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MTHFR stands for methylenetetrahydrofolate reductase. That's certainly a mouthful but our guest, Dr. Rostenberg of the Red Mountain Clinic in Boise, Idaho will help us navigate this intriguing topic. Today's show will cover the MTHFR gene, its origins and prevalence among the population, related genetic vulnerabilities, downstream effects, methylation in relation to infection, methylation as it relates to the environment, general treatment protocols and much more.

Also included will be Zoya's Pet Health segment on strange behavior, trauma and PTSD in your pets.

Running Time: 02:35:00

Download: MP3


Here's the transcript of the show:

Tiffany: Good morning everybody. Today is July 10th, 2015. I'm your host Tiffany and joining me in our virtual studio from all over the world are our regular co-hosts, Jonathan and Doug. We have two guest co-hosts today, Peter and Tom. Say hello guys.

All: Hellos.

Tiffany: We have a very special guest in our virtual studio today. His name is Dr. Andrew Rostenberg. He's going to help us navigate the topic of the MTHFR Gene and methylation. But first a bit about Dr. Rostenberg. He is a board certified chiropractic physician who serves the Treasure Valley region. He's a graduate of Northwestern Health Science University in Bloomington, Minnesota and he's licensed by the state of Idaho as a chiropractic physician. He founded Red Mountain Natural Medicine in 2011 and it's located in Boise, Idaho. He uses a holistic approach to uncover the causes of illness.

Dr. Rostenberg's understanding of the body's system and how they interact with each other have provided him with a unique insight into the body's musculoskeletal structure, biochemistry and neurology. By using natural, non-invasive tools like applied kinesiology, functional medicine and functional neurology, he thoroughly assesses all aspects of a patient's health. Dr. Rostenberg is also a leading figure and researcher in the field of methylation genetics allowing him to uncover the genetic imbalances that lead to ill health and disease.

As an avid reader and lifetime learner, Dr. Rostenberg continuously keeps us up to date with the latest natural medicine research and recommendations. He also attends a multitude of health seminars and workshops each year taught by the most successful chiropractors and healers in the world. So let's give a hearty Health and Wellness Show welcome to Dr. Rostenberg.

Dr. Rostenberg: Thank you Tiffany. It's nice to be with you all this morning.

Tiffany: So, Dr. Rostenberg can you flesh out your bio a little bit for us? What led you to your interest in health? What led you to become a chiropractor? And above all, why MTHFR and methylation?

Dr. Rostenberg: That's a good question. I think I can give you some ideas about that. I'm going to actually start that conversation back in third grade. This will give you an idea of how my mind works. When I was in third grade and that was when Reebok pumps came out and I thought Reebok pumps were the coolest thing that I'd ever seen. They were on TV and I was captivated so I just begged and begged my parents and they didn't have a lot of extra money but they were kind enough to get me some Reebok pumps. I finally got what I asked for and then I spent the next week in class with the mechanical pencil taking them apart stitch-by-stitch to see how they worked. I was so happy that I could finally get my head wrapped around what a Reebok pump was and how it worked and what made it do what it did. Of course my parents weren't too excited about that.

But that right there is kind of a summary of my whole approach to health and well-being as I just really love knowing how things work and how to solve problems. So chiropractic came into my life when I was 19. The father of one of my best friends growing up was a chiropractor. I wasn't raised in a household where the discussion about organic food was taking place or you were going to a massage therapist or going to the chiropractor getting adjusted. So it was kind of a new paradigm for me. But this individual didn't just put me down on the table and help my back pain go away, he taught me how to think differently about health and well-being. I began to realize that healthy people don't get sick.

Before I just thought "Well you just get sick because that's what people do. Everything happens by happenstance. We don't know why some people get sick and others don't. It's just bad luck, boo-hoo." And so that whole idea that healthy people don't get sick and the body really does heal itself captivated my imagination. Chiropractors have been keeping that philosophy going for a long time and even Hippocrates, the father of medicine, when they dig up old archaeological artifacts, there's pictures of Hippocrates giving people upper cervical adjustments and lumbar adjustments and they haven't yet found Hippocrates giving people vaccines and stuff like that. (laughter)

Tiffany: Thank God for that.

Dr. Rostenberg: So that's why chiropractic. I love the philosophy that the body heals itself. It gives me the freedom I guess, and I mean this in a good way, to be a little weird and to go and learn about other things that are just emerging from our scientific research. So that's why methylation becomes this passion of mine as well. If I can say one other thing about this; when we were in chiropractic college of course we learned about x-rays, proper alignment of the musculoskeletal system, really the architecture of the body, if you want to put it in that type of language. But when we got our x-rays back there were certain things that chiropractors are taught that are called "normal variance". I'm not sure normal really is the right word. I would rather that they change it to common variance because normal to me is perfect symmetry, the way that the body was designed to be built and then you're going to see variations from that in the spine. Many of your listeners and maybe even some of the hosts on this show will know someone in their family who has spinabifida or some changes to the shape of their skeleton.

So that was my first introduction to the idea that your vitamins and nutrition while in utero, while your baby's forming actually influences how you look and the shape of your spine and if it can influence the shape of your spine, how much can it influence the rest of your health as you go through life and are there different things we need to be aware of to optimize our genes and optimize our lives as we go through this process?

Tiffany: So we're talking to Dr. Andrew Rostenberg and we're going to be addressing the MTHFR gene in methylation. If you want to call into our show with any questions, you can call 718-508-9499. At first glance MTHFR looks to me like a shorthand version of a curse word, but why is MTHFR important and why should we know about it?

Dr. Rostenberg: That's a great question Tiffany. We joke about that in the office all the time and when I show family members my website, they're like "Maybe you should consider changing your name or your website" and I'm like "I would certainly do that but MTHFR is what science has labeled it and now we're stuck with it." It's chemical abbreviation and anybody listening who's gone through organic chemistry realizes that fluid speech and nice-sounding syllables is not what organic chemistry's all about. It's more of this arcane language. Science really is a whole different language and I think that's one of the reasons why we're so sick, because we're kind of kept in the dark as to what the language even means. It's almost like giving maps in Latin and you're an English or French-speaking person and you can't really understand what's being said.

The reason that MTHFR is important, and I should also point that of course that's an abbreviation for the following mouthful of garble-di-gook. It basically means methyltetrahydrofolate reductase. And when you break that word apart you hear methyl, which is a carbon group, tetra has to do with what position it is on the molecule and then the rest of those syllables inform what kind of chemistry it's made out of. But what the audience needs to know, the important part of MTHFR is that it's dealing with carbon and we are carbon-based living spiritual creatures and our bodies are made out of carbon and our DNA is made out of carbon and that's how we live.

I kind of like using the analogy of an economy. So if you go to the store and you swipe your debit card or you give some carbon units to the cashier, you get to exchange that for some groceries. You get to go home and feed your family or fill up some gas and go to work or take a trip, whatever you're going to do that day. That's a lot like how your body deals with carbon. Carbon is kind of the US dollar of our body's economy and our body is dependent on having access to these methyl groups - and I say methyl because again, back in chemistry, those of you who are going to remember this or maybe need to review it. One carbon is methyl. As you increase the carbons you get into propane, butane, octane. Those are just different words to describe the different numbers of carbon.

But for today's conversation and for all research going on in methylation, it's one carbon and the importance of this, I want to point out, is that the value of looking at methylation is that methylation explains a lot of things that don't seem to be connected otherwise because it's happening at a real fundamental, root level in your body's biochemistry. It's happening from the moment of conception up to today. These methyl groups are being moved around and the processes involved at first seem overwhelming and very complicated. I spend some of my days being confused and I know that a lot of doctors aren't even willing to approach the subject because it's so intimidating. But what I like to remind everybody of is that if you're willing to be confused, you're going to learn a lot.

So that's methylation. I want to articulate that more and more for your audience, but the reason MTHFR is important at the end of the day is that it explains why certain people get sick, certain people get autism, certain people get cancer when everybody else around them is exposed to the same toxins, garbage and stress. So that information right there, at the end of the day, is probably the most important take-away from this whole conversation; understanding why certain people get sick whereas others don't. The methylation cycle provides a window to understand how that happens and what you can do to prevent it. That's the nice thing. It's not all just bad news. It actually empowers you to take control of your health and optimize your genes and great strategies are available to do that naturally.

Tiffany: Thanks for explaining carbon that way, comparing it to a currency. I never heard it explained that way and that really makes it clear about how carbon functions. Can you get a little bit more into methylation? I think it converts RNA to DNA. It turns on and off genes. Can you explain the importance of methylation as it occurs in the body?

Dr. Rostenberg: Absolutely. So we've pointed out already that we are carbon-based living creatures and you have DNA in every cell. So the DNA in your toe is identical to the DNA in your eyeball, incredibly! But how can those two cells be that much different, right? How can the cells that make your retina and actually allow you to see the world around you be genetically identical to the cells in your toe or your earlobe or something? And the answer to that is that your genes represent this enormous, I would dare say, infinite capability of adapting to information. So the human genome project has identified about 30,000 different genes that make us who we are. Science has said those are the 30,000 genes that we have as people.

And then what they're also going to say is that a gene can be turned on or off. So that's kind of a simplistic understanding but it is a good model, meaning if you have a gene for dark hair and you have a gene for blond hair and you inherit one from each parent, if the gene for blond hair is shut off then the gene for dark hair will express because it's a math problem. But all the genes in your body and every cell - as I said they're all identical - so these 30,000 genes you have in each of your cells are wrapped up in your 23 pairs of chromosomes. The genes are turned on and off by getting a little methyl group stuck on top of it. So it's kind of like a light switch. When the switch is turned on, there's no methyl group on top of that gene and your body will have the ability to turn on to read that information and then do the actions that come after that.

So DNA basically gives instructions to build proteins. That's what DNA is. It's like god's blueprint for life and when you have a methyl group on top of it, it's like the book is closed for that chapter and when you take the methyl group off it's like opening up the book.

Tiffany: So is a methyl group one carbon bound to three hydrogens? Is that what a methyl group is?

Dr. Rostenberg: Yes ma'am! That is a methyl group. So if you think of carbon, carbon has four connecting points. Based on its chemistry typically it's going to form four bonds and when it has the methyl group, three of those parking spaces are already taken up with the hydrogen and there's one parking space left. There's one bonding site left. And that's what attaches to your DNA. So as I was saying, you have 30,000 genes and they can turn on or off so the math problem is to figure out how much variability there is in that system. I'm not a mathematician. I don't play one on television but I figure these are the equations we want to look at real quick.

You have 30,000 and you have two different possibilities so it's the number 30,000 to the second power. That's what math would say. That's how many different variations there are and that's a pretty big number. But what we really know about genes is that researchers like Bruce Lipton and if your audience has ever heard of him, he's great to check out. Bruce Lipton. He's a genius, a stem cell researcher, but he has pointed out that one gene can make about 30,000 different proteins. So if you have 30,000 genes and each gene has 30,000 variations, now you're getting a number that's so big our minds can't comprehend. We can't comprehend what 30,000 to the 30,000th power is. To me that's a better reflection of the potential that we all have as people to express health. That explains also the differences between everyone. How can we have 7 billion people on earth and no two people really look the same? Pretty incredible.

So that's methylation in terms of genetics, turning it on and off, but what's interesting is that every cell in your body has a methylation cycle. Some of your listeners have heard of glutathione.

Tiffany: Right.

Dr. Rostenberg: I consider glutathione to be a lot like body armour. So when you get sick, we've heard that when you have a cold you take zinc, vitamin C and selenium. Well those help you get over the cold. I've experienced that. How about you guys?

Tiffany: Yes. Oh yeah, definitely with vitamin C.

