- How You May Benefit From DEPLIN®
- DEPLIN® FAQ
- Methylfolate and Resistant Depression
- The Missing Link To Weight Loss – MTHFR
How You May Benefit From DEPLIN®
How can DEPLIN® help me?
DEPLIN® can provide the body with already-active folate that is ready to help promote the production of natural chemicals in the brain that affect mood and help you get the most out of your antidepressant therapy.
Is DEPLIN® safe? What are the side effects?
Yes, DEPLIN® is generally safe and does not have the side effects of traditional antidepressants. In clinical trials, the side effects of DEPLIN® were about the same as those of a placebo (a pill or liquid with no active medicine, such as a sugar pill). DEPLIN®, which is safe to take with antidepressant medications when taken as indicated, is not associated with weight gain, insomnia, or sexual dysfunction.
How is DEPLIN® different from over-the-counter (OTC) options?
OTC folic acid needs to be activated by your body before it can be used. Unfortunately, up to 70% of people with depression may have a compromised ability to complete this activation. DEPLIN® capsules can provide you with already-active folate so your body does not have to activate it for you to see a benefit. DEPLIN® addresses the body’s nutritional requirements and creates an environment that allows you to get the most out of your antidepressant therapy.
Is there a program to help me save on my prescription?
Yes, you can save on DEPLIN® with Brand Direct Health® pharmacy, which offers savings, support, and resources to patients through a program called RxDirectPlus Powered by Brand Direct Health. To fill your prescription through Brand Direct Health® pharmacy, call 1-844-824-5918 or visit www.RxDirectPlus.com to learn more.
Methylfolate and Resistant Depression
Source: Wikimedia Commons
Methylfolate is one of a handful of supplements with better quality data showing it could be useful as a possible adjunct treatment for major depressive disorder in addition to standard treatment. This special form of folic acid (or vitamin B9) can be carried through the blood-brain barrier and used for all sorts of goodies we need, such as neurotransmitters, DNA, and cellular detoxification.
Synthetic folic acid from supplements or its form in the food we eat has to be metabolized, but taking methylfolate will bypass any inefficiency that comes from genetics or medications that inhibit folate metabolism, so that you can ensure your brain gets the type of folate it needs. Up to 70% of folks with depressive illness have this genetic inefficiency of folate metabolism, at least in a European population (1). The brain could potentially work better with methylfolate supplements, and medicines (such as antidepressants) that need folate in the brain to work could potentially be more effective.
At least that’s the idea that researchers have looked into and supplement makers have bet quite a bit of money on. When it comes to randomized controlled trials on methylfolate and depression, we now have a collection. These studies are for adjunctive treatment, meaning added to antidepressants, often in populations resistant to depression. Acute side effects in the controlled and observed trials seem to be minimal, which is always good news (anecdotally some people report irritability**). When you sort out the data, a couple findings have popped up more than once:
- Methylfolate can be helpful, but not generally in doses below 15 mg.
- Methylfolate seems to be especially helpful in obese patients.
Both of these findings are a bit surprising. First off, 15 mg is a massive dose of folate. It’s over 35 times the recommended daily allowance. I asked a prominent psychiatry researcher why the makers of methylfolate supplements settled on 15 mg even before a lot of the data came in supporting the higher dose, and he told me that earlier studies of folate in humans of up to 50 mg a day seemed to be safe at least in the short term, and higher doses such 7.5 mg and 15 mg would maximize the amount that goes through the blood-brain barrier. Folates are water-soluble vitamins, so it is generally thought that in the worst case, if you have too much methylfolate, you will end up with expensively supplemented urine.
But let’s not be too glib. There are three major safety concerns about high-dose folate supplementation. First, as folate helps cells to divide, there’s some worry that massive doses of folate can increase risk of colon cancer, which is controversial. However, colon cancer patients treated with anti-folate chemotherapy use advanced folate metabolites such as folinic acid to keep folks from experiencing the serious effects of folate deficiency caused by the chemo. Since methylfolate is further along the metabolic pathway than folinic acid, the risks of methylfolate may be lower.
