Down the Folic Acid Rabbit Hole

Is folic acid supplementation contributing to the autism epidemic and other chronic conditions?

This post started out as a missive about my somewhat-controversial decision to not take prenatal vitamins for my second pregnancy (which I am now just past halfway through). But as I began to do the research to justify my decision, I learned way more than I expected and found myself in another rabbit hole about autism and other forms of “neurodivergence.”

This is the second of two parts; the first concerned prenatal vitamins and synthetic vitamins in general, while this part will do a deep-dive into the possible consequences of folic acid (synthetic folate) in prenatal vitamins and various “enriched” foods.

I’m not a medical professional, and this is not medical advice.

This post is too long for email and you’ll have a better reading experience if you click the title to read it online or in the Substack app.

Down the Folic Acid Rabbit Hole

In part one, I briefly discussed a Substack post by Dr. Jen Gunter entitled “What’s In Your Prenatal Vitamin?” The first half of her post discussed how many prenatal vitamins were contaminated with various heavy metals and how they rarely have the amount of nutrients they claim to on their labels (including some having dangerous amounts of synthetic Vitamin A, Vitamin C, and Vitamin E).

The second half of Dr. Gunter’s post concerns the difference between two forms of synthetic folate, “folic acid” and “methylfolate”; the latter is used in some prenatal vitamins due to concerns about a variation in the MTHFR gene which may result in some people being less able to use folic acid.

She writes:

“You know who isn’t agnostic about folic acid vs methylfolate or other non folic acid forms of folate? The experts at the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists. This is because we have clinical trials showing folic acid reduces neural tube defects, and there are no clinical trials showing that non folic acid forms of folate in supplements, like methylfolate, reduce neural tube defects. This means that people taking a supplement with a form of folate other than folic acid cannot be sure they are getting the needed benefit. There is no upside, with a big potential downside. Why should you, the consumer, bear the risk with an untested form of folate when a tested and safe form is available? 

The evidence also does not support the claim that people with an MTHFR genetic variation do better with methylfolate. The experts at the CDC say that people with an MTHFR variation can get all the folate they need from folic acid.”

Hmm. Okay. I don’t particularly trust the CDC¹ so I did some digging. Why do some people think folic acid is harmful? (Dr. Gunter’s take on why you should opt for a folic acid supplement over relying on folate from food or methylfolate was … unsatisfying, to say the least²).

It turns out a lot of the concern about folic acid has been shared on social media, in particular Instagram and TikTok. Here are some examples of posts:

And here are a few examples of comments on these posts:

As I discussed in my previous essay, prenatal vitamins are a relatively new invention. They entered the market in the 1970s, after folic acid was added to regular multivitamins and marketed specifically to pregnant women. They increased in popularity throughout the 1980s as studies emerged linking supplementation to lower rates of various complications, however, “much of the evidence for vitamin supplementation in pregnancy comes from studies carried out in low-income countries, where women are more likely to be undernourished or malnourished.”

While a 2016 study found that there was no evidence that supplementation with most of the nutrients in prenatal vitamins improved pregnancy outcomes in women who were eating a well-balanced diet, there were two exceptions: synthetic Vitamin D and folic acid (synthetic folate).

It’s recommend that pregnant and women trying to conceive get 600 micrograms of folate every day, and achieve this by supplementing with 400 micrograms of folic acid.

It’s been very well established that deficiencies in folate can result in neural tube defects in pregnancy (e.g. spina bifida), in particular if the mother is deficient in the trimester. This is one of the reasons why women are encouraged to start taking prenatal vitamins while trying to become pregnant, as a deficiency in folate in the first 4-6 weeks before most women know they’re pregnant can have dire consequences.

Prenatal vitamins with folic acid began to take off in the 1980s. In Canada, nearly 90% of women now take a supplement with folic acid at least in their first three months of pregnancy. In 1998, the United States and Canada made it mandatory for folic acid to be added to “enriched” grain products. Many other countries followed.

Around 1/500 pregnancies worldwide have neural tube defects. Most of these occur in low-income women and are disproportionately high in developing countries. Various sources indicate that the rate of neural tube defects decreased around 50% in developed countries that implemented a folic acid supplementation program, and these countries have lower rates of neural tube defects than countries without a folic acid supplementation program.

In Canada, this meant that the rate dropped from around 11.1 per 10,000 births in 1989 to 5.6 per 10,000 births in 1999. Between 350,000 - 400,000 children are born in Canada each year (peak was 405,486 in 1990), so this means the folic acid supplementation program has successfully prevented neural tube defects in between 161 - 184 children each year in Canada since it was implemented—at most. This would be a high estimate as presumably the increase in public awareness regarding the importance of folate in pregnancy would have also had at least a slight impact on pregnant women’s dietary choices.

A study in the United States found that the rates of births with neural tube defects declined by about 20% after the fortification program, from 37.8 per 100,000 births to 30.5 per 100,000 births. Let’s make things easy and round up and say that 4 million children are born in the US per year. This would mean that folic acid supplementation prevents around 292 births with neural tube defects in the US per year. A 2015 CDC report estimates the number to actually be closer to 1,300 cases prevented per year; let’s go with the larger estimate.

Around half of pregnancies worldwide are unplanned. As such, a majority of women do not take prenatal vitamins or a folic acid supplement prior to becoming pregnant. On the other hand, of women who are trying to become pregnant—and therefore, presumably, are more likely to be taking prenatal vitamins—around 10% or so struggle with infertility, and between 10-20% of known pregnancies end in miscarriage. Infertility may affect as many as 1/6 people worldwide.