Dr. Rostenberg: So there's vitamin C that kill bacteria and viruses. How does that actually help you feel better, is kind of the open-ended question. Well what it actually does is it optimizes your methylation cycle because you need zinc, selenium and vitamin C to produce glutathione and to recycle it because glutathione is like the body armour that your immune system wears. So if your immune system is out there killing viruses and it's fighting with big guns but it's naked and it can't defend itself from the explosions and the shrapnel flying around, then your immune system's going to get damaged really easily. It can deliver the blow but it also can't protect itself. So when you take zinc, selenium and vitamin C just as an example, those nutrients recycle and help you produce an increase in glutathione which is what your immune system uses as its antioxidant to protect itself.

So that's one example of how the methylation cycle works. If you're just tuning into this subject, people ask "Well what does methylation mean?" and everything like that and I hope that you just take this information you're hearing today and begin to do some reading because it is accessible to you. You don't have to be a PhD to understand this stuff. You just have to have a willingness to be a little confused for a little while, but like all things, the more you work on it, the more you learn.

I mentioned before that you have to be able to have the carbon on the DNA in order to control which genes turn on, but you also have to make new DNA. So when cells divide, they double the amount of DNA and then they form two cells and then those two cells double the amount of DNA and then they form four cells. So all that DNA production, cell division and growth, requires that your methylation cycle is working. That's another big part of the whole picture. That's why it's so important to get an appreciation for this carbon cycle because it's literally the most fundamental process in our body producing not just DNA but proteins, enzymes, tissue growth. It explains why some people when they grow up have a dent in their chest. They're born with a cleft palate. They have other different physical attributes and it's all coming back to what's going on inside of their cells with carbon. It's fascinating.

Tiffany: So if your body doesn't have the proper methylation going on you can end of with developmental issues or neural tube defects?

Dr. Rostenberg: Absolutely Tiffany. I would like to just suggest that we look at it from three different points of view. There's a few problems that start at the moment of conception. That's a different set of problems than one that shows up during puberty or one that shows up in middle age or beyond. I think there's three different categories. If the problem starts at the very beginning of life; let's say that the mom is under a lot of stress, she's not the healthiest person, she's had some toxic exposure, hormone imbalances, issues with her cycles, some heavy periods and fibroids, maybe she's a little aged, in her late 30's, those are situations where there may not be enough methyl group around when cells divide in her uterus if she gets pregnant - and I'm not trying to scare any females out there who are trying to get pregnant. Please don't interpret it this way. Don't be up at night worrying about this. I'll use white blood cells as an example. If you take two cells from your immune system and you put them in two identical little Petri dishes, and then what you did is put a little bit of nutrition in the cell like the kind of fluid that you'd find inside your body like plasma, and then you took out the methyl group, you took folate out of one of those Petri dishes and you left it in the other, what you're going to find is that when those white blood cells separate and divide into two new cells, if you create a situation where there's no folate in a Petri dish, no methyl groups, when those cells divide, the cells that are created have Down's syndrome or some kind of chromosome disease. Does that make sense.

Tiffany: Yes.

Dr. Rostenberg: So we can create Down's syndrome in a Petri dish by taking away methyl groups from the environment. So we work backwards and say "Okay, in the human body, if a mom is growing a baby and the mom doesn't have enough methyl groups, the odds of her having a cell divide in her uterus with the wrong number of chromosomes goes up significantly. The cure of course is make sure that the mom gets lots of green leafy vegetables and is eating a wonderful clean diet and gets the right kind of folate in her body and that will essentially prevent the occurrence of that type of a challenge.

Tiffany: So if I can just try and clarify a little bit, a person can have a methylation problem but not necessarily have the MTHFR gene. But if you have the MTHFR gene, you definitely have a methylation problem, is that correct?

Dr. Rostenberg: I think that's a wonderful summary. People with MTHFR genes can never show any symptoms. They can live a long, healthy, happy, awesome life. I guess we should back up and just point it out to the audience as well. So we talked a lot about heady genetic stuff. Bear with us, it's a lot like drinking from the fire hydrant. When you have an MTHFR gene that you inherit, what it means is your body is slower at converting folic acid into folate and what that means is that your body really can't use folic acid until it gets converted into a more natural optimized form called 5-methylfolate, 5-methyltetrahydrofolate.

That's the big idea to take away from this whole understanding of MTHFR. It just means that the road, instead of being an 8-lane super highway that you can go full speed on and it doesn't matter how much folic acid's in your body, you can convert it into the right kind. It's almost 75 percent of the population has one of these genes, so it's not even rare anymore. There's a lot of it going on. But it just means that individuals with MTHFR problems, as Tiffany has pointed out, are going to be more susceptible to health problems if they do not get the right amount of folate in their body because their body's not as quick to produce folate from folic acid.

The way I explain it is that people with MTHFR issues who have the C677 or the 1298 genetic polymorphism that we talk about - and again a polymorphism just means it's like you have a train that's 600 cars long and they're all supposed to be red cars and then you have a blue car on position 300 and that's all that's changed in the whole train but that change in colour would be analogous to a change in a sequence in your genes and that changes a little bit the speed of the enzyme.

MTHFR issues that we inherit from our parents change the shape of the lock. So if you think of folic as a key, people with MTHFR problems have a slightly different shaped lock so that you have to wiggle that key in a little bit more and wiggle it back and forth before the lock will open, whereas peoples' key and lock without MTHFR issues are moving a lot faster. There's no friction. There's no issues getting the key into the lock and opening the lock, if that makes sense.

Tiffany: Yes it does. Seventy-five percent is a very, very large number of the population that will have this gene. So if MTHFR is so prevalent, what are the symptoms? How would you even suspect that you have it?

Dr. Rostenberg: That's a great question as well. You would look at your family tree is what I would start with. I never had the pleasure of knowing my grandfathers because they passed away way too young, 58 and 63. That's too young. That's middle-age. And what I came to learn is that one of my grandparents died of cardiovascular and the other one died of brain cancer. So those are two giveaways that there's a methylation problem in your family; people who are susceptible to cancer, heart disease and depression. And the reason that cancer, heart disease and depression are methylation related problems is that the lack of methyl groups in your body, the lack of carbon-methyl groups, the lack of that causes heart disease because it creates inflammation and you get high levels of homocysteine and that begins to damage your cardiovascular system and promotes a lot of stress through the heart and the arteries. That's a lack of methyl groups.

Cancer is a lack of methyl groups because remember that the methyl group turns the gene off and if you cannot turn the gene off because you do not have enough methyl groups to stick on all those genes that you want to shut down, you can close the book of DNA, the DNA book is going to get read without that methyl group, then you're going to have less control over whether the cancer gene gets turned on or not.

I just want to share one research tidbit with everybody. Studies were done at Duke University, I believe the PhD's name was Randy Gerdahl. And what he did was bred mice that had the gene for obesity. The mother had the gene turned on so the young mice were overweight and obese and so and so forth through the generations. Then what they did was give the mice methyl groups. They gave them folate in their diet and then the mom that was obese would give birth to normal shaped, healthy offspring.

Then they did another experiment in Washington State. The name of this PhD escapes me for the moment, but they used BPA, which as many of you know, is a endocrine-disrupting, carcinogenic toxin that we've been exposed to. We all used to microwave stuff in plastic. It's still used to line aluminum cans and stuff like this. But they took a mouse and they got BPA into her system and this mouse then gave birth to daughters who got cancer. The daughters gave birth to granddaughters who got cancer and the great-granddaughters got cancer. It was a huge study because it showed that exposure in generation one caused cancer in generations two, three and four, even though the daughters, granddaughters and great-granddaughters never were exposed to BPA.

So what happened is that being exposed to toxins is consuming resources so the mother has to detoxify BPA and that's going to waste or soak up or I should say burn up her nutrition to detoxify the chemical. And as she gives birth and grows a baby there's less nutrition available to make sure the genes of the baby got the methyl groups put on the DNA. So the error got passed on and on and on to allow cancer to grow. But the good news is, they did this study again and they gave the original mouse another round of BPA but they also gave her Vitamin B9. They gave her folate and then she gave birth to daughters who didn't get cancer. Nobody got cancer for four generations. So they blocked it with nutrition. I think that's really a powerful story.

Tiffany: Well can we get a little bit more into the differences between folic acid and folate, how folic acid builds up in people with MTHFR gene and causes a traffic jam and causes them to be bad detoxifiers?

Dr. Rostenberg: Absolutely. This is a pretty important subject and there's a lot of misunderstanding. Again, I'm not the world's authority on methylation research. I just spend all my free time reading it and working on it in my clinic. I used to think as well that folic acid was a toxin, that it really was this man-made chemical that is making people super sick. And of course the truth is somewhere in between. That's not quite accurate.

What ends up happening in your body is that, as we mentioned before, the MTHFR gene is a step in a recipe that has to go on in every cell in order to provide the cell with a methyl group. It's like hot potato. It comes in on one molecule then the potato gets passed to another one and then that one holds on to it for a second and then it passes it to another one. What happens is folic acid has to go through more steps in order to get converted into the form your body can use. I think that's the important thing to understand, is that folic acid is just a different chemical nature, slightly different type of folate. Because there's all kinds of different folates. There's folinic acid. There's 5-methyltetrahydrofolate. There's folic acid. There's several different derivatives and they all have basically the same chemical shape.

So folic acid was synthesized by a man in around 1946 and we erroneously thought that it was man-made, but what we now know is that our gut bacteria actually poop and provide for us vitamins and one thing that gut bacteria poop out is folic acid. We found this to be true.

So when people have really high levels of folic acid in their body it'll usually be tested for as unmetabolized folic acid. What that means is one of two things in our clinic. This is how we interpret it. It means that they've been taking way too much folic acid, they've been eating the standard American fortified food that's got a lot of folic acid in it and then they have an MTHFR problem that's allowing the folic acid to keep building and building because they're so slow at converting it.

But now we have new information as of last year that people are dealing with gut infections. You think of all the people in this country who are on antibiotics or who have been on antibiotics, who are on proton pump inhibitors, you think about how stress affects our digestive system and how much of a negative impact that has, what we found is that people have small intestinal bowel overgrowth. They have infections of bacteria in their gut because of these different factors that I've just mentioned and the bacteria is usually an overgrowth of what's normally there. So I'm not saying that they have a terrible bacteria that doesn't belong in their gut. What I'm suggesting and what we find is that it's the normal type of bacteria, it's just way overgrown.

So what's happening is people's guts are producing large amounts of folic acid and sometimes they produce large amounts of B6 and you get this high level of folic acid in your blood because your gut is so imbalanced that it's just dumping folic acid into your system. This is what happens when people take vitamins. They might do a genetic test and they have MTHFR, C677++ and all these other related enzymes that are off or slowed down a little bit and they say "Oh my gosh! This is the answer to all my problems! I'm going to run out and order some methyl support and I'm going to get it and I'm going to feel great!" Don't get me wrong, we use this stuff all the time that does help many, many of our patients, but there are people who take B vitamins and they get way worse very quickly. And what's happening is they're throwing fertilizer like rocket fuel down their throat onto weeds and dandelions and thistle that's going to take that fertilizer and grow super-fast. So we have to treat the gut first in situations like that.

I didn't want to get too off-topic but I just wanted to point out that folic acid is a) made by man and put in our food as fortification and b) it comes from your gut. We've always had folic acid in our body. Why would our body have the ability to convert it into folate if it wasn't there since the beginning of time?

Tiffany: That's a good point. I wanted to open an opportunity for Tom and Peter to give some of their experiences with MTHFR and methylation. So Peter do you want to give some examples?

Peter: Yeah sure. There is a couple of things, now that I've learned about this a little bit more that I can look back on and that I think probably were related to having these polymorphisms. And I should state really quickly, my particular profile in regard to MTHFR is that I'm what is called a heterozygous for both the 677 and the 1298 polymorphisms that Dr. Rostenberg mentioned a couple of minutes ago. One of the things that actually happens, speaking of how it affects the body, when I was growing up I had a lot of problems with my right knee in particular. It would be extremely painful sometimes. I used to have to wear a little wraparound brace to hold it in place so I would be able to walk. And what I think that stems from now is the fact that my leg lengths are actually a little bit different and I think that they grew differently. As Dr. Rostenberg mentioned, things like body symmetry can be related to how and when you methylated when you were younger, starting when you're in the womb.

