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Case study protocol

A non-exhaustive list of case study protocol is given below.

In many cases, we provide detailed information about the case study, including PRISM language source code and experimental results. For others, we just include links to the relevant publication. We are always happy to include details of externally developed case studies. If you would like to contribute content about your work with PRISM, or you want us to add a pointer to a publication about your PRISM-related work, please contact us. If you are interested in PRISM models for the purposes of benchmarking, see also the PRISM benchmark suite. You can find a wider selection of benchmarks, for all models, in the PRISM benchmark suite. I am going to share with you a classic situation which happens all the time.

I hear it a few times a week while working with clients and guiding various doctors. A gentleman with MTHFR homozygous C677T, in his 60’s, is experiencing symptoms of depression and fatigue. Yesterday, I consulted with him for the first time. His physician prescribed Wellbutrin, Armour Thyroid and Arimidex.

Then, his physician prescribed methylfolate without tapering down the medications. June 25, 2:46 PM:  I think you are going to have to taper down on your thyroid, Arimidex and Wellbutrin once you begin methylation. You’ll have to have your physician monitor and help you with this. June 27, 4:03 PM: Well if I wasn’t a case study protocol before I am now! I felt better almost immediately after restarting the methylfolate at 400 mcg.

Short case study

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This morning I felt a bit anxious so I took 50 mg niacin and felt calmer within the hour. I spoke with my psychiatrist this morning and he said that the methylfolate will boost the effectiveness of the Wellbutrin, but I suspect that it’s reacting more with the Armour and making me hyperthyroid. That’s easy to test though so if it persists I’ll do a lab to see. This is a classic balancing act between how much methylation is ideal. You can see exactly how fast the balance can shift. First, the client is obviously undermethylated due to his symptoms so his doctor appropriately addressed it through prescribing methylfolate and methylcobalamin.

The only issue is the doctor did not realize how effective methylation is at supporting neurotransmitters and thyroid hormone production. Then, upon restarting the methylfolate and methylcobalamin, and maintaining his current dosage of medications, he felt great for a few hours. Then anxiety hit due to excessive neurotransmitter production and likely thyroid hormone production. I told him about how niacin works and how to take it and his anxiety decreased almost immediately. There is no set MTHFR protocol for anyone. You’re likely wondering why niacin was so effective at reducing this gentleman’s anxiety. I’ll let you in on the secret and wonderful actions of biochemistry.

SAMe is a major methyl donor. Thus, when one consumes niacin, SAMe gets used up and methyl donors drop. Nicotinic acid also supports the elimination of glutamate. Many with elevated levels of glutamate do not do well with methylfolate or any type of folate until the levels of glutamate are balanced. Niacin supports the feedback inhibition of the IDO1 gene which feeds into the kyurenine pathway. This pathway can deplete one’s tryptophan levels which makes them low in serotonin.

The niacin slows the loss of tryptophan by pushing it towards serotonin formation. Share your stories and experiences of undermethylation and overmethylation. Did it happen to you in the same day as well? Hi Doctor Ben, I have a heterozygous mutation for the C677t and A1298, I started on 200mcg of 5mthf, then after a week moved up to 400 mcg and stayed on that for a week or so. I then added 1 mg of methylb12 and had some adverse reactions.

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