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Common MTHFR-only approach An MTHFR variant is identified Methylfolate or folinic acid is recommended Anxiety, insomnia or depression worsens The reaction is labeled detox The actual biochemical pattern remains unidentified More complete functional approach Review the mood, anxiety and behavioral phenotype Assess previous reactions to folate and methyl donors Measure whole blood histamine and SAM/SAH Evaluate homocysteine, copper, zinc and pyrroles Consider inflammation, gut health and toxic burden Select nutrients according to the complete pattern Where Folate Reactions Fit Within the Five Walsh Biotypes The Walsh Approach does not ignore genetics

In 1973, Engel and Angelini reported the first case of L-carnitine deficiency and treated it with carnitine