https://www.youtube.com/watch?v=8qezmdDnY0s
In our last video Dr. Rostenberg laid out the fundamentals of how COMT and MAO polymorphisms affect our brain. This video expands on these ideas and explains why and how methylation nutrients can heal the imbalanced brain. The peer-reviewed research is clear that proper methylation is needed for normal brain function. It also shows that methyl support prevents dementia and cognitive decline, even for those who are already suffering from the ravages of brain disease like Alzheimer’s and Parkinson’s. Future videos will address these and other issues more in-depth.
When we have a polymorphism that slows down, its tempting to think we will forever be handicapped. And in a way, that is true. But consider that having COMT expression slows down your ability to degrade neurotransmitters. When the body releases these powerful chemicals in the brain, people with COMT genes will have more neurotransmitter activity compared to someone without COMT SNPs. This can make someone smarter, more focused, better reflexes, and better memory. It can also harm them since excess neurotransmitters can damage the tissue/neurons in the brain itself. Dopamine and adrenalin are like gasoline. Without it, our brain doesn’t fire correctly. Too much of it and our brain catches fire!
The good news is that methyl vitamins which support proper SAMe levels protect us against the harmful effects of excess neurotransmitters. In other words, as you’ll see in this video, methyl groups are the key ingredient to help your COMT work at its best. If you are born with a slower COMT, you still want to make sure it is working at maximum speed. I mean, if you drove a car that only had a top speed of 40 miles per hour, and the speed limit is 60, wouldn’t you want to drive as fast as possible? This is exactly the same phenomenon in the body. SNPs slow down our top speed, but vitamins makes sure we can still drive at our own individual top speed. That is why making sure you have enough methyl donors to break down the catecholamines becomes so important. If you would like help with your methylation genetics to heal your neurotransmitters and/or hormones, please contact Dr. Rostenberg at Red Mountain Natural Medicine today. Phone 208-322-7755. Email care@redmountainclinic.com.
I am very confused. I was under the impression that COMT + individuals needed to limit methyl groups. This is what I’ve read in yasko, genetic genie, and heartfixer. I’m working with a ND who is a Bastyr graduate and very well versed in all things mthfr. I understand that some new info is coming to light about COMT (she just went to a conference on this) and maybe this is new that more methyl groups are needed, and not less?
COMT + will make a person susceptible to elevated dopamine and adrenalin. Methyl groups are needed whether COMT is normal or slowed. Without methyl groups homocysteine will rise and cause damage. And being confused is the first step to figuring this stuff out. If your COMT is slowed….don’t you want to make extra sure it goes as fast as it can? Thats what SAMe and methyl groups are going to make happen. Overmethylation is really a symptom of excess catecholamines. Hope that helps. – Dr. Rostenberg
Thanks for the very useful information.
How about if you have low homocysteine (5)? Snps are homozygous 677, MAO, PEMT and heterozygous for COMT. Could it just be that methyl sups have been taken for too long, or is something else going on.
Ideal homocysteine levels are 4-8 so 5 isn’t technically low. Low methionine diets low sulfur diets and not eating or absorbing protein in general will lower hompcysteine even more. Below 4 we are really looking at gross malnutrition. 5 is a good number. Dr Rostenberg
I heard from an expert that homocysteine below 6 is a problem.
The ideal range would be between 6-8. Below 6 based on his
experience (many years) he sees a lot of children with autism.
I have a COMT SNP and taking SAMe made me over methylate. I would feel like I was having a horrid panic attack. I do fine using a methylated B complex though my concentration is still pretty poor.
You say overmethylation is a symptom of EXCESS catecholamines, and that the MAA/COMT SNPs SLOW DOWN the breakdown of catcholamines. And YET, you claim that methyl-donors are especially important fro individuals with these SNP’s? That does not make sense at all. People experiencing overmethylation should certainly REDUCE their consumption of methyl donors. Your theory is blatantly contradictory, is it not?
Please let me know if I am missing something here.
Hi Pete,
Yes, people experiencing OVERMETHYLATION symptoms must reduce their consumption/exposure of methyl donors. People with MAO/COMT SNPs also need methyl groups because COMT is SAM-e dependent, thus lack of methyl donor availability will slow down COMT systems. Its just not a matter of looking at SNPs; you must look at people and at the individual. I hope you continue to look at the articles I’ve written and the other videos on my site. You will find that there are many aspects to balancing COMT/MAO-A pathways that go far beyond looking at the genetic report. Namely, the gut plays a major, major role in aggravating these pathways and causing symptoms of overmethylation. https://www.beyondmthfr.com/2014/12/28/the-gut-origin-of-methylation-problems/
Its not a contradiction when you get down to the nitty gritty of how the body works. People need methyl donors – the question is HOW MUCH? And of course if they are experiencing overmethylation (a very basic term) then methyl donors aren’t need…at that time! But rest assured, every person you meet has a requirement for methyl donors to protect and optimize their epigenome.
In Health,
Dr. Rostenberg
Hey Dr. Rostenberg,
My Name is A.J. Kivela, im currently a 5th year senior at University of New Hampshire, and im about to graduate with a B.S. in Neuroscience (with plans to matriculate into the BU Medical School, next fall) I stumbled upon your video/website, by happenstance, as I was wondering if you/this company is still active ?
I have a lot of questions regarding my personal research I’ve conducted and I was hoping to reach out to you or your colleagues and discuss your current research – in regards to findings from my research and personal findings from the 23andMe genetic mapping of my family.
I can be reached at ajkivela@yahoo.com.
I look forward to your reply!
Very Respectfully,
A.J. Kivela
Hey Dr. Rostenberg,
My Name is A.J. Kivela, im currently a 5th year senior at University of New Hampshire, and im about to graduate with a B.S. in Neuroscience (with plans to matriculate into the BU Medical School, next fall) I stumbled upon your video/website, by happenstance, as I was wondering if you/this company is still active ?
I have a lot of questions regarding my personal research I’ve conducted and I was hoping to reach out to you or your colleagues and discuss your current research – in regards to findings from my research and personal findings from the 23andMe genetic mapping of my family.
I can be reached at ajkivela@yahoo.com.
I look forward to your reply!
