Can someone please help me understand this?
Hi guys! (First time posting here I am so sorry if I am asking for too much!)
I am one of those people who were misdiagnosed from an early age, all my problems were blamed solely on Major Depression (which later became treatment resistant) and GAD, instead of AuDHD and Autistic Burnout. I have never experienced any positive effects from SSRIs only side effects which after 22 years of on and off SSRI treatment (I have been threatened with non-compliance and being labeled a difficult patient, or told I just haven't had the "right" combination and they "persuade me" (which means ignoring everything that I say) so I always give in) has left me fat, sweaty, brain zappy a boat load of negative side effects etc.
I have CPTSD from a vicious series of traumatic events, I am recovering from dissociative amnesia I am also still in Autistic burnout. I can't take my ADHD medication without some form of anxiety suppression as my meds can trigger my CPTSD. I am so fcking tired of having doctors medically gaslight me and being medically neglected and traumatized. I want to recover, I am too young to be stuck in this cycle which leaves me unable to work or take proper care of myself and home. Which is why I need help understanding this and what I should do next as my brain is fried from burnout and CPTSD.
I am also poor AF.
As you can see I have the hetero MTHFR C677T gene mutation and as I am reading more about this methylation panel it seems these other gene mutations play a strong role in how my body processes (or doesn't) neurotransmitters, vitamins etc. I have an appointment with a psychiatrist on Monday, I am mildly hopeful as he is a recent graduate but I don't know of which medical school (some are more biased than others) and I want him to actually help me instead of just throwing random meds at me.
What takeaways should I take from this panel? If you can, explain it to me like I'm 12 so I can explain this to the psychiatrist. What do I need to do to help make myself healthier, as specifically as you can if at all possible. I have read the info section below the panel but keeping track of how the mutations interact with each other and what that ultimately means is way too much for my fried brain to handle.
If this is way too much of an ask, please let me know. If there is a website that better explains my results, again please let me know.
I am adding that info below:
CBS
CBS (cystathionine beta synthase) catalyzes the first step of the transsulfuration pathway, from homocysteine to cystathionine. CBS defects are actually an upregulation of the CBS enzyme. This means the enzyme works too fast. In these patients, it's common to see low levels of cystathionine and homocysteine since there is a rapid conversion to taurine. This leads to high levels of taurine and ammonia. The CBS upregulation has been clinically observed to result in sulfur intolerance in some patients. It has also been observed that BH4 can also become depleted with a CBS upregulation. BH4 helps regulate neurotransmitters and mood. Other mutations, such as MTHFR A1298C, Chronic bacterial infections, and aluminum can also lead to low BH4 levels. Lack of BH4 can lead to mast cell degranulation and possibly mast cell activation disorder (MCAD).
Note: While some physicians think the CBS mutation is one of the most important mutations to address, there is very little medical research to support these claims and some doctors in the field disagree. In normal populations, studies have shown CBS upregulations to be protective against high homocysteine. However, CBS upregulations have shown to be harmful in Down Syndrome. Medical research has not determined if CBS upregulations are harmful in those with syndromes or disorders leading to impaired methylation.
MTHFR C677T
One function of MTHFR (Methylenetetrahydrofolate reductase) is to help convert homocysteine to methionine. A MTHFR C677T mutation means that the MTHFR enzyme may have trouble performing its task leading to high levels of homocysteine. According to Dr. Ben Lynch, impaired function of the enzyme can cause or contribute to conditions such as Autism, Chronic Fatigue Syndrome, Fibromyalgia, Miscarriages, IBS, many birth defects, Multiple Sclerosis, Alzheimer's, Bipolar Disorder, blood clots, Stroke, Chemical Sensitivity, and many other conditions.
MTHFR C677T can also lead to high homocysteine. High levels of homocysteine can be related to MTHFR C677T mutations. While homozygous (+/+) or heterozygous (+/-) mutations indicates reduced activity of this enzyme, it does not necessarily mean there will be high homocysteine levels in a clinical setting. The gene is compromised about 70% in MTHFR C677T (+/+) individuals, and about 30% in people with a heterozygous (+/-) mutation.
As S-adenosylhomocysteine (SAH) accumulates, the COMT enzyme may become impaired. Inhibitiion of COMT can increase dopamine levels in COMT V158M (-/-), but for those with COMT V158M (+/+), the high level of SAH can lead to behavior problems and mood swings according to Dr. Amy Yasko.
MTHFR A1298C
MTHFR A1298C is involved in converting 5-methylfolate (5MTHF) to tetrahydrofolate (THF). This reaction helps generate BH4. BH4 is important for the detoxification of ammonia. Unlike MTHFR C677T, A1298C does not lead to elevated homocysteine levels unless paired with a MTHFR C677T mutation (i.e. compound heterozygous).
BH4 acts as a rate limiting factor for the production of neurotransmitters and catecholamines including serotonin, melatonin, dopamine, norepinephrine, and epinephrine. A MTHFR A1298C + status may cause a decrease in any of these neurotransmitters or catecholamines. BH4 is also a cofactor in the production of nitric oxide. A dysfunctional BH4 enzyme may lead to mental/emotional and/or physical symptoms. Mercury, lead, and aluminum may act as a drain on BH4.
