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Is Your B-Complex Vitamin Doing More Harm Than Good?

b complex
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Supplementing with a B-complex can be a valuable addition to your healthy diet and lifestyle. But choosing the wrong one for your unique needs may prevent you from reaping all the benefits.

Choosing the right B-complex vitamin for you isn’t as easy as picking any supplement off the store shelves. There are unique properties to these vitamins that make choosing one somewhat complex. You’ll likely need more research and understanding of your own body to find the right one for you.

The symptoms of B-vitamin deficiency range from anemia and digestion issues, to muscle weakness and poor memory. B-vitamins are definitely vital nutrients that we need to ensure we’re getting enough of.

And even if your diet is full of B-vitamin rich foods like meat, fish, shellfish, eggs, beans, and veggies, you might be part of the population that still needs to supplement.

In this article, you’ll learn:

  • Who likely needs to supplement with a B-complex
  • The main issues with taking any vitamin B-complex
  • My recommendations for the best brands to take depending on your health needs


Who Needs to Take a B-Complex

A whole foods diet with lots of variety (including many different types of both plants and animals) is usually enough to keep most people healthy and not need the use of many supplements.

But, even with the healthiest diet, there are still many reasons why someone may need to use a B-complex.

Here are a few reasons why you might want to consider adding a high-quality B-complex into your routine.

B Complex

If You Have Certain Gene Mutations

There are certain genetic mutations (you’ve probably at least heard of the most common one, MTHFR) that may make you a good candidate for supplementing with a B-complex.

Specifically, gene mutations that affect your methylation processes need extra attention to the type and amount of B-vitamins you’re supplementing with.

Methylation is a biochemical process that occurs in every cell in our bodies. This process enables our bodies to regulate and express certain genes, detoxify, metabolize hormones, build immune cells, and so much more.

Chris Kresser has a great podcast all about methylation if you want to dig deeper into this topic.

But, if you think you might fall into this category of someone with methylation issues, I recommend you get your genetics tested.

This will help you understand exactly what genetic mutations are behind your body’s inability to methylate, and will inform your decisions around how to supplement with B-vitamins.

You can use a service like 23AndMe to determine your genetic makeup, and then you can input your data into GeneticGenie for a free PDF that will show you your unique methylation and detox capabilities.

Once you’re armed with that data, you can then work with a healthcare provider to determine how you should use a B-complex supplement to best support your health.

Here are three of the most common genetic mutations that require special attention to the type and quality of B-complex supplements that are used.

If You Have an MTHFR Mutation

The MTHFR enzyme metabolizes folic acid into 5-MTHF. We need 5-MTHF to metabolize homocysteine and to facilitate methylation processes.

With one or more defects in this gene, the enzyme works slower and thus allows homocysteine to build up. The buildup of homocysteine may increase the risk of heart disease and stroke.

A poorly functioning MTHFR enzyme also limits a person’s methylation capacity.

With reduced methylation capacity your body is less able to break down compounds like histamine, serotonin, and dopamine. It also may prevent the proper regulation of gene expression.

This means with an MTHFR mutation, you’re more likely to suffer from mental illnesses like schizophrenia, depression, and bipolar disorder, as well as autoimmune disease, ADD, autism, spina bifida, Down’s syndrome, miscarriages, and cancer.

But don’t let this scare you. Our genes don’t have the final say. By living a lifestyle conducive to good health (eating whole foods, exercising, not smoking, etc.) we can override much of our genetic destiny.

The primary treatment for this specific mutation is supplementing with high-quality forms of folate, B12, B6, and choline avoiding processed fortified foods, and making sure not to over supplement.

Those with the MTHFR SNP need to avoid folic acid and supplement instead with an active form of folate, specifically 5-Methyltetrahydrofolate (5-MTHF).

Talk to your personal healthcare provider about specific dosage recommendations.

If You Have a COMT Mutation

A COMT mutation is another commonly seen genetic defect that affects a person’s methylation functions, but in a different way than the MTHFR mutation.

The COMT enzyme degrades catecholamines such as dopamine, epinephrine, and norepinephrine.

When the COMT enzyme isn’t working, as is common with this mutation, these catecholamines can build up. In excess, these chemicals can be stimulating to the nervous system, promoting anxiety, mood swings, and possibly leading to disorders like schizophrenia and bipolar, or even Parkinson’s disease.

People with a COMT mutation (particularly homozygous) often need to limit or avoid supplementing with methyl donors. As methyl groups tend to build up, they lead to overmethylation symptoms like irritability, anxiety, insomnia, migraines, nausea, and more.

Those with COMT mutations may need to limit their intake of methylated folate (check out folinic acid), and use hydroxycobalamin or adenosylcobalamin rather than methylcobalamin as a B12 supplement.