Very Respectfully,
A.J. Kivela
Hello A.J.,
Thanks for reaching out and contacting me. Yes, we are very much still active. I run a busy natural medicine clinic in Boise, ID, where I spend about 30 hours per week treating patients and applying the science of methylation, epigenetics and functional medicine. I see patients from all over the country and the world, both in person and via a telemedicine model. If you would like to speak with me regarding your health, genetics, research, etc. then a consultation is the best option. That way we can spend the necessary time to address your unique individual genetic+environmental situation – your unique phenotype. We can be reached at 208-322-7755 or care@redmountainclinic.com.
In Health,
Dr. Rostenberg
Isnt lab testing needed to indentify the genetic expression and monitor effects of supplements? My friend got a test from Sabre Sciences and they found that even though she had COMT her catecholamines were all normal
Hi Jenine,
Thanks for your comment. Yes, testing is valuable. But even more valuable is examining a patient and performing an indepth assessment of their symptoms, history, sleep, energy, mood, digestion, etc. I test dozens of patients every week. What we find is that the symptoms of catecholamine dominance (insomnia, worry, panic, anxiety, pain) or catecholamine deficiency (anger, cravings, moodiness, excessive sleepiness, fatigue, high risk behavior) allow us to determine the imbalance without performing testing. COMT genes by themselves don’t guarantee anything; rather they are a tendency or a likelihood. Not our destiny but our tendency. Just because we have the gene doesn’t mean we get the problem. It just means that when our body is under stress we are more likely to get the genetic problem. Symptoms can guide us once we become knowledgeable of what they mean. Hope that helps!
In Health,
Dr. Rostenberg
I find I have a hard time with methyl groups. Methyl b 12 leaves me feeling completely stoned and dizzy. I have cut back on my b vits to introduce again lower and slower. I am also taking andeso b12 instead of the methyl. Still somewhat foggy but could be my other sups. I am comt ++ as well as mao++. Confusing to figure it all out. I really enjoyed this video as well as the preceding one. Makes sense to speed up the comt to help solve the mao problem as well.
We need b12 to stay alive but if you are getting symptoms from it there are definitely other holes in the bucket we need to address. Low serotonin is usually the problem, and taking b12 can cause your body to make more dopamine quickly which would exacerbate the low serotonin issue. Dizzyness is a common side effect of excess catecholamines (or of relatively low serotonin in conjuction). More to come in future videos. Reach out to my office if you would like more help one on one. – Dr. Rostenberg
My OAT test said I was low seratonin, so that could be the problem. I have been taking 5htp, but a low dose so combined with the b12 that could be the problem. Thanks for getting back to me!
Thanks so much for the quick response. Last year my ND diagnosed me with mthfr A1298C +/+ and we started with methyls (folate, b12, SamE, glutathione IV, NAC, etc), but when my 23andme results came back she pulled all of those. I thought my COMT +/+ status meant that I already had too many methyl groups floating around and therefore needed to limit methyl donors (Yasko). My doctor (she is a Bastyr grad in Dr. Lynch’s class) recently went to a conference on COMT and it was suggested to follow a low histamine diet and add B1 and riboflavin. But we haven’t reintroduced any methyls. I guess I am confused as to why I would add more methyls if I can’t use the ones I have… She is really good about not just treating the snps. My biggest issue is chronic fatigue and significant brain fog. Also headaches, IBS, insomnia, anxiety. I have also been on an antidepressant for 25+ years and I am weaning off of that (since ssri’s have been known to cause these exact symptoms too…). It’s all just such an interesting, terrible, confusing, and frustrating puzzle.
It is confusing. Just remember to stay flexible. There isn’t one recipe for every patient, nor for every gene. COMT is one of over 150 different enzymes that use methyl groups. Remember your body may use methyl groups in the liver, or in the growth and repair of new cells, or in the gut. It may never even get to your brain. IF you are COMT ++ is a guarantee that you don’t process estrogen well, and there are non-methyl approaches to fixing that. The GB will suffer and the brain will get foggy when the GB doesn’t clear its toxic load. Looking at genes helps. But look at the history, and the whole body symptoms to guide what supplements to take. – Dr. Rostenberg
You didn’t mention sulfates. I’m getting frustrated with Yaskos protocol online and finding no guidance with this treatment. My sulfates are consistently >800->1200 and there is so much I can’t eat due to reflux lpr symptoms. Can’t get sulfates to come down despite low thiol (cut NAC after years on it), low histsmine and low acid diet as well as cut out all food sensitivities evidenced in iGg test. Drinking Fiji water to detox aluminum (silica). Couldn’t tolerate high methyl so only taking what is in my multi. Compound heterozygous, homozygous dao, Mao a and others and heterozygous CBS and COMT and others. I’m stuck. Homocysteine is 6. I just want my anxiety, panic attacks, acne, mood swings, and bloating from many foods to go away.
Sulfites are the problem. Sulfur in our diet/bodies turns into sulFITE before being processed into sulFATES. We get sick if the body can’t break down the sulfites. So the recommendation with high sulfite/sulfate load is to eat a low methionine/low sulfur diet and avoid nutrients that contain sulfur in excess quantities. You’ve already done that by avoiding NAC. Homocysteine at 6 is a good number. Acne in a female is directly related to excess insulin and testosterone production (blood sugar). Insulin combines with testosterone to produce acne. You appear to suffer from excess neurotransmitters. All genetics aside there is a some metabolic and digestive imbalance in your system. Contact my office if you would like more assitance. – Dr. Rostenberg
Thank you, I will be contacting your office. My sulfITES are fine on urine tests. Just the sulfates that have a problem. I have all my SNPs, food sensitivities, and blood work done and am waiting on oat and amino acid urine test results. My current doctor wants me to EDTA chelation testing with urine test but I’d rather not.
I´m COMT V158M +/+, COMT H62H +/+, MAO A R29TR +/+, MTHFR 1298 +/-
Dopamine 200, DOPAC 1821, Glutamate 64, everything else in range.
Extremely high mercury according to Tri-test Quicksilver Scientific. No amalgam but big fish eater (not anymore).
Have severe IBS with cramps, moderate chemical sensitivity, sensitive to mold, not noticed any sensitivity to different types of b-vitamines. Extremely sensitive to many foods and food textures/fibres, supplements.
I´m not tired all the time. Often good energy levels. Easy to be happy even if my life is so sad and sometimes even I (with high dopamine) feel like giving up. So I´m thankful to these SNPs keeping my neurotransmitters for a longer time.
