Acne, Amenorrhea, and Anxiety: What a MTHFR!*



For those of you playing the home game, you already know that I’ve been seeing a functional medicine doctor, and that we’ve already figured out that I’m dealing with stage 2 adrenal fatigue, a messed up thyroid, and a hormone imbalance. On Friday, I had a consultation with my doctor regarding the results of my follow-up blood and stool tests, and…

…for the first time in my adult life, things are starting to make sense. All of the angst, the suffering, the confusion, the money spent (and wasted) on supplements, the experiments, and the failures…Finally, finally, I feel like I’m getting somewhere.

Before I explain, let me tell you a quick little story, which will play into the findings:

When I was going through the worst of my last relapse with ED, I had starved myself to a point where the depression was so bad that I honestly could see no reason for keeping myself alive.

It was about that time that I left New York and moved home with my parents–because I knew that living alone, I would become a hazard to myself. There was still a shred of “me” buried in the bag of bones that was quickly transforming into a walking “ED,” and that “me” wanted to get fixed (even as ED tried to suppress that desire).

In Florida, I started seeing a psychiatrist, even though I have never had good results with pharmaceuticals. The various and sundry pills to which I was subjected did nothing but up my anxiety, give me weird side effects like twitchy legs and tremors in my hands, or dull my senses to the point where I became depressed about not being able to feel my depression.

Eventually, I told my doctor where he could take his pills and shove them. He threw up his hands and said, “Fine.” But, he suggested, should I want to go the “natural” route, I might try supplementing with an all-natural chemical called SAMe. I shrugged and bought a box from Whole Foods, because, hey, what was the worst that could happen?

Turns out, SAMe was the best thing that could have happened to me. Over the course of a couple of months, the SAMe helped me turn my depression around and even get over my social anxiety, so much so that I was able to enjoy my then-brand-new job at the “Fruit Stand” and even go out in the evenings with some incredible new friends.

And now, as of Friday, I finally understand why.



So here’s what my doctor found:

I have a polymorphism in a gene called MTHFR (methylenetetrahydrofolate reductase, which is a “mthfr”* to type, hence the abbreviation!), which causes problems with methylation. If that sounds like German to you, don’t worry–it was for me as well:

Basically, methylation is a process by which your body breaks down chemicals. When your body can’t methylate chemicals, those chemicals build up–and your body stops being able to detoxify itself.

In the case of MTHFR, when things are working properly, MTHFR produces an enzyme that breaks down certain B vitamins, most notably folic acid (vitamin B9), into 5-methyltetrahydrofolate (stay with me here!), which converts the amino acid homocysteine into methionine.

Why is this important, and what does it have to do with me and my silly little acne, anxiety, and amenorrhea? Well:

Methoinine is, according to Stop the Thyroid Madness!, “used by your body to make proteins, utilize antioxidants, and to assist your liver to process fats.” It’s anti-inflammatory, and it also assists in the conversion of estrodiol to estriol.

Even more notably, it converts into SAMe in your liver–and SAMe, that wonderful little chemical, helps act on neurotransmitters like serotonin and dopamine so that your brain can use them.

So let’s recap:

With a “broken” MTHFR gene, your body can’t make the enzyme that breaks down folic acid. No folic acid breakdown means that there’s no chemical to convert homocysteine into methionine.

Too much inactive B12/folate can actually cause acne. Too much homocysteine means a build up of inflammatory toxins that put a BIG stress on the body. Too little methionine means your estrogen can get out of whack and your neurotransmitters become imbalanced (which can cause depression, anxiety, and compulsive behavior).

This helps explain, at least in part, why:

  • Taking B vitamin supplements makes me break out
  • It has been so difficult to fix my amenorrhea
  • SAMe pulled me back from the brink of suicide
  • I still struggle so hard with depression, anxiety, and compulsive behavior

In other words, MTHFR is one mother-you-know-what-er* of a genetic polymorphism. Obviously, it’s not the only explanation for why things are so out of balance in my body, but it IS a good explanation for why my body is having such a hard time regulating itself, when so many other people seem to have an easier time of becoming an “after” picture on Mark’s Daily Apple. Not that I’m bitter about that, or anything…

Now, this wasn’t the only thing that came back on the test results, but because it’s the first thing that my doctor wants to work through, I figured I’d spend a little time with it here for you. As I go through the methylation/detoxification process over the next two weeks, I’ll keep you updated on my progress–and as we move on to healing the other stuff, I’ll go more into depth there too.

So, for those of you who would like to continue playing along and want a sneak peek of what’s to come, the other findings from my tests included:

  • Epstein-Barr virus (not a surprise, ‘cause my mom has it too)
  • Anaplasmosis (definitely a surprise, and not something I know anything about)
  • Imbalanced gut flora (more of the bad, less of the good)
  • And a fungal infection (not Candida, as I had originally guessed, but close)

Just a little side note, before I let you go about your days: remember how I was upset about the decision to take an antibiotic for the acne flare up a few weeks ago? Well, it turns out that it’s a good thing that I did: the urgent care clinic gave me a call while I was on vacation to confirm that I had contracted a non-MRSA staph infection, so if I hadn’t swallowed my pride (or the antibiotics), I’d be in a much more unpleasant situation.


