Hi ladies

I am heterozygous for MTHFR, and I was informed that taking Folgard is a good idea. I live in Asia, and it is not available so I have to take each vitamin separately. Can someone tell me the amounts in the prescription strength version? I know the folic acid is 2.2mg, but unsure of the rest. I tried to look it up onlne but could not find this info anywhere. My doctor has never even heard of it(the Folgard), and also did not give me any idea of how much of each vitamin I should have, so I have to go it alone. Thanks!!

Superkitty--
According to the Folgard 2.2mg Product Insert (the sheet that lists all the drug info) the contents of the pill are as follows:
2.2mg Folic Acid
25mg Vitamin B-6
500mcg Vitamin B-12

Other brand names that you dr can try:
Folgard, Folgard RX 2.2, Foltx, Homocysteine Formula

Generic:FOLGARD RX - generic (cyanocobalamin/fa/pyridoxine)


Hope this helps and good luck!

Thanks kzb for the info. Most of the posts do not mention the amounts of vitamin B6 & B12.

First of all, I am new to this, so I apologize for not knowing all the abbreviations there are...I have had 2 m/c within the past 4 months, and have just found out that I am heterozygous for MTHFR and was told to take baby aspirin and 4 mg folic acid once I have my period after my m/c. My ob/gyn said to talk to my primary care dr to see if I need to take something all the time, or just while ttc and pg. So, I don't know what Folgard is, but it seems that there might be another "rememdy" that you might be able to get over the counter.
Good luck to you!

You can always substitute over-the-counter vitamins for the vitamins that are in prescription Folgard. Folgard just makes it easier by putting everything in one pill, and many people's insurance covers Folgard, making it cheaper than buying all the over-the-counter pills. But I'm concerned that your doctor doesn't understand MTHFR well enough to know that you need baby aspirin and high-dose folic acid everyday for the rest of your life, or to know that folic acid must be accompanied by proper ratios of the other B-vitamins in order to be absorbed. :( I'm glad you'll be getting a second opinion from your regular doctor. Also, please know that many MTHFR patients must use Lovenox (low molecular weight heparin) in a ttc cycle and while pg in order to avoid m/c. For more information about this, look at the extensive files on MTHFR here on the genetics board and on the immune issues board, look for information on thrombophilia and pregnancy in the files of the Yahoo Immunology group http://health.groups.yahoo.com/group/immunologysupport/ and Google "thrombophilia and pregnancy." MTHFR is still new in the medical field and many doctors do not yet understand it. Keep pushing until you find a doctor who deals with MTHFR all the time. Then you'll finally be in good hands :hug:

Kind regards,
Lauren :wave:

Thanks Lauren. I am going to see a genetics counselor tomorrow to talk about everything. My doctor is referring me to someone else, I am hoping it is someone who knows about this. In the meantime, it looks like I will be doing a lot of research on my own to try to figure out the right questions to ask. Thanks again for your help.
Jules

Since I am unable to get Folgard(or anything similar), I have had to purchase the vitamins separately. I am unable to find them in the proper quantities, so I have to just come close with the amounts. My question is, the Folgard is in addtion to the prenatal vitamin, correct? And what dosage of the folic acid should I be looking for in the prenatal? The one I have now has 800mcg. So, it seems I would need the 2.2mg, plus the 800mcg? I am curious since the proper ratio of folic acid and B vitamins seems to be important.

Another option is called FolaPro, which some consider to be superior to Folgard, because FolaPro is a form of folate that MTHFR patients can actually metabolize. You can buy this from an acupuncturist or anyone who has an account with Metagenics. Be sure to click on the link to "additional product information."

http://www.metagenics.com/products/catalog/detail.asp?pid=215

Yes, any folic acid supplements are in addition to your daily prenatal, which should contain between 800mcg and 1mg (1000mcg) of folic acid.

The Folgard RX 2.2 has 2.2mg of folic acid, and some say you should take one Folgard (or its equivalent) per MTHFR mutation. I have two MTHFR mutations and I choose to take one Folgard (2.2mg) and on FolaPro (800mcg but my body can actually absorb it) daily, plus my prenatal.