I´m underweight, need 100-120 mcg estradiol patches even if I´m still menstruating/ovulating. If I don´t use enough estradiol patches I loose so much water and cramp in my legs. What´s the connection estrogen and these SNPs? Does this mean estradiol is both bad and good for me? I would´t survive with lower.
Estrogen is broken down by COMT and methyl groups so your genes will make it harder to detox estrogen that you make and estrogen you are exposed to in the environment. Low body fat in a female (underweight) can lead to low levels of estrogen. Not enough body fat and a woman will stop menstruating all together – not good. The problem with high dopamine is you need good antioxidant and methyl support to keep them from degrading into toxic byproducts that can irritate you. COMT will slow down the Gallbladder, and that can cause all kinds of issues down the road. Its real important to keep the GB working well and that will is the topic of a future video for sure. Please let me know if you would to consult and get more information. – Dr. Rostenberg
What do you think of the herb vitex (chaste tree) being a dopaminergic, does this mean it would have a negative impact on those with COMT/MAO snps? I know it can help a lot of people with sleep and anxiety etc but could it also have a negative effect on some people?
I would say chasteberry/vitex is weakly dopaminergic at best. Its most often used to stimulate progesterone production in females who are suffering from adrenal fatigue/estrogen dominance/pregnenalone steal. The key to remember with COMT and MAO is that methylation both produces the neurotransmitter, but also breaks it down. Its a double edged sword. There are many lifestyle factors that can be used to lower dopamine. The question is why is the body releasing adrenalin/dopamine/catecholamines in high quantity? Is there an infection? Deficiency? Autoimmune reaction? Allergy? etc. etc. The big issue with anxiety is either a) low serotonin and normal dopamine or b) normal serotonin and elevated dopamine or c)low serotonin and elevated dopamine (worst case). Lack of sleep is another indicator of serotonin, aka tryptophan deficiency. This brings into play B3/niacin/NAD as the body will divert tryptophan into NAD to keep the cells alive at the expense of producing serotonin to calm the mind and promote sleep. I’d be happy to discuss further if you would like to set up a consult. Hope that helps. – Dr. Rostenberg
Thanks so much for your quick reply.. I would love to book a consult with you however I am in Australia! Do you do consults over email or skype?
Skype would be best of but I am in Mountain Standard Time. How far is that from your time zone? I’m sure we could work something out. We both speak English so that is a plus :). If Skype doesn’t work I am willing to work over email with you. If you decide to move ahead with that you will need to contact Amber my front desk manager redmountainclinic@gmail.com and we will work it out from there. You’ll be better! – Dr. Rostenberg
Thanks I will figure out timings and schedule and get in touch over next couple of weeks. Will contact Amber on email above. Thank you! 🙂
Any time I take methyl-donors, over a week or so I feel extremely edgy, irritable and honestly like my brain is on “fire.” From all the reading I have done, I understood that I should avoid methylated B vitamins. I can tolerate methyl-B12 if doses are spaced out appropriately. I also have trouble with circumin, which is a methyl-donor and to a lesser extent, caffeine in high doses. I can usually take low doses of niacin when I get into that state and get very quick relief. I don’t understand how amping up the number of methyl groups I take in is going to jump start my COMT gene into functioning properly. My next step was going to be trying a low dose of lithium orotate to see if it could improve my transport of b12 and folate and not cause a “backup” of dopamine, etc. After watching this video, I am again confused in an area I thought I finally understood. How does taking more of a thing my COMT enzyme cannot process make it “go faster?”
Hi Jenn,
You are describing perfectly someone who is overmethylating. And for individuals with this issue, taking more methyl groups will not make you feel better. Niacin is a good choice b/c in addition to a methyl sponge it increases the activity of the enzymes that break adrenalin/dopamine down. I can assure you than many people have both MTHFR and COMT genetic polymorphisms and they tolerate methyl folate and methyl b12 at high therapeutic dosages (1-3mg/day each). However, other people can hardly tolerate them at all. I will suggest that if an individual is reacting to B vitamins, esp. methyl folate and methyl b12, then they are likely having a gut infection or other issue that is disrupting their metabolism of the B vitamins. What you need to know about COMT is that it is not static – COMT RNA can be upregulated or downregulated depending on the signals in the cell. I tell you this to encourage you to keep learning and realize nothing is set in stone. If you are having edgy, irritable feelings then yes you have too much adrenalin / fight or flight stress. This in turn slows down the COMT enzyme which makes the problem worse. If you want to stop the release of excess adrenalin and take pressure of the COMT system then you need a holistic health approach aimed at removing all the triggers of your stress response. If you would like more help…then reach out and contact my office 208-322-7755 or redmountainclinic@gmail.com. In Health, Dr. Rostenberg
Hi Dr R,
Im currently working with an ND and slowly building up to 5mg of mtfr/5mg of methyl b12. According to my 23andme results, I am ++ for MAO A and VDR BSM, and I am +- for 1298C, 03P39P, and MTRR A666.Can you recommend any additional course of action/supplementation for me? My ND is very familiar in working with MTHFR snps but as familar with MAO A, etc. Thanks for any assistance you can provide.
Sincerely,
Patrick Marron
PS-Each time I increase my mthfr/methylb12 dosage to the next increment, I get brain fog/loopy feeling and some irritability for the first few days of each new dosage.
I have a lot of these mutations – COMT V158M +/+, COMT H62H +/+, MAO-A R297R +/+, MTHFS +/+, compound heterozygous A1298C/C667T. Heterozygous for BHMT-08, ACAT1-02, MTRR A66G, MTRR K350A, VDR Taq, VDR BSM, COMT P199P.
On the positive side homocysteine is low – 3.8 umol/l. , no CBS issues and the genetic genie detox profile was almost all good, only a couple of heterozygous mutations. Have a few issues – gut problems, premature menopause, myelodysplasia (life threatening bone marrow condition, causes severe anemia), muscle cramps, tendonitis. Very obsessive mind (which comes in handy here) but can go manic under extreme stress, and rely on alcohol as a self-med for stress/social anxiety rather too much.