Second, folic acid competes with methylfolate at folate receptors, so a high amount of folic acid floating around in the bloodstream may reduce the amount of methylfolate in the brain. Imagine a crowd of people in yellow jackets (methylfolate) trying to get into an elevator, but you flood the hallway with people in blue jackets (folic acid) trying to get on the same elevator … you effectively reduce the ability of the yellow-jacketed folks to get a ride on the elevator. By supplementing with the “advanced” form, methylfolate rather than plain old folic acid, you bypass this problem.
Third, both folate and B12 deficiency cause the same type of megaloblastic anemia, and folic acid supplementation can effectively “mask” this anemia by shrinking the blood cells back to normal and lead to untreated B12 deficiency. In modern times, B12 levels can be measured directly (and should be if you have a diagnosed depression) and there are other symptoms of B12 deficiency besides megaloblastic anemia, so I don’t consider this much of an issue, but if you are concerned about taking high dose methylfolate, ask your doctor to measure your B12.
Now that we have the major safety questions out of the way, let’s go back to methylfolate used as an adjunct for treatment of depression. Methylfolate at prescription dosage comes in 7.5 mg and 15 mg forms from places like Brand Direct Health and Methylpro, and it is pricey. The 7.5 mg form failed to separate from placebo in adjunctive depression treatment, but 15 mg has worked. It’s also been shown to decrease unhealthy metabolic markers and improve depression in folks who are for reasons of genetics less efficient in making methylfolate from folic acid.
Also, 15 mg of methylfolate seems to help folks with resistant depression who are also obese. Follow up studies show reductions in inflammatory metabolic markers, which suggests the methylfolate is doing what folates are supposed to do, help cell machinery clean up after the messy cellular engines do their thing making energy for the cells.
Finally, a very important issue is raised by the success of methylfolate for adjunctive treatment of depression and the tests for inefficient MTHFR alleles. Genetic testing (usually including MTHFR c677t and sometimes MTHFR a1298c, along with what sorts of liver enzymes you have to metabolize psychiatric meds and measures of what type of serotonin reuptake transporter promoters you have) is now available and marketed to psychiatrists to ostensibly help them design personalized medication treatment plans for patients. This genetic testing is now paid for by Medicare and the VA, but I’ve seen skeptics and fellow psychiatrists call all genetic testing “quackery” at the worst or “not yet ready for prime time” to show gentle displeasure at the marketing and enthusiasm that has come with these tests. Personally, I have found the tests useful in certain situations (usually resistant depression or repeated weird side effects) with careful acknowledgment of the caveats and unknowns.
MTHFR c667t is just one gene in a long circle of interdependent genes that are translated into the enzymes that are part of the folate cycle, which we saw in the last post. It may be the most important and the most studied gene, but a lot of other stuff has to be working efficiently** for us to make methylfolate. Second, some of the interactions of psychiatric medications and the genetic findings (particularly of the serotonin reuptake transporter promoter region gene) seem to be applicable only to certain ethnic groups, and more studies need to be done to see if it can be generalized to everyone. Thirdly, just because you metabolize a medication poorly doesn’t mean it won’t work, you just have to be careful about the dosing, and the reverse is also true. Giving folks lists of medicines they metabolize normally or poorly may cause some people to cross some meds off the list that may well be inexpensive and effective.
With those caveats (i.e., the genetic testing is not a rosetta stone but rather a somewhat limited tool), I’ve found it to be extremely helpful in the following instances: people with rarer and unusually poor metabolism of medications and homozygous MTHFR c677t (meaning the person has very inefficient processing of folic acid into methylfolate). We’ll have to wait for more data and understanding of the genetic interactions before these tests become solidly mainstream. Genetics tells us some things, and at this point we don’t know how all the combinations of all the alleles interact in the vastly complicated folate cycle, leading folks like Walsh to lean more towards measuring metabolites than using genetics to see how metabolism is actually working.**
*For the purposes of this article, “folic acid” is the common supplement in multivitamins and added to grains in many countries.“Folinic acid” and “methylfolate” are also specific forms of folate that are metabolites of folic acid. “Folate” refers in general to folic acid and its various metabolites.
**I know some of you have read Walsh and/or Yasko, who take a much bigger view of folate, the folate cycle, and genetics, particularly since Walsh warns against high-dose methylfolate for certain conditions. That’s an upcoming post, and I do want to say upfront that Walsh and Yasko are not mainstream, and the complexity of the system, the genetics, and the number of supplements they recommend have not been systematically studied in straight-up head-to-head supplement vs. placebo as methylfolate has. I do get a lot of questions about Walsh/Yasko, so I will give you my opinions in the next post.