Besides that, the way I started looking into this originally and the way I found out about this topic in the first place was that I was having heart issues. I had started in my late 30s intermittently having chest pain and symptoms where I would get shooting pains that would go down my left arm, things that you might consider to be sort of warning signs for something like a heart attack. I had gone a couple of times to the ER to get checked out and each time I did, they did the EKG, they drew my blood, did a couple of different tests to see if I was in some kind of cardiac distress and the results always came back negative. People looked at me like it was all in my head.

Finally there was one time a little bit more than a year ago where I had an experience where I had gone to give blood and then I went to go get something to eat right after that and I ended up passing out several times in succession. They ended up calling the ambulance. I didn't actually go to the hospital that day but afterwards there was this increase in chest pain. So my parents were encouraging me to go see a heart doctor and I didn't want to go to a "regular" heart doctor because I was afraid that they would just run the same tests, do the same things that had happened when I'd gone to the ER.

So I found a functional medicine doctor who specialized in cardiac issues. I went in and she tested me for something called endothelial dysfunction which is a problem with the cellular lining of your blood vessels basically, and found out that I had a problem with this. But I had none of the risk factors for it. I was fairly young. I wasn't overweight. So she thought that one of the things that we could rule out was that I might have an MTHFR polymorphism. So I had blood drawn.

Tiffany: Can I jump in here real quick?

Peter: Sure.

Tiffany: Dr. Rostenberg, how can MTHFR play a part in endothelial dysfunction? Is that another aspect of failure to develop properly because you don't have enough methylation in the womb?

Dr. Rostenberg: When you see cardiovascular disease developing in an adult, it's not so much what happened at a young age, it's more that over time, as the person lives, there's just a steady increase in inflammation and dysfunction. It's a little bit at a time, death by a thousand cuts. And as I mentioned earlier, you have problems that happen in the womb. Those are severe. I'm talking about people born with spina bifida that's life-threatening, cleft palates, fetal alcohol syndrome, Klinefelter's syndrome, Marfan's syndrome, problems with your chromosomes. That's obviously more severe than going into the doctor at 35 or in your 30s. I think the definition of what medicine says is healthy, "I've got this weird heart thing going on, I've got inflammation in my blood vessels".

What I understand from what Peter's describing, when you have a methylation problem, you're prone to being inflamed and one of the risk factors for cardiovascular issues is homocysteine. When you talk about your endothelial issues, the destruction of the inside of your blood vessels is the triggering factor that there's always some form of inflammation. Then that starts the process of causing what people know as clogging of your arteries or getting cholesterol on your arteries.

But definitely people with methylation imbalances are just more inflamed because they have more homocysteine. They're not detoxing as quickly, so that's the general idea behind cardiovascular disease and methylation. It's inflammation that goes unnoticed and untreated for too long.

Tiffany: Okay Peter, you'd gotten to the point where your functional medicine doctor decided to test you for MTHFR.

Peter: Right. Thank you Dr. Rostenberg for bringing that up because one of the reasons that she wanted to check homocysteine levels, which we did, and they ended up being high. That's why we ended up doing the genetic test and once we figured out exactly what was going on there with those particular polymorphisms, we started developing a program where I started supplement to try primarily more than anything, to bring my homocysteine down.

Dr. Rostenberg: If I may, do you remember what number your homocysteine was in the beginning?

Peter: Yeah. Actually hold on. Let me take a look here. I've got numbers in front of me. I started at 7.4 which is not terribly high. It's not astronomical but I think it is in the high side of normal, if I understand correctly, but Dr. Rostenberg can comment on that.

Dr. Rostenberg: Some doctors say 8 is the upper limit. Somewhere between 7 and 8 is as high as you like to see it. And we don't like to see it below 4 either. Something too low is not beneficial either. So that's getting towards the upper end of normal for sure.

Peter: Okay. And it's pretty much stayed there since I've been treating it in the last year. I have noticed that most of the symptoms I've been experiencing have either calmed down or gone away altogether, but my homocysteine levels have actually been pretty stubborn.

Dr. Rostenberg: That's just showing you too that blood tests, lab tests and gene tests are just a tiny picture of what the total experience of being alive is like. We don't want to treat a blood test, we want to treat people. You can have perfect homocysteine but have all the risk factors for heart disease and still need to be supporting that. So I think it's important to remember when you work with professionals and health care providers, the best tool is to just look at the patient and talk to them and see what's going on with their body. If somehow all the power went out and EMP goes off and we get kicked back into the stone age, it's not really going to change my practice that much. So go ahead. You saw some benefit from the methyl groups and the support you took. Can you share with us what kind of vitamins you took?

Peter: Yeah. So what I started taking was something called MethylProtect. That's what my doctor started recommending for me. It puts together a number of different things. There's riboflavin as riboflavin 5'-phosphate sodium, vitamin B6 as pyridoxal 5'-phosphate, the kind of folate that you've been talking about where it's a form of tetrahydrofolic acid instead of just regular folic acid and then Vitamin B12 as methylcobalamin and then finally something called Betaine Anhydrous. So there's about six ingredients that are packaged together in a single supplement and I take it once a day.

Dr. Rostenberg: Yeah, we use something very similar in our office and I think you're on the right track with what you're taking. The reason they give you all those different methyl groups is that you have back-up systems in your body. I just want to point that working with hundreds and hundreds of people with their genetic issues is that your genes are not your destiny, but they are your tendency and we aren't sick because of our genes. We're sick because the world is sick. The planet is polluted. I just want to point out that there's a few people who are born, like I mentioned, because the methylations problems started at birth, they're missing genetic material from their body. That is totally a genetic health problem.

Everybody else, we have the responsibility to change the environment that's inside of our head and inside of our bodies. That's what starts to change your genetic expression to a much more positive way to be and live. That's what we do in the office is coach people on how to change their lifestyle; what do they need to change with their diet; are they sleeping; are they pooping; are they drinking enough water; what's their history like; do they have a gut infection? I know we'll probably get into that here shortly, but Peter's example, if I understand you right Peter, you saw chronic pain and joint issues and bizarre symptoms that had medicine scratching their head going "it seems like you have a heart problem but all your tests are normal". But now you take your methylation support to optimize your pathways and your symptoms are practically gone. Is that correct?

Peter: Well they've improved quite a bit. I'm still trying to work a little bit to find out how to bring everything into the balance it needs to be in and to take care of everything. So the chest pain symptoms, for example, I would say that that's 90 percent cleared up. Every once in a while I will still experience the same kind of symptoms but it's much more rare now than it had been for the five years before I started doing the right kind of supplementation.

The one other thing I hadn't mentioned in terms of things that I'd experienced and symptoms, is that I've had a problem pretty much all my life with fairly high anxiety levels. As a kid when I was in grade school I was always known as being one of the really sensitive kids. It didn't take much to upset me or make me cry about something. When I got older I didn't always express it but the same way but I would still be very sensitive about things, be stressed really easily, feel anxious really easily. I always thought that was just me, that's my personality. It was true of a lot of people in my family also, when I look back at it now. But that's something else that, once I started supplementing, I've noticed quite a bit of improvement in that area. I wouldn't necessarily consider it perfect right now, but I have noticed a real difference.

Tiffany: Well thanks for sharing your experiences Peter. That was a very good comment that you made Dr. Rostenberg about genetics not being destiny. It's an empowering message, that people do have the ability to change. They can take their health into their own hands.

Dr. Rostenberg: I think you have to. I think radio shows like yours in the alternative news and media is the journalistic equivalent to natural medicine and working on these cutting-edge natural ideas and I want to just say that medicine will eventually come around but in 20 or 30 years we may be all sicker, beyond repair at that point. So you just have to take matters into your own hands and go. There's no time like the present.

Tiffany: I think in a lot of ways allopathic medicine's still in the stone age. Hopefully we'll make some strides. I wanted to give Tom a chance to share his experiences with MTHFR.

Tom: Sure. I'd say that I'm very similar to Dr. Rostenberg in that I like to figure out how things work and always have. So I've always taken the approach, even from a relatively early age, of wanting to know why things work or why things go wrong. I'm very similar to Peter in that I have a very similar personality with anxiety and being quite sensitive. It was more a gradual series of minor health problems that built up over the years. There was depression at university. I developed hay fever and began to develop food allergies in my mid-20s. So trying to work out what these things were I tried different diets going dairy-free and eventually gluten-free. I had terrible problems with trying to do vegan. That didn't work.

I was slowing testing to the point where I've tried to eliminate as much inflammation as possible, so sorting out gut health and things like that. But there was always this inability to deal with stress. I think that's probably the main one along with a kind of chronic fatigue syndrome. So I think they were the biggest ones that were still niggling at me. I also experienced lack of capacity when it came to exercise as well. That was always quite interesting.

Tiffany: What do you mean, Tom by lack of capacity to exercise? You just couldn't muster up the energy?

Tom: Yes. Even from the age of 6 or 7 it was something that I noticed compared to everyone else. With running and things like that I would get exhausted pretty quickly. This is something that my parents relate to me as well, is that I was generally quite sensitive to excitement, things like that. I'd also get tired extremely quickly. So exercise, stressful situations, I would get over-stressed. My adrenalin gets going I can get the shakes and things like that.

Tiffany: Have you seen similar situations to Tom's, Dr. Rostenberg?

Dr. Rostenberg: Absolutely. That's a common type of presentation. I want to introduce a vocabulary for our audience too. We've been talking about genes and your genetic report represents your genotype. That's the genes that you inherit. Then you have your haplotype and your haplotype is groups of genes. We're going to get into that here in just a minute to touch on Tom's experience and also what Peter has mentioned as well. But what we end up seeing in people, when a patient walks into my office or when you walk into a doctor's office, what you are is a phenotype and your phenotype is your genes, all of them expressed over time with the environment influencing them.

So in other words, when someone walks into the doctor with chest pain and left shoulder and left arm pain, they have a phenotype of having cardiovascular disease. When someone comes in and says no matter what I do I'm just super depressed. I have no motivation. I just don't have any joy in life. I just feel down all the time. Well that phenotype is depression. So I just wanted to introduce that idea because phenotype is kind of what science uses to describe what your symptoms are, what your genes plus the environment is producing in your body, okay?

And what we do by working with your methylation cycle is you rescue the phenotype which means rather than listen to a prediction like "Oh because of your heart disease in your genes, you're destined to have x,y,z disease and you're going to live x,y,z months". They tell that to cancer patients all the time. Well when cancer patients beat cancer naturally, what they've done is they've rescued the phenotype. They've derailed the train that science says that "this is what's going to happen next" by changing the environment. So I just wanted to introduce that word. I think it's a good way to understand what we're talking about. But when individuals have a low tolerance for stress, what we're going to be looking at is in fact they're actually stressed out all the time underneath the surface.

What I mean is that when you exercise, for example, as we all know we've all exercised. We've all felt our pulse go up, our sweat increase, our breathing increase and we've basically felt what happens adrenalin is released in your bloodstream but it's also released into your brain. It's a little bit different. It's called noradrenalin. These are the catecholamine stress hormones, stress transmitters. Even beyond MTHFR I think this is the area that really affects how people feel. I think MTHFR affects your risk for disease and health problems, but I really think on a day-to-day basis, what makes you feel good or bad or anxious or worrisome or have chronic pain or have insomnia, what does that are the genes COMT and MAOA and those genes work with MTHFR but they break down your neurotransmitters of stress.

So when patients can't tolerate exercise, what I would suggest is happening is that their body is already flooded with or full of adrenalin, norephinephrine and they have too much dopamine already. And people who have a lot of dopamine in their brain are very intelligent people. They're super sharp. They have great memory. They can take tests really well. They're probably the type of people in school who don't have to study a long time for tests. They are good test-takers. And this is what the studies have proven; people with a slower version of COMT and a slower version of MAOA are going to have higher levels of dopamine.