If You Have a CBS Mutation

We must address the CBS genetic defect before starting an MTHFR treatment.

The CBS enzyme converts homocysteine to cystathionine and removes sulfur-containing amino acids. Thus those with a CBS mutation are sensitive to high dietary sulfur intake, as well as vitamin B6.

There is a long process required to help clear excess sulfur in those with CBS issues. This includes dietary restrictions and a variety of supplements.

I recommend anyone with a homozygous CBS mutation to seek guidance from a health professional well-versed in treating this mutation, as it’s one of the more complicated defects to manage.

As you can see, defects in your methylation enzymes can have an enormous effect on your health, as well as the appropriateness of taking a B-vitamin complex.

If you’ve ever had a negative reaction to a B-Complex, consider the possibility that you have one or more of these genetic issues and get your genome tested to make sure!

b complex

If You’re a Vegan or Vegetarian

Plant foods do not contain vitamin B12. And while beans and legumes do contain a decent amount of folate, without consuming any animal products, you’re not giving your body the complete B-vitamin profile that it needs.

If you’re on a vegan or vegetarian diet, supplementing with a high-quality B-complex (especially B12) is the best way to ensure you won’t become deficient in these essential vitamins.

We add B-vitamins to many foods, like bread, nut milk, and meat substitutes. But you can’t be certain of the quality of these added vitamins, which are usually synthetic. They’re usually not the highest quality versions of these vitamins and it’s best that we avoid or limit them when possible.

b complex

If You’re Pregnant or Breastfeeding

The primary population that should supplement with high-quality B-vitamins are women who are pregnant, looking to become pregnant, or breastfeeding.

The biggest reason why B-vitamin supplementation is so important during this time is to ensure adequate folate intake. Folate is the primary nutrient shown to protect against neural tube defects (NTDs) and promote healthy neurological development in unborn and newborn babies.

But folate isn’t the only issue when it comes to a baby’s brain health. Choline and vitamin B12 are also related to the risk of NTDs and are crucial for proper fetal brain development.

Deficiencies of these B-vitamins during pregnancy are also associated with insulin resistance, increased adiposity (e.g. “fatness”), and reduced cognitive function in the offspring of those mothers who were deficient.

It’s important to ensure you’re getting enough of all these critical B-vitamins while you’re pregnant or breastfeeding. Some ways to do this are:

  • consume eggs at least 2-3 times a week
  • make sure you’re supplementing with a whole food prenatal that includes folate, B12, and choline

b complex

If You Drink (or Used to Drink) A Lot

One last population that definitely needs a B-vitamin supplement is people who consume more than 1-2 alcoholic drinks a day or have a history of alcoholism.

Those who drink excessive amounts of alcohol are at risk for deficiencies in nearly all the B-vitamins. But thiamin (B1), B12, B6, and folate deficiencies are particularly well-evidenced issues for people who have a history of consuming excessive amounts of alcohol.

Anyone who is currently drinking more than the recommended 1-2 alcoholic drinks per day, or who has a history of alcoholism, should take a high-quality B-Complex.

This will help to address any lingering nutrient deficiencies that exist and prevent some of the neurological damage that can come from long-term alcohol abuse.

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Why You Should Be Picky About Your B-Complex

We should care about the quality of the supplements we put in our bodies as much or even more than the quality of the food we eat.

And unfortunately, not all B-complex supplements are created equal.

Supplements provide targeted support at higher doses than what your body normally gets through everyday food consumption. So it’s important that the nutrients you’re giving it through supplementation are the highest quality and are right for your unique needs.

This is why choosing a B-complex is more involved than grabbing one off the store’s shelves. Without doing proper research into both the supplement and your own specific needs, it’s likely that you’ll be wasting your money on pills that aren’t truly beneficial. And in some cases, the wrong supplement can be harmful.

Here are some of the main issues that I see with most generic B-complex supplements.

b complex

Issues with Cheap B-Complex Supplements

The biggest issue I see with the general population taking a standard B-complex from the grocery store is that most B-complexes don’t contain the best forms of the nutrients that they provide.

Some forms are just less effective. Others are downright dangerous when taken in excess.

Here are some of the most common cheap B-vitamins to avoid, and their higher-quality alternatives.

Folate vs Folic Acid

The best example of this issue is with the B-vitamin folate. Folate is a crucial nutrient for good health in all stages of life, and especially while you’re pregnant or planning to become pregnant.

The primary supplemental form used in both B-Complexes and fortified foods is folic acid. And the problem with folic acid is that it’s synthetic, so it’s not processed by the body in the same way as natural folate.

Research shows that there are many benefits to using the natural form of folate (5-methyltetrahydrofolate, or 5-MTHF).

