avoid nitrous oxide, propofol, epinephrine | Anesthesia and MTHFR Mutations

allergic reactions due to impaired methylation and sudden drops in B12 aka low MTHFR enzyme, with neurological symptoms should avoid or reduce heavy doses of these anesthetics (at the very least warn the patient so that they can take nutritional/detox measures for a week ahead and a week following the operation):

nitrous oxide

propofol 

epinephrine 

https://mthfrsupport.com.au/2018/10/anesthesia-and-mthfr-mutations/

Anesthesia and MTHFR Mutations – MTHFRSupport Australia

Anesthesia and MTHFR Mutations

MTHFR is a condition that predominantly affects the methylation process and how the body processes chemicals, including medications like anesthetics. Anesthesia is not always dangerous for those living with an MTHFR mutation, but some types can be deadly. If you find yourself in a situation in which you may need to have anesthesia, it is important that you know which kinds are safe to take. This article details useful information on MTHFR and anesthesia to inform you on what precautions you should be taking if you need anesthesia.

Why does MTHFR cause reactions with Anesthesia?

There is always a possibility that medications may react in unexpected ways in a person living with an MTHFR gene mutation. Anesthesia is no different. MTHFR gene mutations prevent you body from detoxifying chemicals present in anesthetic medications. Additionally, some types of anesthesia may deplete the body of important vitamins and minerals, like Vitamin B12 for example. If you have an MTHFR mutation, that sudden depletion of nutrients can be harmful and cause severe symptoms of vitamin deficiency.

MTHFR and Nitrous Oxide

There are several types of anesthesia, and while not all are dangerous, some may have harmful consequences. One of the more common types is nitrous oxide, also known as laughing gas. It is a common dental anesthetic for oral procedures. Laughing gas causes increased levels of homocysteine in the blood for people with a homozygous MTHFR  677C>T or 1298A>C gene mutation. Elevated homocysteine levels can increase the risk of heart disease and Alzheimer's disease. Studies even show that the effects of nitrous oxide on people with MTHFR can increase neurotoxicity levels. There have also been instances of death linked with homozygous individuals occurring several days following the procedure where nitrous oxide was administered. Luckily, most people with an MTHFR gene mutation are heterozygous, and so the risk is not as severe in those individuals.

People who are administered laughing gas are not the only people at risk. Dentists, surgeons, and nurses can be exposed to laughing gas second-hand if they are in a room where it is administered. So, if you have MTHFR and are employed at a medical facility where laughing gas may be administered, take precautions not to inhale it. Those with severe symptoms of MTHFR should not take nitrous oxide under any circumstance. If you have mild symptoms of MTHFR, nitrous oxide may still be administered, but your doctor may also recommend week long course of Vitamin B12 to counter the effects of the anesthesia.

Other Dangerous Anesthetics

You should avoid Propofol. It is toxic to mitochondria, and some variants of the MTHFR gene already cause mitochondrial damage. One study showed that Propofol can even affect the heart's performance. Similarly, lactated ringers can also cause mitochondrial dysfunction. Those living with an MTHFR gene mutation should also avoid any types of anesthesia that contain adrenaline, also known as epinephrine. Other general anesthetics may increase the risk of blood clots, heart attack, and stroke.

Not All Types of Anesthesia are Dangerous

If you need general or local anesthesia, you still have several options. You should familiarize yourself with these options because not all surgeons may be aware of MTHFR and anesthetics. These options include:

• Carbocaine
• Sevoflurane
• Versed
• Fentanyl

What if You Cannot Avoid the "Bad" Anesthesia?

You may find yourself in a situation where you cannot avoid anesthesia that may cause adverse reactions. However, there are a few things you can do to prepare your body before taking it:

1. Living with MTHFR means your body has problems detoxifying certain enzymes, and anesthesia may worsen that. You can help out your body by detoxing with Epsom bath salts before administration.
2. Replace vitamins depleted during anesthesia. For example, nitrous oxide depletes the body's stores of Vitamin B12, so replenishing those stores with additional supplements can counter the negative effects.
3. Eat and drink foods high in antioxidants.
4. Take glutathione before and especially after the procedure.

Take-Away

If you have an MTHFR mutation it is crucial to educate yourself on the possible reactions anesthesia may cause. It is important to speak with your doctor about anesthetic options to ensure the best healthcare.

POSTSCRIPT 

for good measure, you may want to also reduce exposure to:

heavy metals 

heavy fluoride

bpa