When you're healthy and the world is a nice nourishing, calm place and there's not a lot of stress around, you're actually born with more dopamine in your brain, so you're going to be sharper. But what happens is when you start eating processed food and all the toxins in the air, water and soil, all the stresses that we deal with, what it does is push people into having too much dopamine and catecholamines in their body and that's where you start to get unexplained anxiety, insomnia. A lot of uncomfortable feelings that people go through are due to the side effects of stress hormones. If we can agree that stress is the biggest health threat we all face every day, then we want to look at the stress hormones as being what are mediating or translating the stress in the world into the stress into our bodies.

It sounds like Tom, and even Peter mentioned this, just being a little more anxious, that's the conversation we have every day in my office because people are not effective at breaking down their stressed neurotransmitters as well as they could be.

Tom: Interesting. Thank you very much.

Tiffany: Well that explain things a bit more. I wonder if I could ask a question for the ladies in the audience and how MTHFR interacts with menopausal or perimenopausal symptoms?

Dr. Rostenberg: Absolutely. About 85 percent of my practice is females and it's simply because women are just smarter about their health. They pay way better attention to it. Us guys have got to sort of grow up and get with the program here because we're not getting any healthier. But definitely MTHFR is going to make certain things more likely. It involves your detoxification system so you have to methylate as part of the way for your liver and your gallbladder to get rid of estrogen, for example.

So if you can imagine estrogen, it's in your body, you produce it in your ovaries and it's produced in your adrenal glands. It's also produced from fat tissue. The estrogen that you make every day as a woman, which is also true of men to some degree, you have to get rid of it. If you just simply make something all the time but never get rid of it then the level's going to go sky high. So your body has to remove estrogen on a daily basis. And the pathway that that takes place in is in the liver and then it goes into the gallbladder. We know that women have a lot of problems with their gallbladders. The typical person who has gallbladder stones is female, fat, 40, fertile (she's had a lot of children). Each times you get pregnant there's 30 times the amount of estrogen going into your body than just regular living.

So your methylation being slowed, having an MTHFR issue that's not yet being supported - I should point that out - that's not yet being addressed, just eating regular food, not knowing that it's there, not knowing that you're slow in that pathway, what's going to happen is women with that genotype are going to have a lot of inflammatory estrogen in their body. Methylation calms down your hot estrogens. And when I say "hot estrogens" I want to point out that estrogen, once it goes into your liver can turn into two different outcomes. One outcome is that the estrogen is more inflammatory than it was. The type of estrogen that's related to fibroid, endometriosis, heavy bleeding, extremely bad cramps, and in worst cases like uterine, breast, cervical and ovarian cancer.

The other type of estrogen that your liver can produce is a very calming estrogen. It has opposite effects. It has of course a methyl group attached to it. So if you methylate your estrogens in your liver, you protect your body from the effects of a very important but powerful hormone that can get out of balance. So with the methylation nutrients we have tools that combine methylfolate and methyl B12 with some of the other nutrients from the plant kingdom, herbal estrogen and things that really help speed the liver up in its ability to convert toxic estrogen into the calming type. That's a strategy to avoid cancer. It's a strategy to stay cancer-free if anybody in your family has dealt with breast cancer. This is why methylation is so valuable. You're getting leverage. You do one thing right and you get dozens of benefits down the road.

Tiffany: I wanted to touch briefly on a couple of other topics related to MTHFR. The first one is autism. That's kind of a hot topic. A lot of people blame it strictly on vaccines but not all children who are vaccinated get autism. So how does MTHFR come into play when it comes to autism?

Dr. Rostenberg: Well let me first point out that autism is a very complex challenge and what they're finding with kids with autism is that they all have a gut problem. They all have a big change in their gut bacteria. Your brain health is very much a reflection of your gut health and we can all agree that autism is a brain-based dysfunction or disorder. There's a researcher by the name of Stephanie Seneff. She's a PhD at MIT in Massachusetts and she has basically proven that if nothing is changed with the rate of glyphosate used in our food supply that by 2025 50 percent of the population will have autism if the current trends are not altered.

So we're living in a very interesting time where information is easy to gain but it's mostly meaningless whereas the real problems are ignored until they just show up at your doorstep. I know that's not true with your listeners but we do have some work to do. So with autism, methylation plays a role because when inoculations are given you're bypassing the defence mechanisms that the body has. So your body has all these defence mechanisms that line the surface of your gut, lungs and skin and it's a time-honoured tradition and extremely effective.

If the vaccine was given orally your body would detoxify it and destroy it before it even got into your body because it doesn't want that inside of it. But when it goes into the bloodstream directly, the heavy metals like mercury inhibits methylation severely. It just slows it down. It doesn't slow down MTHFR per se, but it slows down the next step in the process called methionine synthase. I'm just going to look this reference up as we talk, but the mercury in vaccines is so much worse than the mercury that's in fish. Let me look this up real quick.

Here's my reference. This is from the 2005 study in neuro-endocrine letters and it was basically saying that thimerosal was 100-fold more potent than inorganic mercury in inhibiting methylation reactions. So this is what you do to children. You inject Mom with garbage and make sure you give her food that's poisonous to her gut bacteria and so Mom starts to degenerate and as Mom's pregnant, Mom can't produce the vitamins and deliver vitamins to the placental environment at the optimum dose. So now the baby's born with sub-standard immune systems, sub-standard detoxification. The baby's nutritionally deficient upon birth. We don't recognize it because medicine doesn't know what to look for but that's happening.

And then you give the child a large dose of neurotoxins, sometimes up to three times in one visit and now the body's really becoming overwhelmed. And what do you do when a baby gets a bad reaction to a vaccine? What medication do they suggest? Does anybody know?

Tiffany: Some kind of fever reducer.

Dr. Rostenberg: Exactly. And what's the most common one that we use?

Tiffany: Tylenol.

Dr. Rostenberg: Tylenol. They don't even know how Tylenol works by the way. Just keep that in mind. The active ingredient in Tylenol kills 4,000 people a year from acute liver failure. It's also the number one method for teenagers to kill themselves, is to drink Tylenol and take liquor and you will not wake up. But what you do with Tylenol, acetaminophen, the active ingredient, depletes your liver of glutathione. So what they do incorrectly and ignorantly is give the child a giant dose of neurotoxic substances that his body can barely detoxify then the body gets a fever by reacting because it's trying to work super hard to get rid of it and then they give it acetaminophen to deplete the body of its glutathione reserves. They've proven that giving children - I'm going to look this reference up for you too - giving children a vaccine and then giving Tylenol increased the odds of getting autism by 500 percent.

Tiffany: My God!

Dr. Rostenberg: That was the University of San Diego peer-reviewed published study. It's terrible man. The world's full of bad ideas. That's what I get pissed off about, is the world's full of bad ideas. So that's a bad idea.

Tiffany: Yeah, you and me both. Do you guys have any questions you want to chime in with? I want to get into some basic treatment but does anyone has any questions they want to jump in with?

Doug: I had a question actually. This is Doug here Dr. Rostenberg. I guess I'm trying to get through the treatment a little bit. You were mentioning before in regards to gut bacteria, it isn't necessarily that it's the wrong bacteria but that it's too much of the right kind. So I'm wondering if in situations like that, it's actually counter-productive to be supplementing with probiotics.

Dr. Rostenberg: Yeah, that can absolutely be true. God is in the details, right? Who would argue, and it certainly wouldn't be me, that probiotics are bad for anyone. But we have to consider that there's a lot of complexity to life and patients come in with different issues. So what we do is we would look at the most common drugs in the world, especially in the United States. What's the most common prescribed medication? It's typically going to be an antidepressant, cholesterol medication or a stomach acid block.

So we work backwards from that and say those are the biggest problems in our population. We know there's huge methylation issues because of all this depression and that's also a blood sugar problem, by the way. The gallbladder is getting destroyed so we have this cholesterol imbalance. But then we have stomach acid problems. So your body has many mechanisms to make sure that the environment in your gut is optimal. I used this analogy the other day so I'll just share it with you. I grew up in Arkansas and it's a beautiful place, kind of like North Carolina where Tiffany's living. The hardwood forest is beautiful with the loam on the forest floor. So when a tree falls or appears to be dying, you're going to see mushrooms growing all over it. That log falls to the ground, there's going to be fungus growing all over that log to break it down. The reason the fungus grows is because it's an optimum environment for fungus to thrive.

You take that same tree, that same log and throw it down in you front yard in Phoenix, Arizona, you're not going to see any fungus growing on that at all because the difference is the environment changes. Fungus bacteria will grow where the environment promotes it. You're going to have gangs, gangsters and criminal behaviour in society wherever you create an environment to promote that. So you change the environment in your gut to create health and you will not have an overgrowth of bacteria. You'll have the hearty folk that do the hard work to keep it healthy. But long story short Doug, what ends of happening is your gut becomes promoting the growth of bacteria. And what bacteria does, it's going to grow towards food. So you have a 26 foot long tube with food coming in one end and waste going out the other. The bacteria are going to grow up towards your stomach because that's where all the nutrients are coming down.

So what ends up happening is you normally don't have much probiotic in the upper two-thirds of your small intestine because that's where you absorb a lot of your macro-nutrition. But your bacteria begins to grow up into that space, now it eats your food first. And we don't know if it's going to poop out more toxins or more vitamins that you don't need and it begins to create nutritional imbalances. It's really the case that people aren't as malnourished from eating wrong. They're malnourished because they don't absorb at all. That's what we find over and over again. People come in and say "Man, my diet's perfect and I feel like crap." And it's true, they have a great diet. But we just have to change the environment in their gut and help them absorb their food again and it just changes lives that way.

Doug: I have a follow up question to that. Is that what's commonly referred to as SIBO or Small Intestinal Bacterial Overgrowth? I've come across a lot of different protocols for dealing with SIBO. Just online Chris Kresser talks a lot about that. There's a few other guys as well. Is that something that would be recommended?

Dr. Rostenberg: Yeah. You're right on target. When we see that people are getting sick when they take probiotics, have a bad reaction to it, they're eating B vitamins and they're getting flares of anxiety and heart palpitations and high blood pressure, insomnia and all this pain from taking B vitamins, like how is that happening? Well it's because there is some infection in their gut and whether it's a true SIBO or not, the nice thing about the work we do is that you kind of treat it the same no matter what. If it's a fungal infection, bacterial infection, dysbiosis in your gut, the cure is very simple. It requires discipline and hard work but the tools that fix it are quite simple, regardless of whether you have a diagnosis of SIBO or not.

There are some people that are so sensitive that they can't take any probiotics at all. I have people who take Vitamin D for example, and it makes them sick to their stomach, they're about to puke. Well that's not a reaction to vitamin D, that's something in their gut not allowing them to digest it and doing something really weird with their vitamin. Then 10 days later they're taking 10,000 IUs of vitamin D and they're feeling fine.

There's a lot to it. There's a lot of good things that come from treating your gut and that's where most people have to start.

Tiffany: Yeah, I've read that over and over. You have to start with healing the gut. That's the foundation of everything. Peter did you have a question?

Peter: Yeah. I've got a couple of probably inter-related questions before we move on to talk about actual treatment. Dr. Rostenberg, we've been talking primarily about the MTHFR polymorphism but there's actually several others that are involved in methylation issues. You've mentioned a couple already. There's the MAO and COMT polymorphisms, for example. So I was wondering if we could talk a little bit about some of those. And then related to that, in my understanding there's four big subcycles in the methylation process. There's the methionine cycle, the folate cycle, BH4 and the urea cycle and I was wondering if we could discuss those a little bit individually too?

Dr. Rostenberg: Absolutely. So to answer the question about these other pathways, I've talked a little bit about how the methylation cycle moves carbon atoms around. It produces antioxidants to help you detoxify. But what it also does, it helps you produce both neurotransmitters and break them down. Look at the research that's coming out of the schizophrenia research to try and understand why people have schizophrenia, in every case that I've heard of, it's always been a giant stress that's triggered schizophrenia or psychosis.