This version of folate is preferable to folic acid because it is better absorbed, does not mask B12 deficiency as easily, and helps avoid the pitfalls of unmetabolized folic acid in circulation. All of which can lead to an increased risk of cancer.

For more about the folate versus folic acid issue, check out Chris Kresser’s comprehensive post on the topic.

Cyanocobalamin vs Methylcobalamin (Vitamin B12)

Vitamin B12 has a few different forms that vary in efficacy and safety.

Cyanocobalamin is the most commonly used (read: less expensive) form of the nutrient, and yet this form is not found in nature.

Rather, the B12 form that is most desirable is methylcobalamin (or adenosyl/hydroxy cobalamin for some folks), which is the form found in food.

This is not only because of this version’s function as a methyl donor but also because of concerns that the metabolism of cyanocobalamin may release small amounts of cyanide into the system.

This would never be enough to cause cyanide poisoning. It’s a potential issue for people who have impaired detox due to genetic issues, nutrient deficiencies, or chronic illness.

And Dr. Chris Masterjohn believes cyanocobalamin may not be effective. This is because we need B12 to excrete cyanide from our bodies (discussed at the 18:01 mark).

There may be other quality issues with the typical B-Complex vitamins you’ll find in the grocery store (such as B6 variations). But these are the two primary ones I see and are the primary nutrients I consider when assessing the quality of any B-Complex my clients are taking.

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Not All B-Vitamins are Represented

One would think that a B-Complex should provide adequate levels of all the important B-vitamins, right? Unfortunately, there are some nutrients often completely absent from the typical B-vitamin supplement.


Choline is the primary nutrient that I see getting left out of most major B-Complexes. This may be because we’ve only recognized choline as a vitamin (i.e. essential) since 1998.

But isn’t two decades long enough to get with the program? I don’t quite understand why choline isn’t a regular feature in most B-Complexes. And if it is included at all, it’s usually in a woefully inadequate amount.

You can get choline from egg yolks and a variety of vegetables. But there are some people who may have higher needs or that cannot eat egg yolks due to intolerance or autoimmune issues.

Plus, choline may be as important as folate and B12 for promoting a well functioning methylation cycle. Plus it can actually protect against deficiency symptoms of the other B-vitamins. So any B-Complex worth taking should contain at least 200 mg of choline, in my opinion!


Biotin is another nutrient that is frequently underrepresented in B-Complexes. Some don’t contain it at all, while others only provide around 1/3-1/2 of the daily value.

Biotin is a great supplement for skin, hair, and nail health, and may also help improve blood sugar control. So look for a B-complex that provides 100% of your daily needs of biotin.

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Look for Supplements with Appropriate Quantities of Each Vitamin

The amounts of the individual vitamins contained in each supplement dose vary as well. And you want to be careful about how much of any specific nutrient you’re getting, especially if you’ll be taking the vitamin daily.

Vitamin B12 has no established upper limit, meaning there’s no toxicity seen even at high doses. But other vitamins like folate and B6 can potentially be toxic or cause poor long term health outcomes if taken in excess for a long period of time.

For most people, I don’t suggest taking over 800 mcg of folate and 100 mg of B6 on a daily basis (but those with MTHFR are a different story).

You should read the label carefully of any B-Complex you’re buying. Some supplements (this one for example) don’t even contain B12 or folate, which I’d think are two of the B-vitamins you’d expect to see in a B-Complex.

So as with any supplement, ALWAYS read the label to see exactly what you’re getting, and do the research ahead of time before you go to the store.


My B-Complex Recommendations

Assuming you don’t have a methylation genetic defect, I like Integrative Therapeutics Active B-Complex as a well-rounded, high-quality B-vitamin supplement.

It has the active forms of B12 and folate, as well as a good amount of a highly bioavailable form of B6. This supplement contains 250 mg of choline, 100% of the daily value for biotin, and a significant amount of all the other important B-vitamins.

You can also take it in a half-dose if there are concerns about over-supplementation, as each dose is 2 pills (i.e. take 1 pill for a half dose).

Integrative Therapeutics is also a fantastic brand with a hypoallergenic formulation, making it appropriate for people with food sensitivities. And there’s no magnesium stearate in it, which some people report issues with.

Remember, those with the MTHFR SNP need to avoid folic acid and supplement with 5-Methyltetrahydrofolate (5-MTHF), while those with COMT should limit 5-MTHF and use adenosyl/hydroxycobalamin as a B12 supplement.

I hope you have a better understanding of the thought process that goes into choosing a B-vitamin complex, and now know how to confidently choose the right vitamin that works for you and your specific health needs!

Did this article change your perspective on B-Complex supplementation? Are you planning to change the B-vitamins you use? Let me know in the comments below!

