Do you find yourself worrying excessively about the future,  about money or about fearful things in general?  Does a small amount of stress cause you to feel very stressed out?  Do you feel good while you exercise, but afterwards feel drained and worn out?  Are you easily agitated, nervous or upset?  Is your behavior erratic and combative when stressed? Do you organize your life very carefully, living with rules like careful eating and other disciplined behavior?  Do you make efforts to fix problems as soon as they show up?  Do feel you have to use meditation, prayer, yoga, or other mindful pursuits just to stay level-headed?  Are you diligent about being organized even to a fault?  If you answered yes to any of the questions above, you may have a genetic imbalance in your catecholamine neurotransmitter pathway – your dopamine, adrenalin and noradrenalin system.

The genes mainly responsible for these behaviors are called MAO-A and COMT.  People with MAO and COMT are predisposed to simply have TOO MUCH ADRENALIN in the body.  When we are born with COMT or MAO-A SNPs it means those enzymes are SLOWED DOWN in the body – current research has proven that COMT and MAO-A SNPs slow down these important chemical processes.  You can confirm if you have a problem by looking at your MTHFRsupport or LivewellO report.  If you see YELLOW or RED in those categories this means you have the SLOWER version.

Typical Genetic Report Showing COMT and MAO SNPs:

MAO and COMT Variants

* NOTE: for the genes shown above red or yellow means they are slowed down.

** NOTE: only one SNP needs to be present to impact these genes, although often there are multiple SNPs for COMT in a single individual.

Slowing down these enzymes will impact our lives and our behaviors because the catecholamines  – dopamine/noradrenalin/adrenalin – are broken down by the COMT and MAO enzymes.  This means that a small stressor can make us feel very stressed out.  Believe me…I know first hand because like you, I also have these genes.  It is the quest to understand WHY we feel so stressed out that has led me to uncover the genetic roots of our stressed-out state of mind.

Since the moment of conception we are programmed to respond to stress in our environment.  It is how we survive.  People with MAO and COMT have a unique ability in that they are able to produce an excess of adrenalin.  The body uses adrenalin to shift resources around during stress, aka fight or flight.  Adrenalin helps sharpen our focus, releases stored energy, increases blood pressure and muscle strength.  In fact, we are lucky to have adrenalin.  We’ve all heard about that mother who, when her child was trapped under a vehicle during a car wreck, was able to physically move the car and save the child.  Such is the power of adrenalin!

Anything that powerful must be kept under tight control, otherwise we will develop other issues that can damage our health.  Some common issues that result from too much adrenalin:

  • insomnia – people with too little catecholamines are narcoleptic, they can fall asleep anywhere; those with too many catecholamines simply can’t turn their mind off and lay awake for hours!
  • chronic pain – pain fibers become more sensitive in the presence of adrenalin, leading to syndromes like fibromyalgia and allodynia; this may cause pain just walking around the block, doing the dishes or rolling over in bed.
  • high blood pressure – adrenalin increases the rate and force of the heart; excess adrenalin will raise blood pressure – think bulging veins on side of forehead when someone is filled with rage!
  • POTS and other sympathetic disorders – while the causes of these issue may be complex, they each involve imbalances of the catecholamine stress hormones.
  • arrhythmia – excess stress placed on the heart often depletes the heart of taurine, magnesium, and nitric oxide; this causes an epilepsy-like effect on heart; that is arrhythmia should be considered a seizure of the heart.
  • excess sweating – adrenalin actives skin receptors to cause sweating; excess adrenalin often causes excess sweating.
  • tingling and numbness – excess catecholamines (adrenalin) can cause tingling and numbness on both sides of the body, in the hand and feet; this may mimick neuropathy but is just a side effect of excess adrenalin on the nervous system.
  • poor circulation – adrenalin pushes blood away from the gut and can cut off flow to the tips of our fingers; for example people with Raynaud’s phenomenon have so much adrenalin that it shuts off the flow of blood completely leaving the skin white and cold.
  • digestion problems – since adrenalin pushes blood away from the gut, people with MAO and COMT may suffer from IBS; for with less blood there is less oxygen, and we cannot properly digest our food.  Bacteria in the gut also use adrenalin to grow very rapidly.
  • OCD, anger, mood changes and anxiety – the increase of adrenalin comes at the expense of the loss of dopamine; every molecule of adrenalin is first a molecule of dopamine and so whenever the body produces excess adrenalin/noradrenalin, it will lower the available dopamine.  High adrenalin with low dopamine doesn’t feel good, and may make you cranky and hard to be around.
  • low thyroid – tyrosine is used to make dopamine, and dopamine is used to make adrenalin; tyrosine is also used to make thyroid hormone, so when we are stressed, thyroid function often drops as there is less tyrosine available to make T3 and T4.
  • and more…

Remember its not just our genes that cause us to have elevated adrenalin and the anxiety associated with it.  Inflammation is also a potent activator of the fight or flight system.  In other words, inflammation (of any kind) irritates our body and triggers the alarm.  And since so many things can cause inflammation – food allergies, poor digestion, chronic infections, physical exhaustion, blood sugar imbalances, etc. – is it any wonder that anxiety is a big problem in our lives?

Other genetic SNPs like MTHFR, MTR, MTRR, ACE, GAD, NOS and PEMT also predispose us to being anxious and depressed.  Each of these genes makes it more likely we will be inflammed and will have trouble detoxifying things like lead, mercury, aldehydes, petrochemicals, etc.  Having too much inflammation and heavy metals will constantly stimulate our sympathetic fight or flight system, activating our adrenals, and can lead to high anxiety.  One of the main reasons we feel stressed and anxious is from the methylation cycle not being optimized.  Without optimum methylation we can never have optimum detoxification; and weak detoxification predisposes us to having too much inflammation. In other words, our methylation controls our detoxification, and our detoxification controls our inflammation.  This is why healthy environmental signals and proper stress management are so important for those of us with COMT and MAO SNPs.

Four Ways to Manage Your MAO and COMT Genes:

1) Calm down gut inflammation by avoiding food allergens and processed, garbage GMO foods.  Shop the outside of the supermarket, avoiding the isles.  There is no one perfect diet for everyone but as Michael Pollen said, “eat food, mostly plants, not too much.”  You may need to consider digestive aids and anti-inflammatory supplements and foods to help reduce inflammation even more.  70% of inflammation comes from the gut, so taking care of digestion is always the first priority.

2) Exercise moderately as this creates a calming, relaxation response in the nervous system.  However, one must avoid working out after 7pm as it raises adrenalin.  People with MAO and COMT are going to have a difficult time sleeping after a workout that ends at 8 or 9 pm.  We can do that when we are 10 years old, but the older we get, the more sensitive we become.

3) Get 8-9 hours of sleep.  Most people need 7 hours minimum.  Often people who are recovering from an acute or chronic illness need more like 8-9 hours of sleep to optimize their healing and wellness.

4) Avoid unnecessary stress and take time for yourself.  Learn to say no to stressful situations and take time for yourself.  Recharging your batteries is not selfish; rather it allows you to be your best which helps you help others.  If we are sick and tired, how much of an asset can we be to someone else?

