Part 2: Why is No One Talking About MTHFR – Especially in Perimenopause?
This is part 2 of my perimenopause journey.
In part one, I shared the symptoms, the wild dismissal from doctors, and how I ultimately landed on HRT (hormone replacement therapy). If you haven’t read that yet, you might want to circle back so this all makes a little more sense.
Even though I didn’t know it, I was born with the MTHFR gene mutation. But it wasn’t until recently did I realize it had been silently affecting me in some way my whole life. And honestly, I wouldn’t have been able to see it clearly if I hadn’t ended up on HRT after being pushed around by perimenopause. Getting my hormones supported brought me back to baseline so I could actually feel like myself again — and more importantly, gave me the mental capacity to start asking, “Wait . . . what else is going on here?” Because something absolutely was.
Perimenopause didn’t create this issue — but it definitely exacerbated it (as it does with so many things). It basically poured gasoline on symptoms that were already there . . . and turned them into something I could no longer ignore. Let’s just say perimenopause and MTHFR teamed up and started kicking my ass haha!
A quick overview: The MTHFR gene mutation is a very common genetic variation that affects how your body processes folate (vitamin B9). About 40–50% of people carry at least one variant, and around 10–15% carry two variants. This gene plays a key role in something called your methylation pathway — which sounds technical, but really just comes down to how your body handles the basics.
Things like:
Processing important nutrients (especially folate and B vitamins)
Clearing out toxins (think excess hormones, environmental toxins, alcohol, even stress byproducts)
Supporting brain chemistry (producing and regulating neurotransmitters like serotonin and dopamine)
Regulating mood, energy, and inflammation
So when there’s a mutation, even just one copy, that process can be less efficient. And before you spiral: this is not a disease. There is nothing wrong with you if you have it. It just means your body might need a little more support to do what it’s already trying to do. Because when this pathway isn’t running well, it can start to show up as issues with energy, mood, hormones, detox — basically all the behind-the-scenes systems that keep you feeling like yourself. And when left untreated, it can branch off and cause other symptoms that don’t seem related (but they totally are). Then you’re chasing treatment of these symptoms unsuccessfully.
So what in the hell does this actually look like in real life? It shows up differently for everyone, but here are some of the most common ways it can show up:
Fatigue / low energy
Brain fog
Anxiety and depression
Neurotransmitter imbalances — especially serotonin and dopamine (aka your mood regulators. It can also worsen things like ADHD and bipolar)
Low iron / ferritin issues (affects how your body builds and maintains healthy iron levels)
Poor stress tolerance
Hormone imbalances (can exacerbate perimenopause, PMS, PCOS, PMDD — love that for us 🙃)
Headaches or migraines
Sleep issues
Reduced ability to process toxins efficiently (leaves you looking bloated or puffy)
Digestive issues
Skin issues
Elevated homocysteine (a heart health marker — high levels are linked to things like blood clots, stroke, and high blood pressure)
Chronic pain and inflammation
Pregnancy complications
Low immunity / getting sick more often
So tell me you’re asking the same question I was: “Why in the hell have I never heard of this before?” Or better yet, “Why is this not talked about more?” Because if nearly half the population has at least one variant, shouldn’t we maybe be testing for it? Talking about it? Connecting some dots here?? I’ll let you sit with that.
Like I said before, HRT did its thang. It brought me back to life and I was feeling better than I had in months. I had the energy, clarity, and capacity to engage with my life again. However, I know what it feels like to feel my best. And while this was better . . . it still wasn’t that. And I could feel it. There was still something going on under the surface.
So what did this actually look like for me? Some of the symptoms were subtle, but when I zoom out, they were very much there. Let’s start with the anxiety. I’ve had it my whole life. Although I’ve learned tools to manage it in my adult life, it has always creeped in and out. The hormonal anxiety I got from perimenopause was very different. I spoke about it in the last blog — about how my tools didn’t work on it. After HRT, the hormonal anxiety mostly went away, but my very familiar anxiety returned.
My lymphatic drainage was so slow. Even my lymphatic masseuse, Adeline, mentioned it multiple times. I constantly felt puffy and bloated — especially in my face, under my eyes, my stomach, and even around my knees. Then there was the fatigue that hit in the middle of the day. Not just “I’m a little tired,” but the kind that hits you mid-day like a truck. I’d need to close my eyes for 30 minutes just to function (and this was after 8+ hours of sleep).
The brain fog lingered too. It wasn’t as intense once I started HRT, but my mind still didn’t feel clear. Like I wasn’t fully online. My bloodwork showed low ferritin levels — and if you’ve ever looked up how to remedy that, you know there isn’t a straight line to do so. I was sleeping enough, but my body wasn’t actually recovering. I still woke up after a long night of sleep feeling like I had not slept that long. Then there was the inflammation and bloating — it never went away.
Last, but most definitely not least, was emotional numbness. Not full-blown depression, but moments of sadness that felt heavier than they should. Or the opposite — just feeling kinda numb. Like I couldn’t fully access joy, even in moments that were truly joyful! Enter the loss of neurotransmitter support. So yeah, when I look at it all together, it makes a lot more sense now. If you’ll notice, a lot of these symptoms overlap with my perimenopausal symptoms. So when these didn’t completely remedy after 6 months on HRT, I knew something else was happening. I didn’t write off the hormones . . . because I could feel the difference. Instead, I kept looking for what else it could be.