Got interested in the nutritional links to mental health 25 years ago when I stopped drinking suddenly and had a manic episode. Noticed I was getting weird reactions to certain foods, eg at one point mild visual hallucinations to high protein foods, which turned into more of a brain fog. Nearly got sectioned for anorexia as I was scared to eat anything. Managed to get myself back to “reality” fairly quickly and trained in nutrition, but have never managed to fix the gut problems – don’t leave the house without immodium. Tested negative for celiac. FODMAP foods seem to aggravate, and I have Bile Acid Malabsorption which knocks out fat soluble vitamins especially vitamin K. Also a carrier for Alpha-1 Antitrypsin Deficiency – AAT level is at the lowest end of normal.
Currently doing own protocol: multivit containing methyfolate instead of folic acid, shark liver oil, B12 (hydroxy), vitamin A, vitamin K, vitamin D, NAC, DHEA, bioidentical oestrogen/progesterone, B1, magnesium, probiotics, boswellia.
What I am trying to work out is whether I generally need an overall low/high protein/fat/carb diet, as there is so much conflicting info. Paleo seems to make most sense, but most meat turns my stomach!
Also do you see any obvious ‘tweaks’ I could make to my protocol, or things that may be drastically wrong? The more I read up about MTHFR supplementation the more I see it is easy to take one thing that puts something else out, and end up needing something else to counteract it..and maybe end up at square one!
My son has MAO-A, COMT V158M + VDRTAQ snps. His neurotransmitter test shows high dopamine, epinephrine, and norepinephrine. low Gaba and serotonin. He also has severe Neuro Lyme disease. His ND is suggesting not taking additional methylcobalamin and said she didn’t feel that MTHFR is that significant in his case. She wants to focus on trying to increase serotonin and GABA to balance the elevated levels of excitatory transmitters. He has terrible anxiety, depression and insomnia. Does this sound like a good approach and should I ask her about St. John’s Wort for him?
Thank you for any help!
Hi Danielle,
Thank you for reaching out and contacting me. Cases like this are complex and without more information (without performing a history and in-depth review of your son’s symptoms) it is challenging to offer advice. The ideas behind St. John’s Wort are that it will increase all neurotransmitters – dopamine, serotonin, GABA, norepinephrine, etc. If your son is dealing with an ongoing infection, that presents a great deal of stress for the body and this shows up as increased activation of his sympathetic nervous system. We know this because of the elevation of his catecholamines – dopamine, norepi, epi. This is a pattern that is commonly seen with excess “stress” in the body.
Obviously high levels of these neurotransmitters cause insomnia, anxiety, pain, poor digestion, poor memory/learning, etc. It all goes together. The key is not making his genes “go faster”. Rather the key is to take the pressure of his genetic pathways. People with COMT/MAO SNPs are going to be very poor at removing stress hormones, ie they will be prone to elevated dopamine, norepi and epi. This fits your son’s pattern perfectly.
What we do in our office is figure out what we need to do to reduce the amount of stress in the body. This involves not just looking at trying to treat Lyme; it involves treating people. Meaning, everyone must sleep, digest, repair, detoxify, and grow. If we can get these basic systems working better, then people will get stronger.
So just know that your son, like many others, will always be prone to elevated stress hormones because of his pathways. However, much can be done to take the pressure off those systems. That is what we do for individuals young and old from all over the world. There are many strategies to increase GABA but the key point to know is that reducing inflammation in the brain-gut-body will reduce dopamine, epinephrine, and norepinephrine. Lowering inflammation will also raise serotonin. I would love to help you in your quest to heal your son. If you would like my help then please contact my office at 208-322-7755 or redmountainclinic@gmail.com.
Yours in Health,
Dr. Rostenberg
Thanks so much for breaking down this information!
I just got finished an MS in nutrition and also happened to just do 23andme with my husband. Now I’ve found all sorts of contradictory genes that I’m trying to get down to the bottom of. I feel like my degree just scratched the surface of this and I’m not sure how these different genes may relate to one another.
My husband’s mom has parkinson’s and the beginning stages of Alzheimer’s. At a relatively young age (40s) she had heart surgery and breast cancer.
Looking through his genes he is homozygous for COMT V158M and COMT H62H, MAO AR297R and MTHFR A1298C. It seems to me that COMT and MAO lead to decreased breakdown of NTs (so increased levels) but the MTHFR mutations lead to low BH4 which is needed in the production of NTs. (so low levels..)
I guess my question is: do these mutations kind of negate each other since one is leading to high levels and another to lower levels? Or is everything out of whack and would supplementation of active B12/folate and Pregnenolone be helpful?
Thank you for any help!
Hi Megan,
Thanks for your comment. Genes are very complex and powerful but they don’t control our lives. The environment we live in has more to do with our genetic expression that the genes themselves. In other words, genes aren’t your destiny but they are your tendency. Anyone with heart disease and cancer is going to need a lot of methylation support since those conditions are textbook for hypomethylation – lack of methyl donors. Parkinsons and Alzheimer’s are two conditions that also are related to methylation deficiencies, albeit in the brain rather than the breast or the cardiovascular system. I cannot comment on supplements without performing a consultation first to assess the full picture of the individual. If you would like help with these questions, to save you time, frustration and money, then please don’t hesitate to contact my office. 208-322-7755 and redmountainclinic@gmail.com.
In Health,
Dr. Rostenberg
I am confused if a person has a mutation of the MTHFR gene they are more likely to have lower serotonin, dopamine, and adrenaline levels. But if they have the COMT mutation it increases dopamine and adrenaline. So wouldn’t having both of these mutations balance the low and high levels?
Hi Kim,
Thanks for your comment. Genes create tendencies, like probabilities, but they aren’t the only thing that influences our health. The environment controls 95% of genetic function. So we focus on changing the environment inside and outside the cell and this actually changes how the genes act and respond. Some mutations do cancel each other out, but when dealing with genetic information we have to always view it as a probability, not a certainty. If you would like help in figuring these issues out please don’t hesitate to contact our office. 208-322-7755 and redmountainclinic@gmail.com.