Because the side effects of too much stress are so damaging, people with MAO and COMT must be very careful to manage stress effectively. To manage stress we have to remember that stress comes in many forms – physical, mental, and chemical. To reduce physical stress I suggest you work with a kinesiologist/chiropractor who can accurately assess your structural body and keep your joints, muscles and nerves functioning optimally.  Other strategies that can improve physical stress is massage, acupuncture, epsom salt baths, moderate physical activity, coffee enemas, avoiding prolonged sitting, and getting at least 7 hours of sleep.

Mental stress is a spiritual concern, finding your place in the world and learning to let go and cope with life’s changes and challenges.  Without a doubt those of us with COMT and MAO genes have the hardest time “letting it go” because adrenalin just doesn’t let you do that.  Be strong and keep practicing though, because you truly can learn to be at peace – your genes and your brain will thank you!

Chemical stress can be avoided by optimizing your methylation cycle, cleaning up your gut, and promoting healthy detoxification.  Helping you optimize your genes and your life by figuring out what your body needs is what getting healthy is all about.  While success on this journey requires that individuals commit to getting well, it is impossible to make it alone.  To get the best results you need to work with a clinician who knows about genetics, in addition to the other important factors like blood sugar, adrenals, thyroid, acid alkaline balance, etc.  To really succeed you need a holistic approach.

People with MAO-A and COMT are some of the smartest, most-intelligent people you will ever meet.  The reason is that these SNPs increase dopamine, noradrenalin and adrenalin in the frontal lobes of our brain.   If you are blessed with increased dopamine and adrenalin you will be able to focus like a laser at times, and usually be very detail oriented with a good memory – as long as the system isn’t over-stressed.  But if your body becomes over-stressed from gut inflammation, food allergies, physical exhaustion, too much exercise, vitamin and mineral deficiencies, chronic infections, etc…then you have a recipe for being a stress-mess!

But it doesn’t have to be that way.  By targeting the root causes of our anxiety – too much adrenalin – we can change the environment inside the brain.    When we optimize our genes, we optimize our life…and when we do that, anything is possible.

Yours In Health,

Dr. Rostenberg

By studying the current peer-reviewed research, Dr. Rostenberg has discovered powerful, natural strategies to restore your health and heal your body.  He can help you uncover the genetic or root causes of your health problem and find a natural solution!  If you would like help with your methylation genetics to improve your brain function and reduce/eliminate your symptoms, please contact Dr. Rostenberg at Red Mountain Natural Medicine today. Phone 208-322-7755. Email Website


  • November 11, 2014 Reply


    Hello Dr. Rostenberg.
    Adrenalin and catecholamines are catabolic substances.

    It is general opinion that nervous or irritable people have a tendency to be thin or skinny and to have some digestion problems like gastritis, ulcera or others.

    Before Marshall and Warren’s discovery of H.P, doctors said gastritis and ulcera were a “stress problem”.

    Obviously I don’t intend to say it’s a perfect rule, but I’ve noted that to be true in many cases.

    Could the lack of adrenalin/catecholamines reabsorption be the explanation for this tendency to be thin and for their (our…) different body composition?

    Thanks a lot.

    • November 11, 2014 Reply


      Hi Marco,

      That is a brilliant observation. People with slow COMT genes and MAO genes are literally more often LEAN and MEAN. So yes, the increase in circulating adrenalin predisposes one towards a catabolic phenotype. It may be that people with COMT and MAO SNPs have a lower average BMI. Why bother to stop and eat food if you can simply use adrenalin to eat your own body? Could possibly explain a lot. Thanks for the comment.

      In Health,

      Dr. Rostenberg

  • February 16, 2015 Reply

    Angela M Berry-Koch

    I have read that even if one is not born with COMT – our biochemistry can be triggered into COMT like reactions when overwhelmed – by inflammation, toxins, malabsorption ( leaky gut), etc.

    I know we are born with the genes (SNP) we have and these do not change, but the enzymatic reactions may deviate to “COMT like” behavior .
    Can you comment on this?

    • March 10, 2015 Reply

      Dr. Rostenberg

      Hi Angela,

      Excellent question! Yes, there are many mechanisms that influence our genes. Imagine what it would be like if our genes were “static” and couldn’t adapt to the environment around us. We wouldn’t survive very long with a system like that. Our genes are dynamic, fluid, and programmable. They change based on the signals they are given. We all have SNPs that create a tendency but the real cause of health problems comes from environmental signals. If a woman (or man) has an excess of estrogen flooding the body due to poor gallbladder function, hormone therapy, birth control, gut infections, etc…then the estrogen levels will SLOW DOWN COMT and MAO-A just like someone who has a SNP. That is one situation where the gene can be slowed just like having a SNP. So hormones heavily influence (through environmental signals) the enzymatic reaction of important genes like COMT. People who are estrogen toxic will be prone to anxiety, intolerance to stress and other issues like insomnia, poor digestion, and rapid heart beat. This is due to the hormone impact on the genes, regardless of any SNP.

      Hope that Helps,

      Dr. Rostenberg

      PS – I would like to invite you to call my office (208) 322-7755 and set up an appointment and allow me to help you optimize your genes!

    • November 21, 2017 Reply

      Feed Bauchs

      Every human has COMT. I don’t get what the author of this article is saying, but we require COMT.

  • March 18, 2015 Reply

    Suzannah White

    Dear Dr Rostenburg – I just discovered you via YouTube and your wonderful, informative presentations. I’m very lucky to have found you as I have only just started on my pathway to optimum health and it seems like I hit lucky first time! I’ve received my 23andMe raw data and even though I’m no expert I can see what looks like quite a bit of conflicting genetics especially within methylation. I’ve tried researching myself and instead of becoming more informed, i’m getting more confused. Please can you work with me even though I’m in the UK (I do travel to the US for business several times a year)? I have a recent, full blood work profile including CRP etc. Additionally, I believe I have other issues apart from Methylation as I can ‘see’ it in my genes which totally fits with symptoms i’ve suffered for most of my life. If you would agree to work with me, would you also be able to give me a broader overview outside of the methylation cycle? (Please say yes – now I KNOW I have a problem I’m keen to optimise as much as I can as soon as I can and start to feel really well.) regards Suzannah

    • March 19, 2015 Reply

      Dr. Rostenberg

      Hi Suzannah,

      I will absolutely give you the BIG PICTURE which includes, but is not limited to, the methylation cycle. I look forward to working with you soon! We will dig into the WHY behind your symptoms and your health. And you should know that being confused is par for the course; if you are willing to be confused, then you will learn a lot. It looks like you have already contacted my front desk and are in the process of getting scheduled. We will be connecting on the phone in no time. Have a great weekend!

