The Carlat Psychiatry Podcast
Should You Test MTHFR?
May 5, 2025
The discussion centers around the MTHFR gene and its variants, which play a crucial role in mental health, particularly in depression. Testing for MTHFR's impact on treatment with methylfolate is analyzed, revealing important links to clinical outcomes. The effectiveness of SAMe as a depression treatment is evaluated, showcasing mixed trial results. Additionally, the podcast emphasizes the significance of folate and its affordable options, highlighting its historical importance and benefits in mental health treatment. It's a fascinating dive into genetics and psychiatry!
18:53
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Quick takeaways
- The MTHFR gene variants C677T and A1298C significantly correlate with depression risk but are not definitive causes of psychiatric disorders.
- Methylfolate is recommended as a first-line treatment for depression, especially due to its proven efficacy compared to folic acid.
Deep dives
Understanding the Role of MTHFR in Depression
The MTHFR gene, with its common variants C677T and A1298C, has been linked to an increased risk of depression, showing a prevalence of around 60% in depressed patients compared to 30-40% in the general population. Despite this association, MTHFR mutations alone are unlikely to be the sole explanation for psychiatric issues. Understanding its complexity, expert Victor Hofbrand points out that MTHFR does not completely block folate production; rather, sufficient doses of folic acid can still lead to adequate levels of methylfolate. This suggests that while MTHFR is one factor in depressive disorders, it should not be seen as a definitive cause.
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