COMT
COMT (catechol-O-methyltransferase) helps break down certain neurotransmitters and catecholamines. These include dopamine, epinephrine, and norepinephrine. Catechol-O-methyltransferase is important to the areas of the pre-frontal cortex. This area of the brain is involved with personality, inhibition of behaviors, short-term memory, planning, abstract thinking, and emotion. COMT is also involved with metabolizing estrogens.
COMT (-/-) individuals can usually break down these neurotransmitters efficiently, but COMT (+/+) individuals may have trouble breaking these chemicals down from impaired function of the enzyme. With a COMT + status, it has been clinically observed by physicians that people may have trouble with methyl donors. This can lead to irritability, hyperactivity, or abnormal behavior. They may also be more sensitive to pain.
VDR
VDR (Vitamin D Receptor) encodes the nuclear hormone receptor for vitamin D3. Low or low normal vitamin D values are often seen in those with chronic illness and even the general population. Low vitamin D is related to a lot of neurological and immunological conditions. Vitamin D stimulates enzymes that create dopamine.
VDR Tak and VDR Bsm are usually inverse from eachother. So if there is a (+/+) VDR Tak, there would be a (-/-) VDR Bsm. However, this is not always the case.
It has been clinically observed that the body may have trouble tolerating methyl donors with a COMT V158M + and a VDR Taq + status. VDR Taq (-/-) individuals may already have higher levels of dopamine, and combinations of variations COMT and VDR Taq can lead to a wide range of dopamine levels. Those that are VDR Taq (+/+) and COMT (-/-) may have lowest dopamine levels.
Note: Some have pointed out that VDR Taq is reported backwards since majority of medical journals report a different risk allele or use different notation. These arguments are well-founded, but Genetic Genie reports this way so results are compatible with existing methylation nutrigenomics literature. Many claims about VDR and methylation are clinical observations. There are no medical studies to support some of the observations.
MAO-A
MAO-A (Monoamine oxidase A) is a critical enzyme involved in breaking down important neurotransmitters such as serotonin, norepinephrine, and dopamine. Males only have one allele since the gene is inherited through from their mother since it is located on the X chromosome. Only females can be heterozygous (+/-) for this mutation. When a (+/+) MAO-A mutation is combined with a (+/+) or (+/-) COMT V158M mutation, imbalances in neurotransmitters may be more severe. These imbalances can potentially lead to neuropsychiatric conditions and symptoms such as Obsessive Compulsive Disorder (OCD), mood swings, and aggressive and/or violent behavior.
Note: Genetic Genie reports the wild type as the defective variant as doctors have clinically observed that patients with methylation problems (especially those of Autism) often have trouble breaking down neurotransmitters. The high activity version of MAO-A (which is represented as -/-) can contribute to major depressive disorder. The significance of this SNP should be interpreted with caution.
ACAT/SHMT
ACAT1-02 (acetyl coenzyme A acetyltransferase) plays a role lipid metabolism and energy generation. It can also deplete B12.
MTR
MTRR (Methionine synthase reductase) helps recycle B12. The combination of MTR and MTRR mutations can deplete methyl B12. MTR A2756G, MTRR A66G, MTRR H595Y, MTRR K350A, MTRR R415T, MTRR S257T, and MTRR A664A all work together to convert homocysteine to methionine.
MTR (5-methyltetrahydrofolate-homocysteine methyltransferase) provides instructions for making the enzyme methionine synthase. Methionine synthase helps convert the amino acid homocysteine to methionine. To work properly, methionine synthase requires B12 (specifically in the form of methylcobalamin). An MTR A2756G mutation increases the activity of the MTR gene causing a greater need for B12 since the enzyme causes B12 to deplete since it is using it up at a faster rate. Mutations in MTR have been identified as the underlying cause of methylcobalamin deficiency. Megaloblastic anemia can occur as a consequence of reduce methionine synthase activity.
A homozygous mutation of MTR A2756G is not very common (<1% of CEU population). Some studies have demonstrated that people with a combination of MTHFR C677T and MTR A2756G have persistently high homocysteine levels unless they are treated with both B12 and folate.
BHMT
BHMT (betaine homocysteine methyltransferase) acts as a shortcut through the methylation cycle helping convert homocysteine to methionine. The activity of the enzyme can be negatively influenced by stress. The Information on this enzyme related to methylation is mostly based on Dr. Amy Yasko's clinical experience and research.
According to Dr. Yasko, a homozygous mutation of BHMT 01, BHMT 02, BHMT 04, can produce results similar to one with a CBS upregulation even if you don't have a CBS upregulation. In her book, Autism: Pathways to Recovery, She also states that a BHMT 08 mutation may "increase MHPG levels relative to dopamine breakdown (HVA)". This can result in attention type symptoms. It is common to see elevated glycine in someone with a homozygous BHMT 08 mutation.
AHCY
AHCY (S-adenosylhomocysteine hydrolase) is involved in breaking down the amino acid methionine. It controls the step that converts S-adenosylhomocysteine hydrolase to adenosine and homocysteine. Adenosine plays an important role in energy transfer as ATP and ADP. It helps promote sleep and suppress arousal. Dysfunction of this enzyme can affect levels of homocysteine and ammonia. Some physicians claim AHCY mutations may actually take the strain off the CBS enzyme and may even prevent taurine from becoming very elevated.