      In Health,

      Dr. Rostenberg

    • April 22, 2017 Reply

      Katy Davidson

      Hi Susannah, was wondering how your treatment went? I’ve not found a good practitioner here in the UK and am keen to optimise! MTHFR C766T Homozygous amongst other things…A lifetime of great difficulty finally being resolved 😊

  • April 7, 2015 Reply

    Anne B

    Have you encountered any individuals with Misophonia aka Selective Sound Sensitivity Syndrome? It’s an extreme form of Sensory Processing Disorder, which when a sufferer hears certain sounds, especially chewing and swallowing by another individual, there is an immediate severe flight or fight adrenaline response that renders the sufferer helpless. The NYT recently had an article by Dr. Barron Lerner, who personally suffers from Misophonia. There are many of us who thought we were crazy, until a few years ago, when Misophonia was “outed”. Here is Dr. Lerner’s article:
    I personally have had this affliction for over 55 years and am learning that it may very well be in my genetic code. Most doctors have not heard of Misophonia, so most of the time we are given SSRI’s, CBT and Pschyotherapy, which does not alleviate much of the distress. I just wanted to familiarize you with the term and perhaps you have thoughts on the disorder. Thank you for your consideration. Anne B

    • April 12, 2015 Reply

      Dr. Rostenberg

      Very interesting Anne! Thank you for sharing this with me. I will look deeper into this health issue and what the research suggests is are the causative factors. Because this is a processing disorder, it brings into question the brain’s neurotransmitter pathways and thus the methylation cycle – MTHFR, COMT, MAO, and many others. This subject needs more research but looking at it from the point of view of neurotransmitter balance would be a good place to start.

      Yours in Health,

      Dr. Rostenberg

    • May 2, 2016 Reply

      Eve G

      I searched google for “mthfr and misophonia” because I believe them to be linked in my child. MTHFR runs in our family, although I have not had him genetically tested yet. He suffers from misophonia that seems to improve when we are consistent with his methylfolate supplements. I would also like to know if there is a link.

      • May 4, 2016 Reply


        Hello Eve,

        Thanks for your comment. I am unaware of the exact connection to MTHFR pathways and misophonia. Except to remember that the brain requires adequate methylation in order to function properly; so as you support methylation pathways you in essence speed up the brain. A faster, more functional brain will improve neurological function which includes language and nerve conductance, etc. Hope that helps!

        In Health,

        Dr. Rostenberg

  • April 22, 2015 Reply


    Hi, thank you so much for sharing all of this knowledge! I have learned a great deal from your videos and writings in just the past 24 hours since I discovered your website and know I will be learning much more. I have been on a journey for optimal health for most of my adult life, but in the past couple of years this has been amped up as I felt a noticeable decline in my health with severe exhaustion, pain in my muscles and in general, just a cranky, stressed out mess. I attributed this to the onset of menopause at 48 and adrenal fatigue. For the past year I have been on bioidentical hormones (estrogen, progesterone and DHEA – which were tanked out) and I have noticed a big improvement, although far from optimal. I have continued to study and read to figure out this puzzle and was recently led do the 23andme. I found out that I am homozygous for COMT and MAO and heterozygous for MTHFR. I am definitely interested in getting your guidance, although I live in NYC. My question for the moment is considering my COMT mutation, is it wrong to be taking bioidentical estrogen? and perhaps even DHEA (I seem to convert to testosterone). Should I be taking something like DIM to help metabolize estrogen. Thank you for your time. I look forward to connecting with you personally soon.

    • April 23, 2015 Reply

      Dr. Rostenberg

      Hi and thank you for reaching out and sharing a comment! Without more information about your history, symptoms, etc. it is very hard to give advice concerning hormones and methylation pathways. What I will say is that estrogen influences our COMT and MAO systems by slowing them down. This is what helps make women feel less depressed when they take bioidentical hormones. The flip side of the coin is that too much estrogen slows down COMT and MAO way too much, leading to states of panic, anxiety and insomnia. DHEA is a great tool for stressed out bodies but it can increase testosterone levels is the dose it too high. I too look forward to connecting with you and helping to improve your health and well being. You may reach my office at 208-322-7755 and In Health, Dr. Rostenberg

  • April 28, 2015 Reply


    I posted a ? on the MAO-A understanding the SNP page and haven’t rec’d any feedback……….know how busy you must be so maybe it is a time issue………….should I repost ? here??


    • April 28, 2015 Reply

      Dr. Rostenberg

      Hi Raven,

      Yes, things have been exceedingly busy as of late. But that doesn’t mean your question isn’t important. Thank you for reaching out and contacting me as your friend is obviously going through something very challenging at the moment. In my experience as a clinician, I have seen far more damage from Lyme treatment using antibiotics than I have seen benefit. Most of the time, the IV garbage they are pushing through the body makes people much worse. This case seems to suggest the same.

      You asked about serotonin syndrome and if that was at play here. Serotonin syndrome is referred to in the medical literature as an side effect of SSRI’s and other drugs. People with serotonin syndrome, which is a life-threatening condition, are those who are either overdosing on SSRI’s or are having a nasty reaction between different drugs. In practically every other situation, such as the one you describe your friend going through, serotonin excess is not the problem. The problem is excess catecholamine signaling.

      When people get lots of antibiotics in their body, it severely disrupts gut homeostasis. This in turn changes who and what live in the gut. There is 100x more DNA in your gut than in your body, so the gut influences the genes more than anything else. When people take supplements like 5-MTHF they are taking ROCKET FUEL that could potentially make them feel better. The problem is that when you swallow something what goes on in the gut determines whether or not you benefit from the food or supplement.

      10mg/day of methyl folate is an ENORMOUS dose that has made many, many people sick including many patients of mine. Your friend may actually have gut bacteria in her small intestine which are pooping out folate and folic acid. Even though she has the genes for MTHFR compound heterozygous, she doesn’t necessarily have a folate deficiency. Esp. since her symptoms of panic, anxiety are suggesting that she is in fact OVERMETHYLATING to a great degree.

      Overmethylation is just a word that means something is going too fast and thus creates and imbalance. What we see clinically most often is that the Bh4 cycle escapes and produces excess catecholamines when methyl groups are taken. This increases the body’s ability to produce catecholamines and since many people are SLOW TO BREAK THEM DOWN, they get toxic levels of powerful stress hormones and neurotransmitters from taking B-vitamins based on their genetic report.

      In short, your friend has all the signs and symptoms of a gut problem. That MUST be treated first. She is even reacting to Vitamin D! They only way that is possible is that some microorganism in the gut ate her Vitamin D first and then pooped out all manner of toxic waste that bled into her body triggering her sympathetic nervous system to go on high alert. This is the pattern that explains why taking vitamins like Vit. D and folate/methyl support can cause wild symptoms. The number one reason people can’t tolerate vitamins is that the gut is in bad shape and is causing a side effect in the person’s body like anxiety, panic, insomnia, fatigue, brain fog, pain syndromes, etc. All these issues are the direct result of excess production of catecholamines into a person’s body who is slow at metabolizing them. For this reason it is highly likely your friend’s gut is eating her food/supplements first and robbing her of the benefit while at the same time leeching toxins into her system that trigger chronic fight or flight.

      We see this and treat this type of problem every day in our office. If you would like help please contact my office 208-322-7755 or and we will take good care of your friend.

      In Health,

      Dr. Rostenberg

  • April 29, 2015 Reply


    Thank you for your reply. FYI it is myself attempting to deal with this mess, friend (great researcher) just sent me info.