Hope that's helpful!
Lauren :hug:

I was just told I have MTHFR too. My doctor doesn't seem to know much about it and I'm doing all of the research! They put me on Natelle prenatal vitamins that have 1mg of folic acid, 30 mg of B6 and only 12 mcg of B12. Looking at the above posts it seems I need double the folic acid and lots more of the B12. I'm still learning about this. Can anyone help? Thanks! :o)

Thanks Lauren. I am pretty sure I am unable to get FolaPro as well. I live in Asia, and they tend to have different products over here. I have asked my doctor about Folgard, and he didn't even know what it was. His office sells folic acid in 5mg size. I am not sure I need that much. It seems that for hetero MTHFR, I would need a total of 3mg, since there is 2.2mg with Folgard, and another 800mcg with my prenatal. Does that sound correct?

Superkitty: Yes, what you said sounds right. Can you break those 5mg pills in half?

Weddinggirl: That prenatal sounds good, but anyone should be on that. You're right that you'll need more folic acid, etc., than that prenatal can offer. Can you tell him you want an rx for Folgard RX 2.2?

Both of you: remember that daily baby aspirin is also of critical importance.

Kind wishes,
Lauren :hug:

Hi Lauren

The 5mg pills are quite small, so I don't think I can break them in half. I guess the best I can do for now is to take 3 of the 800mcg, plus the prenatal so that will give me 3.2mg, so it is pretty close. It would be so much easier if they only sold the Folgard! Thanks for all your help. Oh, I am on the aspirin as well, I believe it is a low dose aspirin, Cardiprin. They do have that available overseas!

I have high homocysteine levels and basically need to be on the extra folic acid, vitamin B6, vitamin B12 & baby aspirin every day for life to help break the levels down, or it puts me at higher risk for stroke, heart attack, thrombophylia and other clot-related worries.

Once I finished my pregnancies, I decided to use over-the-counter vitamin versions since the Folgard was more expensive per month. It would have been no problem to do that during pregnancy too. I just decided to spent the extra $$ on the 1 Folgard pill during pregnancy to have less pills to take.

You can definitely build the same doses of folic acid, vitamin B6 & vitamin B12 over-the-counter, it just takes several pills. They've addressed the folic acid dose above. On the B vitamins, I've found that all B vitamin bottles contain way more vitamin B6 per pill & more vitamin B12 per pill than you need. However, the pharmicist said that's OK, since with B vitamins your body only absorbs what you need and passes the rest through in your urine.

So, in addition to your prenatal, you'd likely need folic acid pills to equal an additional 2.2 mgs, plus 1 vitamin B6 pill and 1 vitamin B12 pill (each of which will contain more of the B vitamin than you will need, but your body will pass the excess on through). Most OBs also recommend taking 1 low-dose baby aspirin a day to those of us with MTHFR, homocysteine or other clotting issues. So you may want to add that in too.

As you near delivery, at about 36 weeks I think, you will want to stop your baby aspirin, since they won't want your blood thin at delivery in case of a c-section operation. After you go home post-delivery, you add the baby aspirin back in again. But you would continue on with the folic acid & B vitamins throughout the pregnancy. You'd only stop taking them if they're giving you some kind of medication in the hospital that the extra folic acid & B vitamins would conflict with. You would let them know at the hospital that you're taking them and ask them what to do. They'll likely want you to stop while you're there, just to make sure there are no conflicts with anesthesia, etc. Then you'd start them again after you get home, along with the baby aspirin.

Importantly, as mentioned above, you'll want to continue taking them every day for life. I'm bad sometimes about not taking them, but I have to keep reminding myself that they will reduce my risk of stroke, heart attack and other blood clot issues, and it's just taking extra vitamins every day. It could be alot worse!

In fact, our condition is usually inherited, so please urge your family members to be tested as well. It's likely one of them also has it and needs the supplements every day. My dad does...I inherited it from him. And he's in his 60's, the prime age for all the dangers of elevated clotting levels! His doctor put him on the supplements as soon as he came back positive for elevated homocysteine levels. Thank goodness we found out!