In Health,
Dr. Rostenberg
I did 23 and me because my kids and my sisters kids were all born with birth defects midline and my sister kept miscarrying. After she exhausted all options her doctor suggested genetic testing. She tried protocol as she is compound for all and she successfully had a healthy baby. I then tested and suddenly my hysterectomy endometriosis cervical cancer hives and adhd all made sense. I’m on bio hormones have been for years. Decided to start vitamin d3, c, calcium, magnesium potassium, and general nutrition in yasko. and was doing a b12 injections methy12. No folate. Taking Probiotics. At first I had breakout acne the next day and I thought it was something else causing it. It went away and I got another injection the next week. Same reaction still made no connection. Started taking oral mb12 sublingual. By the 4th injection within 4 hours my face had postules on top of postules in cheeks and jaw. It is severe and I’ve stopped all b12 and took niacin and tried all kinds of acne topicals and and it has been 8 days and nothing has helped
My face. I need to know what I can do to get this severe painful acne to go away. I plan on trying to reduce candida and avoid sugar alcohol and take probiotics and general nutritional vitamins but I need to know what to avoid and what I can do to get this to go away before progressing to anything else. Please help. My test is below.
SNP Gene Variation Result Call
RS4680 COMT V158M +/+ AA
RS4633 COMT H62H +/+ TT
RS769224 COMT 61 -/- GG
RS731236 VDR Taq TT AA
RS2228570 VDR Fok Ff AG
RS6323 MAO A R297R +/- GT
RS3741049 ACAT 1-02 -/- GG
RS1801133 MTHFR C677T +/- AG
RS2066470 MTHFR 3 -/- GG
RS1801131 MTHFR A1298C -/- TT
RS1805087 MTR A2756G -/- AA
RS1801394 MTRR A66G +/+ GG
RS162036 MTRR K350A -/- AA
RS1802059 MTRR 11 +/- AG
RS567754 BHMT 2 +/- CT
RS651852 BHMT 8 +/- CT
RS819147 AHCY 1 +/+ CC
RS819171 AHCY 19 +/+ CC
RS234706 CBS C699T -/- GG
RS1801181 CBS A360A +/+ AA
Hi Sarah,
Thank you for your comment. Clearly the methylation cycle and genetic pathways are very important in your family. You’ve been through a lot dealing with your estrogen-related issues and the reaction to methyl b-vitamins is causing acne. These situations happen when there are untreated issues in the gut or some chronic infection-type issue in the body. When you take B-vitamins for methylation support its like rocket fuel for your cells. If you dump fertilizer onto weeds as well as the grass you will see more weeds grow also. This is the issue we see over and over again with patients who have bad reactions to B-vitamins.
Allow me to help you by contacting my office 208-322-7755 or redmountainclinic@gmail.com. We work with patients all over the country and the world. We can find a natural solution that supports your genetics while helping to improve your health and well being. You need a powerful gut-healing program before you embark further on trying to support your methylation cycle. And I can help you figure all that out.
Yours in Health,
Dr. Rostenberg
Hi Dr. R,
I’m a 35-year-old woman with COMT V158M++ and COMT H62H++ who has been dealing with hormone imbalances since day one. The last couple of estrogen profiles I’ve done through Genova are alarming, as in my estrogens and estrogen metabolites are pretty much opposite of what they should be and put me at high risk for developing an estrogen-related disease (which runs in the family on both sides). I have been eating an organic, paleo diet for over two years, exercise 3-4x/week, and have removed as many environmental toxins from my home as possible, using mainly essential oils to make my own cleaners and cosmetics. I’ve done all that I can do to reduce toxic load, but my hormone imbalance remains. I know that the COMT++ mutations are playing into this. I can’t find much information on how to deal with COMT++ to improve estrogen metabolism. Any advice???? Thank you!
Hi Hilarie,
Thank you for your comment. You are describing a problem that many women face: how to detox estrogen in a healthy way to protect their cells from cancer and disease. You are doing everything right by eating organic, exercising, and avoiding toxins in your home and bathroom. So keep that up! The only thing missing from your approach is to use the right nutrients and methylation support to optimize how your body detoxifies estrogens. In my office we have some very effective natural tools that help people with COMT++ improve their estrogen hormone profile. We have been down this road with many patients and have seen wonderful results. I would like to invite you to connect with me via phone or Skype to get your hormonal health in order. Please contact my office redmountainclinic@gmail.com and 208-322-7755 and we will find a time to consult soon. – In Health, Dr. Rostenberg
My mother is the poster child for ADHD, and unsurprisingly turned out homozygous for H62H and V158M. It’s been a blessing in some ways, as she’s active and mentally razor sharp while pushing 80. The only problem she complains about is being unable to sleep. I understand giving methyl donors will help, is there anything that can act as a quick fix for the nights she is up very late?
Hi Julian,
Thanks for your comment. People with COMT genes are notorious for becoming over-stimulated. Things which help calm them down is melatonin, green tea extract, niacin. There is no secret weapon to make someone fall asleep, but there many strategies we use with patients on a daily basis to improve their sleep. If you would like more detailed information please contact my office redmountainclinic@gmail.com and 208-322-7755. – In Health, Dr. Rostenberg
Green tea extract has a high level of catecholamines, so wouldn’t that be contraindicated in someone who is COMT++ and overstimulated? More catecholamines mean slower COMT functioning, and worse anxiety, I thought.
Hi Margaret,
The green tea extract we use is DECAFFEINATED, so all the catecholamine-stimulating properties have been removed. So with a decaffeinated extract, you will see an INCREASE in COMT speed often providing relief for people with excess catecholamines, etc.
Hope that helps!
Dr. Rostenberg
Doctor(s),
Please help.
I am COMT V158M ++, COMT H62H ++, MAO A ++, & VDR Taq Tt (No MTHFR mutations, thankfully). Doing very poorly, sick for ages.
When I take methyl B12 I don’t really have a bad reaction (side effects) but also my body doesn’t seem to use it (b12 tests are consistently very low even after a year of taking it). I feel no increase in energy and it all seems to go to waste(?). And so far I think we have ruled out absorption issues.
When I take Hydroxy or Adeno B12 I become very agitated, stressed, confused, rapid heart rate, even with low doses.
It could be that the other methyls in my supplement blend are making me feel poorly as well.
So if I am methyl intolerant/over-methylator but I need methyls to help process those neurotransmitters (with the MAO & COMT mutations), what do I do?
I am desperate for answers.
Thank you
I have same gene issues and no mthfr and have signs of vitamin b12 deficiency and feel awful. And taking any decent levels of methyl vitamins gives me a crippling headache. If you get an answer let me know as I havent’ found anyone who understands what we have as yet. I was hoping you would get a reply from the doc to see if its worth me doing a consult but even he doesn’t seem to have anything to say.