    My use of abx was very limited (opting for more natural approach), IV (limited to 2 wks) was almost 4 yrs ago with add’l yr 1/2 doxy/amox………choice of probiotics mainly bifido and s. boulardi and do know I need to rotate.

    All kinds of “whammies” for me as the add’l mutations you mention (MTR, MTRR, GAD, etc) either hetero or homo are part of the pix. Though the genetic ‘world’ is a tad over my head and don’t know if specific markers within i.e MTRR mutations (as I have many) are more relevant.

    If you’re willing, one last ? It seems I cannot tolerate the prebiotics (inulin, FOS) included in many probiotic products. I have learned through excellent source (LL) that many lyme pts have issues with same. Is it possible they might contribute in some way to the the excess catacholamines and/or the metabolization of them.

    Again my thanks, saving my pennies for any potential help with this.


  • April 30, 2015 Reply


    Hello Dr Rostenberg,

    I’m posting about my 6 yr old daughter. It’s been a long road for us but I feel like I finally see the light since I found methylation. She has a SLEW of snps that are impared which makes it VERY hard to know where to start. Basically every gene talked about is impaired in some way, we have order the MAP, CDSA and UAA but the results are not in. We have done wonders by balancing her diet (GF, DF, SugarF, Low Histamine, Lower Sulfur, No Fruit, No nuts, Grain Free), we eat meat, veggies, fat, broth and eggs and she take prescriptassit probiotic. Her mood has improved most of the time but we still have random MASSIVE blowouts and random sleep disturbances. I’ve been watching her for years so I can see it in her body language when its about to start. Her eyelids droop a bit during an episode. Oh and your right about intelligence! She is really SHARP!

    I guess what I am trying to ask is she is MTHFR A1298c (+/+) and Comt (+/-), Maoa (+/-). As well as a host of others. How do you go about finding a balance in this system? I still feel like we are walking on egg shells waiting for the other shoe to drop AND we cant go about eating the way we are forever having some fruit or nuts is usually a healthy thing.


    • May 2, 2015 Reply

      Dr. Rostenberg

      Hi Andrea,

      Thank you for your comment. You are right – you cannot eat that limited of a diet forever. What happens to most people isn’t so much that they eat the wrong foods all the time; its that they don’t absorb the foods very well. Hippocrates said “let food be thy medicine and medicine be thy food”. That is a true statement, but it only works if people are able to actually digest their food. I know that your daughter, like all similar patients we work with, needs some help digesting her food. You’ve done some good work by taking foods away which irritate her. Now you need help determining what foods and supplements will help her the best. In addition, looking at how the genetic pathways influence the situation is also very important.

      You find a balance in this situation by looking at the 30,000 foot view; by taking in all the information and synthesizing it into a model that best explains what is going on. That is precisely what we do in my office for patients just like your daughter. If you would like to save time, money and frustration then please reach out and contact my office – 208-322-7755 and

      Your Daughter will be better!

      In Health,

      Dr. Rostenberg

    • October 1, 2016 Reply

      Micaela Widman

      Hi, Andrea, I am doing research for my son, and came across your comment. I hope you don’t mind my interrupting. My son has had similar issues for almost all of his life (he is 17 now). He has a multitude of health issues, including a MTHFR mutation. We have described his disturbances as “episodes,” as well. We are taking several approaches to helping him. One is (just like you) through genetic testing and supplements. Another approach was through the Brain Balance Centers, one of the best decisions and some of the best money we have EVER spent. Honestly, he is so complex that we have to do Brain Balance, support for his genetic mutation/s, and also, believe it or not, serious help for his neuro autoimmunity. He has improved LEAPS and BOUNDS the last six months since starting BB and also getting help in the other areas (which we discovered through the doctor at BB). They will cost a lot, but their work digs out problems completely and that you can’t put a price on! 🙂 The thing that made me comment to you was when you said something about her super intelligence. That is our son, and surprisingly, is an indication of a left-brain dominance (which can cause all sorts of disconnections between the left and right sides of the brain). Just wanted to share. Thanks.

      • October 7, 2016 Reply


        Hi Micaela,

        You are right on with your support of Brain Balance. Being a chiropractor and knowing that a chiropractic neurologist created the brain balance program makes me proud. It is an amazing tool for helping children, and adults, optimize their brain and their lives. Sounds like you are doing all the right things as a mother and are seeing phenomenal results. Good work! So yes, Andrea, you SHOULD use Brain Balance since it is unlike anything else in the world for improving brain function!

        In Health,

        Dr. Rostenberg

  • May 2, 2015 Reply


    Thank you for all this great information! How amazing to see myself here – the focused racing mind, heightened startle response, and ridiculously speedy inflammation to any allergen. A loud noise, a flinch, sweet smelling lilacs, a friendly dog, a fearful thought – almost anything! – can rev me up and spiral into a migraine. Even being near an anxious person can give me a knot in my gut that takes a long time to ease. Now I see why… I have MTHFR C667, COMT, and MAO-A.
    Have you had success treating chronic migraine? I have been working on this for about a year and a half, eating a keto diet and supplementing with methyl folate, Vit D, etc. I keep talking to my doctor about neurotransmitters while she talks about digestion. After reading your posts I am finally getting it – especially “some microorganism in the gut ate her Vitamin D first and then pooped out all manner of toxic waste that bled into her body triggering her sympathetic nervous system to go on high alert.” What a picture! I’m hoping a phone consultation with you will help me see what we are missing. Congratulations on your new baby son!

    • May 2, 2015 Reply

      Dr. Rostenberg

      Hi Anne,

      Thank you for your kind comment. You are on the right track looking at how your genes and your gut are influencing your brain and stress levels. We look forward to working with you. I know we can help guide you towards a better level of health and well being.

      In Health,

      Dr. Rostenberg

  • May 4, 2015 Reply


    Could this cause seizures? epilepsy or other types of seizures?

  • July 6, 2015 Reply


    Hi and thanks for this highly interesting information. I’m on the autistic spectrum, and have as of late desperately been trying various supplements and remedies. I have recently learnt I have some of the Mao and comt snps, and generally fit the description you gave very well.

    Now for my question, do you have any thoughts about a low dose pregnenolone, which, I’ve been told, increases Mao activity if converted to progesterone? I realise this one of the more “dangerous” Otc supplements, but also fairly researched at the moment.



    • July 9, 2015 Reply

      Dr. Rostenberg

      Hi Joel,

      Thank you for your comment! The research isn’t very clear as to whether progesterone actually increases the speed of MAO systems. But since estrogen levels slow down MAO-A systems, and progesterone increases the healthy detoxification of estrogen, it is likely that progesterone does speed up MAO by way of lowering estrogens. Lower estrogen levels causes a faster MAO system, while higher estrogen causes a slower MAO system. Hope that helps!