Ok- another question.... Is it possible to have MTHFR but not have high homosysteine levels? Because, according to my doctor I have MTHFR but my homosysteine levels are not high and they said I wouldn't need the baby asparin. Is this right? I'm really starting to think I should find a new doctor that knows more about MTHFR.

Thanks! :)

I'm not sure. Ladies, any info?

Homocysteine levels are not always accurate predictors for women, says my doctor. I have low homocysteine but am required to have baby asprin and the other meds. This is true for dozens of women whose doctors note that in recent studies show that homocysteine tends to in women in response to, but not necessarily as a precursor to, adverse pregnancy events. Women whose homocysteine is high make it easy for their doctors to decide. Women whose homocysteine is low will get different reactions from different doctors. My understanding is that the more educated a doctor is, the more likely s/he will ignore homocysteine levels for MTHFR women. Besides, what's the worst that could happen by giving a patient extra vitamins plus a very common, very tiny amount of aspirin? Compare that to what might happen if she needed it but didn't get it. Definitely either find a different doctor or get a second opinion. :)

Meanwhile, great comments Leslie. One comment to add: not all doctors agree to stop baby aspirin prior to delivery. In fact, those patients whose pregnancy protocol also includes heparin injections are often advised to NOT stop the aspirin. The heparin stops either a week before natural delivery or 48 hours before planned delivery in those cases. But to simply stop everything at once puts mom and baby at risk for stroke, heart attack, DVT, etc. So there are some differing protocols out there on that particular point.

My own protocol is baby aspirin and high-dose folic acid everyday for life. When ttc, Lovenox injections daily starting CD6. When pg, Lovenox twice daily until one week before delivery. Once delivered, Lovenox for six weeks post-delivery (a dangerously hypercoagulant time.)

Hope that's helpful.

Kind regards,
Lauren :D

To clarify...I'm learning as well and just diagnosed today.....

Supplement Daily Goals:

Folic Acid - 2.2mg
B6 -25mg
B12 - 500mcg

Is this correct? If not, please clarify so that we can all do our best to reach our healthy daily goals of these vitamins.

Thank ya
Jep ;)

Jep, (pg. ment)


I'm the board coordinator at the Immune Issues boards and sorta followed your post back to here...

I reread this particular post and see that Lauren was writing info. back in 2006 here - Lauren also remains on the Immune Issues boards as well and has a post about her current prg. as she is due to deliver in mid August!!

Lauren is bang on with all her info and has well researched all to do with MTHFR. If you want to reach more members who deal with this it would be a good idea to post over at the Immuen Issues boards - many members end up there if they have to go on the injections for blood thinning and to get support from those with similar experiences and diagnoses.

I think you are right about the dosages as I've read up to the beginning of the thread and remember that the folic acid of 2.2 mg woudl be in addition to any prenatal vitamin you are taking that will likely have around 1 mg of folic acid in it. OH and you should also be taking a daily low dose aspirin right? did your doc also recommend this?? it is always used in conjunction with the lovenox injections as well thruout prg. as you will see this also mentioned in one of Lauren's posts above. (she is extremely well educated on the condition btw)

I/m not sure why you wanted to delete your original posting there but I hope to encourage you to post over at the Immune boards as well ...it is a bit slow for summer months but there are alot of girls who deal with MTHFR and who can be supportive to you there!! hope to see you posting there! :wave: & best of luck in the sept. ttc cycle!

Ally

Wedding girl, yes that is possible. It appears (from all the fab info I have read here and on the yahoo group) that some docs won't treat MTHFR without high homocysteine. I experienced this first-hand today. I just went to the RE today to discuss my MTHFR. My homocysteine is at the very high end of normal (12/13). She said therefore it was sort of maybe borderline a concern, but otherwise hetero MTHFR did not affect my seven failed pregs at all! I am not buying this for a second. Now I know how hard it is to find someone who takes RI seriously...I have learned to expect this from all the valuable info posted by ladies on this and other boards. I was so surprised though! It was from someone who runs an RM clinic. She didn't mention aspirin at all, only 5mg folate. She did however offer me clexane (lovenox in the US) in the absence of any "known" cause of my RM.