Copyright Emily Deans, M.D.
The Missing Link To Weight Loss – MTHFR
As seen on Today Tonight, Adelaide GP Dr. Peter Tunbridge believes that up to half of Australia’s population (and the rest of the world) could be unknowingly carrying a genetic defect which can cause weight gain.
“It’s called the MTHFR gene polymorphism and the actual problem that occurs is that these people can’t change naturally occurring folate or folic acid supplements, into the active form that the body requires to carry out its biochemistry,” said Dr. Tunbridge.
By supplementing the diet with a daily dose of Methylfolate which is an activated form of folate, and adhering to a comprehensive diet and exercise program, many patients have experienced significant weight loss success.
Now Gene Foods is a company that helps you match your diet to your genetics to help with weight loss and to improve your health – find out more here
Methylfolate is available around the world but is only available in Australia with a prescription from your naturopath, but you can order from www.iherb.com and the brand that I recommend is Thorne which makes a great B complex with all the activated B vitamins which provides a better balance.
Amazon also sells the methylfolate
As a result people with the faulty gene store fat instead of burning it off. It’s also been linked to chronic illnesses like heart disease, diabetes and depression.
Integrative medicine expert, Dr. Tania Ash: “It is in a capsule form, you take it as a once a day daily supplement. At this point of time we would recommend it as ongoing treatment.”
Dr Ash prescribed a course of the activated folate to patient Graham Little. Just 500 micrograms a day appears to have helped him shed eleven kilos in two months.
“My weight was exploding, and it’s managed to curb that issue completely and yeah, I recommend it,” Little said.
“He’s reported that his energy levels are the best they’ve ever been for years he’s got excellent mood stability now he doesn’t have the mood swings that he used to have before he came to see me,” Dr. Ash said. “So if you can add something back into their diet which is very simple and safe to do which will help that process then that’s a massive step for that group of people.”
I am a strong believer that there is no magic pill for weight loss but if you are eating the right diet for your body type and doing an exercise program and still having trouble losing weight, well you could be one of those people who has the gene defect which could cause difficulty losing weight, and the Thorne B Complex maybe what you need to help remove those unwanted kilo’s.
How do you know if you have the MTHFR gene defect?
You can organize a test through your doctor which costs about $70 just for the MTHFR gene, or you can order a test through 23andme which test for 1,000’s of genes for $149 plus postage, this does not come with a report but a consultation will help you to interpret your results.
A comprehensive gene test is the best option as different genes interact with each other and you cannot just treat one gene in isolation. Your gene’s are not your destiny and your diet, environment and lifestyle can have a big effect on how they express themselves. By having a gene test you will learn the best way for you to improve your health now and prevent disease in the future.
If you have had a genetic test with 23andme or ancestory.com I can help you interpret the genetic data and give you all of the health information in regards to cardiovascular health, weight loss, nutrient abosrption and much more. Your genes are not your destiny and knowing your genetic strengths and weaknesses can help you prevent these conditions from occurring.
There is a lot more to genetics that just the MTHFR gene and for some people they can actually feel worse if they take methylfolate, or take it in the wrong dose. Genes like COMT and MAOA can affect how much folate and what form of folate that we can tolerate which is why doing a more comprehensive gene test is a better idea that just testing MTHFR.
Knowing that you have the MTHFR gene is like having an important piece of the jigsaw puzzle, but it is necessary to have all of the other pieces of the puzzle to optimize your health.
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Does MTHFR gene mutation cause weight gain?
Many people now being diagnosed with MTHFR gene mutations are finding out that in addition to having the gene mutations. They are also finding out that this problem has been a big contributing factor to their weight gain for years. Once you’ve tested for the mthfr gene mutations and get an understanding of how the gene mutation works. It becomes clear how easy it can be to put on weight and how much harder. While it is for people with the gene problem to lose excess weight.
MTHFR and weight gain
Millions of people worldwide have weight issues. However, for the most part, eating less than you need, eating a healthy diet along with moderate amounts of exercise. Even more than enough to ensure you maintain a good or ideal weight. There is however a very large percentage of society that finds it very difficult to lose weight. Even when they do all the diets, exercise, and the many weight loss programs. These people need to seriously consider genetics and one of those genes that can make you put on weight. No matter what you do is the MTHFR gene, so let’s take a closer look at MTHFR. Weight gain and how it might be affecting you.