Feeling pretty grateful for the respite from acne, provided by those stupid antibiotics…


Now I just have to get rid of those awful scars

This also gave my face a little bit of a break. I had no major break outs for the entire 10 days while I was on the Clindamycin….although the second I came off of it, I ended up with painful hormonal acne on my jawline and neck, so that was awesome.**


And here is an incredibly unsexy photo of my jawline and neck, which is worse than it looks. Hooray for acne. Not.

So a couple of lessons out of all of this:

  1. You can’t rely on n=1 to answer everything. I would NEVER have been able to guess that I had an issue with my genes that was going to make it harder to detoxify my body than simply doing a Whole30 or taking Oil of Oregano. Spending the (ridiculous amount of) money (out of pocket) to see a functional medicine doctor was painful, but not as painful as living in the dark for the last several years has been.
  2. Sometimes, you have to go the conventional medicine route to stave off the acute problems. Allopathic medicine has its time and place, and it doesn’t make you a bad person if you don’t simply try to heal yourself with juice fasts and garlic.
  3. There is hope for healing. And knowing thyself is the first step toward getting better.

Okay. Long post done. Today marks the beginning (hopefully) of the end of my acne, amenorrhea, and anxiety. I have faith that this time, this time, I’m on the right track.

Stay hungry,


*You can add in the missing letters to construct your own expletive, if you’d like. This is a family-friendly blog (all about sex, missed periods, and suicide. Woo!).


6 thoughts on “Acne, Amenorrhea, and Anxiety: What a MTHFR!*

  1. I’m SO EXCITED for you, Kai! FINALLY!! I’m a big believer in “try everything and figure out what combo works best for you”, and I’m glad you found what you needed.

    • Thanks, Kelly! It’s definitely been a process…and I know there’s still a long way to go…but knowing that I’m not just crazy and throwing mud (and money) at the wall to see what sticks makes me feel a little bit less stressed about the whole thing…which will hopefully mean that it’s be even easier to heal my poor burned out adrenals…

  2. Very awesome post. I have a few questions!

    1. How did they determine the gene polymorphism? Did they actually genetically map your entire genome (most likely your exome)? Did they map a specific portion looking for that?

    2. If antibiotics and birth control pills have controlled your acne before, why are they stupid? I understand that taking antibiotics for more than acute situations is bad. But if the birth control pills worked and you’re willing to take bioidentical hormones which are the same molecule from a plant source, why not just do it? Seems to me like it’ll at least take away the pain of some of the symptoms and let you focus on others?

    • Hi Ally! Thanks for the questions 🙂

      To answer:
      1. My functional medicine doctor ordered a blood test for MTHFR. I didn’t have my whole genome mapped, although I think it would be cool to do something along the lines of 23andMe to get a more complete picture. Maybe someday!

      2. I don’t want to control my acne. I want it gone. I want my body to relearn (or learn for the first time) what it means to make hormones the right way so that I’m not dependent on any source of exogenous hormones long term. Moreover, taking synthetic hormones can be majorly damaging to the body long term–the fact that most birth control pills come with warnings about breast cancer and blood clots should be reason enough to stay away, but there are so many more repercussions. Personally, when I’ve taken BC in the past, my depression and anxiety increased–and that was on the pure estrogen AND the estrogen/progesterone pills. Both times I ended up nearly suicidal–not exactly my idea of a good time!

      Basically, working with these plant hormones under the care of a functional medicine practitioner is intended to be a short term thing, and not a lifelong dependency. By fixing these hormones, I’ll also be focusing on other issues in my body, because they’re all interconnected–the gut, the brain, and the skin.

      I’m putting my trust in this process because the old methods have failed me. And there is, of course, always a possibility that this process may not work either, but I can’t NOT give it a try…at this point, it seems like the only sane option for me.

      But I promise to be open and honest about the whole process for your guys–the good, the bad, and the ugly. My goal is to figure out what’s going on and use that as a way to help others find the answers they need…

  3. Also, and I bet you’ll find this really interesting, but SAMe is actually a prescription medication in lots of other countries! People who don’t make enough of it can have trouble with all of the various bodily functions that rely on it. I’m so glad you found it!

    • That IS really interesting. I can understand why it might be labelled as a prescription–neurotransmitters are so delicate, and it can be incredibly dangerous to mess around with them without being under the care of a practitioner who knows what they’re doing!

      I think at some point I’d like to look into Julia Ross’s certification, because it’s one thing to know about neurotransmitter balancing and completely another to actually safely do it!

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