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Do you supplement her at all? 5-MTHF (methyltetrahydrofolate) is the type of folate (activated folic acid) that should be supplemented for MTHFR per my integrative naturopath doctor. Both my daughter and I are suspected to have MTHFR due to our midline defects, so we both supplement. I honestly don’t know a whole lot about it. What I do know is that regular folic acid is not absorbed properly, so the special folate is absorbed so you can help to avoid problems. I believe methyl B12 should be supplemented as well. We were supposed to get tested, but got sidetracked by our EDS and my POTS diagnosis. Our ND did tell me that the supplement is all that she would add even if we were positive, and we are already on it. I do remember her telling me that people with MTHFR defect sometimes have a hard time with the methylation (detox) pathway if burdened with heavy metals, etc. We already had previous lab work that showed we both were having methylation problems.