COMT V158M rs4680 AA +/+
COMT H62H rs4633 TT +/+
COMT P199P rs769224 GG -/-
VDR Bsm rs1544410 CT +/-
VDR Taq rs731236 AG +/-
MAO A R297R rs6323 T +/+
ACAT1-02 rs3741049 GG -/-
MTHFR C677T rs1801133 GG -/-
MTHFR 03 P39P rs2066470 GG -/-
MTHFR A1298C rs1801131 TT -/-
MTR A2756G rs1805087 AA -/-
MTRR A66G rs1801394 AA -/-
MTRR K350A rs162036 AA -/-
MTRR A664A rs1802059 AG +/-
BHMT-02 rs567754 CT +/-
BHMT-08 rs651852 CT +/-
AHCY-01 rs819147 TT -/-
AHCY-19 rs819171 TT -/-
CBS C699T rs234706 GG -/-
CBS A360A rs1801181 AA +/+
These are from a genetic genie Methylation report.
CYP1A1*2C A4889G rs1048943 TT -/-
CYP1A1 m3 T3205C rs4986883 TT -/-
CYP1A1 C2453A rs1799814 GG -/-
CYP1A2 164A>C rs762551 AC +/-
CYP1B1 L432V rs1056836 CG +/-
CYP1B1 N453S rs1800440 TT -/-
CYP1B1 R48G rs10012 CG +/-
CYP2A6*2 1799T>A rs1801272 AA -/-
CYP2A6*20 rs28399444 II -/-
CYP2C9*2 C430T rs1799853 CC -/-
CYP2C9*3 A1075C rs1057910 AA -/-
CYP2C19*17 rs12248560 CC -/-
CYP2D6 S486T rs1135840 GG +/+
CYP2D6 100C>T rs1065852 AG +/-
CYP2D6 2850C>T rs16947 AG +/-
CYP2E1*1B 9896C>G rs2070676 CG +/-
CYP2E1*1B 10023G>A rs55897648 GG -/-
CYP2E1*4 4768G>A rs6413419 GG -/-
CYP3A4*1B rs2740574 TT -/-
CYP3A4*2 S222P rs55785340 AA -/-
CYP3A4*3 M445T rs4986910 AA -/-
CYP3A4*16 T185S rs12721627 GG -/-
GSTP1 I105V rs1695 AG +/-
GSTP1 A114V rs1138272 CC -/-
SOD2 A16V rs4880 GG +/+
NAT1 R187Q rs4986782 GG -/-
NAT1 R64W rs1805158 CC -/-
NAT2 I114T rs1801280 CT +/-
NAT2 R197Q rs1799930 AG +/-
NAT2 G286E rs1799931 GG -/-
NAT2 R64Q rs1801279 GG -/-
NAT2 K268R rs1208 AG +/-
Gene Result
GSTT1 Present
This is from the Detox report.
I’m a Hypothryoid 32 year old male with cortisol in the morning that came up low in the morning and high at noon and night while being good at bedtime. I’m trying currently to get my Thyroid medication right and taking Seriphos for the high cortisol.
In about 5 days I plan on testing Serum Zinc, Copper, and Ceruloplasmin along with RBC Magnesium to see if those need to be addressed as I’ve read that having too much Estrogen which is likely due to being overweight will lead to too much copper and lower zinc.
I’m not sure what to take or anything in regards to Methylation though.
Thanks for any input you can provide.
Hi Jonathan,
Thanks for your comment! You’ve completed a lot of important testing, and it looks like more is on the way. I would say you are on the right track by testing your methylation pathways, blood labs, adrenals, etc. The question I have for you is are you trying to figure this out on your own or are you working with a skilled practitioner? Women get hypothyroid issues 9 times more than men, so I like to look at hormones and toxins with all men (and women) who are hypothyroid. The thyroid is also very sensitive, like a check engine light in your car. Often the problem is somewhere else, but the thyroid is all that is tested and checked. Many times the thyroid is treated and the real cause is missed. But it doesn’t have to be that way.
Estrogen is a big issue with men and we have protocols and approaches that enhance estrogen clearance while supporting optimum testosterone. I would like to invite you to contact my office 208-322-7755 and redmountainclinic@gmail.com. I work with patients all over the world dealing with similar issues. Working to treat the root cause is the most important factor.
Yours in Health,
Dr. Rostenberg
I had a NutrEval done (I’m “severely deficient” in all of the Vitamin Bs). I started taking the methylated B12, and it worked well for a while, but I felt like I was backsliding, so I pulled back on it. I’ve had the 23andme testing done, and these are the mutations it’s showing I have:
Homozygous: MTRR A66G, BHMT-08
Heterozygous: MTHFR C677T, COMT V158M, COMT H62H, COMT P199P, VDR Bsm, VDR Taq, MAO-A R297R, ACAT1-02, BHMT-02, CBS C699T
I was working with a doctor but left when she kept telling me to just keep doing the same thing (that didn’t seem to be helping after 6 months).
My son is also having growth issues (he’s almost 8 and the size of a 6 year old). He’s very deficient in all of the Vitamin Bs, as well and his 23andme test show these mutations:
Homozygous: VDR Taq, MAO-A R297R, CBS 699T
Heterozygous: ACAT1-02, MTRR A66G, MTRR K350A, BHMT-08
He’s currently with a Pediatric Endocrinologist who is talking about possibly starting him on growth hormones (he is scheduled to go through STIM testing in August). I would like to see if he can be helped naturally before subjecting him to the tests and growth hormones.
Dear Angela,
Thank you for your comment. When we look at genes things get complicated fast! It is very overwhelming. But please keep in mind the environment controls the genes, not the other way around. In fact, we have 100 times more DNA and genes in our gut than inside our entire body! Clearly the gut has a profound influence on our own methylation pathways and other genetic processes. I have found after working with thousands of patients that people who get sick from taking B-vitamins (which should make us feel better and more energetic) usually have a gut-based problem that must be treated first. Many patients of mine begin their treatment unable to eat B-vitamins, Vitamin D, and other helpful nutrients. After healing their gut and getting their digestion back on track, they are surprised how well they can tolerate those vitamins. Your genes are your tendency, but not your destiny. I see people with your genetic profile every day. IMO there is something that hasn’t been treated which is reacting to the vitamins.