You have to remember that too much of a good thing is a bad thing. We can die of dehydration but you can also kill yourself from drinking water. It happens in the Grand Canyon every year. So we have to find that balance between the things we need, not too much, not too little. What happens is the people with the COMT and MAO polymorphisms, what ends up happening is they have a reduced enzyme speed which means that they break down their stress neurotransmitters slower. If you break something down slower, you're going to be more likely to have higher amounts of it, just like the folic acid we talked about earlier. If you're slow to convert folic acid into folate the odds of you having high folic acid go up.

Well the same is true of your adrenalin, dopamine and norephinephrine. The side effects of excess dopamine, the side effect of excess norepinephrine in your brain is high levels of anxiety, worry, it triggers chronic pain syndromes, it causes insomnia and in really severe cases it causes psychosis and schizophrenia. I don't pretend to understand everything about the brain and the brain's about as vast as the known universe. That's what scientists are telling us. Think of it like musical tones. So when you have a bunch of instruments in a classical music concert and they're all in tune, all playing together, you get more than the sum of its parts. You get this incredible, spine-tingling sound that just peaks and crystallizes the energy that's coming out of those instruments. But now as those instruments start playing faster and faster and the horns start blowing faster and faster and stop being in tune, now you start to get an opposite reaction where it starts to sound pretty bad and it's really obnoxious and it sounds terrible.

Well your brain's kind of the same way. When your dopamine is optimum and you have enough of it but not too much, you get that crystallization of brain function. Your brain works really well. It's clear. Your memory's sharp. Your energy's good. You're a quick learner. Then what happens is as your dopamine increases and increases, it actually burns out the frontal lobe so your frontal lobe cannot handle all that extra stimulation and so it begins to malfunction. And when the frontal lobe malfunctions, the parts of your brain that are deeper and more fundamental or ancient start to creep out.

I have a blog post coming out with this in a week or so but in neurology you have the part of your brain called the limbic system and limbic is like your mammalian brain, your urges, sexual urges, fight-or-flight system. When the cortex, the frontal executive CEO part of your brain is working well, it keeps the lid on these weird urges and primordial impulses that you have deep in your brain. But when your frontal lobe gets swamped with all this dopamine and stress hormones and it can't detoxify them fast enough, then you're going to see the frontal lobes stop function and then you're going to see the limbic system with all these primordial urges just start bubbling out.

So this is why people who get head injuries have personality changes, they're super aggressive, inappropriate social behaviour, OCD behaviour. It's the same story with having COMT and MAO problems. Whatever is causing your frontal lobe to become dysfunctional, you'll also see with COMT and MAO OCD, anxiety, people who are not tolerating stress well. And I'm not saying it's always going to be that way for those people. I'm saying that's the gene and the pathway that's really making them not tolerate stress well and I think that's an important point for our conversation; regardless of whether it's a head injury, an extremely stressful divorce when you're a kid and your parents are divorcing, or you're a brilliant PhD scientist, doing this heavy work trying to get your dissertation together or you move out of the country in high school and changed high schools and you go to a different country with a different language, these are really stressful things that happen to people. I have personally heard of individuals going into psychosis and kind of a schizophrenic type reaction to that and that's because it's overwhelming their body's ability to detoxify the stress hormone and it just simply hurts the brain.

So the methylation cycle is important for that too. That's a whole other conversation. I'd love to answer any questions or comments on that, and just real quick before I take that next step; just to talk about the four different cycles. This is something for your listeners to research and read about on their own, but the methylation cycle has been divided into four cycles. You have the methylation cycle we've talked about. You have the neurotransmitter cycle that involves the production of dopamine and serotonin. This is why when people take B vitamins they sometimes feel worse because they are producing more neurotransmitters too quickly. So you need to back off and we'll talk a bit about that.

Then you have the nitric oxide cycle, the urea cycle. This is all complex chemistry. I don't want to overwhelm everyone too much. It basically means that, as Peter was pointing out, your methylation cycle has an impact across multiple body system, every body system actually, and it's not just about the MTHFR system, it's about your neurotransmitters, how you deal with ammonia, how you produce nitric oxide, which is another one of those chemicals that is protective for cardiovascular disease. So endothelial dysfunction, as Peter mentioned earlier, can be a result of not enough nitric oxide and nitric oxide is produced from arginine and if your methylation cycle is not optimizing then you cannot produce inside of your body, enough nitric oxide and you may see that as circulatory problems, cardiovascular risk issues, you have less growth hormone, less energy. I'm just touching on some of the high points. There's a lot to it and even in two hours we're just going to scratch the surface.

I would like open up to any questions about the neurotransmitters. I think that's just an important one.

Tiffany: Okay. Anyone have any questions on neurotransmitters?

Peter: Yeah, if I can just ask a couple of questions regarding that. Dr. Rostenberg, thanks for going into the previous questions. I have an MAOA polymorphism, so I think that is probably directly relevant to some of my own history of having difficulty dealing with stress and stressful situations. I was wondering if you could go into the connection between that and the gut a little bit more. You've talked about that a little bit I think that there are some important connections in terms of what happens with dopamine, serotonin and the methylation issues on the one hand, and the microbiom in the gut flora on the other. Is there anything else that you'd like to say about that connection?

Dr. Rostenberg: That's a great question Peter. We can kind of articulate all these problems. We can do a genetic report and see all of these things that are just imbalanced and out of whack and it sort of blows your hair back and then you get fried thinking "Well what do I do to fix it! Oh my gosh, it's so complicated!" What I want to share with everyone is people have always been treating their genetic problems. They just didn't know they were. They didn't know they were. When people change their diet and they start detoxifying and doing coffee enemas and repairing their gut and doing yeast cleanses and all these things, when you do that, you've been helping your methylation cycle. When you do that, you've been helping your methylation cycle. When you've been improving your diet and taking supplements, you've been improving your methylation cycle, you just didn't know it.

So that's what the value of this work is, it's wanting to explain why people do what they do and why are some people so much more stressed out than others. And why do some people not tolerate stress.

When we think about stress it can feel like "Well because I have the MAOA gene and because I have the COMT gene I'm always going to be screwed. I'm never going to be able to tolerate stress. I'm just stuck." And it's not true. What happens is you have recognize why your body releases adrenalin in the first place. Does it just do it because it wants to? Of course not! It's getting signals to do this by a very sophisticated set of conditions. So we have to recognize that the immune system is what is the producer of the release of adrenalin in most cases. So most of the adrenalin that gets into our body and most of the alarms that go off in our body are due to chemical messengers released by the immune system.

Your immune system is something that we can modulate. We can control it, turn the temperature up, turn the temperature down, by changing what's going on in our gut. So if we can agree that the immune system is the main player in producing inflammation in our body and it's what's releasing the chemicals that cause our body to react to stress, then we have to recognize that the gut is where about 70-80 percent of the immune system lives. So by getting the gut under control and functional, you're calming down 70-80 percent of the inflammation, probably more than that.

That's why the gut is so key in people who have COMT and MAOA issues because if you have an infection, for example, in your gut, what happens is it's not even that the invading bacteria bothers your body. In fact your body doesn't really get irritated to invading bacteria. What irritates your body profoundly are dead bodies floating around. So it's the dead bacteria. Not to be gross, but think about our realm. People walking around is one thing, but a bunch of dead bodies in your environment is a toxic waste. This decomposing tissue is carrying disease. Well dead bacteria in your body do the same thing and your body's hypersensitive to this.

So when you have a gut infection you get what's called lipopolysaccharides, LPS, and that can trigger high blood pressure, tachycardia, difficulty breathing, panic, insomnia, and the reason it can do all those things is because the dead bacteria irritate your immune system. Your immune system sends the alarm off into the rest of the body and then you get the release of the stress hormones.

So it's like four or five steps removed from where the problem is, where you get the symptoms.

Tiffany: Thanks for elucidating on how important the gut is. That gives me justification for liking to talk about poop so much. (laughter)

Dr. Rostenberg: Yeah, you've got to talk about poop man. Poop's important.

Tiffany: It's important. So any other questions from the peanut gallery? I wanted to get some general treatment protocols. If a patient comes into your office, Dr. Rostenberg, and is complaining of x, y, z symptoms, where do you start?

Dr. Rostenberg: I have one question to ask. The first thing I would talk about is how is their digestion. That's the most important part of the conversation and the reason why is I've got to find out if they've been on antibiotics for 20 years for sinus infection? Even though they're coming in for insomnia or back pain or irritable bowel, they may have just gone through 20 years of taking antibiotics twice a year for sinus infections. That's critical information for me.

So that's where you've got to start. You've got to look at what their complaint is because the nice thing about the body is unlike us, the body's perfect. It's completely perfect. It's just not invincible, but your body's perfect. And it doesn't do things to spite you because it has that attitude, because it needs attention or is playing passive/aggressive. It's giving you symptoms because it's telling you the truth. Our job is just to use some inspiration and wisdom to understand what that symptom really means.

We kind of work backwards from there. That's the game that we play every day. Starting with patients, you've just got to see "How are you pooping? How's your digestion? What's your exposure to antibiotics? How do you sleep?" Sleep is huge. More than any other vitamin, if you want to de-stress yourself, you need to sleep. What the research shows is that melatonin, which we use in our practice all the time, inhibits the release of both cortisol and the catecholamines I was telling you about that come from COMT and MAO problems. So people who are just really overwhelmed with stress, sleep and rest is the antidote to stress.

So the chemical of sleep and rest, melatonin, has biochemical impacts in your body that really do calm down your adrenal system and your stress system profoundly. We talk a lot about sleep and digestion and kind of go from there.

Tiffany: So as far as supplementation, we had a question in our chat room regarding folate versus folic acid and what amounts do you use, what types. I think this question came from Zoya, if I can find the question here. What kind of folate and how much?

Dr. Rostenberg: Zoya, that's a good question. Just remember that folic acid is being produced in your body every day in small amounts from your gut bacteria, so it's not the poison that it's made out to be, but people with MTHFR need to make sure that they don't have high amounts of folic acid. I would never want to take more than a milligram of folic acid every day. And if I ever did, which I probably don't see how I would do that at this point, if I ever did, I would want to make sure that I took three-to-four milligrams of folate to keep the ratios appropriate for methylation. So when you're looking for supplements you want to find supplements that have 5-methyl-tetrahydrofolate when you're supporting your methylation cycle. Those are going to be more body-ready. You're going to be able to get more out of them.

So that's important to recognize. And people with severe methylation issues, the highest amount of folate that we use in our clinic is right around three-and-a-half to four, maybe five milligrams a day. I haven't found that higher doses are necessary.

This is getting a little off-topic, but some individuals, for instance in the autistic population, they actually have antibodies to folate and so what happens is, you can give them all the supplements you want, but the body will not absorb it in the gut and whatever amount that gets into the gut, the brain won't allow it across the blood/brain barrier. So even though they're taking seven or ten milligrams of folate every day, they're hardly getting any into their brain. And that's the case where someone might want to do a trial with folinic acid because folinic acid uses a different carrier and receptor that isn't blocked by the immune system and they've been seeing really good results with folinic acid in people who aren't responsive to methyl folate. But just to keep it simple, always look for methyl folate in your supplements when you're working with MTHFR issues.

I would say everybody out there should limit their exposure to folic acid. Folic acid is in some products and I don't believe that they should be thrown away. I don't have that opinion. You just want to make sure that the ratio of folate to folic acid is 3:1 to 4:1, that you're always getting more folate than folic acid. I would also add that folate comes from leafy greens and vegetables and as I mentioned before, people don't absorb very well so we use a lot of stomach acid support in my office. That's probably the number one product that we use, stomach acid replacement.

Tiffany: Which product in particular do you use? Is it bile or HCL or betaine?

