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Depending on individual needs, strategies may include: Use of active nutrient forms (methylfolate, methylcobalamin, adenosylcobalamin) when appropriate (3,12) Avoidance of excessive synthetic folic acid (pteroylglutamic acid) in susceptible individuals with reduced MTHFR activity (8) Lifestyle measures that support mitochondrial and liver function, including sleep optimisation, stress management, and antioxidant-rich nutrition (5,14), often addressed alongside gut microbiome health Next Steps Review your symptom pattern: If chronic fatigue persists despite normal routine testing, consider whether methylation-related factors may warrant further investigation

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10.1016/j.aninu.2021.11.009 64 MastN.PetrovA

The Lancet 396 (10264), 17111712