CLICK HERE to order high-quality supplements, including the B-vitamins I mentioned above!

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  1. I have signs of a methylation defect but have not spent the money to get a genetic test done, although I plan on it soon. In the meantime, I am supplementing with 5-MTHF and methylcobalamin but have overlooked choline. In grad school I remember reading several animal studies demonstrating the importance of prenatal exposure to choline for brain development, so this is probably something I should begin to supplement. This was very informative, thank you!

  2. Whoa, thanks for the info. Are there any obvious methylation problem symptoms that we should be on the look out for?

  3. For almost 10 years I took, folic acid 3mg QD related to RA, still take Methotrexate. Discovered last year I was 1298AC hetero, so shifted to Methyl Folate, should I take the same dose? My Rheumy never heard of MTHFR, so he is of no help. My own reading has not found this answer. Thanks

      1. 23 and me can’t provide the genetic risk info anymore due to FDA regulations. So sad. I got the test done right after that happened. Are there any other routes to finding this out? I know I have the MTHFR gene, but don’t know about COMT or CBS.

  4. Laura, you ROCK! This was more informative than the one-hour interview with a world renown expert I recently listened to. Thanks!

  5. Are you familiar with pyroluria? It’s connected with mental disturbances and alcoholism and treatment includes supplementation with B vitamins.

  6. Can someone please tell me what the COMT and CBS snp’s are so I can find out if I have a mutation? I can’t find them anywhere on the web. I have a 23andMe profile from way back and I’d like to start using it more since I have recently been having a lot of health issues that my doctors just can’t seem to help me with. I found the MTHFR snp’s easily and I have a mutation there.

  7. After reading this, it sounds like I should not be taking them? Does anyone else feel this way?
    Also, I was about to buy a Vitacost brand that was BOGO free, looked really good, untill I read the part about the Folic-acid, increasing your risk of frickin cancer!!!!!!!!!!!!! wth?
    After reading this, I am about to get off of this,” taking vitamins to make me healthier trip!”
    Heck, sounds like slow-suicide to me!!!!!!!!!

  8. I was given some bad advice from a doctor who told to take a b complex with methyl b’s and I have homozygous COMT. I do not have any mthfr defects but do have others. One month later I was a mess and figured it out. I am deficient in B2, biotin, glutathione and have daily migraines along with debilitating muscle pain. I am also exclusively breastfeeding a 6 month old. I am trying to find a doctor to guide me in this process and am reading as much as I can to figure it out myself (there isn’t a lot of info I’ve discovered). My question is, since I don’t have the mthfr defect can I take a regular bcomplex without methylation? I need to address my b2 deficiency especially because it is directly linked to the migraines. I’m not sure what I can take at this point and feel terrible. Thank you for your help!

  9. Hi Laura! I was reading your other post about amenorhia and wanted to start on a B complex along with magnesium because my prenatal does not have that. I’m confused about how much to take. Should I find another prenatal with actual folate and magnesium or can I take the B complex along with my prenatal? Thank you so much for all of these posts!

  10. What’s your approach for impaired methylation? Do you recommend Dr Amy Yasko’s tests/protocol? I have impaired methylation and gut issues and have been trying to find a practitioner that is familiar with both. I have been chronically sick for more than a decade now and going in circles.

  11. You said you’d recommend “brands” – Plural with an S. That you didn’t speaks poorly of your motivations.

  12. Hi Dr Laura, I was recently diagnosed with heterozygous MTHFR A1298 and C677T, and Homozygous COMT 1324A. I am confused as to which B vitamin to take Hydroxy, Methyl or both? My integrative doctor put me on methyl max and methyl B12, but I saw that methyl is not recommended with COMT. My doctor does not have much experience treating this.

    1. Hi Gina, just FYI I’m not a doctor! And unfortunately it’s impossible to know which B-vitamins would be ideal for you to take simply by seeing your mixed genetics. I would recommend finding a functional medical practitioner (such as a naturopathic doctor) who can order a blood test to check your current methylation status.

  13. Hi Laura. i was recently diagnosed with a pulmonary tuberculosis. I was prescribed myrin-p forte for the firs two months, and recommended to take vitamin b complex as well. i have chosen neurobion tablet which contains vitamins B1, B6 and B12… Now i wonder if i made the right choice for the brand of said vitamin…Can you advise me please? Thank you.

    1. Hi unfortunately I can’t make individual recommendations online to a non patient. I suggest following your doctors instructions and asking him or her for guidance on your case.

  14. Hi Laura- I was diagnosed with the MTFHR mutation. You recommend to take high quality forms of folate, B12, B6, and choline. I know you mention that the folate should be methylated but I am wondering about the B12, B6, and Choline. Thanks so much!