So how did I even come across this? Honestly, it’s almost embarrassing how many times the Universe laid this in my lap before I actually did something about it. First, it showed up on my son’s genetic test while I was pregnant. It was literally the only thing flagged on my side. But when I looked it up online, everything kept telling me the same thing — that this gene mutation didn’t affect my health at all. I cannot believe that’s still the narrative! It makes me mad because so many people turn their back on this (and look for answers elsewhere) when this one thing might be what’s causing so many symptoms! Next, for a full year after giving birth, every single time I got a lymphatic massage, Adeline would comment on how much lymph she had to move.
Then a spiritual practitioner in Sedona mentioned it in passing. Then I started seeing it everywhere on social media. I kept telling myself that I should probably test, but never did (eye roll). And THEN, what finally got me, was during a Reiki session in February. While working on me, Kindy straight up asked me if I had ever been tested for it. Okay, Universe, I freaking hear you.
I told her, “No, but this is not the first time it’s come up, so I’m going tomorrow to get tested.” I walked my happy ass in and got tested that next day. And sure enough, it came back with one copy of the mutation. Check.
Soooooo, is this a complicated, overwhelming fix? Honestly, no! It’s actually pretty simple. If you test positive for one or two variants, the goal is to support your methylation pathways — aka help your body do what it’s already trying to do, just more efficiently. Please talk to your doctor about what’s right for you. And if they try to dismiss you, pretty please keep advocating for yourself. We’re done ignoring our bodies, remember?
Now, let me tell you what this looked like for me. My Reiki practitioner, Kindy, recommended a supplement that had been really effective for her, and turns out, it’s been really effective for me too. It’s called EnbraceHR. No, I’m not sponsored (I’m just a very happy user). It’s a prescription-strength, bioactive folate and B-vitamin supplement — which basically means it gives your body the forms it can actually use (which is kind of the whole issue with MTHFR in the first place). They also offer free, 15 minute, patient consults, which I love because it doesn’t feel like you’re just guessing and hoping for the best.
Here’s exactly what’s in it (without getting too science-y about it). This is how it supports the exact pathways that tend to struggle with this mutation.
Bioactive folates (the kind your body can actually absorb and use): L-Methylfolate (Magnesium) and Folinic Acid
B vitamins in their active forms (key for energy, mood, and brain function): B12, B6, B1, B2, B3, and Piperine (B Vitamin Bioenhancer)
Supportive minerals like Magnesium Ascorbate, Magnesium L-Threonate, Zinc Ascorbate, and Iron
Omega-3s for brain support
CoQ10 for energy
And a few absorption enhancers so your body can actually do something with all of the above
After about 3 weeks of taking it, I started feeling more like myself again. And each passing week got a little better. And now, at 11 weeks in, I genuinely cannot believe the difference. It feels like my body is finally getting what it needs to actually function efficiently for the first time in YEARS.
My brain fog is pretty much gone. I’m now just dealing with what my lovely cycle gifts me. But overall, I’m thinking so clearly again! The mid-day crashes are rare. I’ve only needed a handful of naps since starting it, and again, mostly around my cycle. My anxiety has decreased dramatically. And when it does show up, it’s way less intense.
I’m noticeably less puffy and bloated. My energy is back. I feel calmer. More present. My sleep quality has improved. And maybe the biggest one, I can feel my joy again. It’s not forced or something I have to work for either. My sense of humor and playfulness has returned as well. And overall, I feel like the best version of myself on most days. If you’ve ever not felt like yourself, you know how big of a deal that is. I can genuinely feel my body functioning at a different level.
And one more thing . . . because this is important. If you do test positive and you have children, it’s worth considering getting them tested too. The earlier you can support them (even something as simple as a gummy supplement), the earlier their little bodies can start properly supporting these pathways. It’s an advantage I didn’t have. And honestly, I wish I did.
Now that this is on my radar, I kinda want to scream it from the rooftops. And in my own way, I have been! I’ve started pointing people in my close circle toward getting tested if their symptoms line up. So far, every single person who’s followed through has tested positive. Which is . . . wild, but also not surprising. And even if someone doesn’t test positive? That’s still valuable because it’s something you can rule out.
I’m also seeing more and more holistic and functional practitioners testing for this now because the data is catching up to what people like me have been experiencing. When this goes unsupported, it can create way more chaos in the body than most people realize.
Look, gone are the days of going to your general practitioner and getting all the answers about why you’re not feeling well . . . especially as you get older. Your health is not one simple issue with one simple solution. It’s a puzzle with a lot of different pieces that make up the whole. It’s usually not contributed to just one thing. And most of the time, it’s not a quick fix. You’re probably not going to find all the answers in one place. You’re absolutely going to have to do your own research outside of appointments. And you most certainly will have to advocate for your own health. This is just the reality.
This might look like:
Asking questions
Challenging things that don’t feel right
Bringing what you’re learning into the appointment room
Speaking up for what you need
And not being afraid to switch doctors if you’re not being heard
Your doctor might not know more about what’s going on in your body than you do. You’re the one living in it. You’re the one experiencing it every single day.
I can say this with complete certainty: If I had not searched for answers and let it rest in the doctor’s hands, I would still be struggling every single day. Wondering what the hell was wrong with me. Unsure if things were ever going to get better. And that’s a hard place to be. I’ve always been healthy, so to hit my 40s and feel like my body completely turned on me threw me way off.
BUT we are super lucky to live in a time where we have access to information the way we do. The internet. Social media. Other people sharing their experiences in real time. It’s all right there if you choose to take advantage of it. So please use it. And speak up for yourself in those doctor’s offices.
Because at the end of the day . . . Health is the new wealth.
If you don’t feel well, nothing else in your life will feel as important as getting back to a place where you do. You deserve to make your health and well-being a top priority. And when you do, it doesn’t just change how you feel physically, it trickles into everything.