Infertility has been on the rise for a while now, for various reasons. The global in vitro fertilization market is currently around 23 billion USD and expected to grow to 32 billion by 2032. In the US in 2024, around 1/42 babies were born through IVF. As approximately 1/3 of births are from unplanned pregnancies³, this means around 1/28 of intended births required IVF.

And yet, plenty of women are getting pregnant without even trying, and without taking the recommended vitamins.

“Folic acid” is made from petroleum products, chemical acids and acetylene.

“Back in the early 1990s when discussions regarding the addition of folic acid to the food supply were taking place, it was suggested that after fortification was implemented, the dose of folic acid in prenatal supplements should be revised to prevent excessive intakes. The new problem is…the doses were never revised.”

— Nutrition.org, “The Folate Fortification Story – How we fixed one problem…but may have created another”

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But What About Too Much Folic Acid?

“Unlike folate, not all of the folic acid you consume is converted into the active form of vitamin B9 — 5-MTHF — in your digestive system. Instead, some folic acid is converted to 5-MTHF in your liver. Yet, this process is slow and inefficient in some people […] Even a small dose, such as 200 to 400 mcg per day, may not be completely metabolized until the next dose is taken. This problem may become worse when fortified foods are consumed in addition to taking folic acid supplements. As a result, unmetabolized folic acid is commonly detected in people’s bloodstreams.”

— Healthline, “Folic Acid vs. Folate — What’s the Difference?” (emphasis mine)

Most prenatal vitamins contain between 400 - 1,000 mcg of folic acid. However, thanks to mandatory fortification, this is far from the only source of folic acid in most pregnant women’s diets.

This is particularly true of women who experience significant nausea in the first trimester of pregnancy—as I discussed in part one, many women suffering from morning sickness rely on refined carbohydrates, such as bread, pasta, cereal, and crackers. All of these foods are fortified with folic acid. (Furthermore, prenatal vitamins are often one of the causes of morning sickness!)

For example, 100 grams of Multigrain Cheerios contain 162 mcg of folic acid! One cup of cooked enriched pasta will give you between 130-150 mcg, 55 goldfish crackers will give you around 45 mcg, and a slice of enriched bread will give you around 37 mcg of folic acid. All of this can add up quickly.

Again, the recommended amount of folic acid / folate for pregnant women is only 600 micrograms!

Folate from food sources, unlike folic acid, does not accumulate in the blood. There is no upper limit for folate consumption. Unmetabolized folic acid may lead to accumulation of dihydrofolate, disrupt the one-carbon cycle and adversely impact DNA synthesis and repair, and methylation.

Doses of more than 1,000 mcg of folic acid per day may cause the following side effects: abdominal cramps, diarrhea, rash, sleep disorders, irritability, confusion, nausea, stomach upset, behaviour changes, skin reactions, gas, excitability, and “other side effects.” High concentrations in the blood may cause cognitive and immune issues. In addition, long-term supplementation of over 800 mcg of folic acid per day may increase the risk heart attack in some people and of certain cancers (e.g. lung, prostate, breast, and colorectal). In the United States, there was an uptick in colon cancer diagnoses following folic acid supplementation, of as many as 15,000 additional cases each year.

Furthermore, our bodies appear to prefer folic acid to folate (folic acid is more readily absorbed)—this means that folic acid binds more readily to receptors than folate, and can block the receptors from using natural forms of folate. This can cause a “functional folate deficiency”, where symptoms of folate deficiency appear despite lab tests reporting normal or high “folate” levels.

Symptoms of a folate deficiency include: pale skin, decreased appetite, irritability, lack of energy, diarrhea, and a smooth or tender tongue.

Folic acid can mask a B12 deficiency, and the combination of high folic acid and a B12 deficiency can lead to anemia and cognitive impairment. “FA supplementation may increase the demand for vitamin B12, exacerbating its depletion, pernicious anemia, and associated neurological and hematological decline.”

Readers will recognize many of the symptoms I just discussed as being common in pregnancy. In addition, excess folic acid in pregnancy may increase the risk of gestational diabetes mellitus.

Excess folic acid (not folate!) may slow brain development. Research has also linked high folic acid consumption during pregnancy to an increased risk of insulin resistance, to a higher risk of obesity, and to poor psychomotor development in children. As folate modulates the epigenome and plays a critical role in methylation, excess folic acid may also “potentially alter gene expression and lead to aberrant epigenetic programming” in offspring. Both insufficient folate and excess folic acid in pregnancy has been linked in studies to a higher risk of autism spectrum disorder in children.

Animal students have found that excess folic acid in the prenatal period is associated with an “adverse impact on behavior, memory, embryonic growth, methyl metabolism, and neurodevelopment”, including anxiety, hyperactivity, and a vulnerability to seizures, an increased risk of childhood asthma and respiratory tract infections, an increased risk of allergies, and an increased risk of tongue-ties in children.

And it gets more complicated …

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A MTHFR of a Problem

The MTHFR enzyme “facilitates the addition of a methyl group to folic acid, rendering it usable by the body.” It is essential for folate utilization. It also “plays a crucial role in the conversion of homocysteine into methionine, vital for proper metabolism, muscle growth, and the creation of glutathione [an important antioxidant].”

Around 40% of the world population has a mutation on one or both of their MTHFR genes which can impair the ability of the enzyme to break down folic acid into its useable form.

“Individuals with reduced MTHFR enzyme activity may exhibit heightened homocysteine levels, a condition linked to inflammation and cardiovascular diseases, birth defects, challenging pregnancies, and a potential compromise in detoxification capabilities.