      In Health,

      Dr. Rostenberg

  • July 14, 2015 Reply


    Hey Doc, thank you for the info. I just learned I have the MTHFR mutation c677t. I have been sick most of my life with anxiety and nausea, leading to an eating disorder, but seemingly remedied with Xanax. After 15 years of Xanax I became tolerent, having a paradoxical result, causing me to stop c/t from a 3 to 4 mgs daily (doctor ordereds), rendering me helpless and in a mental hospital. Released from the hospital and now home, I have started a new diet, dealing with the chemical problem I have with a herbalist, but it is very slow. Can the events I have had be a result of MTHFR? If so, please explain. Thank you.

    • July 19, 2015 Reply

      Dr. Rostenberg

      Hi Stan,

      Thank you for your comment! MTHFR and methylation has a major impact on how efficiently we produce neurotransmitters. From your history it seems that you are not very good at producing GABA, therefore you felt the benefit from Xanax. The methylation cycle is very crucial in producing GABA, as Taurine (a product of transfulfuration) and B6 are required to upregulate and activate the GAD1 gene. GAD1 converts glutamate into GABA, creating the calming effects it is known for. In situations like this we look at methylation cycle pathways to determine if you are making enough Taurine and other nutrients needed to calm the brain (such as Serotonin). So in short the MTHFR mutation can alter the availability of Taurine, lowering GABA production in the body. Also, people with MTHFR are simply prone to more inflammation since their detox and repair pathways are slowed. So in a round about way MTHFR can impact the level of inflammation in the body and the brain, and by extension, influence the production of GABA.

      If you would like more help then please reach out and contact our office directly. 208-322-7755 and

      Yours In Health,

      Dr. Rostenberg

      • July 2, 2017 Reply


        Hi Dr. Rostenberg,

        Could I ask if I get overmethylation and anxiety easily from supplements like Sam-e, would taking Taurine also increase or worsen methylation, anxiety?

        I see that taurine is at the very bottom right of the methylation chart here:

        Does that mean that taking any taurine would mean it would not have any effect further up the chart and hence not contribute towards methylation?


        • July 8, 2017 Reply

          Dr. Rostenberg

          Hi AdrenalHealth,

          Thanks for your comment. While any supplement is capable of causing a reaction, in my experience Taurine is very well tolerated, esp. by people who are “overmethylators”. In other words, taurine helps produce bile which detoxifies adrenal, estrogen, drugs, heavy metals, etc. It also is needed to support the formation of GABA. All of our GABA is made from glutamate, and if we cannot create enough GABA we are stuck with an excess of Glutamate. So Taurine helps there as well. For people with high catecholamines and symptoms of anxiety/panic/worry/insomnia/fear/paranoia/etc. Taurine is usually something that helps them. It doesn’t increase methylation, rather it is anti-oxidant, signaling molecule, bile supporter, and GABA agonist. Hope that helps!

          In Health,

          Dr. Rostenberg

  • February 4, 2016 Reply


    Wow! Great info.
    Can you explain the impact of the CBS C699T along with COMT V158M and COMT H62H, MAO-A? All ++ (No MTHFR)
    One swooshes things away quickly (CBS) and the other is low activity at receptor, (COMT). Do they cancel each other out somewhat?
    Also, we were diagnosed as undermethylators, high free copper, leaky brain, immune deficient (IgG 3 deficiency-strep trigger), OCD, Pandas, low serotonin, low cortisol, pyroluria. We have symptoms such as Major methyl sensitivity and high anxiety. So, how can we have symptoms such as high adrenaline, irreg heartbeat, anxiety, panic which seems to be what you describe as an over methylation? Even the tiniest amount of Sam-e or methylfolate drives us nuts.
    I surely would need to know if I should be treated for under OR over methylation so we don’t make things worse as I have done by experimentation!
    Truly you rock!

  • March 10, 2016 Reply


    Hi mate,

    Thanks for sharing this important information.
    I have a question, more of an acedemic one. We have all heard of DNA repair processes (there are few different ones) that are carried out within our cells, is it not then possible for these processes to repair snp? thoughts?

    • March 14, 2016 Reply


      Hi Indy,

      Thanks for your comment! SNPs cannot be repaired in the same way that DNA damage is repaired. DNA damage is severe and it will kill the cell, so it has to fix that to survive. SNPs on the other hand are functional disorders, not bad enough to harm the cell but just bad enough to give us symptoms when the body is stressed. We fix SNPs by supporting the pathways they are related to. We heal people with SNPs by taking pressure of the pathways which are going slow. By doing this we prevent flare ups and disease processes from occurring. It is rewarding work that consistently helps to change peoples’ lives. If you would like more help please contact my office 208-322-7755 and

      Yours in Health,

      Dr. Rostenberg

  • March 14, 2016 Reply


    Hi Dr. Rostenberg,

    Thank you for your very informative post. I notice many neuroprotective supplements contain ingredients to calm neuroinflammation and MCAD like quercetin, luteolin, catechins, rutin, and others. However, I see from my reading that these ingredients actually inhibit COMT further. What can people with COMT/MAO mutations (and who have neuroinflammation) take that won’t further inhibit COMT enzyme?

    Thank you.


    • March 21, 2016 Reply


      Hi Susan,

      Thanks for your comment. You are asking a good question. How can supplements with phenols in them be good for people who seem to have a phenol-based problem? Keep in mind the phenols from the gut are also called Volatile Organic Compounds – VOC’s. You’ve likely heard this phrase before when shopping for paint or reading about toxins from the petroleum industry. It is fascinating that the same chemicals which pollute our external environment are also found inside our internal environment. So its not a question of whether we are exposed to phenols. Rather it is a question of how many toxic phenols do we have to deal with? Everyone has a different limit to how many volatile organic compounds, aka organic acids, which they can tolerate before symptoms develop. That being said we also have to realize that just because something is a phenol doesn’t mean it is a toxin. Green Tea Catechins for example are proven to SPEED UP COMT in vivo. When studies were performed en vitro (outside the body) they appeared to inhibit COMT. But when the same nutrient is placed inside the body it actually makes COMT go faster. We are so lucky to have these phenolic compounds like Green Tea Catechins because they act differently than the toxic, volatile organic phenols. Therefore based on the research of how “good” phenols actually work in our body, we can say that phenols like quercetin, luteolin, catechins, etc. should be well tolerated by individuals with a GUT-BASED phenol issue.

      At the end of the day we have to realize that food is medicine and supplements are concentrated food. If you have a COMT issue that is being provoked by gut bacteria or gut infections, taking healthy phenols will likely not be a problem. I would not hesitate to use supplements with healthy phenols like the ones you mention. The vast majority of people will be perfectly fine taking them, even if they have a gut infection at the same time. Of course deep healing must involve treating the gut infection / dysbiosis but drinking green tea and taking those healthy phenols should not increase neuroinflammation or exacerbate symptoms.

      Yours in Health,

      Dr. Rostenberg

  • March 23, 2016 Reply


    This video explains so much for me, thank you. I was the most healthy person I knew, and then 5 months ago, out of the blue, I got serious insomnia whereas I never had sleeping issues before. I ran multiple tests, including Adrenal Stress Index and 23andme. This revealed VERY high cortisol, and MAO-A +/+, as well as issues with GAD1, DAO and HNMT. I also have very low Secretory IgA, which I am trying to fix without taking glutamine (due to the GAD1 issues). I thought that the high cortisol was caused solely by the leaky gut issues, but now I understand the MAO-A is a big contributing factor. It is all really fascinating, and I wish I had run my 23andme BEFORE I was sick. I will definitely be running genetic reports on my kids, to help them stay well.

