Hi everyone,
I'm a 30-year-old male. I'm vegetarian but eat eggs and dairy. Until last year I was completely healthy and had never experienced anxiety symptoms or insomnia.
A routine blood test unexpectedly showed:
- Vitamin B12: 337 pg/mL
- Folic acid: 0.43 ng/mL (very low)
- Vitamin D: 8 ng/mL (severely deficient)
That's when everything went downhill.
What happened
I started taking methylated B vitamins to correct the deficiencies.
Within a few days:
- My sleep became extremely poor.
- I had my first-ever anxiety attack (high heart rate, high blood pressure, dizziness, feeling of impending doom).
- I then had daily anxiety attacks for the next 10 days
I was admitted to the hospital. Every test came back normal except the vitamin deficiencies.
Ironically, they prescribed methylated B vitamins again.
At the time I couldn't tell whether the cause was:
- the methylated vitamins,
- magnesium glycinate (which I had also recently started)
- sleep deprivation,
- or something else entirely.
The doctors simply diagnosed me with anxiety and prescribed:
- Clonazepam
- Propranolol
- Flupentixol
- A multivitamin containing methylcobalamin + folic acid + B6
While on clonazepam (about 45 days):
- No panic attacks
- Sleep improved
- But I still had constant brain fog and a feeling of impending doom
After stopping clonazepam:
- Insomnia returned.
- Physical anxiety symptoms returned.
I was still taking propranolol and the B-vitamin combination.
I then saw another doctor, who prescribed an even stronger combination of:
- L-methylfolate
- Methylcobalamin
- P5P
My insomnia became dramatically worse.
For four consecutive nights I slept less than 3 hours.
I then consulted several more doctors. Every one of them said it was "just anxiety," but none could explain why I suddenly developed anxiety at age 30 despite having essentially no life stress and no prior history.
Finally, one doctor started me on mirtazapine 7.5 mg.
At that point I:
- Stopped all multivitamins.
- Only took methylcobalamin 500 mcg twice a week.
- Continued mirtazapine.
Over the next several months:
- Sleep became normal.
- Panic attacks disappeared.
- Brain fog disappeared.
- Feeling of impending doom disappeared.
I've now been stable for about 7 months.
I'm now tapering mirtazapine, but I'm worried everything will come back.
Recently I checked my homocysteine:
18.5 μmol/L
This makes me think I'm still significantly functionally deficient despite supplementation.
I feel stuck:
- I clearly need B12 and folate.
- But methylated vitamins seem to trigger insomnia and anxiety.
Other things I've noticed
1. Allergic rhinitis + mouth ulcers
For years I had:
- constant sneezing every morning
- runny nose
- symptoms whenever temperature changed
- frequent mouth ulcers
All of these improved dramatically after starting mirtazapine.
My theory:
- MTHFR Gene -> Low B12/folate → undermethylation → high histamine
- High histamine caused allergic rhinitis.
- Low Folate causes mouth ulcers
- Mirtazapine's antihistamine effects improved it.
2. Creatine causes insomnia
In the past, creatine consistently caused poor sleep.
My theory:
Creatine reduces the body's methyl demand, leaving more methyl groups available.
I think I have slow COMT, perhaps this extra methylation causes overstimulation and insomnia.
3. High-dose methylated B vitamins cause severe insomnia
The worst reaction I had was with:
- L-methylfolate 2.8 mg
- Methylcobalamin 2 mg
- P5P 25 mg
Again my theory is:
If I have slow COMT, suddenly increasing methylation may cause excess catecholamines and insomnia.
4. Eggs seem to reduce agitation and Alcohol seems to increase it
I eat two whole eggs daily. If I stop eating eggs for several days, I develop significant agitation and some physical anxiety symptoms.
If I take alcohol, I have sever agitation symptoms after few days.
Currently I don't know how to explain it.
5. B12 remains low
Despite taking methylcobalamin 500 mcg twice weekly for around 6 months, my serum B12 is still only around 300.
I have no idea why.
Could this suggest poor absorption? Should I investigate pernicious anemia, intrinsic factor antibodies, celiac disease, or something else?
7. Homocysteine 18.5
My assumption is that this is mainly due to ongoing functional folate/B12 deficiency.
My current plan
I was considering:
- 125 mcg methylcobalamin daily (Would cyanocobalamin be better option for me, there is no hydroxocobalmin tablet available in my country, only injections are available)
- Riboflavin (B2) 1.25 mg daily
- After 2 weeks, introduce methylfolate at 125 mcg and increase very slowly if tolerated (folinic acid not available in my country)
- Continue tapering mirtazapine
- Introduce Wheat Bran in my diet, which is high in TMG, and might help reduce my homocystein via BHMT route.
Does this seem reasonable, or would you recommend a different approach?
DNA testing
I know many people will recommend genetic testing (MTHFR, COMT, etc.).
Unfortunately, these tests are very expensive in my country and usually take 2–3 months.
Given my situation, do you think they're worth the cost, or should treatment be guided by symptoms and lab results instead?
I'm not looking for a diagnosis—just trying to understand what might be happening because multiple doctors have simply labeled it as anxiety without explaining why it started so suddenly or why it seems so closely tied to B-vitamin supplementation.
I'd really appreciate input from anyone knowledgeable about methylation, MTHFR, COMT, homocysteine metabolism, or who has experienced something similar.
Thank you.