Regarding your son and children with slow growth, just think about it logically. If he has a gut problem, cannot absorb correctly, then he will develop nutritional deficiencies which can slow growth. A growing body needs high amounts of vitamins to function optimally. Before you go the route of pharmaceutical intervention, I highly recommend you contact my office first. Growth hormone is ONLY released in significant quantities during delta or theta wave sleep. So in fact your son might actually have a problem sleeping deeply, digesting correctly, and he may be low in arginine (required for growth hormone release). Again this isn’t medical advice but it is an overview of what natural tools are available to help. Please contact my office 208-322-7755 and redmountainclinic@gmail.com if you would like my help.
Your family will be better.
In Health,
Dr. Rostenberg
Hi there. I have found your information very helpful. I have rs4860 Met/Met, I guess it means I have l lower COMT and therefor higher dopamine. I have experienced problems with anxiety/unwanted obsessive thoughts, I’ve also had problems with alcohol. I am currently on zoloft 125 mg per day.
Form the information I have gathered I am starting to take b12 methylcobalamin in a daily dose to boost my COMPT. With a desire to eventually get off zoloft, how much methylcobalamin should I take per day to keep my COMT levels up? Also, I am a vegan and I try to stick to whole plant foods. I have found eating complex-carbohydrates regularly throughout the day is beneficial to my well being. Is there anything else I should eat or avoid to keep my COMT levels up?
Sorry I meant rs4680.
Hi Matt,
Thanks for your comment. Your COMT gene means it is slowed down and all thing being equal you will have higher dopamine levels and estrogen levels in your body. Veganism is a challenging diet, esp. since modern food is very weak compared to our ancestral soil and diet. That being said, you can help your COMT with a product called Trancor from Metagenics. It has ingredients which increase the speed of COMT and help convert glutamate into GABA. There are other things you can do as well, like making sure to eat frequently and getting enough fat and protein in your diet. Avoid having hypoglycemia because that increases dopamine and adrenalin and leads to anxiety more often. For more info please contact my office 208-322-7755 or redmountainclinic@gmail.com. We would be happy to work with you personally on how to optimize your genetics and improve overall wellness.
Yours in Health,
Dr. Rostenberg
Hi thereI see a Naurathpath here in California and am still dealing with on going issues. I am
– – for comt v158, — comt h62h, –comt p199p but ++ for comt rs6269 do these affect each other??? I am also Vdr taq++ and MOA r297r?? Also am Herero for one cbs gene… Any thoughts??? Low dopamine or high??? Would love any insights on the comt genes:) thank you
Does anyone know why my bogey, my sweat, my breath all smells of sulfur/onions. I get gassy from high sulfur foods like onions too.
Hello,
I have the 23&me results for myself and 3 of my children. What is the first step to getting detailed information from the raw data? One person told me to send it to MTHFRsupport.com and another to Livewello. Are they the same thing?
I have two sons; one 16 and has ASD, dyslexic and ADHD with other symptoms looking like SPD. The other son is 21. We have been battling his illnesses for many years. He was diagnosed with extreme adrenal fatigue by a ND a few years back with no mention of MTHFR. After more of my own research we got him on L-methylfolate along with a lot of other nutritional support and he’s doing much better but I don’t think we have all of the puzzle pieces together yet. I think if we could get an interpretation of his genetic results we may be able to piece together some of his other symptoms. Anyone able to help or direct?
Hi Karen,
Thanks for your comment. You are on the right track to look at his genetics in combination with everything else you are doing. To get the process started with your 23andme information you want to download the raw data from their website. Then upload to MTHFRSupport.com (I think Sterling Hill has the most up-to-date information) and get the variant report for your family. Once you have those in hand, you can set up a consultation where we will delve into each individual’s biochemistry, history, symptoms, digestion, sleep, neurotransmitters and of course genetics. By putting the picture together in such a way, we will be able to treat the root cause and help optimize genes in a healthy way. Please contact my office 208-322-7755 or care@redmountainclinic.com.
In Health,
Dr. Rostenberg
Hi,
I live in New York but would love to start working with you on both a personal and professional level. Can you treat the patients that live out of state?
Hi Dawn,
Please contact my office directly at care@redmountainclinic.com or 208-322-7755 and we will be able to schedule a consultation where you can work with us directly. So yes we work with patients from all over the United States, Canada and the world!
In Health,
Dr. Rostenberg
Dr,
Dopamine will be LOWER in individuals with the defects in comt/mao because it is the precursor to NE/EP. In individuals with this defect(s), they are experiencing much more NE in the body and stress, albeit improved cognitive function. Dopamine is recruited to make more of NE, and actually results in a loss of dopamine. I have an adequate source I am happy to share. I will also look for primary via google scholas/ncbi/through my veterinary school. Please beware that individuals with these mutations are more likely to develop parkinsons etc due to, not only issues in antioxidant metabolism and buildup of wastes within brain, but the dopamine deficit. Thank you.
I have a son with COMT, 2 heterozygous mutations. He’s on Propanolol to lower Norphrephrine levels and that helps, but only halfway. The rest of his severe mood swings, agitation and neuropsych symptoms have to be from Dopamine. At times he will destroy property, threaten himself and others, he has had mild hallucinations as well. All hallmarks of dopamine levels being too high. We’ve addressed almost all the other mutations through Genetic Genie/23 and me. Just started hydroxy b12 at low dose yesterday and he’s a little bit calmer yesterday and today.
I enjoyed reading the blog on COMT ++! I would also encourage those with sensitivities to foods, chemicals and molds or EMF to seek out treatment by an environmental physician boarded by AAEM. Stopping the exposure is the first step in getting well. So figuring out if that is the case is the most vital thing one can do. while getting better then one can address genetics and metabolism. I feel hormone management is key at the onset so those that are anxious and female I suggest getting progesterone (orally form Belmar pharmacy is my preference). Sometimes we glob onto a genetic issue once we get our testing one but this is not the cause of our fatigue, anxiety or insomnia at all. Just a thought. You tube has educational videos if you want to learn more about. Nagy NIEHS is government lecture with colleagues. Have fun!,,, Lisa Nagy MD government liaison for AAEM.