Dr. Rostenberg: Yeah, we use betaine HCL with pepsin. The product we use is called Metagest. It's from Metagenics. It works phenomenally well. I take it every single day at every meal and I have patients taking it. Your stomach requires a massive amount of energy to produce the juices that break your food down. I rarely meet patients who say "Hey doc, I've got so much energy I don't know what to do with it." Most of the time we're dealing with low energy. When you're low energy, when you're not sleeping well, when you're not feeling healthy, there's not going to be a situation where you're feeling tired but your stomach is going to run a marathon for you. It's all going together.

So that's a key piece of advice. You've got to make sure your stomach acid is adequate and optimized. On my website beyondmthfr you can look at protocols. We have a tab for that. I'm trying to share as much as I can with what we do in my office on the worldwide web. My goal with all this work is to have people figure out their help problems as easily as finding a plumber in the phone book. We shouldn't stop until that's been accomplished.

Tiffany: Doug, did you have a question?

Doug: Yeah, I just had a quick question. I'm wondering if, as far as people listening here and getting some ideas and connecting some dots on their own issues, if somebody does have any of the multitude of symptoms that have been mentioned here, is it okay for them to just start experimenting, maybe just start taking some methyl folate or some other methylators, methyl B12, and to see if that improves things, or is it really necessary to go through the whole genetic testing and taking all those kinds of steps?

Dr. Rostenberg: Some doctors might disagree with what I'm going to say, but I don't think that it's necessary for everyone to do the testing. Again, I believe we treat people, not tests and once you understand methylation and you know what you're looking for, you don't need a test. You just look at somebody. Have them walk through the office because they have different shapes to the way their body is or they have a history of cancer, heart disease, depression, or they had pre-eclampsia when they were pregnant with their children, etc.

I don't like ultimatums like that necessarily and I wouldn't say if someone's not interested in knowing all the little ins and outs and details, if that's not how your brain works, you don't need to go through the rigmarole of doing all the testing. Sometimes more information is not better. Look at our culture. We're saturated with information and we're more tuned out than we've ever been. It's almost like information overload. So that's one answer.

And then the other thing of course, doctors who treat themselves have pools for patients too. So you find somebody in your area, you find somebody who's working on this and you support them and what you're doing is you're voting with your dollar to get more people to do it. So that's how you'll change health care. I'm not saying it can't be done by yourself, I'm just saying it can be frustrating.

Tiffany: Well you've already mentioned that a healthy gut is the foundation of a healthy life. A lot of our listeners and myself and the other hosts on the show, follow a variation of the ketogenic diet or paleo diet. What's your thoughts on that kind of diet as far as gut health and methylation goes?

Dr. Rostenberg: I think it's the best type of diet for most people. I have a wonderful staff and on my staff here I have a vegetarian, I have a vegan and then everybody else is kind of the way you've described it. Let me point out that there's a gene that produces choline in our body and this is something that I discovered that I think is kind of interesting. Basically choline prevents fatty liver. So without choline in your body, you will develop fatty liver. You'll develop a lot of other issues as well. But choline is critical for the processing of sugar, converting it into fat and getting the fat out of your liver and to store it in your body. Choline kind of helps you produce cholesterol and all these other things.

The Japanese and the Chinese have almost 90 percent of their population born with very quick choline-producing genes. So what this would mean is that they're able to eat rice and vegetables for years and years and years and never develop fatty liver or any of the high triglycerides and visceral adipose fat that us in the west are facing. So when people in the west eat that way, people in the west have a lot of slow choline-producing genes and that gene is P like Peter, E as in egg, M as in money and T as in Tom, PEMT. That gene produces choline. It's the only way our body does it. There's only one place, that one gene.

What's interesting is that we're born with really crappy PEMT genes and so they're going slower, so we have a higher need for animal products because animals have a lot of choline in them; seafood, beef and eggs are full of choline. So it's just fascinating and that's why we have different dietary requirements. That's why there are tribes in Africa that live on animal blood. They eat a lot of that and they're actually really healthy and people in Indonesia are eating really high carbohydrate diets and they're doing fine. It sounds like the backgrounds of most of the people on this show would work really well with the ketogenic diet. And it's anti-cancer. It's my favourite diet. I can't think of a better all-around diet than to eat a modified paleo, high quality fat, protein and no refined carbs is the way to go, no doubt.

Tiffany: Alright. Yay keto diet! Doug, did you have a follow-up question?

Doug: I have a follow-up question from my last one. I was talking about somebody on the opposite end of the spectrum, who wasn't interested in doing all the genetic testing. If somebody was interested in mapping their genome and seeing these kinds of things, how would one go about that?

Dr. Rostenberg: Well it's pretty simple. The best place to do it financially and probably the best amount of information is the 23andMe. Again, I personally opted out of research. It's a privacy thing, but honestly if the powers that be want to get your DNA they don't have to try that hard. They're going to get it. So you can be paranoid about it or you can just have an open mind and say "Okay, I'm doing this for my own spiritual education to learn about myself and health and wellness" and if you approach it that way it makes sense.

So 23andMe is the way to go. It's super inexpensive. It's $99, $10 for shipping. They break your genes down completely. They tell you who you're related to. They give you some really good information on your family history. What you need to ignore is your risk of diseases because people with certain genes have a higher risk, but don't let what 23andMe tells you influence your mind. You have to learn how to read your own genetic report and make sense out of it.

But what you do is you do 23andMe, it takes about a month to get the report back and you download your raw data. So you download this huge file of scientific nomenclature and garbledegook. It doesn't make any sense. Then you upload it to another website that I've worked with and admire the effort they've made to raise awareness is MTHFRSupport and you'll find their Facebook page. I post on that page. I'm an administrator on their website. They've been doing a really good job raising awareness and they build a report.

So long answer to a short question - do your genetic report, 23andMe, four weeks later you log in, download your raw data, you upload it to another website. You pay $30 and they have a colour-coded, easy-to-read report that's going to be where someone like myself - that's what we ask our patients to get if they want us to go over their genes. We work off that and we can map out where their big roadblocks are and it's the best report.

Tiffany: Okay. 23andMe if anybody wants to get tested. Dr. Rostenberg, a couple of times in the show you mentioned a spiritual side to working on your own health and improve your daily functioning. Is there anything more that you wanted to mention in that direction?

Dr. Rostenberg: That's a pretty good question. I think that at the end of the day we're talking to a group of people who are passionate about educating people, the alternative media and I think that you have to own your health care. You have to be your own bank, army and doctor a lot of times. You really have to take your health into your own hands and that's an active responsibility. I'm a parent and having kids is stressful in the beginning but then you see the joy and the love that it brings into your life so I kind of think that every time we take responsibility for something, our ego or something gets afraid of losing our self - whatever goes on in our mind that we have apprehension about.

But I really want to encourage people to take responsibility for your health. I don't believe in victimness. I think being a victim is the biggest poison you could ever give somebody and if you don't like the way your health is then you should get pissed off and do something about it. This is a good place to start, but it's not required. I think the genetic information is an emerging field. It's a new field. That's where I get the joy out of it because, as I mentioned, I like solving problems. I'm self-taught. This is just a drive to understand how things work and it keeps me going and we've been able to see some really amazing results with patients.

But at the end of the day it's not the money in your bank account, it's not the car you drive, it's not the $10,000 vacation to Hawaii because you may be more stressed out when you come back from that vacation. No good vacation goes unpunished guys. It's not like you can take a vacation from who you are. Own your health. That's what I want to say. The more people that stand up and take advantage of their health, the better off we are and there's never been a better time to get information on how to get healthy.

The take-aways from today are to start with your gut, whether you want to nerd out on genetics with me and talk to me on the phone and have me help you guide you through your genetic report, I'm happy to do that, but you should check out my website beyondMTHFR.com. We're going to be upgrading it soon to make it even more user-friendly. I'm giving all my information away for free. I want to educate people and share my thousands of hours of study into a 10-minute video and a little blog post.

Start with your gut and have gratitude in your life because at the end of the day, you don't just swallow food. You swallow ideas and you swallow thoughts, so be careful what you're swallowing. If it gives you indigestion you probably shouldn't eat it. You know what I mean?

Tiffany: Yeah.

Dr. Rostenberg: I just want to thank you guys for having me on and I really hope this brought some value to your audience. It's an exciting time to be looking into this type of health care.

Tiffany: Well thank you so much for being on. It was very enlightening. I feel much smarter just from having talked to you. (laughter)

Doug: Yeah.

Tiffany: Peter wants to ask one more question.

Peter: Yeah, thank you Tiffany. Dr. Rostenberg, how are you doing on time? Do you need to go soon or do you have time for one or two more questions?

Dr. Rostenberg: I've got time for a few more questions. I have to be out of here in about 15 minutes. How's that?

Peter: Okay, great. Maybe it would make sense for me to list a few topics I would like to ask about and maybe you can just comment on them according to how much time you've got on your end? One of the things that I've got in mind is we've been doing some research on chronic infection recently and so I'm interested in asking if you have any comments on the relationship between methylation blockages and chronic infection. I also wanted to ask just briefly if you could say anything about heavy metal toxicity and pyroluria.

Dr. Rostenberg: Sure. I'll start with the infection part. A large percentage of our patients seek us out because they're dealing with something like Lyme disease or some other problems. Oftentimes people want a label because a label give them comfort in at least having a name to call it. It's like going into the doctor and saying "I have a headache" and he looks at you and tells you something in Latin. He says "You have a migraine." You go "Ah, I have a migraine!" And just getting the label kind of helps our little monkey brain calm down a little bit.

The reason I'm saying this is yes, chronic infections are a big part of peoples' life in our society. When our body becomes stressed out, the body has a pre-programmed set of responses. So it goes into chronic survival mode, it pushes blood away from our gut to try and get blood into the muscles and activate energy so that we can run for our life or fight for our life. That's hardwired into who we are.

The chronic infections come around because our body's under chronic stress and when we have methylation issues we don't have the flexibility that other people have. That's really what having an MTHFR problem means. It means that your body, when under stress, is less flexible, less quick, to put resources into a certain area and so the infection will be able to grow while your body's trying to get the resources over there to fight it.

Virus infections are a big problem as well because, remember viruses put their DNA into our DNA and if we cannot put the methyl group on top of the viral DNA then the virus is more likely to continue to proliferate in our body. So especially with viruses, and that would also relate back to cancer - cancer and viruses share that in common, it's sort of the DNA that we have that we would like to silence that we're unable to silence very well. I mentioned Lyme disease and I'm not trying to put anyone down for looking for that answer. I've never met a patient who said "I had Lyme disease and I took the antibiotics that they gave me for Lyme disease and I felt better." It's always "I was treated for Lyme's and it destroyed my gut. They gave me IV antibiotics, tonnes of antibiotics for six months." It's like "My gosh! Maybe we need to just get you healthier and optimize your methylation cycle and get your gut working and then your own immune system will kill Lyme disease." And it will.

So that's the point I'm trying to make. We built pyramids. We mapped the stars. We sailed around the world. People live 110, 115 years. We have the potential inside of us to do anything and when you optimize your methylation cycle, you optimize your genes and you optimize your life and your immune system can kill anything. It can kill anything. When I see chronically ill people there's chronic infections, as I mentioned. It's usually only the gut, but there are those individuals who have more of the deeper infections in their body and as I mentioned in the beginning too, that if we take vitamin C, zinc and selenium for our immune system when we have a cold. Optimizing your methylation cycle and improving your glutathione not only helps your immune system fight all your infections, it's also what's required to combine with heavy metals.

I want to mention that we're all exposed to heavy metals. One problem with heavy metals is they act like estrogen. So when lead, arsenic, tin, cadmium, aluminium and mercury are in your body they will actually bind in the nucleus of your cell in the same location as estrogen. So we see a population-wide feminization of our whole species. That's just the observation of fact. You see women with really bad estrogen-related problems. There's a lot of estrogen-related cancers and a lot of that has to do with heavy metals. I'm pointing this out to your listeners to start to think about people who have estrogen-related problems, low testosterone, high estrogen, heavy bleeding, fibroids and endometriosis, that kind of thing. They also need to do heavy metal detoxification.

