencedirect.com/science/article/pii/S0002916523239982?via%3Dihub
5. Additional B2
Especially if you also have slow MAO: "This finding suggests that riboflavin deficiency renders MAO more susceptible to inhibition."
https://cdnsciencepub.com/doi/abs/10.1139/o63-008?journalCode=cjbp
What To Avoid
Coffee, specifically for those with slow COMT, this can slow it down further, so reducing or eliminating this from your diet may be helpful.
"In the present study, we demonstrated that chlorogenic acid, caffeic acid and CAPE (three common coffee polyphenols) are effective inhibitors of the O-methylation of 2-OH-E2 and 4-OH-E2 catalyzed human liver and placental cytosolic COMT. "
https://pmc.ncbi.nlm.nih.gov/articles/PMC2674329/
Certain herbal supplements - "phytochemicals with a catechol structure (quercetin, catechin, and (-)-epicatechin) concentration-dependently inhibited COMT activity, while phytochemicals without a catechol structure (genistein, chrysin, and flavone) showed no effect up to 30 microM"
https://pubmed.ncbi.nlm.nih.gov/15254334/