Brief Answer:
Please find details below

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. MTHFR is methylenetetrahydrofolate reductase which is the name of an enzyme that functions in the breakdown of folic acid to methyltetrahydrofolate which an active form.

2. Gene mutation might be involving C677T or A1298C gene location. People with mutation in the gene might not be able to breakdown the folate efficiently. Hypothyroid state might be closely related to MTHFR gene mutation and close monitoring is recommended which you are doing.

3. The MTHFR gene mutation also causes hyperhomocysteinemia which is a substance metabolized in the liver. Some studies also show that people with non alcohol fatty liver disease might be more common in people with hyperhomocysteinemia which is a compound that is increased in inflammation.

4. AST and ALT are liver enzymes. Your AST is 3 times that of ALT and this might show a condition due to possible heart, muscle or liver conditions causing mild inflammation. Hypothyroidism might also have a complex relationship with liver function and this should also be kept in mind.

5. It is possible that you might have a mild inflammatory condition due to which the AST and ALT are raised or it might be a complex manifestation of the hypothyroidism and MTHFR mutation. It will be important to know if you had any symptoms which prompted you to get liver function tests done and if your doctor has made any diagnosis after clinical evaluation.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Have a balanced diet and lead a stress free life

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. Please get your homocysteine levels monitored regularly because of tendency of people with MTHFR gene mutation to have it elevated.

2. You should avoid items that might alter folate metabolism like birth control pills and also avoid taking medicines like proton pump inhibitors for gastritis because it reduces absorption of vitamin B12.

3. In diet you might include green leafy vegetables and rich supply of vitamin B12, B6, B2, C, E, D. Please avoid too much of processed foods and those foods which might increase level of metals like mercury, aluminium and heavy metals.

4. Taking a balanced diet should keep the liver in good health. You might consider repeating yout ALS and AST after 3 to 6 months.

5. The TSH being slightly above your usual level is not a serious concern. Thyroid monitoring should be continued as you are doing. Avoid any stress and anxiety in your mind.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Please take methofolate with caution as mentioned below

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. Please continue taking methofolate cautiously. If at times, you suddenly feel symptoms of methofolate side effects like anxiety, nausea, insomnia, pains and aches, irritation, then please discuss with your doctor and either lower methofolate dose or stop for two weeks and start again. The B Vitamins might be continued.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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