The Carlat Psychiatry Podcast Should You Test MTHFR?
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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!
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MTHFR Gene and Depression
- MTHFR gene mutations raise depression risk by about 40%, but dysfunctional variants are common even in healthy people.
- The effect of mutations on folate metabolism depends on folate intake, not a complete deficit.
When to Try Methylfolate
- Consider methylfolate trials especially for patients with obesity, inflammation, and known folate-depleting medications.
- Start methylfolate supplementation at 15 mg daily and evaluate depression symptoms after one month.
Role of Folate Among B Vitamins
- Folate, a B vitamin, and several other B vitamins play key roles in enzyme functions linked to depression.
- Clinicians routinely test folate and B12 because deficiencies in these are common and relevant to psychiatric conditions.