MTHFR and fat storage
MTHFR has a role in fat storage, this is based on a number of factors. That the gene plays important roles in that leads to fat storage. When you have MTHFR gene mutations one of the first problems you have that causes weight gain is methylation imbalances. Which cause metabolism problems, once you develop metabolism problems, no matter what you put in your mouth. Fat or otherwise on many levels has to be stored as fat until such time, as a sequence of events occurs. Such as chemical reactions in the body that force fats to get used.
The problem here is that those people with MTHFR gene mutations have significantly less of these important chemical reactions. Which makes fat accumulate in body tissues instead of being transported around the body, used up or burned.
Here’s the math…..
A person who has the MTHFR gene C677T, for example, has a 30-60% reduction in the enzyme responsible. For processing the pathways or chemical reactions in the body that cause methylation or metabolism. That means it is at least 30% – 60% harder for you to burn fat or lose weight. This also means that your chances of gaining weight go up by the same percentages…
This makes it really hard to understand why you gain weight and can’t lose weight at the same time. No matter what you do, unless you know you have the gene mutation. Yet you know what to do to make it work for you to lose weight.
Homocysteine & MTHFR weight problems
Homocysteine is the chemical that is released into the body as a result of a process called methylation. It’s a normal process as long as the homocysteine your body produces. Hence they broke down into other use health-giving chemicals. Those with MTHFR gene problems often have homocysteine imbalances either high or low. Higher homocysteine levels such as those above 8 µmol/L causes fat accumulation in your body’s tissues. Fats accumulate in all areas of your body including organs. So in this case, the liver become fatty which affects many people who have MTHFR gene problems.
When fat accumulates as a result of higher homocysteine. This increases the risk of cardiovascular disease, fat deposits find their way into the arteries. Where they get stuck and form clots that lead to heart disease, high blood pressure, heart attack, stroke etc. So people with higher homocysteine have a higher risk of cardiovascular disease. In the case of MTHFR gene mutations, homocysteine becomes high because methylation is poor. This leads to fat accumulation & this causes an indirect effect on insulin resistance and when insulin resistance becomes involved. There is a further impaired inability to use fats and energy which results in further weight gain.
Signs of MTHFR and weight gain
If you haven’t been tested for mthfr gene mutations yet. You may be wondering if you can tell if you have the gene problem based on your weight problem. The most common signs include:
- Accumulation of fat around the abdominal area first
- You will more likely have a larger BMI (body mass index) and a larger hip to waist ratio which means that more fat and weight is being collected around the waistline
- You have fatty liver
- Signs of cardiovascular disease (high blood pressure)
- Poor results from dieting & exercise
- Unable to lose weight
- The family history of weight problems
- Slow metabolism
- Any of the symptoms of mthfr gene mutations
MTHFR & fatty liver
Many people have the condition known as fatty liver or fatty liver disease. Often those who drink alcohol are said to be more susceptible to getting fatty liver. However many people who test positive for MTHFR gene mutations get or have a fatty liver that leads to weight gain. When you consume and digest foods the fats and cholesterol are transported to the liver. They are then packaged into these very low-density proteins for transport through the blood. To all the tissues that require the fats for good health. When you have MTHFR gene problems these fats get stuck in the liver and build up to cause fatty liver. The problem is that the reduction in the MTHFR enzyme can’t keep up with the processing of the fats. So they are stored for later.
Often fatty liver can be reversed once the MTHFR path is supported with the right treatments for those with the gene mutation. This can also result in those fats being properly used by the body. So increasing repairs and resolving many of the symptoms of mthfr gene defects. Which are related to the inability of the body to properly use fats?
Losing weight with MTHFR
People who have for years had trouble losing weight despite many efforts have found that their genes in terms of genetics. They have played a major role in the reasons behind their weight gain. Finding out if you have MTHFR gene mutations is easy and if you find out that you have the gene problem. Losing weight becomes a lot easier, this is because each person’s symptoms can be identified with their particular gene mutation. The right treatment can help to speed up methylation. Which means increasing metabolism, which means using your fats instead of storing them.
Did you have any questions about MTHFR and weight gain? Contact us here.