Mandatory disclaimer: I am under the care of a physician, and am following her advice. I want to know how off-the-wall her colleague’s opinion was, and while I trust her medical judgment, I don’t think I’d have any luck getting her to rat on a partner even if he’s a whackjob.
I am pregnant with my second child. I developed preeclampsia in the first pregnancy, so the perinatologist ran a full thrombophilia panel on me. It came up compound heterozygous for MTHFR (both the C677T and the A1298C variants) and heterozygous for Factor V Leiden. The perinatologist kind of freaked out - called me after hours to insist that I be put on Lovenox the very next day. Even one more day of delay was totally unacceptable to him. He also put me on megadoses of folic acid - between the Foltx he prescribed and my prenatal vitamin, I’m taking 5.8 mg/day.
When I went to see him the next day, having done quite a bit of reading on reputable medical sites in the interim, I asked him what my homocysteine levels were. After berating me for “reading too much,” he admitted that they were normal (actually right on the low end of normal). Then he told me that he doesn’t believe that homocysteine levels are predictive of anything. (The berating me is why I’m now seeing his partner. She hasn’t changed dosages on anything or directly criticized anything he’s said, although she did order another AXA level, since he had changed my dosage of Lovenox without subsequently rechecking the level.)
So my question is, if homocysteine is normal, is the MTHFR variant doing any harm? Everything I can find that talks about the variant says that the danger of it is that your homocysteine levels will rise. I figure I should still take the giant doses of folic acid anyway - they’re not doing me any harm as far as I can tell, and I guess it’s possible that my homocysteine levels could rise without me knowing it. But does the attitude that homocysteine levels are irrelevant make sense?