MTHFR, Part II

>> Wednesday, February 21, 2018

I first just want to thank everyone who has guided me a bit through this whole MTHFR thing since the weekend. It's a bit overwhelming to hear you have something different about you. But after chatting with a good number of you . . . I don't feel so alone or, well, mutant.

To answer a few questions:


// 1: Vitamins, etc.


I have switched my vitamins to Thorne Basic Prenatals. These have a L-methylfolate (bioavailable form) in them, which is recommended. I was fortunate enough to chat with a registered dietitican who explained that these vitamins are safe and a good choice.

I will also be taking an additional L-methylfolate supplement, also by Thorne. The doctor said I could take up to 4mg more (total of 5mg combined with prenatal), but I'll start with just an additional 1mg.

// 2: Sourcing information


I understand that not all the information I linked yesterday is from the most reputable sources. As a medical writer, I have a skeptical eye when reading over such material. MTHFR has been anecdotally linked to a lot of conditions, which I do find interesting. MTHFR does seem to be an emerging thing. As a result, the medical community obviously has the best information . . . but they don't necessarily have all information. Also: There's much more research on homozygous individuals. I'm simply piecing together everything I find -- with caution.

I'm not doing anything drastic based on random online articles I find without guidance from a doctor. It just gives me some fuel for questioning.


// 3: Lovenox 


Many of you have written to me about Lovenox. So, I did meet with my doctor and had some anxiety about the possibility of taking injectable blood thinners. After meeting, we decided that upon pregnancy I would keep taking baby aspirin and not do Lovenox.

I understand the two drugs perform different functions (BA thins the blood, Lovenox deals with clotting). But I don't have even borderline levels for other clotting disorders and have only one mutation for MTHFR. He did provide clinical examples of when he would have required the Lovenox (he even joked and said if it was required, I would have to come in every day and hold his hand to get them), but said that 8 out of 10 doctors would likely not indicate the drug in my case (hetero, no clotting disorders, no history of clotting).

It was a suggestion based on my miscarriage history (but there weren't formally diagnosed clots) . . . but that it was more as an "ease my mind" measure versus necessity. Since it amps up anxiety instead, he explained he wasn't super attached to the idea.


// 4: Feelings


It's a lot of information. It's a lot of "what if" scenarios running through my mind. Like, what if this is what caused my miscarriages. What if we found this out sooner? What if this had something to do with Ada's brain cyst (MTHFR is linked to neural tube defects -- her cyst isn't exactly that, but it's not terribly far off). What if by not taking Lovenox something happens?

My doctor assured me that there is still a chance that the MTHFR may have had nothing to do with my experiences. It could have as easily been the progesterone. It could have even been bad luck (which I hated hearing when I was going through it, but -- with time -- I do see bad luck as a cruel possibility).

In all, I have to have an element of feeling there's a bigger plan. If I hadn't miscarried, for example, I wouldn't have my sweet Eloise. Throughout everything I have experienced, I do truly feel like on some level we end up with the family and life we are meant to have. I'm not a terribly spiritual person . . . but when my anxiety gets the best of me, I try very hard to give my thoughts to whatever the greater purpose is or could possibly be.

// 5: THANK YOU


Again, a HUGE thank you to everyone who has spent time writing to me in the last several days. I love this online community and its kindness. Though SO many situations I've encountered in my life, you guys have been there. We all have so much to share in way of experiences and empathy, it's incredibly heartening.

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Fertility results + MTHFR -- Say WHAT?

>> Tuesday, February 20, 2018

I got my results back from my fertility blood work. Well, I actually called to ask about it and was told everything came back normal and that I'd be getting a letter in the mail. And I did on Saturday. It detailed my results for a wide array of tests.

Anti-Mullerian. This is your ovarian reserve. For someone my age (34), the number should fall somewhere between 0.176 to 11.705. My result is 7.644, which is apparently solid, indicating a good number of eggs.

My thyroid test came back totally normal.
My ANA screen was negative.
Anti-cardiolipin antibody, Cardiolipin, APC resistance -- all great numbers.

The receptionist had said everything was normal, so I kind of breezed through my report feeling like I aced a test. And then I dug into the MTHFR results . . . where I did a double-take. I saw a pesky "ABN" meaning abnormal next to the MTHFR c.665C>T (formerly known as C677T) and the word "heterozygous" -- WHAT?

I thought everything was "normal" . . . but seeing an abnormal result did make some sense.

The doctor's note on the letter included with my tests said that he wanted me to start daily Lovenox injections upon seeing a positive pregnancy test. I was all sorts of confused but assumed maybe it was a broad protocol if you've had recurrent loss issues in the past. I had made a note to call about that, but when I saw the MTHFR mutation, I immediately realized why he had recommended this course of treatment.

Because I'm a mutant.


OK. Back up.

What is MTHFR besides looking a lot like "m*therf*cker"?