Deficiencies in folate, B6, and B12 nutrients have been correlated with elevated homocysteine levels.

Those with the MTHFR gene face challenges in processing folic acid, commonly found in inexpensive supplements and added to processed foods.”

— https://mthfrexperts.com/

Studies have found a significant increase in vulnerability to autism spectrum disorders in people with a MTHFR C677T (rs1801133) gene polymorphism or a A1298C (rs1801131) polymorphism. C677T is also associated with a higher risk of bipolar disorder and schizophrenia, while the A1298C polymorphism is linked to a higher risk of bipolar disorder and ADHD. The A1298C polymorphism affects MTHFR enzyme activity and homocysteine levels to a lesser extent than C677T and so the effect is smaller. Both polymorphisms are associated with a higher risk of several other conditions, including cancer.

If you have your 23andMe data, you can access information on your MTHFR genes by browsing your raw data and searching “MTHFR”. G/G on rs1801133 and T/T on rs1801131 are considered “typical” and a low-risk of methylation issues. A/A on rs1801133 (two copies of C677T) indicate around 70%-80% reduced activity, whereas G/G on rs1801131 (two copies of A1298C) indicate around 20% reduced activity. If you are heterozygous on rs1801133 (A/G) then you have around 40% reduced activity. Heterozygous on rs1801131 (G/T) indicates a mild reduction. These mutations indicate a risk for higher levels of homocysteine in your blood.

I have my 23andMe results and checked—I’m A/G and G/T, which indicates my enzyme activity is reduced by over 40%. I was born in the late 80s and my mother confirmed she took folic acid supplements while pregnant with me—as her doctor advised her to.

Both of these mutations are significantly more common in European populations and people of European descent.⁴

Because of this research, many people—in particular on social media—are now advising women with these MTHFR polymorphisms to avoid folic acid and take prenatal supplements with methylfolate instead. The same advice is given to parents of autistic children (avoid folic acid in supplements and fortified foods).

While looking this up, I stumbled across a surprising post on r/asktransgender:

I followed the link to several posts by Dr. Will Powers, of Powers Family Medicine in Michigan, USA. Dr. Powers is a licensed physician (with high functioning autism and two “bad” copies of the MTHFR gene) with a “special interest in LGBTQ/gender diverse care, gender affirming services, hormone therapy (HT/HRT), HIV care, and preventative health and education.” A controversial figure in transgender medicine, my overwhelming impression from both my email correspondence with Dr. Powers and from perusing his work and responses from transgender people to him online is that he genuinely cares both about his transgender patients and scientific truth—and like a lot of autistic people he can be “blunt” and “outspoken” in ways that rub some the wrong way.

“My thing [with] transgender people is that I treat them with hormones because I don’t have a way of flipping their brain back. If I could make somebody be thrilled with the body that they were in, that’s a lot simpler of a solution. But if I can’t do that, then denying them medical transition seems cruel to me as well. Just trying to do what I feel like is the most ethical thing.”

— Dr. Will Powers (reddit)

Dr. Powers describes and provides some evidence for what he admits is a “crazy”, “unproven conjecture” that he has no means to conduct a proper study on; that folic acid supplementation is “PART” of the reason for the rise in autism cases—as well a co-morbid gender dysphoria and transgender identification.⁵

Autism rates by year of birth. Source: https://www.reddit.com/r/DrWillPowers/comments/13q28zq/dr_powers_crazy_conjecture_on_the_cause_of_autism/

I was intrigued; I’ve observed that many social media activists who identify as both autistic (and/or ADHD) and with one or more identities under the “queer” or “transgender” umbrellas seem to also have diets high in processed foods—foods that would be fortified with folic acid and other synthetic nutrients. Prior to conducting this research and engaging with Dr. Powers’ work, I’d long believed that refined sugars and flours and various nutrient deficiencies were playing significant roles in the autism epidemic. A link between low cerebral folate and autism has been found.

In addition, as I’ve previously discussed in other articles on this Substack (e.g. this one and this one), there seems to be a well-established link between autism and gender dysphoria, in particular the “rapid onset” variation.

It is also well established that “ARFID” (avoidant restrictive food intake disorder)—an eating disorder that manifests as extreme picky eating and often leads to a diet high in processed “safe” foods—is highly correlated with autism spectrum disorder. Up to half of people with ARFID may be autistic, and/or have “other neurodevelopmental, psychiatric, or somatic diagnoses”, in particular anxiety, depression, sleep disorders, and learning difficulties. One study (albeit with a small sample size) found that girls with anorexia were 2.66x more likely to carry C677T and/or A1298C genes.

Common “safe” foods in ARFID include: white bread, pizza, french fries, sweets, chicken nuggets, plain noodles, crackers, and cereal. With the exception of french fries and many types of “sweets”, all of these foods are fortified with folic acid.

It is also well established that transgender and non-binary people are more likely to suffer from eating disorders than the general population; this includes ARFID.

As I mentioned above, a folate deficiency (including a “functional folate deficiency” caused by folic acid blocking receptors from using folate) can cause low appetite.

In my article on prenatal vitamins and synthetic vitamins, I also noted that a Vitamin B1 (thiamin) deficiency⁶ can cause low appetite, and so can excess synthetic iron. I also described the following study:

“Eating lots of highly-processed foods may also cause an aversion to healthy, whole foods. In one interesting study by Paul Kenny, he found that rats who were fed a processed-food diet for a while, when the junk food was taken away and replaced with healthy food, rejected the healthy food. “The animals would rather starve themselves.””