Hello. My son is 13, with allergies, asthma, learning disabilities, ADD, depression, anxiety, panic attacks and we’re probably going to test him for hypoglycemia at his new pediatrician, next week. He also has hypersensitivity to medication and we’ve seen bad reactions to Ativan and Vicodin, that include hallucinations, vomiting, suicidal thoughts and full body rash. After switching to the Failsafe Diet, we realized that he is very sensitive to preservatives, dyes, salicylates, nitrates, potassium benzoate and sulphites. He has very sensitive skin and if he touches sulfur (a scabies cream) or salicytic acid, his skin turns bright red, it burns and he gets a rash. With the very strict diet, he improved a lot. Adding in zinc has been a miracle (it’s like he NEEDS zinc to function), next was B vitamins, magnesium, chelated manganese, cod liver oil, molydbenum and unflavored pedialyte. All helpful, all slowly tested to see if there’s a reaction. We tried TMG but he did not feel right with that. The amino acid glycine has been a life saver. Some days he gets 500 mg, some days 2000 mg, if he’s had a food with salicylates and feels like a reaction. With glycine he has been able to eat berries, if he’s careful and we give the glycine several times a day (to add up to 2000 mgs). Without these supplements, he is The Hulk, breaking things, holes in the walls, screaming, crying, chanting repeatedly that he can’t control himself, suicidal, depressed and miserable. He is so much better now, home schooled, eating and sleeping when he needs to, not tempted by food if he has a variety of home made foods. My question is what else can i do? I have had no help from Dr.’s, they tell me he’s a puzzle and seem relieved that we don’t come back. He had 2 pediatricians, a neuropsychologist, many therapists, two allergists and a gastroenterologist. What type of Dr. do we need and what blood work should be done? I would like to find out his histidine levels and supplement if he needs it but after that I’m out of ideas. This is the 5th year of google and guessing.
Homozygous
MAO-A R297R TT +/+
CBS A360A rs1801181 AA +/+
Hetrozygous
COMT V158M rs4680 AG +/-
COMT H62H rs4633 CT +/-
VDR BSM rs1544410 CT +/-
VDR Taq rs731236 AG +/-
MTHFR C677T rs1801133 AG +/-
MTRR A66G rs1801394 AG +/-
MTRR K350A rs162036 AG +/-
BHMT-08 rs651852 CT +/-
AHCY-01 rs819147 CT +/-
AHCY-19 rs819171 CT +/-
CBS C699T rs234706 AG +/-
Any ideas or help are welcome. Thank you.
Why is it that when talking about COMT mutations. It’s almost as if it’s an isolated condition.
Every time I see someone talking about a COMT mutation, they say if you have a COMT mutation you have too much dopamine and need to take lithium orotate, Magnesium and SAM-e to increase its activity.
What about people with fast COMT who already have low dopamine?
Should they also be boosting their COMT?
If the treatment for COMT is universal regardless of your status, why get tested?
++ is prescribed the same treatment as +- and –.
I have yet to find an article where someone talks about anything other than COMT++.
“people with COMT genes will have more neurotransmitter activity compared to someone without COMT SNPs.”
So if a person had a COMT polymorphism, whether it’s ++, +- or –. They have too many catecholamines.
The whole thing kind of reminds me of how Doctors will talk about any neurotransmitter and agree that SSRIs will help balance it. Like low serotonin is the only option.
Hi Jeff,
Thanks for your thoughtful comment. All COMT treatment is NOT universal. We are working under the assumption that “wild type” or -/- COMT individuals do not need the same support as do those who are COMT +/+. Believe me we see all kinds of COMT people in our practice, and we obviously have a different set of tools if your COMT is “fast” or if its “slow”. If you give someone who has LOW DOPAMINE supplements to lower dopamine even more, you often make them feel tranquilized and shut down. Conversely, if you give someone with HIGH DOPAMINE the supplements to raise dopamine even more, you can put them into a psych ward or mental tailspin. This is why we categorize people according to their dopamine phenotype. People either have a HIGH catecholamine/dopamine tendency or a LOW catecholamine/dopamine tendency. Each phenotype has their own set of nutrients. Hope that helps!
In Health,
Dr. Rostenberg
Hi. I am 34 years old, female. I have been suffering with extreme panic disorder the last several months. My hormones came back high estrogen, very low progesterone.
Also,
Comt rs6269 +/+
Maoa +/+
Ace +/+
Mthfr 1298 +/-
Bhmt +/-
Mthfd +/-
Cbs +/-
Vdr bsm +/+
Mtrr +/-
Doctor has me on celexa 40mg. Are there any sites that can test what medications will work/wont work based on genetics?
Thank you.
GeneSight testing. My son had to have the test because so many of his psychiatric medications made him sick. It gave him a list of what meds he could take and at what dosage and which would cause him to get sick.
Been fascinated by all the content here, great work! One question about this video. In regards to dopamine you say that inhibiting mao would keep the transmitter around longer but with epinephrine you mention inhibiting mao would move the process towards comt and eventual breakdown. Wouldnt mao inhibition just cause the adrenaline to stick around longer?
Thanks for all the fascinating content!
Hi Saul,
Thanks for your question. You are right and this is a contradiction that we resolved by later research. Anything that inhibits MAO or COMT will cause an excess of dopamine, norepinephrine, and epinephrine. Our later videos show how this process works better so make sure to have a look at those as well. The big idea is this – some people because of genetics and their environment are programmed to have HIGH CATECHOLAMINES and a whole host of symptoms associated with those. Others are programmed to have LOW CATECHOLAMINES and the symptoms which follow from that. The key is knowing who you are because the tools to fix these issues are different. Hope that helps!
In Health,
Dr. Rostenberg
Hello,
I’ve been reading this post with interest. My 23&Me results came back compound heterozygous for MTHFR, COMT and MAO +/+, and VDR taq +/+. I can handle methyl donors in moderation, but I have to stay away from B-complex: it gives me acne and my B6 levels are toxic. My fatigue symptoms have improved dramatically by simply taking some hydroxy B12 and methylfolate, and I am actually feeling quite allright at the moment, but this has created a new problem for me: I can no longer sleep at nigth. I’ve tried SamE which was hit and miss at times, but was told better not to take it continuously. Could this be a COMT issue, and, if so, what to do? Would Lithium help?
Any help would be greatly appreciated.