    1. Hi Michelle, the B12 can be a methylated form, whereas the B6 can be P-5-P and the choline can be phosphatidyl choline.

  15. Hi Laura…Do you feel it’s necessary for vegetarians to supplement with b-vitamins? If you do, I would definitely encourage my daughter to take one of the quality complexes you have recommended. Thanks.

    1. As a vegetarian, I’ve survived w/out them just fine for 14 years already. So I’d say, just make sure your daughter eats lots of diff. fruits, veggies, nuts, seeds, legumes, adds mushrooms, etc….
      I once was convinced to take some B complex but it didn’t make any difference, moreover, wasn’t even absorbed by my body. It’s such a waste of money. Out of fear, I bought B12 in the form of methylcobalamine (first time after being a veg. for 12 yrs) and sometimes take it just in case. But as with other B vits., I feel no difference. So it’s your call.

      1. There is a different SNP that has to do with how the body processes Vitamin A from plants. I have the mutation so I need Vitamin A from meat sources as I don’t process the plant form efficiently. Just something else to keep in mind when eating vegetarian. (This is possibly one reason why some people see their health decline on vegetarian/vegan diet).

  16. I only read this to find out if some of the weird things going on with my body is or could be caused by the new B Complex I got from a grocery store AND WOW. I’m not taking it anymore for one. Two, I used to take it because my endo suggested it, but she never tried to find out if I had a methylation defect, which I didn’t know was a thing. Three, I’m sure I do have a defect because of the way my body has reacted to the B Complex and me being a type 1 diabetic. I’m SO HAPPY I ran across this article.
    Thank you for sharing this information!

  17. Hi Laura,
    I am not sure shy inisitol is not considered in your list. I thought inisitol and choline are complementary each other.

  18. Laura, what are your thoughts on higher amounts of Niacin in many B-Complex products. I take Thorne Stress B-Complex which has 80 mg Niacin as Niacinamide per capsule. Integrative Therapeutics brand you linked to has similar amounts in its Vit B products. Are these levels fine for an everyday supplement without prescription? I’m confused about some reports that high doses of Niacin can be pro-ageing. Are there any good similar B-Complex brands with less Niacin or are these levels ok? Thanks

      1. niacin is nicotinic acid. niacinamide is another form that doesn’t cause the flushing effect. it helps brain function, but not the cholesterol lowering benefit of plain niacin.

  19. Dear Laura,

    I apologize for the long comment, but this was in a recent newsletter and I don’t have a link to it on the Web. I would greatly appreciate your thoughts, as I’m struggling to figure-out who/what to believe.

    Many thanks,

    Medicine’s Shiny New Thing: the MTHFR Gene Mutation

    While there have been many medical discoveries that have saved lives (like antibiotics), and improved lives (such as joint replacement), many medical discoveries have proven to have little usefulness. An example is genetic testing. Even advocates for the practice acknowledge that we don’t know what to do with most of the information learned from genetic testing, and that in many cases we are just turning healthy people into worried healthy people after they find out that they have an abnormality. If we look hard enough we can find something wrong with almost any human, but this does not mean that the human benefits from knowing about it.

    It appears that this is the case with the MTHFR gene mutation. More and more doctors are testing for it, but it is not clear that anyone other than the labs that run the tests are benefitting from this practice.

    The MTHFR gene, or methylenetetrahydrofolate reductase gene, produces an enzyme that assists in the regulation of homocysteine levels in the body. Homocysteine is a byproduct of the breakdown of methionine, an amino acid concentrated in land animals, dairy, and fish. High homocysteine levels are associated with increased risk for atherosclerosis, blood clots, heart attacks, and stroke.

    It is estimated that as much as 50% of the population has a mutation of the MTHFR gene. Humans have two MTHFR genes, one inherited from each parent. In order to cause any detrimental effect on health, mutations must be present in both copies of the gene. But even when mutations are present in both copies, studies have not shown that those with the mutation have reason to be concerned. Research shows that as long as homocysteine levels are normal, having the gene mutation does not increase the risk of heart attack or stroke. Some studies have shown a slight association between the mutation and venous blood clots, but most have shown no association.

    For people who do have high homocysteine levels, with or without the gene mutation, the best remedy is to increase dietary folate. Folate is found in plant foods, so a plant-based diet that includes lots of green vegetables is the best treatment. In addition to lowering homocysteine levels, a plant-based diet can improve other markers for cardiovascular disease and lower the risk of a cardiovascular event.

    Women are frequently tested for the mutation, a practice justified based on the claim that women with the mutation have an increased risk of having a baby with neural tube defects. But most people who have the mutation do not have neural tube defects and their children are almost never affected. According to the National Institutes of Health, the nutritional status of the mother (specifically folate intake) and homocysteine levels (with or without the gene mutation) are much more important factors than the gene mutation.