I have some personal experience with ARFID. I was always a picky eater (but a fairly healthy one), sensitive to certain textures and intense flavours; then, in late 2017, I had to take a strong round of antibiotics for an infection and they destroyed my gut microbiome. I was under a lot of stress at the time, and very busy, and therefore eating out more. After the antibiotics, I quickly developed ARFID; I had no appetite and lost a lot of weight and couldn’t eat many foods I’d previously enjoyed without gagging or feeling nauseous. I recovered in spring 2020 with multiple high doses of psilocybin mushrooms⁷. I’m not the only person who has recovered from ARFID with psilocybin. ARFID has been dismissed by some writers (e.g. Freddie deBoer, Abigail Shrier) as an excuse for, exaggeration of, or coddling of “picky eating”, but I cannot emphasize this enough, it’s a real thing, and it’s physiological not just psychological. There was something wrong. I had to force myself to eat, and it was extremely difficult. Meat and seafood were particularly hard to get down.

I started eating more processed foods than I ever had before, including developing an obsession with Whole Grain Cheerios, goldfish crackers, and McDonalds’ breakfast sandwiches (all very high in folic acid). Over the same period, I also became significantly more “autistic”, and was evaluated by a psychiatrist as having having “ADHD” and being at-risk for or having a mild case of bipolar II disorder.

Post-psilocybin, I not only recovered completely from ARFID, I quickly became a significantly less fussy eater than I had been before the antibiotics. I mean, I’m not planning on eating an oyster or calamari anytime soon (gross) but if you’d asked me ten years ago if I’d willingly eat mushrooms and beef liver pâté I would have gagged and laughed in your face. (And now I won’t touch Cheerios, goldfish crackers, or McDonalds, and or buy these foods or similar ones for my children). My distressing symptoms of “autism”, “ADHD”, and “bipolar disorder” also significantly alleviated.

I believe, as per Dr. Iain McGilchrist’s work, that autism is associated with right hemisphere dysfunction, which includes, in many but not all cases, an impaired connection to the gut microbiome and to “nature” (broadly speaking). It makes a sort of poetic sense to me that a diet high in synthetic nutrients made in a lab at the expense of real ones from whole foods from nature (keep in mind that folic acid can prevent the body from using folate) would contribute to right hemisphere dysfunction and a disconnection from nature and the gut.

At the same time, I do not believe autism is one condition, or only has one cause. I believe it’s incredibly multifactorial, and that “autism spectrum disorder” is essentially an umbrella term for brain irregularities / damage which arise from a variety of causes but manifest in some common symptoms.

Dr. Powers speculates that vulnerable MTHFR polymorphisms might worsen estrogen production in women who already have low estrogen. Folic acid supplementation during pregnancy would increase estradiol synthesis in these women. Elevated estrogen in utero can increase autism risk in males.

“It is my theory that the introduction of folic acid to the grain supply, as well as its recommendation as a prenatal vitamin had impacts on many mothers who carried MTHFR mutations […] As a result, those with MTHFR mutations or those who were folate deficient suddenly were able to synthesize higher levels of estradiol than normal. These women also would have been more likely to carry to term due to being able to make that estradiol, and this has also been shown in studies.”

I’m not sure about this because from what I’ve seen on social media, many women with the relevant MTHFR mutations are reporting that they had high rates of miscarriages while supplementing with folic acid, and then were successfully able to carry a child to term after switching to methylfolate or meeting their folate needs from food sources. Studies do indicate that supplementing with folic acid reduces miscarriage risk (which, as per Dr. Powers’ hypothesis, could result in autistic children being born who would have otherwise been miscarriages), but my takeaway is that high levels of folate from food sources would be significantly more effective.

However, the rates of miscarriages seem to be rising; I doubt this effect can be solely or even primarily attributed to folic acid supplementation and MTHFR mutations, however, the possibility of a connection has been suggested. The miscarriage rate in the US was around 17.8% in 1990 and rose to 23.3% by 2011. As miscarriage risk increases with age and many women are having children older, this could explain much of the effect.

Dr. Powers notes a rough inverse relationship between worldwide spina bifida and autism rates (see graphs below). Here is a list of countries with mandatory folic acid fortification. While rates of autism are high in European countries, most do not actually have mandatory folic acid fortification, but instead offer both enriched and non-enriched food options and most (with the exceptions of Finland, France, and Sweden) promote the use of prenatal vitamins with folic acid to pregnant women.

Spina bifida rate (Blue low red high). Source: https://www.reddit.com/r/DrWillPowers/comments/13q28zq/dr_powers_crazy_conjecture_on_the_cause_of_autism/

Autism spectrum disorder rate (Blue low red high). Source: https://www.reddit.com/r/DrWillPowers/comments/13q28zq/dr_powers_crazy_conjecture_on_the_cause_of_autism/

This relationship cannot be attributed solely to folic acid, but it’s interesting nonetheless. Recall that the relevant MTHFR mutations (known to increase autism risk) are more common in Europeans than other populations.

Dr. Powers went on to coin a speculative new “syndrome” along with a colleague: “Meyer-Powers Syndrome”. In essence, the combination of certain vulnerable gene variations (in particular MTHFR), synthetic folic acid exposure, hormone disruption, and nutrient deficiencies lead to a high inflammatory load and elevated serum homocysteine levels, resulting in some overlapping effects.