My wife and I found a cheaper one-pill option to Folgard is Folbee. It is in essence a generic for Folgard (although there is technically no generic, since vitamin supplements aren't FDA approved).

http://www.breckenridgepharma.com/valubrand/Folbic.pdf

Our RE prescribed Folgard for my wife's MTHFR. We happened to find Folbee through some research and had him write a prescription for it. He had never heard of it and thanked us for finding a cheaper alternative that he could give his patients.

Our insurance (Medco) wouldn't cover Folgard, because they said it is a vitamin supplement that can be purchased over the counter. We got a 90-day supply (180 tabs) of Folbee through Medco for about $40 (They wouldn't cover this either, but they had the lowest price if we got it through them). Folgard would have been about $79 at the cheapest place we could find.

hi, everyone,

i've been reading your posts and am so thankful to have found others in my same boat TTC. i'm heterozygous MTHFR (A and C) and in the middle of an IVF cycle. acc. to my hematologist, i tested positive for the "prothrombin gene mutation."

i start lovenox today. though he said it was only necessary i take a good prenatal, i've pressed my hematologist for a prescription folate.

if i can get a prescription filled for folate, which presc. brand is recommended to add to a prenatal? since i have so many IVF medications to take, i want to keep it as simple as possible.

also, does anyone know if it is okay to take only lovenox after embryo transfer/2WW/preg? my hematologist has said that i will start lovenox and stop baby aspirin at that time.

thanks very much,
jennifer

Your hematologist is right...once you start lovenox you no longer need to take aspirin. Lovenox does the same thing, but more effectively.

As far as which folate to take...I would recommend that you get one such as Folgard or Folbee (generic version of Folgard and cheaper, see my post below). Make sure that if they give you more than 2mg or so a day of folic acid, that your vitamin also has Vitamin B12 and probably B6. With the additional folic acid you need the B12.

Good luck with everything.

I'm in the 2ww after a blast FET....I'm also on Levonex and according to you ladies I can stop the aspirin :)

QUESTION :confused: - HOW LONG DO I KEEP TAKING THE FOLGARD? WHEN DO I STOP TAKING IT?


Thanks for the help girlies!

Heparin vs. Lovenox? Which is better? Why is one prescribed over the other? I'm homo for A1298C - I'm going on heparin status post an IUI. It's not something my doc probably would have prescribed - but I requested it because I have had four unexplained losses. I almost don't want to know which is better- since I have the heparin sitting right here! Be kind if you think heparin is not the way to go . . . :)

Both drugs perform the same function. Lovenox is longer acting, but is also more stable and thus can be given more safely on a long term or outpatient setting. Lovenox is called a low-molecular-weight heparin. Because it is low-molecular weight it is much more consistent in its therapeutic effects.

Heparin is higher molecular weight and is less consistent in its therapeutic effects. Thus, people on regular heparin need to be monitored much more closely (through blood tests) in order to ensure proper results. The other big advantage of it though, is that it is shorter acting. This allows you to discontinue the blood thinning effects more quickly if needed.

If I were taking it for an entire pregnancy at home, I would suggest Lovenox. The only bad thing is that Lovenox is more expensive. We recently got Lovenox 40mg daily, 90 day supply filled through out mail order pharmacy (we have great insurance). We paid $60 and the plan paid $2425.06.

Hope this helps.

Stacey

This information has helped me immensely.

After my second failed IVF in November, I was tested and found positive for MTHFR C677T and APA. So I'm taking baby aspirin and folgard 2.2 on a daily basis (and will continue from now on).

I'll be starting to stim for IVF#3 in a few weeks, and my RE is going to put me on heparin after the ER. I asked why not before and he said that there could be too much bleeding involved. We'll be doing a 3DT so I hope this is enough time for it to be in my system.

I wasn't sure what the difference was between heparin and lovenox and they do seem very similar. I'm sure my RE has his reasons for putting me on heparin and not lovenox and he's the expert so I shouldn't question him. But I think I will ask him his reasoning nonetheless. Because I do like the idea of having only one dosage per day, especially if its to be throughout the pregnancy.