I first encountered it when I was searching to find out why I kept miscarrying. In different TTC boards, women would all be talking about getting tested for MTHFR. I saw it come up so frequently, and I had planned to be tested for it . . . and then got pregnant with Eloise. This time around, I decided to ask to be tested because it affects more than pregnancy.

MTHFR is an important enzyme in the body that helps convert folic acid/folate into L-methylfolate. When this enzyme function is compromised, it can crop up as a number of different health issues. A heterozygous result means that I have a mutation of one of the two genes. In short: My body has tremendous difficulty processing folic acid in vitamins, foods, etc.

Hetero is the "less severe" version, but it's still associated with recurrent pregnancy loss, neural tube defects, among many other medical issues. And according to my results, some 35 percent of European Americans may have this mutation. So, it's actually not that rare. It's just relatively new as something people are treating and discovering.

Side note: I was foolish and didn't check with insurance before asking for this test. I'm now worried how much it cost! But I suppose it was important, regardless.

If you're curious to learn more about this mutation, I encourage you to do research. I'm just learning more than the absolutely basics. The U.S. National Library of Medicine has a good overview. So does the Genetic and Rare Diseases Information Center. And here it is explained in plain English.

I have more to say on this topic, but I didn't want to go too deep today. I mostly wanted to say that I found something out that may have at least something to do with recurrent pregnancy loss. Losing three or more pregnancies in a row is like a 1 percent possibility. I've always wondered in the back of my mind WHAT was up with it. And it's something that still worries me going forward. And also because I could have passed it onto my kids.

I ended up meeting with my doctor yesterday, and I'll be sure to write more about that soon. But this is already quite long!

Do you have an MTHFR mutation? How has it impacted your life? Any suggestions?

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Sharing Thoughts on Picky Toddler Eating

>> Friday, February 9, 2018

So many of you have asked me how Eloise's eating is these days. I wish I could say we've turned a corner. But, we've hit, like, an even higher peak of picky eating lately. It isn't all bad, but we're definitely in one of those periods of eating ONE big meal every few days and picking the rest of the time. So, it's not all bad . . . just inconsistent and frustrating.

I remember distinctly that she only ate the blueberries:


Despite all my efforts to cook and serve healthy, interesting, and tasty food . . . I have to remember that this phase isn't going to last forever. Or, as a couple of my friends tell me, maybe Eloise will always just be super incredibly picky and never grow out of it and always be super small and never grow much, etc.

Thanks, friends.
That helps.
Sarcasm.

Ada was also picky at this age, but it wasn't quite as frustrating. Some tricks worked with her. Like serving smoothies or pouches when she wouldn't eat solid foods. Heck, I could even puree up e.v.e.r.y.t.h.i.n.g she discarded on her plate and she'd suck it down. I even put scrambled eggs in one of my mixes -- and she didn't notice. Gross but it got the job done.

Ada also loved using the nibble tray. I'd section out different foods -- cheese, fruits, veggies, crackers, tofu, etc. -- and she'd graze for the whole morning to afternoon. I know some people are more for eating proper meals than snacking. I've tried both approaches and Ada's grazing periods were often temporary, punctuated by long stretches of actually eating meals regularly.

With Eloise, I have to take what I can get. The girl will literally starve herself. But at the same time, she'll also eat HUGE meals other days, so I don't think it's necessarily a feeding issue or sensory thing. Last night she ate two scrambled eggs with toast and anything else Stephen would throw at her. She hadn't touched eggs in months. And her preferences of some foods over others isn't consistent enough to pinpoint if anything isn't especially to her liking.

This sounds like a long rant about Eloise. It's not targeted resentment or anything like that. I am just updating to tell everyone that I offer healthy foods. I also offer toddler equivalent junk foods (Goldfish crackers, Nutrigrain bars, etc.). It doesn't seem to matter what it is, my girl is in a picky stage. She eats sometimes. Not others. The doctor isn't worried because she's maintaining her weight and even gaining ever so slightly. So, I'm forging ahead.

I've decided to really give the nibble tray another eager go because when I've tried to wait for proper meals, all hell breaks loose.

I have our old tray, but I cannot find its lid.


And so many of you have asked me where, oh, WHERE can you find this tray!?

Well, here. But it's discontinued and no longer carried by amazon.

Sad face.

So, I'm thinking of buying this oversized silicone ice cube tray that has a lid. It's a 2-pack (glorious!), so I figure I could load one for the morning and one for the afternoon. I like to do berries and peas and other things -- like Cheerios -- that are small and easy to grab.

(This method isn't magic. If you're curious, she only ate the peppers and one section of the Nutrigrain bar.)

PS: If you're interested in what I used to feed Ada -- also vegetarian -- when she was an older toddler/preschooler, check out this Ada's Eats posts with details on that.

Happy Friday!

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