The following conditions are associated with Meyer-Powers Syndrome:

• Congenital Adrenal Hyperplasia (CAH) and Subclinical Hypocortisolism

  • Ehlers-Danlos syndrome (in the form of CAH-X)

  • Postural Orthostatic Tachycardia Syndrome (POTS)

  • DHT levels higher than the average metabolization of ten percent of testosterone due to backdoor DHT conversion

  • Anorexia

  • PTSD

  • Spider veins

• Inflammation:

  • Subclinical hypercortisolism

  • Zinc deficiency (eczema, etc)

  • Vitamin D deficiency, (osteoporosis, etc)

  • Elevated homocysteine (B vitamin deficiencies)

  • Irritable Bowel Syndrome (IBS) / gastrointestinal problems

  • Alopecia (hair thinning / loss)

  • Hirsutism / severe acne in natal females / polycystic ovary syndrome (PCOS)

  • Cherry angioma

  • Temporomandibular joints (TMJ) problems

  • Rheumatoid arthritis

  • Mast Cell Activation Syndrome (MCAS) / Mast Cell Activation Disorder (MCAD)

• Family history of: ADHD, bipolar disorder, Alzheimer’s, type 2 diabetes, schizophrenia and/or autoimmune conditions such as Hashimoto’s thyroiditis, multiple sclerosis, and Sjögren syndrome.

“Queerness”, as in gender dysphoria and gender nonconformity are also associated with “Meyer-Powers Syndrome” and the above conditions are all very common, according to Dr. Powers, among transgender people. He also notes that “increased intelligence” seems to be common in Meyer-Powers.

Dr. Powers notes that not all will be present in any given case, and that these conditions will run in families. He explicitly notes that he does not believe all autistic or all transgender or gender nonconforming people have this “syndrome”, and describes two subtypes with noticeable phenotypical characteristics.

The first (Type I) is a “pixie” or “elf”-like appearance in “skinny, low muscular” natal males and females; FTM transgender people of this type tend to come out as gay men; “the tall spindly 6’4 transgender woman with no muscle mass will have an absolutely enormous Adam’s apple, and significantly above average length penis is the same variant but in MTF.” The second (Type II) is a “dwarf”-like appearance in “stocky” people; FTM transgender people of this type tend to remain attracted to women, and the “gay men of this subtype that have the elevated DHT end up having an early puberty, have a short, thicker penis, are short in height, have male pattern baldness, and basically look like Burl Ives.”

In a separate thread, he also discusses what appears to be a variation of Subtype I (“elves”) in MTF transgender people, which presents similarly to Addison’s disease.

Dr. Powers also states that the people he’s describing tend to have interests in fantasy worlds / gaming, nerd culture, otakus/anime, non-traditional relationship structures, and BDSM, “related to these people being faintly dissociated all the time, often related to VDR/COMT/MAO mutations amplified by MTHFR defects.”

In his reddit threads, multiple people have responded to say that they have a handful of the conditions on the above list and meet one of the phenotypical descriptions.

Other relevant gene variants include abnormalities in the COMT, MAO, VDR, SHMT, CBS, BHMT and AHCY genes.

An interesting study I stumbled across found that childhood abuse increased the likelihood of homosexuality in males with the relevant COMT and MTHFR variations. One could extrapolate from there that male children with the mutations on MTHFR (rs1801133) who experience childhood abuse and/or neglect would be significantly more likely to be transgender as well, at least in a culture that supports and encourages transition.

Regarding this point, Dr. Powers stated (via email):

“The amount of transgender people in a culture is directly proportional to the tolerance of that culture for transgender people. AKA, if your culture is more likely to accept you as transgender, those people are more likely to express that phenotype, whereas it would be more repressed elsewhere, and so you’re only going to see the most extremely gender dysphoric people present. This is historically true in the USA, and likely part of the “surge” of trans people in society. They existed before, they were just gender non-conforming, but now that they have easier access to HRT, they use it simply because it’s there. The people with the most severe dysphoria? They were the people who transitioned pre-1970, when it was a 1/10000 phenomenon. But as the barriers to transition fall, people with less severe dysphoria are more likely to experiment with HRT in the same way that “bi curious” people nowadays are highly likely to experiment whereas heteronormativity of the past would have kept those thoughts locked away.

This is really only my own personal opinion, but people were shocked at the “surge” of LGBTQ people over the past few decades. I think it’s likely much the same with transgender people, it’s amazing how much easier it is to find people in society when they are not actively being punished for existing as they are.”

I’ve previously written about how early childhood stress and neglect seems to be related to a higher likelihood that someone will later come out as transgender or non-binary (and to be autistic and “gifted” in childhood).

Chronic stress depletes B vitamins and can impair appetite and trigger addictive eating and substance abuse (common substances like refined sugars, alcohol, tobacco, and caffeine will all exacerbate relevant nutritional deficiencies).

Anecdotally, I have also noticed that “late-onset” same-sex attraction in women seems to often follow high alcohol and/or refined sugars and processed food consumption. During my “ARFID” period, I became significantly more attracted to women / more bisexual than I had been previously, only to find that attraction faded after the big magic mushroom doses. I had previously blamed birth control pills for this, but I quit taking them when I was 30 and continued to have bisexual attraction for two years until shortly after all the psilocybin mushrooms (after the dietary changes would have started to kick in).

About a month ago, I was hanging out with an old friend of mine and she told me she had recently started dating a woman and been diagnosed with ADHD. She was also having chronic gut issues and admitted she was eating a lot of processed “kid” foods, such as including goldfish crackers in her lunches. As this woman had been “straight” for the 17 years I’ve known her, I was surprised. Now, I just want her to be happy and if she’s happy with a woman then I’m happy for her, but I’m concerned about her health and wonder if her sexual orientation would change again if she got her gut issues sorted out and quit eating fortified processed foods.