    As for the claim that the mutation can increase the risk of complications of pregnancy such as preeclampsia, placental abruption, miscarriage, and intrauterine growth restriction, a meta-analysis showed that there was no association between the gene and miscarriage, and a only small increase in the risk of preeclampsia and placental abruption.

    Overall the consensus seems to be that there are many factors that can increase risks associated with pregnancy, and more research is necessary in order to determine just how much (if at all) the MTHFR gene actually increases those risks.

    There are no guidelines at this time as to who should be tested for the mutation, but The American Heart Association says that “In the absence of elevated homocysteine levels MTHFR mutations appear to have no clinical relevance.” Therefore one could argue that there is no indication to perform MTHFR genetic testing.”

    In light of this information, why are so many people being tested for this mutation? There are several reasons – the same reasons why medicine invests so much money, time, and effort in so many other useless and harmful practices:

    * Money. As long as doctors are paid for doing things instead of producing results, they are going to continue to look for more things to do.

    * Fascination with almost anything new. Some doctors think that almost anything new must be a good idea, which is rarely the case (see the next point).

    * Failure to demand evidence of efficacy before adopting a new practice. The history of medicine includes hundreds of years of adopting new practices without evidence that they are effective or safe, and refusal to discontinue those practices even when evidence is overwhelming that they are useless and/or harmful.

    * Failure to consider the consequences of getting more information BEFORE recommending a test. The MTHFR mutation is common – as many as 50% of Americans have it – but having the mutation does not change anything for most people. Therefore knowing about the mutation is useless for most people. Humans have difficulty forgetting about an abnormality, however harmless it may be, once it is discovered. This means that knowing more is sometimes not better. There are times when ignorance truly is bliss.

    It appears that the “MTHFR craze” is here to stay. A colleague recently informed me that a naturopath in her town tests all patients for it. I receive at least one email per week from someone who has the mutation, is concerned and wondering what to do about it. And a growing number of members are reporting that they have tested positive and are also seeking information.

    I encourage you to stay away from doctors unless you have a good reason for seeing them, such as symptoms that do not resolve after a few days, injury, or the need for emergency treatment. Unless you are in need of emergency treatment, refuse any and all tests until you know how the test will benefit you, the risks of having the test, and what you will do differently once you have the test results. Enthusiasm for most tests usually lessens after reviewing this information

    Ray JG, Shmorgun D, Chan WS. “Common C677T polymorphism of the methylenetetrahydrofolate reductase gene and the risk of venous thromboembolism: meta-analysis of 31 studies.” Pathophysiol Haemost Thromb. 2002; 32: 51-58.

    Klerk M, Verhoef P, Clarke R, Blom H, Kok F, Schouten E. “MTHFR 677C-T polymorphism and risk of coronary heart disease: a meta-analysis.” JAMA. 2002; 288: 2023-2031.

    Rey E, Kahn SR, David M, Shrier I. “Thrombophilic disorders and fetal loss: a meta-analysis.” Lancet. 2003; 361: 901-908.

    Varga E, Sturm A, Misita C, Moll, S. “Homocysteine and MTHFR Mutations: Relation to Thrombosis and Coronary Artery Disease.” Circulation 2005;111:e289-293

  20. This article is very informative, but I still find myself so confused! I was taking the B-complex from Designs for Health (B Supreme) at the recommendation of my health practitioner, but I felt uncomfortable taking it as the dosages in it seemed extremely high to me. Are the dosages in that desirable or are some of them too high?

    Also, would Thorne Research’s Basic B Complex be something you would recommend instead? I noticed it has Choline Citrate instead of regular Choline, is it just as good? Thank you so much!

  21. What if one has both mthfr and comt? Your article says to limit 5mthf and use hydroxy b12. What should be done for the mthfr mutation then?

  22. Hi Laura,
    Great article. I’m have the MTHFR, COMT and CBS heterozygous mutation. I break out with acne, experience mood swings, irritability and anger when I take a B-complex vitamin. I am currently trying to conceive and am not sure what to do about taking folate as I know it is needed during pre-conception and conception but if it’s causing me major flare ups maybe I shouldn’t be taking it? I live in Alberta, Canada and would love to speak with someone with in-depth knowledge about gene mutations.

    Thank you.

  23. Hi Laura: for the vitamin brand you recommended , which form does it include of these? (Those with the MTHFR SNP need to avoid folic acid and supplement with 5-Methyltetrahydrofolate (5-MTHF), while those with COMT should limit 5-MTHF and use hydroxycobalamin as a B12 supplement)

  24. Hi Laura- I am +/- for MTHFR A1298C and +/+ for COMT V158M and COMT H62H – which supplements should i take? thanks

  25. Thank you for this article. I feel that it is important and I appreciate that you present clear information.
    Thank you! Thank you! Thank you!