I'm new to message boards so I'm not sure if I'm doing this right, but here goes.

A little background before I get to the questions. I've had 3 early m/c's. The last one just 3 weeks before Thanksgiving where we did find out there was a genetic reason for the loss. We know nothing about the previous 2 losses. I am currently 8.5 weeks pregnant and had been going to a fertility clinic where I was just released to my regular OB on Monday. When I went to my OB yesterday he was looking over the labs and paper work the fertility clinic gave me to give to him. I was always told by the fertility clinic that everything was normal and where it should be. When my OB checked over everything he said that I had a clotting disorder. He told me that it doesn't affect me what so ever when I'm not pregnant but could while pregnant. I was shocked. I don't understand why I was just hearing about this? When I looked at the labs I see the specific test as being MTHFR with results Pos 2 copies. Not sure exactly what this means. After reading some of the info on this post I'm really starting to worry about the possibility of another loss and that the Dr's haven't been forthright with me.

Is it possible to have this MTHFR but only be affected when pregnant? How could he deduct this just by the result Pos 2 copies? I am taking baby aspirin and an extra dose of folic acid, although I'm sure it's not as high as what I'm reading it should be. I'm definitely not taking any extra B vitamins which apparently I'm going to have to talk to the Dr about. Does taking all these extra vitamins give you more energy? Or better yet does MTHFR affect your energy level what so ever? Just curious because I feel like I have even less energy than usual in a pregnancy.

Is Pos 2 copies the same as having 2 mutations? Does anyone know?

Sorry this is so long just trying to find out some answers so I can go to my next appointment with some knowledge about this to get some action taken.

Thanks for any help you can give.

The Pos 2 copies could mean that you are positive for 2 mutations, but I would ask your doc for clarification. I would think that terminology would mean you have two mutations for MTHFR, but again, I would ask just to make sure.

It is very interesting that the fertility clinic told you everything was okay. I think it is generally accepted that MTHFR mutations can affect pregnancy, but some physicians still think it controversial and don't see it as an issue (and thus they may not treat it). However, it is possible that they simply didn't catch it (I would hope this wouldn't happen, but mistakes do happen).

It is good that you are taking the baby aspirin and folic acid. Baby aspirin will help with MTHFR and most docs will also put you on some form of heparin (especially with recurrent m/c; see the responses above in this thread about heparin).

You definitely should be taking folic acid. MTHFR is an enzyme that creates the circulating form of folate (which it makes from folic acid). Having the gene mutations means you can't create as much folate. By taking supplements you ensure that all the enzyme in the body has a bit of folic acid to turn into folate. Not having enough folate can cause homocysteine levels to rise, which is what causes concerns for increased clotting.


Most docs will prescribe Folgard, which contains plenty of folic acid, B6 and B12 (there is also Folbee, which contains the exact active ingredients as Folgard, but is cheaper, www.folbee.com).

My wife found out after 3 m/c that she had 2 mutations for MTHFR. We are at 10 weeks on pregnancy #4. She is on Folbee (2/day), baby aspirin (1 day), Lovenox (40mg/day), prenatal vitamin (1/day), and Glumetza (brand name of metformin 1000mg, 2/day). The Glumetza is for PCOS. This is the farthest we have ever made it in a pregnancy (longest before was 7 weeks).

I would call your OB if you think the paperwork says 2 mutations in order to clarify. And I would call the fertility clinic and ask them if they were aware of it and if they suggest any treatment.

Good luck and keep us updated.

imaroma,

Hello, I have a link for further discussion on the why's and how's to take Folgard or some form of B vit + folic acid supplements along with the baby aspirin ( you need to stay on baby aspirin for life) and also some stronger form of blood thinner for purposes of conceiving and sustaingin prg.

here is a link from an earlier discussion about the MTHFR stuff:

MTHFR Discussions and dosage requirements:

http://www3.fertilethoughts.com/forums/showthread.php?t=434902

Also your doc is right, many times clotting disorders can be generally "safe" for overall health (altho MTHFR does have health risks and issues associated with it later on in life) and yet the clotting condition can affect the state of becoming or staying prg. The reason is that any tiny miniscule clots in either the uterine lining or the placenta/ umbilical cord can cut off nutrients and prevent proper blood flow to a growing embryo. This is the mechanism behind clotting antibodies and they can actually flare up once there is a conception /prg detected by the body.