Optimizing your methylation cycle allows you to do that. Your body makes a protein called metallothianine and that is a metal-binding enzyme that escorts the metal out of the cell. Glutathione does the same thing. It binds with the metal and it is escorted out of the cell to the liver where it gets pushed into the bile. So when you look at your body and you think of the ways that you get rid of heavy metals, the bile is by far and away the main way. But what do we have problems with in our culture? We have bad stomachs. We have bad gallbladders. So it's all going back to digestion again. When your stomach doesn't produce acid, the food that leaves your stomach is not acidic. If the food that leaves your stomach is not acidic, the gallbladder never gets the chemical and neurological signal to squeeze so it never releases its bile very much.

Without releasing bile you do not remove the heavy metal from your body. So what will happen to heavy metals is, it gets into your bile and it goes into your gut and then it gets sucked back into your body and it re-circulates because 95 percent of your bile that's released during a meal is reabsorbed. That way your body doesn't have to waste energy making it over and over again from scratch. Everything happens for a reason. Your body's perfect and smarter than we are.

So what we do for heavy metal detox Peter, and it's a good question, we use products that increase metallothianine. So it'll increase the excretion of mercury about 900 percent over placebo. So it's really good at getting rid of mercury. I don't do chelation in my office. It's just not something I've embarked on yet. I like to do all the fundamental stuff first and take it a little slower with people. But one thing we do use to help with heavy metals, and for your audience, is to take a really high quality charcoal. The kind we use in our office is from bamboo. It's a bamboo charcoal and as that bile gets released and the charcoal in your gut comes into contact with the metals that are in the bile, it will bind that metal and not allow it to be reabsorbed into your gut. So essentially that's how you draw metals out of your body. You keep your digestion working and as the bile is released you try to bind the metal in your gut to poop it out. That does remove the metals from your body.

Tiffany: So that's a charcoal product that you use?

Dr. Rostenberg: People can probably look it up online and find it. I don't have a store for them to go to right off the bat, but it's called Takesume and it's from Japan. It's the cleanest, purest bamboo charcoal stuff. It's really cool stuff. When I can see someone in person - we do a lot of work over the phone, we have a lot of people do a lot of tests. People send me 60 pages of the lab tests, urine, stool, organic acid test. The organic acid test is a really good way to look for chronic infections because they look in the urine for metabolites of bacteria and fungus. So we can work backwards and say "This stuff is spilling into the urine. If you've got high arabinose in your urine, you've got high benzoic acid in your urine, you've got bacteria in your gut and in your body that's polluting the tissues of your body and interfering with the brain's breakdown of neurotransmitters.

The more we zoom in, the more we can talk about, but oxalate problems are another issue we have. You mentioned pyroluria which is really a chronic deficiency of B6 and zinc. I'm going back to the gut again. As your bile stops being released, what happens is the fat in your diet, the olive oil in your salad, the coconut oil from your sautéed vegetables, etc., do not get absorbed. No bile in your gut means no fat being absorbed, not very much anyway.

Normally if your fat's absorbed, then that allows the calcium that you ate in your diet to get absorbed further down in your gut. And the calcium in your diet will bind with oxalates. This may be a new term for a lot of people, but oxalates are produced inside your body and they also come from food, especially healthy food like blueberries, spinach and kale. There's a lot of oxalates in those foods. Some people are juicing that stuff every day all day long.

So the moral of the story is that your gallbladder shuts down and stops working because you have methylation issues and you've got hormone imbalance. Now you start eating food that you're not going to absorb. So the fat in your diet binds with the calcium in your diet and you poop both of those out. So now you poop out your fat and you poop out your calcium. And what do women often develop, and even men? We often develop gallbladder problems and osteoporosis. And now because the calcium's being pooped out with the fat you'll see the low vitamin D because they can't absorb vitamin D if they can't absorb fat along with vitamin A, vitamin E and vitamin K. Then you also see that the oxalate levels in the body start going up and then you end up with kidney stones in a lot of people. And the kidney stone is a side effect of the gut not absorbing fat because normally your calcium should bind with the oxalate and get pooped out.

I'm throwing a tonne at everybody and this is again, thousands of hours of research, years of work to get all these pearls. But the pyroluria in my mind is really just a lot of funding of somebody who's B6 and zinc deficient. It's not really an inherited problem with their metabolism. These people who develop oxalate problems are going to be very rapidly depleted of B6 so you can see that could in itself lead to a pyroluria-type problem.

So I guess in order of importance in my office: how's your gut working, how are you sleeping. Then we look at oxalate problems. People with oxalate issues have to have that treated first. You have to get the gut functioning better before you can start dumping in methylation support because you can't throw a fertilizer on top of weeds. You have to clean the garden up, remove the weeds, till the soil, get the plants where you want them and the healthy kind that you want and take care of them. Then you can throw fertilizer on. But you've got to do that step first.

Tiffany: Great. I know you only have a few minutes so I wanted to thank you again for coming on the show. And if people wanted to find out more about you and your practice at the Red Mountain Clinic in Boise, can you mention your website again?

Dr. Rostenberg: Absolutely. I have two websites. One is my practice and gives you information about my physical office here. That's redmountainclinic.com. But the one that's my work of love, sweat and tears is the beyondMTHFR.com. Of course that title tells you what it's about. It's not just about the MTHFR gene polymorphism, it's about how your genes influence your health and how to optimize your genes. For those who want to do research, that's the place to investigate because there's hours of videos there, thousands and thousands of words of research that I've shared and continue to share. So that's the place to learn more. There's contact info on either site. So I'd love to talk to anybody in the audience who would like help navigating their health and wellbeing. We work with people all over the country and all over the world via phone or Skype and have people travelling to see us as well.

Tiffany: So they can find information about arranging for a phone consultation at your Red Mountain Clinic website?

Dr. Rostenberg: Yes ma'am. That's the best place to do that.

Tiffany: Okay. Well do you have time for one more quick question?

Dr. Rostenberg: I can do one then I've got to roll.

Tiffany: Quickly, Peter.

Peter: I just wanted to end on what I hope might be a fun and interesting question. We've talked about the what and we've talked about the how but we haven't really addressed the why. I've wondered, why do these polymorphisms happen in the first place? Where do they come from? Zoya mentioned an article last week where there is a group in Europe that has some polymorphisms that have to do with energy conservation, which is great when you don't have enough to eat, but when you do it makes problems for you in terms of obesity. So could these have some sort of adaptive function? Do you have any idea why these things might exist in the first place?

Dr. Rostenberg: Well you know there's a phrase in investing that says when the tide goes out you'll find out who's naked. I believe that if we look at that from a health point of view and we say when the environment is full of nutrients and full of things that nourish us like glacial melt water and pure spring water and artesian wells and organic food, this is how our ancestors lived every day of their life. It didn't matter that your methylation cycle was going slower because you were eating methylation-dense food every meal, every day, all day long. It didn't matter. It's just that it's reflecting back to us what our toxic, sick world has done to our bodies. So you start depleting the food supply and creating all these chemicals that require more vitamins to remove from our body.

So before we had petrochemical industries, we didn't get exposed to all the chemicals that we are exposed to. Every time you inhale a molecule of stain remover or put something under your arm that's a toxic carcinogen, your body has to spend nutrition out of its account and it's forever lost, to try to get rid of that chemical. So we deplete our body of nutrition by the toxic situation that we're in. So I actually don't think there is any reason for the polymorphism except that it didn't actually create a problem when we were thoroughly nourished and eating all of the foods that our ancestors were developed on.

It may just be the case of mother nature creating abundance. She creates lots of different versions of the same thing just to hedge her bets against survival in different circumstances. Obviously people with the methylation problems are not the best to survive the world we've created so we really need to do some work cleaning it up. And it starts with our own cells. That's the way I would answer that question, I just think it didn't matter Peter. The world was so rich with nutrition in most cases, that it didn't matter. It wasn't selected against as we had children over and over and over again.

Peter: Great. Thank you Dr. Rostenberg for taking that last question.

Dr. Rostenberg: No problem. Thank you again for having me.

Tiffany: Thanks for being on the show again Dr. Rostenberg. Your website is beyondMTHFR.com. People can also find you at the Red Mountain Clinic in Boise and that's redmountainclinic.com. Thanks for being on the Health and Wellness Show. We really appreciate it.

Dr. Rostenberg: Thanks for having me and I hope you guys have a great weekend and we'll talk soon. Thanks so much.

Doug: Thank you.

Dr. Rostenberg: Take care. Bye-bye.

Peter: Thanks so much.

Tiffany: Okay guys. That was very, very enlightening and interesting. We do have the pet health segment that we want to air for you, Zoya's pet health segment. It's on strange behaviour in your pets.

Zoya: Hello and welcome to the pet health segment of the Health and Wellness Show. Today, instead of sharing information on a specific topic with you, I'm going to allow someone else to do it. The other day I stumbled on a very interesting video about mental illness or disturbance in animals. It is a recording of a Ted Talk. Ted stands for technology, entertainment, design and it is a global set of conferences that run under the slogan "Ideas Worth Spreading". The speaker of the show's lecture is Laurel Braitman who is a science historian and holds a PhD in history and anthropology of science from MIT and is the author of Animal Madness, a book that takes a close look at our non-human friends and their mental anxieties. In the recording she delves into the history of mental illness in animals revealing the world of parrots that pluck themselves, cats with PTSD, donkeys with a deep neurosis, compulsive bears, self-destructive rats or monkeys with unlikely friends and she asks what we as humans can learn from watching animals cope with depression, sadness and other all-too-human problems. Enjoy!


Oliver was an extremely dashing, handsome, charming and largely unstable male that I completely lost my heart to. (laughter) He was a Bernese Mountain Dog and my ex-husband and I adopted him and about six months in we realized that he was a mess. He had such paralyzing separation anxiety that we couldn't leave him alone. Once he jumped out of our third floor apartment. He ate fabric. He ate recyclables. He hunted flies that didn't exist. He suffered from hallucinations. He was diagnosed with a canine compulsive disorder and that's really just the tip of the iceberg.

But like with humans, sometimes it's six months in before you realize that the person that you love has some issues. And most of us do not take the person we're dating back to the bar where we met them or give them back to the friend that introduced them or sign them back up on match.com. We love them anyway and we stick to it. And that is what I did with my dog.

I'd studied biology. I have a PhD in history of science from MIT and had you asked me 10 years ago if a dog I loved, or just dogs generally, had emotions I would have said yes but I'm not sure that I would have told you that they can also wind up with an anxiety disorder, a Prozac prescription and a therapist. But then I fell in love and I realized that they can. In actually trying to help my own dog overcome his panic and his anxiety, it changed my life. It cracked open my world.

I spent the last seven years actually looking into the topic of mental illness in other animals. Can they be mentally ill like people and if so, what does it mean about us? What I discovered is that I do believe they can suffer from mental illness and actually looking and trying to identify mental illness in them often helps us be better friends to them and also can help us better understand ourselves.

So let's talk about diagnosis for a minute. Many of us think that we can't know what another animal is thinking and that is true, but any of you in relationships - at least this is my case - just because you ask someone that you're with or your parent or you child how they feel, doesn't mean that they can tell you. They may not have words to explain what it is they're feeling and they may not know. It's actually a pretty recent phenomenon that we feel that we have to talk to someone to understand their emotional distress.

Before the early 20th century physicians often diagnosed emotional distress in their patients just by observation. It also turns out that thinking about mental illness in other animals isn't actually that much of a stretch. Most mental disorders in the United States are fear and anxiety disorders. When you think about it fear and anxiety are actually really extremely helpful animal emotions. Usually we feel fear and anxiety in situations that are dangerous and once we feel them we then are motivated to move away from whatever is dangerous.