  26. I have the MTHFR enzyme. I was prescribed Niacin by my doctor, as well as -methyltetrahydrofolate. I need to find a Vitamin B complex without Niacin and folic acid/-methyltetrahydrofolate. I also take Biotin supplements, calcium, and Fish oil. What Vitamin B complex do you suggest that does not have the other essentials, but has choline???

  27. I have comt and 1 mthfr gene. I have been taking Thorne stress b complex For over a year. Do you recommend anything different?

  28. Hi
    I have a double mutation on my methylation and my comt first stage is a little fast and second stage a little slow I am so confused on what to take I avoid synthetic folic acid and take a whole food multi but then I worry that I need the activated folic can u help me on the right track as I am trying to avoid synthetic vitamins but aren’t the activated b vitamins synthetic?
    Regards Linda

  29. Hi Laura,

    What is your opinion for Pure Synergy Organic Super B-Complex 60 Vegetable Tablets by The Synergy Company?

  30. Do you have a B complex recommendation that has the following criteria?

    1. B6 in the p-5-p form
    2. No methyl donors
    3. Niacin in the niacidamide form

  31. Hi Laura
    I have been tested and I have a double mutation on my methylation gene and my comt my first phase is a little too fast and my second phase is a little slow so I am confused what b vitamin to take I have been trying to find a activated b vitamin sourced from whole foods to supplement my diet as these would be better than synthetic could you let me know which one would be best please

  32. Hi Laura, Thank you for the great information. Very interesting and definitely applicable. A friend had recommended I get checked for the MTHFR defect for which I was positive. Since then my primary doctor prescribed B12 injections and recommended taking a menthylated version of the B 12. Big difference! I do have a few auto immune disorders that presented in the last couple of years as well.What other tests would you recommend? Thank you.

  33. I’ve been moving away from using a single B complex supplement to buying the individual components. Your article helped me to see that I needed to use different forms of Folate and B12.

  34. This B supplement you recommended has silicon dioxide, a food additive.

    These guys say its says to use: Finally, the Food and Drug Administration (FDA) has recognized silicon dioxide as a safe food additive, as do the World Health Organization (WHO) and the European Food Safety Authority (EFSA).

    But you can never trust any of these organizations as they are 100% liars and totally corrupt.

  35. I have been tested and it was found that I have the MTHFR mutation. My neurologist suggested the Methyl B Complex by Ortho Molecular Products. I took one morning and one at night and it made me feel amazing! I bought it on Amazon for around $17 but now it is selling for $59! At one time I saw it for $98! Why did it skyrocket in price?! Is there another brand that has the same makeup? I tried one from a health/vitamin store and it made me feel flush and at times nauseous. It had an increase in Niacin which is what made me feel out of whack.
    Can you recommend another brand like Methyl B Complex by Ortho? Do you know why the sales are so high?

  36. Hi there! I love your article on B vitamins. It is very informative. I was wondering about the use of these vitamins for a teenager suffering from depression. I was wondering what your expert opinion on this is? Also would there be a better supplement for this example Ginko Biloba I have heard does wonders for depression. If you could email me I would greatly appreciate it.

  37. Integrative Therapeutics Active B-Complex where can i buy these in the UK. I just want to ensure i get all b vits. i’ll take half dose.

  38. I have just started taking a b complex liquid b12 1200ug b2 1.7mg b3 20mg b5 30mg b6 2mg ..1ml dropper for anxiety is this a good amount or do I need to get a better quality producta

  39. I have both MTHFR and COMT mutations. One says I need 5-MTHF and the other says I should limit it. So, what form of folate should I take?

  40. In my opinion (after using several different methylated B complex containing products), these new coenzymated B vitamins have not been well researched enough and can do serious damage. I found them to be *extremely* energizing, almost ridiculously so, compared to regular non-methylated vitamins. I developed insomnia while taking even a fractional dose of a methyl B complex and dry eyes (which I’ve never had before). I will never again take any of this stuff. (I’m hetero for MTHFR C677T and A1298C.)

    After switching back to a regular “old fashioned” B complex I immediately felt immensely better. I also had to take magnesium taurate/glycinate, taurine, glycine, and a multi-mineral complex for several months to recover.

    If you do take this stuff, please go slowly and listen to your body.

    1. Thanks for your comment, Rich. I’m homozygous for MTHFR C677TT and 1298AA and nervous about taking B vitamins. I’m just about to try the Thorne Basic BComplex 100. How much were you taking when you had your negative reaction?