  • April 3, 2016 Reply

    Neil McNamara

    Dr Rostenberg,

    I’m wondering how one manages these SNPs in the presence of Lyme co-infections such as Babesia, Bartonella etc? I’ve been struggling for 9 years to get well but just can’t seem to rebalance my immune system. Feel very Th2 dominant. I’m COMT, MTHFR & one MAO ++ amongst others. I seem to cycle from wired insomnia to narcoleptic fatigue. I rely heavily on antibiotics still. I’ve been intending to contact your office for some time because just before Lyme I had a massive shift in my personality ( impulsive, narcissistic, euphoric and at the same time as these infections where breaking down my immune system with persistent sinus and throat infections. It was very bizarre and the crashed into chronic illness.
    Do you think there is something you can do for me? Is like to work with a practitioner such as yourself over the phone or Skype. I am 3 years gluten free and juice often, make kambucha etc.

    Many thanks for all your excellent posts allowing us to understand this subject more thoroughly. It has really filled in so many missing pieces of my condition which for so long was just drugs to kill bugs.

    • April 4, 2016 Reply


      Hi Neil,

      Thanks for your comment. We need to find a better alternative for you than to live on antibiotics year after year. At a certain point, a better way must be found. I’m sure you will agree. I have seen more people injured by antibiotic therapy for Lyme than helped by it. We can work together over Skype/phone and dive into your history, symptoms, background, treatment, symptoms, etc. Really dig deep and be a good detective is our process. People with your genes have to be more diligent and more careful to remain balanced in the face of a stressful, toxic world. But even despite our genes we can still create health and improve our genetic expression. Genes are controlled by the environment and there are so many things we can do to improve the epigenetics in our bodies. Please contact my office 208-322-7755 and to set up a consultation so we can begin the process of optimizing your genes and changing your health for the better.

      In Health,

      Dr. Rostenberg

  • April 14, 2016 Reply


    Please, please help! Can I take L-lysine with Mao mutation?I take it for EBV , but I Don’t know if I should . Thank you so much

  • April 21, 2016 Reply


    Hi Dr. Rostenberg/Team,

    I got my 23andme results back. I have COMT +/- and MAOA + (I am female).
    The only medication I ever responded in a positive way were gaba-ergics, antidepressions did nothing or worsend anxiety or insomnia.

    So I guess there’s something wrong with my glutamine – glutamate – GABA – pathyway.

    I have all the results here for my GAD1 enzyme, but how to know which polymorphism is relevant? The first two seem to be rare (2,7%):


    Thanx in advance and greetings from Germany!

    • April 25, 2016 Reply


      Hi Manuela,

      Thanks for your comment! We don’t know which GAD1 is more significant. The way to understand this is what is your TOTAL SNP picture look like. If you have 6, 7, or more of the GAD1 SNPs then that pathway is very likely to need to be addressed. Remember, its a game of probabilities. Hope that helps!

      In Health,

      Dr. Rostenberg

  • April 27, 2016 Reply


    A local doctor discovered 3 months ago that I have MTHFR Heter, MTRR Heter, and COMT Homo. I was diagnosed with Fibro many years ago and recently went back to a doctor I had seen before for treatment as my hair started falling out again. My labs were similar to what they were when I had gone to this doctor 4 years ago. C4A came back 27,000/extremely high inflammation with 2 bacterial pneumonia, high for 4 virus, and many deficiencies (thyroid, D3, T3, adrenal dysfunction, high homocysteine, very low Killer cells, etc). She indicated the majority of Fibro patients have similar genetic issues. Treatment began again. I did great for about a month. I again started passing out for hours, every other day or so after lunch. It was determined I was over-methylated and temporarily stopped, for 2 weeks, the 4 supplements I had with B’s in them and added 200 mg SAMe. After a difficult week I gradually felt better and the passing out stopped. I had 3 good days. Now its 3 am and I’m tearful about a sad situation I have lived with for years and that I have no control over, the negative chatter began as I started feeling better. My biggest challenge is learning when I feel “x” do “y”. I see lists on symptoms but not a corresponding list on what to do/when. I’m not yet sure when I have too much of “x” or have too little. Is there such a list/table? I have read and learned so very much and it is so helpful and wonderful but I don’t understand how I am suppose to learn this. Perhaps I need to build my own list and corrective action through the readings and information available.
    Passing out 30 min after lunch Over methylated: add 200 mg SAMe
    Check BP: if dropping 10 points after eating…
    Negative/sad chatter in head Too much dopamine: Eat/take ___________
    Thank you for any information and thank you for all you have done and continue to do to help others improve and live a better life.

  • May 15, 2016 Reply


    Loved your video! Great information. As I was watching i, I was convinced I was low COMT. Sometimes I just feel the anxiety overwhelming me for no apparent reason, I have hypertension that isn’t responding to natural treatments (I’ve lost about 100 lbs, cinnamon doesn’t work, etc), waking at 3 AM every night. Then you mentioned that low COMT protects you from neuropathic pain. My main complaint is that I have trigeminal neuralgia that is most definitely exaccerbated by stress/anxiety. I try very hard to keep from overwhelming myself with life, but sometimes things happen beyond my control and the anxiety can be really challenging. This in turn leads to pain. I’ve had some relief using Magnesium oil, but not enough. Thoughts, suggestions?

  • June 14, 2016 Reply

    Mary Lou

    So what if your MAO is ++ and comt is val/val? Do they counter act each other? At age 52 I had never experienced anxiety, then out of the blue one night, while sleeping, had the first on many panic attacks. These have subsided, but I seem to get adrenaline surges first thing in the morning and mid afternoon. I know I have low cortisol all day.

    • July 11, 2016 Reply


      Hi Mary Lou,

      Thanks for your comment. Sure SNPs can counterbalance each other and often do. Getting panic/anxiety at night is common and it is often due to a gut problem – histamine excess, heartburn – or even low blood sugar. Most people in this country have a blood sugar imbalance and they experience uncomfortable drops in their blood sugar while fasting and/or sleeping. That is the first place to check!

      In Health,

      Dr. Rostenberg

  • July 16, 2016 Reply


    Top tip for those with slow COMT and a feeling of running on adrenaline. Try some niacinimide, 50-100mg 3x per day. I found this after years of trying to fight against a wired state, that was causing insomnia. I have both SNPs and this has worked wonders to take the edge off and help me sleep deeper.

  • August 25, 2016 Reply


    Was there an answer for Lisa [4 feb 2016] as I have the same question :
    … we were diagnosed as undermethylators, high free copper, leaky brain, immune deficient (IgG 3 deficiency-strep trigger), OCD, Pandas, low serotonin, low cortisol, pyroluria. We have symptoms such as Major methyl sensitivity and high anxiety. So, how can we have symptoms such as high adrenaline, irreg heartbeat, anxiety, panic which seems to be what you describe as an over methylation? Even the tiniest amount of Sam-e or methylfolate drives us nuts.
    I surely would need to know if I should be treated for under OR over methylation so we don’t make things worse as I have done by experimentation!