I mentioned this to Dr. Powers and he responded that he’s seen this sort of thing before and it was only possible if both me and my friend were biologically predisposed to bisexuality already, in which case dietary and/or hormonal disruption, including from severe stress, could trigger same-sex attraction.⁸

In our email correspondence, Dr. Powers mentioned that he uses “very low dose bicalutamide” to treat hormonal acne in cisgender females (most of his patients are lesbians and queer women so pregnancy is less of a concern). He has seen “shifts towards bisexuality in lesbians or of increased straightness of bisexual females on bicalutamide.”

“There seems to be at least “some” malleability of sexual orientation based on hormonal states.”

What this suggests to me is that the potential effects of high folic acid on the development of autistic/ADHD traits, same-sex attraction, and gender dysphoria are not limited to the prenatal stage or even early development, in particular if other risk factors are present. There was a significant spike in gender dysphoria (especially in children) starting in 2020 with the Covid pandemic and lockdowns, which coincided with a rise in consumption of processed foods (and other risk factors, such as excess time indoors, increased screen time, low socialization, and increased stress). However, prenatal and early childhood exposure would have a significantly greater impact. Younger people—those born after 1998—are significantly more likely to identify as transgender than older people.

Dr. Powers’ research, observations, and hypothesis are fascinating because—assuming he’s on to something—this points to the rising rates of gender dysphoria in young people as being largely biochemical, hormonal, epigenetic, and developmental in nature, not solely the product of social contagion and “indoctrination” as others have argued. This makes sense when considered through the significant overlap between gender dysphoria and autism, as the latter clearly cannot be explained by “social contagion.”

It’s important to emphasize—neither Dr. Powers nor I believe that folic acid supplementation is the sole cause of autism or gender dysphoria (obviously, as both existed before synthetic nutritions and fortified foods). I am also not arguing that it is the primary cause of rising rates of autism and/or gender dysphoria.

As autism rates are disproportionately rising in Black children (who are significantly less likely to have the MTHFR mutations in question), this points to other major causes, in particular when autism is combined with intellectual disability (autistic Black children have nearly twice the rate of intellectual disability as autistic European/white children).

As well, it should be noted that in Sweden, where folic acid enriched foods and prenatal vitamins are not commonly consumed, the high rates of autism disproportionately appear in migrant children.

Correlation isn’t causation and more research is needed. However, I believe this is an area well worth investigating.

Based on the available evidence I don’t believe that changing one’s diet in adulthood would necessarily relieve gender dysphoria or “cure” autism—it would, however, improve many of the negative mental health and physical health symptoms associated with being transgender and/or autistic. It is possible that Meyer-Powers Syndrome could be reversed and/or averted if caught early and the necessary dietary changes were made in childhood.

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The Glyphosate Connection?

While researching this essay, I stumbled across an interesting article from the Weston A Price Foundation⁹ (WAPF) on folic acid and glyphosate.

Glyphosate has increasingly dominated the herbicide market since the 1970s, when it was patented for this use by Monsanto and given the trade name “Round Up.” It is sprayed on non-organic wheat, soybeans, barley, oats, lentils, peas, canola, corn, flax, alfalfa, rye, triticale, sugar beets, cotton, buckwheat, potatoes and millet throughout North America. Glyphosate consumption has been linked to higher rates of various cancers, celiac disease, Parkinson’s disease, and possibly also to an increased risk of autism spectrum disorder.

This one is very personal to me because I have an uncle with early-onset Parkinson’s and my step-sister was recently diagnosed with stomach cancer. My step-sister went to a naturopath and got a bunch of tests and it turned out the levels of glyphosate in her system were through the roof!

Anyway, I’ll keep this brief; the authors at the Weston A Price Foundation argue, with lots of sources cited, that glyphosate disrupts the body’s effective use of folate, and its use was a cause of rising spina bifida cases in the 1970s and 80s (emphasis mine):

“[F]olate is produced from products of the shikimate pathway, and this is the pathway that even Monsanto admits is disrupted in plants and microbes by glyphosate. Furthermore, the microbes that synthesize folate for the host, lactobacillus and bifidobacteria, are the ones that glyphosate preferentially kills. A continued rise in spina bifida would raise public awareness of a hidden environmental toxicant that might be causing this rise. Making sure that pregnant women were well supplied with external folic acid might mask the problem.”

The WAPF also argues that glyphosate may be contributing to the autism epidemic. Author Tao Lin in the

Mars Review of Books

summarizes some of the key evidence for this in his incredible essay “The Story of Autism: How We Got Here, How We Heal”.

Screen shot from an After Skool video with Dr. Zach Bush on chemical farming and and human health.

I emailed the WAPF article to Dr. Will Powers and suggested that glyphosate might also be a significant contributing factor to the autism epidemic. He responded with the following criticism (emphasis mine):

“The Weston Price Foundation has a valid point about glyphosate, but overall, I’d probably disagree based on what I’ve seen in terms of the autism bump and other countries. Places like Western Europe, or Chile, used glyphosate for decades without the bump, but didn’t see the autism spike until after the introduction of mandated prenatal high level folic acid. It’s entirely possible it’s contributory, but being as the effect occurs in countries where it’s banned, or countries where the folic acid came later, it seems to not be the primary driver of the problem at least.” 

If you scroll back to look at the screenshot from the After Skool video above, you’ll note that the spike in autism also correlates with the implementation of folic acid supplementation in 1998.