  41. Wow. This info is making my head spin. Especially the part about folates and methylation. I’m one of those people who does very well on SAM-e and had a very bad time with Prozac. Is there a hint in there about whether I’m OK with taking a standard B complex like the one you recommend–or whether I need something else? I read a little about this in William Walsh’s book, but there wasn’t enough there for me to figure out the answer to this question.

  42. Thank you for this information…. Which B complex supplement do you recommend since I have the MTHFR variation?

  43. Hi, I’ve been having problems with flushing while on a B-complex vitamin by Solgar … overall happy with their products as they don’t upset my stomach… But I could not find the version with the inositol hexanicotinate to prevent flushing… also am happy to find a product with absorbable ingredients… lets hope this formulation does not upset my stomach.

  44. Concerning the b-complex from Integrative Therapeutics, I couldn’t find the USP on the label. Does it have it?
    Thank you

  45. what if you have both MTHFR snp and COMT snp?

    I am using methylfolate 400mcg and methyl cobalamine 400mcg in a complex.

  46. I have the MTHFR C677 Homo mutation & I also have the COMT homo mutation. What form of Folate & B12 should I be taking? I didn’t develop health issues until after my 2 healthy kids wer born (although severe morning sickness with both, which I’ve read is related) Thanks!

  47. Dear Dr. Laura,

    Thank you for this very useful information on B-vitamins. After reading this, I am thinking the B vitamins I have been taking might be the culprit in my recent struggles due to their high dosages. I have been feeling awful with liver pain, brain fog, and general malaise and have had increasing liver enzymes after starting a regimen prescribed by my functional medicine doctor (GI Resolve, Megaspore Probiotic, Fish Oil, Pure Encapsulations B6 Complex, Pure Encapsulations hydroxy/adenosyl B12, Pure Enc. Iron-C, CoQ10, Vit. D and K2, Vitamin C-Complex, progesterone, and magnesium malate (switched from glycinate, which made me anxious). I also take Vitex, Berberine, and ground milk thistle seed with the recent liver pain and high enzymes.

    I don’t have MTHFR, but I do have several mutations in the methylation and detox pathways, including some that have been confounding me with catch-22’s as far as recommended supplementation goes.

    MTRR (need methyl donors)
    VDR Bsm, VDR Taq (avoid methyl donors)
    COMT (avoid methyl donors)
    CBS C699T (possible problems with high sulfur foods–and DIM did bother me)
    GSTP1 (need cruciferous veggies-high in sulfur)

    The B6 complex has 100 mg thiamin, 15 mg riboflavin, 110 mg niacin, 200 mg B6 (pyridoxine HCl), 667 mcg Folate (Metafolin), etc. Do these amounts seem too high to you for someone with these mutations?


    1. Thanks for your comment Di! I’m not a doctor and I don’t play one on the internet, so I encourage you to speak to your own healthcare provider about the appropriateness of your supplement regimen based on your individual needs. Best wishes for your health!

  48. Hi there, I am not sure if this thread is still active but am desperate for guidance. I am taking Bio Care, Methyl B Complex. As someone prone to low mood this, at first felt fantastic and really lifted my mood! It was so positive and I was so productive. However, the cumulative effect is extreme insomnia and headaches. I am so frustrated as it is such an unrealistic trade off (not sleeping). I know it is the supplement as I have experimented cycling off.

    Is it there other combination I could take with the same feel good without the insomnia please? Many thanks,

    I haven’t tested genetics, but have done blood tests.

  49. I have both MHTFR and COMPT mutations. For MHTFR, folate is good, but bad for the COMPT? How should l supplement B Vitamins if they contradict each other? Thank you!

  50. Good info, thanks, but some products you recommend have too much vitamin B6 for me. I have Interstitial Cystitis and B6 is an irritant.
    I found out I need unmethylated vitamins for my DNA through Nutra-hacker. They said to stay away from Methyl B12 (then they take me to a customized Multi Vitamin formula that contains Methyl B12!)
    So, I searched and found a company called Methyl-life and they have a multi with low doses of B6 but no B12 and Folate at all since they say this way the doses can be adjusted to my needs. Interesting if not annoying to have to take them separately plus for some reason it doesn’t contain any Vitamin C.
    Have you ever heard of this company? Here’s a link if it’s OK to post here:

    They also sell a methylated multi.
    Any opinions? I’m going to do the Genetic Genie upload tonight when I get home, thank you for the recommendation.

  51. Hi Laura! If my genetic test showed both the MTHFR and COMT, what B vitamins are okay for me?
    Thanks! 🙂

  52. Having trouble figuring out what to take if I am homozygous for MTHFR and COMT mutations, plus heterozygous for MTR and MTRR mutations. One mutation seems to negatively interact with the supplement that the other mutation suggests and vice versa! I smell like homocysteine and sulfur foods make my acne explosive.