I hope this info helps a bit and you are soon on your way with a strong prg. - you can also post over at the Immune issues boards (even though MTHFR is genetic is often accompanied by other forms of acquired blood clotting antibodies which is another reason why may flare up during prg.) and discuss it more there as many members who now take the Lovenox /heparin injections are also combatting the MTHFR stuff.

regards,
Ally

Thank you gsbanks and Ally for the information. I will be praying that everything continues to go well with your pregnancy gsbanks. I to am almost at 10 weeks now and have gone farther than w/ any others. I just got an u/s today and everything is looking good.

The information has been very helpful, although I think I'm still pretty confused especially since the answers I seem to be getting from the Dr are contradicting what I've been reading. I haven't been able to get the fertility clinic to return my calls regarding this test. My OB told me today that he has also put a call in to the clinic and is also waiting for a call back, so I'm hoping it's being looked into before they return our calls. I did ask my OB about it and I'm not sure he knows a lot about it but he's trying to find out. He told me that I have MTHFR heterozygous, but from what I've read on this site http://mthfr.150m.com/ it states that if you have two copies then it's actually homozygous. So understandably I'm confused!!

When I go back in on Tues. I think I'm going to have my OB recommend me to a hematologist. I just don't want anything to go wrong. My OB has also stated that I wouldn't need to go on Levonex or anything until the 2nd or 3rd trimester, which obviously contradicts what I've read on this forum alone. He said that's the time when things could go wrong. I just don't know.

I wish this was a cut and dry thing. Good luck to all!

Hello ladies...I am trying to get the right doses of folic acid and B vitamins since i have no insurance coverage for IF and my OB really didnt know what to tell me other than to take a pre-natal and a baby aspirin? So after reading all your posts i think i have figured it out? I just wanted to run it by you all and get your opinion...so here it goes...

pre-natal:600mcg folic acid
6mcg B12
2mg B6

Extra B6:100mg
Extra folic acid:400mcg
Extra B12:1000mcg
Extra Bcomplex:5mg B6
400mcg folic acid
10mcg B12
OK....now i need your opinions ladies! Is this too much or too little? Should i be taking these vitamins twicw a day?
:confused:

Hello.
My wife had 2 miscarriages at 8 weeks. After some tests, we knew that she have MTHFR. 2 days ago, we knew that she's pregnant. She's taking a 5mg Acid Folic since 2 years continuously (from the first pregnancy). The doctor tells her to take Baby Aspirin after getting pregnant. Do you have other advices? I read in some posts that B vitmanins are very important.
Could you kindly tell me about the required quantities for ACID FOLIC, B6 and B12??
Is there any side effects for the acid folic (Folgard,Fobic,Folbee...) if she's pregnant???

Thx,

I was dx'd with my MTHFR & 2 genes defects in August. I was prescribed Folgard RX. 4 years ago I had been dx'd with a severe B12 deficiency and have had significant difficulty maintaining a normal low level (low to mid 400s) giving myself injections every 2 weeks. In the past two months with the Folgard, my B12 level has soared to 1570-1890, so now I'm not giving myself injections.

Most of the non-prescription supplements the maximum appears to 800 mcgs folic acid. If you can order online, The Vitamin Shoppe has one called Tri-B that contains all 3 with the folic at 800 mcgs. Per my MD, I would have need to take 4 of these to get the proper dose of everything.

At 50 fertility is no longer my issue, but this diagnosis explains many of the difficulties I had with my entire reproductive system.

Best to everyone on the list.

Hi I'm new here and recently dx with heterozygous MTHFR. I know a lot of these posts are older, but wanted to find out if anyone that is heterozygous (1 copy) has had pregnancy success with just Folgard and low dose aspirin? My doctor is not so sure about giving me lovenox since my homocystein levels are normal and I guess I am looking for reassurance that I'll be fine with folgard and low dose aspirin. Thanks!