The problem is when we begin to feel fear and anxiety in situations that don't call for it. Mood disorders too, may actually just be the unfortunate downside of being a feeling animal. And obsessive/compulsive disorders also are often manifestations of a really healthy animal thing which is keeping yourself clean and groomed. This tips into the territory of mental illness when you do things like compulsively over-wash your hands or paws, or you develop a ritual that's so extreme that you can't sit down to a bowl of food unless you engage in that ritual.

So for humans, we have the Diagnostic and Statistical Manual which is basically an atlas of the currently agreed upon mental disorders. In other animals we have YouTube. (laughter) This is just one search I did for OCD dogs, but I encourage you to look at OCD cats. You will be shocked by what you see. I'm just going to show you just a couple of examples.

This is an example of shadow chasing. I know, it's funny and in some ways it's cute. The issue though is that dogs can develop compulsions like this that they then engage in all day. So they won't go for a walk. They won't hang out with their friends. They won't eat. They'll develop fixations like chasing their tails compulsively.

Here's an example of a cat named Gizmo. He looks like he's on a stakeout but he does this for many, many hours a day. He just sits there and will paw and paw and paw at the screen. This is another example of what's considered a stereotypic behaviour. This is a sun bear at the Oakland Zoo named Tingting. And if you just sort of happened upon the scene, you might think that Tingting is just playing with the stick, but Tingting does this all day. And if you pay close attention and if I showed you guys the full half hour of this clip, you'd see that he does the exact same thing in the exact same order and he spins the stick in the exact same way every time.

Other super common behaviours that you may see particularly in captive animals are pacing, stereotypic or swaying, stereotypic. And actually humans do this too and in us we'll sway, we'll move from side to side. Many of us do this. And sometimes it's an effort to sooth ourselves and I think in other animals that is often the case too.

But it's not just stereotypic behaviours that other animals engage in. This is Gigi. She's a girl that lives at the Franklin Park Zoo in Boston. She actually has a Harvard psychiatrist and she's been treated for a mood disorder, among other things. Many animals develop mood disorders. Lots of creatures - this horse is just one example - develop self-destructive behaviours. They'll gnaw on things or do other things that may also soothe them, even if they're self-destructive, which could be considered similar to the way that some humans cut themselves.

Plucking! It turns out if you have fur or feathers or skin, you can pluck yourself compulsively. Some parrots actually have been studied to better understand trichotillomania or compulsive plucking in humans, something that affects 20 million Americans right now. Lab rats pluck themselves too. In them it's called barbering.

Canine veterans of conflicts of Iraq and Afghanistan are coming back with what's considered canine PTSD and they're having a hard time re-entering civilian life when they come back from deployments. They can be too scared to approach men with beards or to hop into cars.
I want to be careful and be clear though. I do not think that canine PTSD is the same as human PTSD but I also do not think that my PTSD is like your PTSD or that my anxiety or that my sadness is like yours. We are all different. We also all have very different susceptibilities. So two dogs, raised in the same household, exposed to the very same things, one may develop a debilitating fear of motorcycles or a phobia of the beep of the microwave and another one is going to be just fine.

So one thing that people ask me pretty frequently is "Is this just an instance of humans driving other animals crazy or is animal mental illness just a result of mistreatment or abuse?" And it turns out we're so much more complicated than that.

One great thing that has happened to me is that recently I published a book on this and every day now that I open my email or when I go to a reading or even when I go to a cocktail party, people tell me their stories of the animals that they have met. Recently I did a reading in California and a woman raised her hand after the talk and she said "Dr. Braitman I think my cat has PTSD." And I said "Well why? Tell me a little bit about it."
So Ping is her cat. She was a rescue and she used to live with an elderly man. One day the man was vacuuming and he suffered a heart attack and he died. A week later Ping was discovered in the apartment alongside the body of her owner and the vacuum had been running the entire time. For many months, up to I think two years after that incident, she was so scared she couldn't be in the house when anyone was cleaning. She was quite literally a scaredy cat. She would hide in the closet, she was unself-confident and shaky. But with the loving support of her family, a lot of time and their patience, now three years later she's actually a happy, confident cat.

Another story of trauma and recovery that I came across was actually a few years ago. I was in Thailand to do some research. I met a monkey named Boonlua. When Boonlua was a baby, he was attacked by a pack of dogs and they ripped off both of his legs and one arm. Boonlua dragged himself to a monastery where the monks took him in. They called in a veterinarian who treated his wounds. Eventually Boonlua wound up at an elephant facility and the keepers really decided to take him under their wing and they figured out what he liked which turned out was mint Menthos and rhinoceros beetles and eggs.

But they worried because he was social, that he was lonely. They didn't want to put him in with another monkey because they thought with just one arm he wouldn't be able to defend himself or even play. So they gave him a rabbit. And Boonlua was immediately a different monkey. He was extremely happy to be with this rabbit. They groomed each other. They became close friends and then the rabbit had bunnies. And Boonlua was even happier than he was before and it had in a way, given him a reason to wake up in the morning and in fact it gave him such a reason to wake up that he decided not to sleep.

He became extremely protective of these bunnies and he stopped sleeping. He would sort of nod off while trying to take care of them. In fact he was so protective and so affectionate with these babies that the sanctuary eventually had to take them away from him because he was so protective he was worried that their mother might hurt them.

So after they were taken away the sanctuary staff worried that he would fall into a depression and so to avoid that, they gave him another rabbit friend. My official opinion is that he does not look depressed.

So one thing that I would really like people to feel is that you really should feel empowered to make some assumptions about the creatures that you know well. So when it comes to your dog or your cat or maybe your one-armed monkey that you happen to know, if you think that they are traumatized or depressed, you're probably right. This is extremely anthropomorphic or the assignation of human characteristics onto non-human animals or things.

I don't think though that that's a problem. I don't think that we cannot anthropomorphize. It's not as if you can take their human brain out of your head and put it in a jar and then use it to think about another animal thinking. We will always be one animal wondering about the emotional experience of another animal.

So then the choice becomes how do you anthropomorphize well or do you anthropomorphize poorly. Anthropomorphizing poorly is all too common. It may include dressing your corgis up and throwing them a wedding or getting too close to exotic wildlife because you believe that you have a spiritual connection. There's all manner of things.

Anthropomorphizing well however, I believe is based on accepting our animal similarities with other species and using them to make assumptions that are informed about other animals' minds and experiences. There's actually an entire industry that is in some ways based on anthropomorphizing well and that is the psychopharmaceutical industry. One in five Americans is currently taking a psychopharmaceutical drug, from the antidepressants and anti-anxiety medications to the anti-psychotics. It turns out that we owe this entire psychopharmaceutical arsenal to other animals. These drugs were tested in non-human animals first, and not just for toxicity but for behavioural effects.

The very popular anti-psychotic Thorazine first relaxed rats before it relaxed people. The anti-anxiety medication Librium was given to cats selected for their meanness in the 1950s and made them into peaceable felines. Even antidepressants were first tested in rabbits.

Today however we are not just giving these drugs to other animals as test subjects but we're giving them these drugs as patients, both in ethical and much less ethical ways. Seaworld gives mother orcas anti-anxiety medications when their calves are taken away. Many zoo gorillas have been given anti-psychotic and anti-anxiety medications. But dogs like my own Oliver are given antidepressants and some anti-anxiety medications to keep them from jumping out of buildings or jumping into traffic.

Just recently actually a study came out in Science that showed that even crawdads responded to anti-anxiety medication. It made them braver, less skittish and more likely to explore their environment.

It's hard to know how many animals are on these drugs but I can tell you that the animal pharmaceutical industry is immense and growing. From $7 billion in 2011 to a projected $9.25 billion by the year 2015.

Some animals are on these drugs indefinitely. Others like one bonobo who lives in Milwaukee at the zoo there was on them until he started to save his Paxil prescription and then distribute it among the other bonobos.

More than psychopharmaceuticals though there are many, many, many other therapeutic interventions that help other creatures. And here is a place where I think actually the veterinary medicine can teach something to human medicine, which is, if you take your dog who is say, compulsively chasing his tail, into the veterinary behaviourist, their first action isn't to reach for the prescription pad. It's to ask you about your dog's life. They want to know how often your dog gets outside. They want to know how much exercise your dog is getting. They want to know how much social time is spent with other dogs and other humans. They want to talk to you about what sorts of therapies, largely behaviour therapies, you've tried with that animal. Those are the things that often tend to help the most, especially when combined with psychopharmaceuticals.

The thing though I believe that helps the most, particularly with social animals, is time with other social animals. In many ways I feel like I became a service animal to my own dog. And I have seen parrots do it for people and people do it for parrots and dogs do it for elephants and elephants do it for other elephants. I don't know about you, I get a lot of internet forwards of unlikely animal friendships. I also think it's a huge part of Facebook; the monkey that adopts the cats or the great Dane who adopted the orphaned fawn or the cow that makes friends with the pig.

Had you asked me eight or nine years ago about these, I would have told you that they were hopelessly sentimental and maybe too anthropomorphic in the wrong way and maybe even staged. What I can tell you now is that there is actually something to this. This is legit. In fact some interesting studies have pointed to oxytocin levels which are a kind of bonding hormone that we release when we're having sex or nursing or around someone that we care for extremely. Oxytocin levels raise in both humans and dogs who care about each other or who enjoy each others' company. And beyond that other studies showed that Oxytocin raised even in other pairs of animals. So say in goats and dogs who were friends and played with each other, their levels spiked afterwards.

I have a friend who really showed me that mental health is in fact a two-way street. His name is Lonnie Hodge and he's a veteran of Vietnam. When he returned he started working with survivors of genocide and a lot of people who had gone through war trauma and he had PTSD and also a fear of heights because in Vietnam he had been rappelling backwards out of helicopters over the skids. He was given a service dog named Gander, a labradoodle, to help him with PTSD and his fear of heights. This is them actually on the first day that they met, which is amazing.
Since then they've spent a lot of time together, visiting with other veterans suffering from similar issues. But what's so interesting to me about Lonnie and Gander's relationship is about a few months in, Gander actually developed a fear of heights, probably because he was watching Lonnie so closely.

What's pretty great about this though is that he's still a fantastic service dog because now when they're both at a great height, Lonnie is so concerned with Gander's well-being that he forgets to be scared of the heights himself.

Since I've spent so much time with these stories, digging into archives, I literally spent years doing this research, it's changed me. I no longer look at animals at the species level. I look at them as individuals and I think about them as creatures with their own individual weather systems guiding their behaviour and informing how they respond to the world. And I really believe that this has made me a more curious and a more empathetic person, both to the animals that share my bed and occasionally wind up on my plate but also to the people that I know who are suffering from anxiety and phobias and all manner of other things.

I really do believe that even though you can't know exactly what's going on in the mind of pigs or your pug or your partner, that shouldn't stop you from empathizing with them. The best thing that we could do for our loved ones is perhaps to anthropomorphize them. Charles Darwin's father once told him that everybody could lose their mind at some point. Thankfully we can often find them again, but only with each others' help. Thank you.

Tiffany: Thanks for sharing that Zoya. That was very interesting. I never even thought about dogs and cats having PTSD but there you go. So we've come to the end of our show. I want to thank Dr. Andrew Rostenberg again for being a guest and sharing so much about MTHFR and methylation. His website again, is beyondMTHFR.com or you can find the website for his clinic at redmountainclinic.com. And on that site you can find information on how to do a phone consult if you would like.

I want to thank our guest co-hosts, Tom and Peter. Thanks for being on the show and sharing your experiences with MTHFR.

Peter: Thanks for having us.

Tom: Thanks.

Tiffany: Sure. Any time if you want to be a guest co-host, just let us know. Thanks to our chatters. We'll be back next Friday at 10:00 a.m. eastern standard time. Be sure to check out The Truth Perspective Saturday at 2:00 p.m. eastern standard time and Behind the Headlines on Sundays at 12:00 p.m. eastern standard time. Everybody have a great weekend and that's our show for today.