    • August 28, 2016 Reply


      Hi Steph,

      Thanks for your comment! You are asking some very good questions, and very complex ones as well. Just throw out the idea of “over” methylation vs. “under” methylation. It doesn’t mean anything for the kind of work we do with patients. You’ve mentioned your symptoms of high adrenaline, heart palpitations, and panic which are caused by HIGH CATECHOLAMINES. Methylation is more complex than just over or under. Catecholamines are very proinflammatory and used when the body is under a constant state of stress or inflammation or infection, etc. Throwing B-vitamins into that situation without treating the underlying cause of the inflammation and imbalances can create massive chain reactions. When you take SAM-e or methylation support and get flare ups or side effects, it doesn’t mean those vitamins aren’t helpful. It means you need to look elsewhere first – gut, oxalates, sulfate, mitochondrial support, etc. Once those issues are treated, methylation support makes much more sense. Again, the free copper = low methylation hypothesis is too simplistic to match what we see clinically. You would likely agree due to your current experience with methylation support also. If you would like to work with a personalized program for addressing the root cause of your body’s challenges, then contact our office at 208-322-7755 and Hope that helps!

      In Health,

      Dr. Rostenberg

  • August 25, 2016 Reply


    I am COMT V158M and H62H +/+ and MAO-A R297R +/+ but have a different CBS than Lisa [A360A +/-]
    also I do have Two MTRR +/+ and an MTR +/- with Two VDR +/- and Three BHMT +/-
    I have lived with your description of high adrenalin all my life [66yrs] with CFS for the last 25yrs without knowing what was causing it until I was in my 60’s.
    So if I am high copper [stress intolerant] high histamine [have allergies] high oestrogen [used to have PMS] query Pyroluria, but with methylation & folate problems, reacting to even a tiny amount of methyl as Lisa says, are we under-methylators, or an over-methylators, or somehow both ?
    It is a puzzle I am struggling to work out in my old age !

    • October 10, 2016 Reply


      Hi Steph,

      Thanks for your comment! Over and under-methylation is just too simplistic of an idea. Our bodies are complex and we work to make things simple for our own understanding. If you react to methyl groups you may have a gut infection, an imbalanced immune system or some other source of inflammation that gets triggered when you take in methyl groups. I have had many patients who couldn’t tolerate methyl groups heal their gut, improve their oxalate issues, and balance their neurotransmitters. Once they get the foundation in place their bodies became able to tolerated methyl groups with zero symptoms. So it is just hard to pin down whether people are over- or under-methylators. It is more important to determine what each individuals’ biggest weakness is and treat that in a holistic, natural way. If you would like more help with sorting this out, please contact my office at 208-322-7755 and

      In Health,

      Dr. Rostenberg

  • September 8, 2016 Reply


    hi Dr. Rosenberg,
    I am homo for A2198 and hetero for Comt h62h, comt v158m, and mao a r297r. I have chronic fatigue, fibromyalgia and Parkinson’s disease, constipation and SIBO.
    Is being hetero ( +_) going to slow me down enough to cause all of this? (as apposed to being homo ++) Is being hetero going to cause the same problems as being homo?
    Also … is stress the deciding factor that causes these genes to express themselves?
    thank you

    • October 10, 2016 Reply


      Hi Barbara,

      Thanks for your comment. Our genes are not our destiny, and just because you have a SNP doesn’t mean you get the full effects of that problem. Our genes respond heavily to the environment and that is the factor over which we have the most control. I would say you are correct that stress – either psychological, infection, trauma, chemical toxins, etc. – is the main precipitating factor determining if you will have a bad genetic expression. Conversely, if we clean up our internal and external world, then we can begin to improve the genetic expression and change our life for the better. Please contact our office if you would like help in sorting out your health challenges naturally. 208-322-7755 and

      In Health,

      Dr. Rostenberg

  • October 5, 2016 Reply


    I live in manchester in the UK and so far cannot find any help. There is so much info to wade through on methylation therapy for ocd, it is draining the life out of me. All are saying different things and I don’t know where to begin. I don’t have much money so Im trying to find out how to do this mostly by myself. There seem to be so many tests I need first, then a wide variety of detox diets, to heal the leaky gut and brain, then lots of supplements to take after that… my brain is boggling and I dont know whose info to trust as a starting point.
    I have severe ocd/tics, chronic fatigue, adrenal exhaustion, psoriasis/athritis, cannot raise core temperature, incredibly light sleeper. I need to sort out my leaky gut/brain, wipe the slate clean and build the brain back up. How on earth do I do this?
    I would love some advice… I cannot call the U.S it is too expensive. Any advice appreciated if you get the chance. Thanks

  • October 8, 2016 Reply

    Paige Mitchell

    Doctor, I am COMT V158M +/-, COMT H62H +/- as well as MAO and MTHFR +/+. After a tremendously stressful and emotional 10 day period last spring, I have suffered with a bout of “air hunger” (dyspnea). I’ve tried many things – MD, ND, acupuncture, chiropractic, and more. Could this unshakeable (so far), unpleasant air hunger sensation be caused by high catecholamines from a reaction to that traumatic period/event? I am otherwise very healthy, eat right, exercise, meditate and am generally happy. I want to be rid of this sensation! Thank you.

    • October 10, 2016 Reply


      Hi Paige,

      Thanks for your comment. Yes, stressful situations can cause the difficulty in breathing you describe. Often there are multiple effects which occur all at once. Typically the body releases as increase in catecholamines due to the perception of stress. These catecholamines make the heart pump faster, harder and raise blood pressure. They also can create states of panic, anxiety, worry and insomnia so common in stress-related disorders. The other area greatly effected by stress is the GUT itself. The stomach especially is sensitive to emotional stress. Many people know that stress can causes ulcers and lots of symptoms to our upper GI tract. I suspect you have a type of GERD and hiatal hernia that was developed during your stressful period. Once the body has a hiatal hernia situation, it causes a lot of irritated to the heart and diaphram which can make breathing very difficult when this is happening. There are other causes of course but these are the most common by far. If you would like help treating this then I would like to invite you to contact my office directly 208-322-7755 or We can get you a natural strategy that can help your body heal from the effects of this stressful period, optimizing your genes and changing your life for the better.

      In Health,

      Dr. Rostenberg

  • October 29, 2016 Reply


    Hello again from Steph [2 messages 25 aug] many thanks for your 2 answers !!
    I have information for Ursula [message 5 oct] if you will please give it to her, as she says she cannot phone the USA :
    I am also in the UK and have contact details for a lady Nutritionist & Allergist near to Manchester where Ursula lives.
    Though I am unable to reach this person’s clinic, she most probably could. I hesitate to put the details here, so is there an acceptable way to do this, please advise ? You are welcome to give her my email address to help her make contact.
    All the best …

  • November 22, 2016 Reply

    Andres Garcia

    Hi Dr.Rosenburg,

    I wanted to get your insight as to why someone would get nerve pain from low dose methylfolate(1mg).