The US Environmental Protection Agency claims that glyphosate is not carcinogenic or an endocrine disruptor. The WHO classifies glyphosate as “probably carcinogenic”. Glyphosate is banned in several countries worldwide, including Italy, France, Austria, Germany, Belgium, India, Denmark, Mexico, Thailand, Costa Rica, the Netherlands, the United Arab Emirates, and Qatar.

I’ve seen many North Americans comment across social media that they believed they were “gluten intolerant” but noticed that “gluten” didn’t seem to bother them while they were vacationing in places such as France, Italy, or other countries.

To avoid glyphosate, look for foods marked “Certified Organic.” In the United States, you can still buy wheat products that are organic and unfortified (do not have synthetic nutrients like folic acid added), but this doesn’t seem to be an option in Canada. However, gluten-free products are often unfortified. Check the labels.

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How To Meet Your Folate Needs

I took the risk of low folate seriously when I made my decision to not take a prenatal vitamin or a folic acid supplement. Fortunately, lots of foods are high in folate, including: legumes, asparagus, eggs (especially organic, pastured eggs), leafy greens, beets, citrus fruits, Brussels sprouts, broccoli, nuts and seeds (especially walnuts), beef liver, wheat germ, papaya, bananas, and avocado.

I figured if I ate around 3 pastured eggs¹⁰ with half an avocado every morning, I’d get around 300 micrograms of folate just from breakfast alone; half of the 600 mcg I needed for the day! For the other half of my daily needs, I’m focussing on eating oranges and lemons, at least one banana, and at least one vegetable high in folate (often broccoli because I love broccoli and a cup of it cooked provides about 150-170 mcg). I make a point of including walnuts in my baking, tossing unsalted mixed nuts in my yogurt, and bought some beet powder to pour in my smoothies. I put chia seeds and black sesame seeds on / in everything I can. I try to eat about 3 ounces of beef liver each week. Voila! Folate needs met.

While I’m trying to avoid foods fortified with folic acid, it’s pretty much impossible to always do so due to mandated fortification, so I’m getting some folic acid from enriched bread and pasta too—although, after researching and writing this essay, I’m definitely going to try harder to stay away from the stuff. (Way to ruin pasta, government! The Italian in me is pissed.)

Now, I’m probably (definitely) not eating 600 micrograms of folate every day. However, I’m not convinced this is an issue (I mean, all my tests so far, including the 20-week ultrasound, have reported I’m having a perfectly healthy baby). Nutrition science seems to be sketchy as hell; the people who brought us the “food pyramid” and “a calorie is a calorie” should not be trusted and I stopped taking dieticians seriously when I saw tons of them promoting processed foods full of refined sugars for their corporate sponsors on Instagram and TikTok.

When I was in my early twenties, I downloaded a diet app and challenged myself to meet all the daily nutritional requirements every day. It was impossible. I eat a lot for a woman of my size (I get lots of exercise and played on 2-4 sports teams until 2020) and there was no bloody way I needed that much food.

Almost as if the whole thing is a scam to convince us all to eat more highly-profitable processed foods full of “fortified” and “enriched” synthetic nutrients instead of real food—the latter of which is increasingly unaffordable and difficult to find.

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Other Nutrients and Folate Interactions

Nutrition is complicated and a deficiency in any given vitamin or mineral can set off a cascade of issues, including other deficiencies. I found this interesting article by

Chris Masterjohn, PhD

on folate interactions and how issues associated with the vulnerable MTHFR mutations may be largely related to a riboflavin (Vitamin B2) deficiency.

Your “MTHFR” Is Just a Riboflavin Deficiency

He points out that there are (at least!) 26 nutrients involved in methylation. If you suspect you have the MTHFR mutation (or really any sort of issue with methylation!), I recommend reading his entire article.

Beef liver is an excellent source of Vitamin B2 (and many of the other nutrients he mentions) so this brings me back to beef liver (which is incredibly inexpensive!) being the ideal “prenatal vitamin”!

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A Sick Society

Folic acid supplementation is justified by the desire to reduce the rate of neural tube defects in children. However, the rate of neural tube defects was always very low, and mostly concentrated in low-income women and in developing countries. Using generous numbers, folic acid supplementation has saved around 200 Canadian and 1,300 US children per year from being born with a neural tube defect.

Meanwhile, high doses of synthetic folic acid (and other synthetic nutrients) may be contributing to:

• Skyrocketing cancer rates (in particular lung, breast, and colon cancers—all of which have been linked to excess folic acid).

• Skyrocketing rate of childhood obesity, metabolic illnesses, and avoidant-restrictive food intake disorder (the latter only became a diagnosis with the publication of the DSM-5 in 2013).

• Skyrocketing rates of childhood asthma and allergies.

• Skyrocketing rates of tongue ties in children (up by over 800% since 1997!). Tongue ties can cause issues with speech development, eating, and with breastfeeding.

• Skyrocketing rates of autism spectrum disorder (up nearly 800% from 1998 to 2018) and ADHD (nearly doubled since 1997-1998 to 2015-2016).

• Skyrocketing rates of other chronic illnesses linked to methylation, DNA synthesis and repair, and immune issues (the rate of chronic illnesses, including obesity, and developmental disorders in children in the United States was between 12-13% in 1994 and jumped to over 50% by 2011).

• Skyrocketing rates of gender dysphoria.

• Deeply unpleasant pregnancy experiences.

To state the breathtakingly obvious; it’s probably not a coincidence that all of these conditions are positively correlated with each other.

You know what would be another good option to prevent neural tube defects (and other issues too!) in children? A nutrition subsidy program for high-folate whole foods for low-income women of childbearing age. And a public health campaign to encourage women to eat lots of eggs (with the yolk!!), vegetables, nuts, seeds, beans, and lentils while pregnant or trying to become pregnant.

