MTHFR Test: What It Shows, What It Doesn't, and At-Home Options

An MTHFR test checks your DNA for two common variants in the MTHFR gene, C677T and A1298C.¹ It can tell you whether you carry zero, one, or two copies of each, but it cannot tell you that you are unable to use folic acid: CDC says people with common MTHFR variants can process all forms of folate and should not avoid folic acid.² This page covers what the test does and does not tell you, when it is and is not useful, and what consumer and at-home options cost as listed in October 2026.

Our guide to MTHFR and folic acid covers the biology in depth. This page focuses on the test itself and the companies that sell it.

What does an MTHFR test actually measure?

The MTHFR gene carries instructions for an enzyme that helps your body use folate. Folate and other B vitamins help break down an amino acid called homocysteine.¹ Some changes in the gene make the enzyme work less efficiently, which can lead to higher homocysteine in some people.¹

A standard MTHFR test looks only for the two most common variants, C677T and A1298C.¹ Results are usually reported as positive or negative for each:¹

Notice that every row depends on whether homocysteine is actually high. The gene result on its own says little.

What CDC's MTHFR data adds

People with the 677TT genotype have, on average, blood folate about 16% lower than people with 677CC at the same intake.² But daily folic acid intake and how long it has been taken affect blood folate more than the common genotype does.² That is why the practical advice does not change: take folic acid consistently if you could become pregnant.

What an MTHFR test does not tell you

This is where most marketing goes further than the evidence.

• It does not mean you cannot process folic acid. CDC says people with common variants can process folic acid.²
• It does not change the pregnancy recommendation. CDC still recommends 400 mcg of folic acid daily for anyone who could become pregnant, even with a common variant, because folic acid is the form directly shown to prevent neural tube defects.²³
• It does not prove you need methylfolate. A common variant alone is not proof that methylfolate is required.² MedlinePlus notes some providers may suggest methylfolate to lower high homocysteine, but it also states CDC recommends folic acid for everyone who may become pregnant.¹ Our page on methylfolate vs folic acid compares the forms.
• It does not predict disease on its own. MedlinePlus says having either variant does not necessarily increase your risk for any health condition, nor does it guarantee high homocysteine.¹
• It is not a test for rare MTHFR disease. Different gene tests look for rare MTHFR changes that cause homocystinuria, a genetic disease in which symptoms usually appear in the first year of life.¹ Rare pathogenic MTHFR disorders need specialist evaluation and should never be lumped in with common consumer results.²

When is MTHFR testing actually used?

MedlinePlus says medical experts do not recommend testing for common MTHFR variants in most cases.¹ Even when a homocysteine blood test is high, the MTHFR test is generally not needed, because treatment for high homocysteine is the same whether or not a common variant is the cause.¹

A clinician may still order it in a few situations:¹

• High homocysteine plus a close relative with a known MTHFR change
• High homocysteine plus early heart or blood vessel disease in you or close family
• Before or during methotrexate treatment, to help choose a safe dose
• A positive newborn screening result for homocystinuria

If methotrexate is part of your care, see our page on methotrexate and folic acid and follow your prescriber's plan.

At-home genetic testing: how it differs from a doctor-ordered test

Direct-to-consumer (DTC) genetic tests are sold straight to customers online or in stores. You usually swab your cheek or spit into a tube, mail it back, and read results on a website or app.⁴ Most health insurance plans do not cover them, though some may be eligible for FSA or HSA reimbursement.⁴

MedlinePlus lists real advantages: easy home collection, no need for a doctor or insurer to approve the test, and results that stay out of your medical record unless you share them.⁵ It also lists limits worth weighing:⁵

• Many conditions involve genes, lifestyle, and environment together, and DTC tests look only at genes.
• A test may check only a few of the variants linked to a condition, which can give false reassurance.
• Oversight and regulation of DTC companies is limited.
• Results usually need confirmation through a healthcare professional before they guide care.⁴
• Genetic privacy can be compromised if data is sold, shared, or breached, or if the company changes ownership or goes bankrupt.
• Companies may be required to disclose data to law enforcement.
• Results may affect your ability to get life, disability, or long-term care insurance.

How to choose an MTHFR or health DNA test

There is no single "best DNA test for health." The right choice depends on your question. Use these criteria:

1. Do you need the test at all? If your goal is pregnancy planning, the answer is folic acid, not a gene test.²
2. What does it report? A plain C677T and A1298C result is different from a broad nutrition report built on hundreds of markers.
3. Who runs the lab? Look for a stated CLIA or CAP lab.
4. Sample type and turnaround. Saliva and cheek swab kits are done at home. Some "kits" still need a blood draw.
5. Privacy terms. Read how the company stores your sample, who it shares data with, and how to delete it.
6. Support. MedlinePlus notes many DTC companies do not provide professionals to explain results.⁵

MTHFR test options and prices (as listed October 2026)

We have not used any of these tests. The table is built from each company's published pages, checked on October 2, 2026. Prices change, so confirm on the official site.

Genate

According to Genate, its test is a prenatal nutrition genetics test that analyzes how you metabolize folate, choline, B vitamins, and DHA, and returns a report with nutrition and supplement suggestions.⁶ The page lists a saliva collection kit, a "CLIA/CAP Lab" badge, and delivery of the report through a secure, password-protected portal.⁶ Genate also states the test does not provide medical advice or diagnose any medical condition.⁶ Read our full Genate test review for what is included and what to weigh.

23andMe+ Premium

23andMe says its Homocysteine (MTHFR-Related) report covers C677T and A1298C and is part of the 23andMe+ Premium membership, which costs $199 for the first year and $99 per year after that.⁷⁸ The company states the report does not diagnose elevated homocysteine or any health condition and should not be used to make medical decisions.⁷ Because it is a membership, the yearly renewal is part of the true cost.

Lab-based MTHFR tests

Ulta Lab Tests and Walk-In Lab sell blood-based MTHFR genotyping that reports only the two common variants.⁹¹⁰ These suit someone whose clinician wants the specific result. They are not at-home in the sense of a spit kit: you still need a blood draw.⁹¹⁰

Privacy: what the companies say

Genetic data is permanent, and it is shared with your relatives. Here is what each company states on the pages we read:

• Genate: its product page says report access will not be shared with anyone, including SNP Therapeutics employees, healthcare providers, insurance companies, or law enforcement, without your consent or a court order.⁶ Its store privacy policy says a separate genetic testing privacy policy is presented when you register the kit.¹²
• 23andMe: its privacy page says genetic data will not be shared with employers, insurance companies, or public databases without explicit consent, that you can choose whether your saliva sample is stored or discarded, and that you can delete your account and request sample destruction.¹³ It also says data is only shared with law enforcement if required by valid legal process.¹³

What to do instead of (or after) testing

If pregnancy is possible, start a daily supplement with 400 mcg of folic acid at least one month before conception, as CDC and USPSTF recommend.¹⁴¹⁵ See how much folic acid for pregnancy for details.

If you want to know your actual folate status, a blood test measures it directly. Our pages on the folate blood test and at-home folate and B12 test options explain what serum and red blood cell folate show.

This article is for general education and is not medical advice. Doses and needs differ from person to person, so talk with your clinician or pharmacist about your situation. Read our editorial policy and medical disclaimer.