    • November 29, 2016 Reply


      Hi Andres,

      Thank you for your comment. Nerve pain is a common symptom in individuals with ELEVATED catecholamines like norepinephrine. When you give methylfolate to people with too many catecholamines they can end up making even more catecholamines. This is why many people get the same side effects you are describing. It sounds like your body is over-producing norepinephrine from the methylfolate supplementation.

      In Health,

      Dr. Rostenberg

  • March 12, 2017 Reply


    Hi doctor, I’m very confused, although you have explained well, i have to many things going on to know where to start and whats the supplements to start with? I’ve been diagnosed with just about everything you talk about. Sibo, leaky gut, yeast, mthfr 1298 heterozygous, mthfr 677 heterozygous, ApoE 112 homozygous, ApoE 158 homozygous, factor v leiden vu homozygous arg/arg, apolipoprotein B, prothrombin G20210a homozygous, very low testosterone, glucose getting higher, comt aa, bloating, hernia, losing hair, skin rashes, hormone imbalances, estrogen dominance, rapid aging, poor nutrient absorption, blurry vision and so many ither things I’ve been dealing with for 16 years thats nearly killed me many times over. I’ve found i can’t tolerate Lectins and some histamine foods so i stay away from those plus I eat antinflammatory foods. I don’t seem to do well with the B vitamins or at least i can’t even tell I’m taking methylation B vitamins. I take at least 30 supplements and yet all my efforts plus all the other different kind if doctors can’t solve my mystery ! No one has addressed the SNP”s. Except trying methylation B vitamins. This all took off after i was given a epinephrine shot by a dentist that nearly killed me but before that i had stomach pain, constipation , memory problems since i was about 5. I was dropped on my head when i was 2 and i believe this caused neurological problems plus i had the measles, mumps and chicken pox plus a bad case of infantigo due to tick infections. So i was on many antibiotics plus not breast fed as a child. Today my mind can’t function well at all. This should give you a good idea what I’m dealing with and it’s probably not the half of it. Could you please give me a supplement idea to get started with ? Anything will help. I just found your site abd I’m feeling excited. Thank you for your time.

  • May 29, 2017 Reply


    Hi! I was being treated for mthfr with methylated folate and b12. I had a horrible, scary reaction. After genetic testing, I found I had mao-a and comt. Lucky me! I assumed I couldn’t handle the added serotonin from the methylated vitamins. I feel at a dead end now. But I also feel fine, and felt fine before treating mthfr. Do I leave well enough alone, or do you think I should be seeking some treatment for this genetic combo?

    Thank you!

    • June 12, 2017 Reply

      Dr. Rostenberg

      Hi Kristi,

      Yes, you should seek treatment to balance your MAO and COMT and MTHFR pathways. In our office we focus specifically on helping optimize these genetic imbalances to give people more energy, better sleep, less stress, and better digestion. We have had some great success applying the ideas from BeyondMTHFR to our patients’ lives. If you are looking for a practice that specializes in this kind of treatment, then please contact my office at and 208-322-7755.

      In Health,

      Dr. Rostenberg

  • July 13, 2017 Reply


    Hi Dr. Rostenberg,

    I watched your video and reviewed your posts about COMT and MAO–thank you for this detailed information. I’m interested in this because we recently discovered that our son (3.5) has COMT V158 +/+ and the doctor who informed us of this suggested we start supplementing immediately with biologically active B12. It seems like you don’t necessarily recommend this path, so I’m curious to know if you have other recommendations for a child of this age. As background, we don’t have any specific concerns about our son’s health or behavior at this point, so I mainly want to set him up for as much good health and success as possible as he grows. I appreciate the dietary and exercise recommendations, etc. but are there other supplements you’d recommend as well given his age?

    Many thanks,


    • July 17, 2017 Reply

      Dr. Rostenberg

      Hi Caroline,

      Thanks for your comment! You are on the right track by looking at your young child and learning about his COMT genetics. He shares this exact gene with 30% of the population (USA). So he is in good company! The big idea with COMT ++ people is to give them ONE THING to focus on vs. overwhelming them with multiple tasks at once. The truth is that COMT ++ people will handle a single stressor better than everyone else. They are some of the smartest people I have ever met, but they have an Achilles heel. IF stressors multiply they will get too much dopamine in their brain and then lose performance, and potentially develop anxiety, phobias, worry, panic, insomnia, etc. Just something to be aware of. I say just give him a multivitamin like Metagenics chewable Phytomulti, vitamin D, chewable probiotic and some DHA (also from Metagenics). This covers the bases for someone his age. No need to treat him for COMT issues unless they develop. Likely they never will (remember 30% of the population has the gene, and only a few of these people actually have the problems associated with it). Nurture > Nature…the environment rules the roost. Keep being great parents and if you need more specific help, just contact my office 208-322-7755 and

      In Health,

      Dr. Rostenberg

  • July 20, 2017 Reply


    I am overweight and have mthfr. From your article it sounds like you are saying only skinny people have this mean moody problem. Can you explain what would cause someone with this gene profile would be significantly over weight especially with the hormones that can be involved

  • July 24, 2017 Reply


    Dr. Rostenberg,
    I loved your presentation. I wondered how the pain mechanism worked in relation to migraines? Would the MAO and COMT SNP also explain chronic migraine pain that is not alleviated by any pain medication. There is also a total lack of sleep as well as high blood pressure. There is adrenal exhaustion but poor clearance of cortisol so it appears high while being poorly produced. It just sticks around longer.
    Thanks for your insight.

  • July 26, 2017 Reply


    Hello there,

    Interesting read. Thank you for all of this information, it has been helpful.

    So, I am wondering if I am taking the right supplement. I was tested as heterozygous for the COMT mutation, and normal for the MTHFR (no mutation).
    I have been taking the following presciption since January:

    B-complex from compounding pharmacy containing: B1 25 mg, B2 25 mg, B6 50 mg, B5 50 mg, methylcobalamin 1000 mcg, methylfolate 800 mcg, 1 capsule each morning.

    At first I had some head aches when taking it but it levelled out and felt really great for a few months. Happier and less stress, quite balanced. Until about April. I skipped a few days in April and when going back on, I felt the anxiety was worse than it had been ever. After this, I had a few months of on and off brutal mind bending panic attacks. I hadn’t had this for awhile. (I went back on the methyl b supplements again after the few days off in April, and would skip maybe a day here and there but was pretty consistent outside of this and have been ever since)

    I was wondering if you think this was because I skipped that my anxiety became very severe?

    Or is it that maybe I’m not on the correct supplement for my mutation and when going back on after skipping I felt slightly nutty?

    I do notice near my period things get more anxious and depressive, as a side note.

    Can you suggest the best method for me to deal with this? Keep taking it consistently and see how it fares? I find if I am consistent and don’t miss, things feel good for awhile, but not perfect.

    Just curious if this is the right treatment or if there is something better suited to my particular mutation, since it is only heterozygous.

    Thanks so much:)

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