If you’ve struggled with stubborn low iron — or oddly high ferritin levels — despite a clean diet and good supplements, your MTHFR gene might be playing a hidden role.
And you’re not alone — I’ve been there too. As someone with an MTHFR mutation myself, I’ve seen firsthand (and in countless others) how iron metabolism doesn’t always behave by the textbook when methylation is impaired.
So let’s unpack what’s really going on.
First, What Is MTHFR?
MTHFR is a gene that helps your body produce an enzyme needed to convert folate (vitamin B9) into its active form — methylfolate.
Methylfolate is essential for a process called methylation, which affects:
- Detoxification
- Hormone metabolism
- Neurotransmitter production (hello, mood and focus)
- Immune function
- And yes… iron regulation
When this gene doesn’t function optimally, the methylation cycle slows down, which can mess with how your body uses key nutrients — including iron.
Problem #1: Low Iron That Won’t Budge
If you’re MTHFR+, low iron can be maddeningly stubborn. You might:
- Take iron supplements (even the good ones)
- Eat red meat or spinach daily
- Still feel tired, cold, or weak
Here’s why that happens:
Impaired Methylation = Poor Iron Utilization
You need methyl groups to activate enzymes involved in iron absorption, transport, and recycling. When methylation is sluggish, your body may:
- Struggle to absorb iron from food
- Fail to convert iron into a usable form
- Lack the cofactors (like B12 and folate) needed to support red blood cell production
In short: you may have enough iron coming in, but your body isn’t able to use it well.
Low Iron Also Affects Neurotransmitters
Iron helps you make dopamine, serotonin, and norepinephrine. When it’s low — and MTHFR is slowing your methylation — you can feel:
- Depressed
- Anxious
- Foggy
- Unmotivated
Even if your ferritin is technically “normal,” it might not be enough for optimal function when your system is already under-methylating.
Problem #2: High Ferritin = Inflammation, Not Just Iron
Now here’s the flip side: some people with MTHFR mutations have too much iron stored in the body (ferritin), and that’s just as problematic.
High ferritin can mean:
- You’re not clearing iron properly
- Inflammation is trapping iron in your tissues
- You’re recycling iron poorly, leading to low energy despite “high iron”
High Ferritin ≠ High Functional Iron
Ferritin is also an acute phase reactant, meaning it rises during inflammation. With MTHFR mutations, you may have:
- Chronic gut inflammation
- Poor detox pathways
- Hidden infections (like Candida, SIBO, Lyme, EBV)
…all of which spike ferritin and throw off your ability to use iron properly.
So What Can You Do?
Here’s what I suggest for patients with MTHFR + iron issues:
Get the right labs, support methylation, and get to root causes
Come see us! Before loading up on iron, you may need to make sure your body can use it. We can support you in the following ways and more:
- Address hidden infections or gut issues
- Lower inflammation
- Support detoxification pathways (especially liver & lymph)
- Choose gentle iron (if needed)
- Modern Methyl Support
- Choline (for liver support)
- Magnesium + zinc (cofactors)
- Liver-supporting herbs like milk thistle or dandelion
Bottom Line
MTHFR mutations affect how your body processes, recycles, and responds to iron — so whether your numbers are too low or too high, it’s rarely just about “taking more iron.”
It’s about supporting the whole system — methylation, detox, inflammation, and gut health — so your body can regulate iron properly.
Still stuck? This is where we come in. At Modern Medicine, we help you look at the whole picture — labs, genes, and symptoms — to build a plan that gets your body back in balance. We can’t wait to support you!
Jade Green, TNC, CHHC