I doubt it’ll happen anytime soon, because a sick society is too profitable and our corporate overlords are getting fat off human misery. The Canadian government, it seems, would rather promote mass euthanasia than implement policies that might actually improve public health. (For example, it’s easier to access MAID than psilocybin mushrooms in Canada—despite overwhelming anecdotal and research evidence indicating the psilocybin may alleviate many of the common conditions people seek MAID for).

Next week, I’ll share three of my favourite pregnancy superfood snacks (including a palatable beef liver pâté recipe!). Warning—I don’t believe in simple recipes with only a handful of ingredients anymore than I believe in simple explanations.

Stay tuned.

Note: In doing this research and exchanging emails with Dr. Powers it became apparent to me that there is A LOT more going on here than I could possibly discuss in this article, in particular when it comes to the connection to the gut microbiome (and dietary factors) and other factors such as sun exposure and Vitamin D. As well, there’s a lot more to explore with MTHFR mutations, including that I suspect that they might serve an adaptive purpose when not bombarded with synthetic nutrients like folic acid.

From a World Grain article:

“Evolution scientists have discovered that people with a fair skin have less folate in their blood than dark-skinned people. According to Jablonski and Chaplin (2003), that is due to the damaging effect of UV light on the folic acid level [sic] in the blood. For example, irradiation of blood plasma with artificial sunlight reduces the folate concentration of the plasma by half within an hour. According to evolution scientists, that also explains why the people of sunny Africa have dark skin: in the course of evolution, dark skin came about as a protection against UV light and thus the folate reserves in human blood.”

I intend to return to this topic in future articles.

1. Check out this article by

A Midwestern Doctor

for corruption in the CDC (Centers for Disease Control and Prevention). But regardless, I’ve seen so much obviously questionable advice come out of the CDC over the past few years, it just seems prudent to doubt anything they claim (e.g. the CDC claims seed oils are healthy, low-fat milk is healthier than whole milk, and fortified cereals are a good first food to feed your kids). Given that various diseases and chronic illnesses seem to be on the rise in the United States, I don’t think they’re doing a particularly good job of “controlling” or “preventing” them.

2. I linked to Dr. Gunter’s essay so you can go read it if you want, I think it’s wise to engage with evidence from both sides.

3. This number is lower than the percent of unplanned pregnancies due to abortion.

4. This includes Ashkenazi Jewish people; research suggests Ashkenazi Jews are more likely to have a MTHFR C677T variant than other Jewish populations, and the general population. In Israel, there are significantly higher rates of autism among the regular Israeli Jewish population than seen in ultra-Orthodox Jews or Israeli Arabs.

5. As his theory is unproven, Dr. Powers still recommends prenatal vitamins with folic acid to his patients.

6. Refined sugars and flours also rapidly deplete Vitamin B1.

7. Psilocybin mushrooms, especially high doses, are NOT recommended for pregnant women or for children! I’m not convinced large doses of psilocybin are psychologically safe for people under 25, and would be very cautious with smaller doses under 18. There is also a risk of Hallucinogen Persisting Perception Disorder with all psychedelic drugs, including psilocybin. Not at lot is known about this, but from my research and from knowing someone who developed this disorder, I suspect the risk factors are: (1) Under the age of 25 (brain still developing); (2) Psilocybin is taken simultaneously with marijuana; (3) Strong visual imagination / “hyperphantasia”; (4) High natural mathematical talent. The last three risk factors applied to me when I first took high doses of psilocybin at age 32 and I was fine, but I’m very glad I didn’t try this while in my late teens or early twenties.

8. I’m not basing this observation on just my friend and myself, I’ve noticed the diet/alcohol link in other women who started same-sex dating in their late twenties or thirties.

9. According to Wikipedia, the Weston A Price foundation has been “criticized for spreading medical misinformation and dangerous health advice”, in particular for its “anti-vegetarian” and “anti-soy” views and promotion of animal fats. (Note: one of the founder of Wikipedia told Unherd he no longer trusts the website he helped create). Rational Wiki also criticizes the Foundation for “dangerous” advice, which includes advocacy against: “artificial” chemicals, veganism/vegetarianism, vaccines, monosodium glutamate, soy, canola, corn and cottonseed oil, fluoridated water, aspartame, synthetic vitamins, agave, high-fructose corn syrup, trans fats, soy milk (in particular in baby formula), microwaves, polyunsaturated oils, white rice, and pasteurized milk (they promote raw milk). The website Science Based Medicine also trashes the Weston A Price Foundation. And here’s another blistering article from McGill University on the Foundation.

As always, take everything with a grain of salt. I don’t think all the advice on the Weston A Price Foundation website is sound (for example, I am yet to be convinced that there is anything to homeopathy)—but I’ve followed a lot of their advice that makes sense to me and really only felt healthier for it. On the other hand, Science Based Medicine has trashed so many remedies I’ve seen work pretty darn well, at least for certain conditions (e.g. essential oils, Ivermectin, acupuncture), and had some other takes I’m skeptical of, like that the harms of puberty blockers are overblown, wearing a mask to protect yourself from Covid was effective, refined sugar isn’t that bad for you, and, of course, glyphosate is safe.

As I think it’s important to engage with both sides of any argument, I leave it to readers to do their own research and arrive at their own conclusions.

10. Funny how fortified breakfast cereals and folic acid supplements became the recommended go-to for meeting our essential need for folate shortly after the successful vilification campaign against eggs drove a massive drop in consumption for decades.