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The best type of B12 vitamin for MTHFR is very much dependent on the following: Which type of MTHFR gene mutation you are diagnosed with The symptoms you experience with MTHFR Your family history of the disease Your homocysteine balance If you are a smoker or have smoked in the past Your blood pressure Your diet Mental status Elevated serum tHcy levels: Monitoring these levels can help determine the effectiveness of B12 supplementation and the need for adjustments