P: 281-298-6742 | F: 281-419-1373|info@TWIHW.com

COMT, MAO, and GAD, Oh MY!

By Brad Mullens, SNP Specialist

You’re lying in bed and it’s after midnight.  Your brain will not shut off and you’re anxious about not getting a good night’s sleep again or worried about what tomorrow may bring.  You have taken your melatonin, gotten plenty of exercise that day, and are eating healthy.  You ask yourself, what am I doing wrong?  Is this a hormone related issue? Did I have too much caffeine?  Questions and thoughts pepper you brain and you are so tired of feeling the anxiety, sleep deprivation and the worry about what else may be going on.

Genetic testing of key genes can give your doctor the clues to help you create a workaround for genetic mutations otherwise known as SNPs (Single Nucleotide Polymorphisms).  A SNP is a small mutation of a gene that creates weaknesses in the structure and function of proteins or enzymes, which, in turn, causes them to not work properly at the cellular level.

When you understand the “why” behind the annoying symptoms above that typically involve several genes like the MAO-A&B, COMT, and GAD1, you will be empowered with knowledge that you are not alone and that there are solutions to the problems.  These SNPs affect the turnover of neurotransmitters dopamine and serotonin which can lead to difficulty regulating mood, behavior, stress level, focus, and sleep patterns.  These mutations also lead to buildup of glutamate, which is an excitatory neurotransmitter, and lower levels of GABA, which is inhibitory (think ‘calming’), and this leads to imbalances with several systems in the body.  When specially trained healthcare providers can see your genetic makeup, treatment plans can be more precise and more personalized. By recommending natural ingredients that bind to specific receptors on certain cells, amazing improvements with mood, sleep, energy levels, and focus can result.

If you’re a patient at The Woodlands Institute for Health and Wellness, talk to your provider there about genomic testing.  If you are not yet a patient there and don’t have a healthcare provider who offers this test, you can visit www.snpspecialist.com for more information on how to get tested.

In good health!

Brad Mullens

By |2020-07-07T09:51:13-06:00June 5th, 2020|Articles, General|

“I am already feeling like a new person.”

I am already feeling like a new person.

“Here is the good part, I am already feeling like a new person. I am amazed that I am not far along with the protocol and I have great energy, no depression at all, I am able to take care of my four year old grandson and do the routine chores here since my daughter has started a high pressure new job. I am doing good on the diet and feel I am starting to lose some weight.”
– L.P.

By |2019-11-25T16:12:04-06:00September 20th, 2019|General, Testimonials|


By Dyvette Warren, PA-C

Edited by Mila McManus MD


Beginning in the womb, and throughout your life, your personal health and happiness, mental capabilities, and propensity for disease are heavily influenced by genetic as well as non-genetic factors, including DNA mutations, nutrition, exposure to microorganisms and toxins, stress, and other environmental conditions.

If you suffer with, or have a history of, migraines, depression, insomnia, anxiety, Alzheimer’s, chemical sensitivities, arthritis, pain, IBS(irritable bowel syndrome), heart disease, stroke, DVT(deep venous thrombosis, ie: blood clot), pulmonary embolism(blood clot in the lungs), side effects with hormones (e.g., birth control pills), miscarriages, autism, birth defects, failure to thrive, anemia, epilepsy, psychosis, ADD/ADHD, seizures, or take prescription medication, particularly those for cancer and autoimmune disorders, we highly recommend that you get tested for an MTHFR gene mutation. This is a piece of the healthcare puzzle that can be treated.

What does the MTHFR gene do?

MTHFR gene provides instruction for making an enzyme called methyl tetrahydrofolate reductase. This enzyme helps amino acids form proteins and influences detoxification efficiency and production of neurotransmitters. A mutated MTHFR gene produces defective enzymes that may perform only 20% – 70% as well as the non-mutated version, depending on the type of mutation.

You ability to effectively break down toxins and eliminate heavy metals, including copper, will be limited. High copper levels deplete zinc levels which can be related to ADHD, depression, headaches, acne, frequent colds, worsening thyroid function, sensitive skin, easy bruising, adrenal stress and more. High copper levels also make it difficult to raise iron levels. Supplementing with Vitamin C and Zinc can help to detoxify and reduce copper levels. Consult with your functional medicine specialist before starting supplements.

A high homocysteine level may develop with an MTHFR mutation, thereby increasing your risk for heart disease, blood clots, stroke, elevated blood pressure, dementia, psychosis, and seizures. A thorough history, along with MTHFR testing, is recommended if you have a high homocysteine level or a history of any of the above listed diseases.

With MTHFR mutation, homocysteine has a difficult time converting to glutathione, the body’s main detoxifier and antioxidant. This contributes to a buildup of toxins and heavy metals in the body.

Also with MTHFR mutation, your body will have reduced capability of converting the inactive forms of folate (folic acid) and B12(cobalamin) into active forms called methyl-folate and methyl-cobalamin.

The Journal of Molecular Psychiatry states that, “Schizophrenia-like syndromes, Bipolar disorder, Parkinson’s disease, Alzheimer’s disease and vascular dementia have all been associated with one or more of the mutations of the MTHFR gene”.

It is likely that MTHFR DNA variation may affect the response to many different medications that affect brain function. Long term use of methotrexate, for example, is associated with elevated homocysteine levels and methotrexate toxicity in patients with MTHFR mutation. We recommend knowing your MTHFR status prior to starting any type of chemotherapy. Chemotherapy neurotoxicity is highly associated with MTHFR mutation. Proper supplementation and future treatment options will need to be discussed with your functional medicine specialist and oncologist once your MTHFR status is known.


Although you can’t change this defective gene, you can help it do its job more effectively.

Repairing your digestive system, including optimizing your gut flora (ie blend of microbes in your gut), should be the first step in improving your health.

Methyl-cobalamin and methyl-folate are additional treatment which will be used by your body for detoxing. You may need to start with a low dose to avoid detox effects such as fatigue, muscle pain, headache, anxiety, insomnia, irritability, achiness, etc. Always consult with a functional medicine specialist prior to starting therapy. Click here to read about Active B-Complex by Prothera.

Avoid toxins, including those absorbed through the skin. Look at household cleaning supplies and wear gloves when using chemicals for cleaning. Check your lotions, soaps and deodorants. Use aluminum free deodorants, and use soaps and lotions with the fewest ingredients. We are now offering Pure & Simple Bar soap at our TWIHW facility and it’s just that! You can also visit http://www.ewg.org/skindeep/ which is a database where you can discover what toxic chemicals are in your cosmetics, lotions, and sunscreen products.

Eat healthfully and organic when possible, avoid processed food, don’t smoke, and limit alcohol intake. These measures will help to decrease toxins in the body and will leave the methylation cycle free for other important functions.

There are more than 40 different MTHFR mutations that can be passed down from your mother and/or father. Only two of these are known to be particularly problematic: C677T and A1298C. You might also hear the words homozygous and heterozygous when discussing MTHFR mutations. Homozygous means that you inherited a mutation from your mother AND your father and, therefore, have both copies of the defective gene. Heterozygous means that you inherited the mutation from either your mother or your father and, therefore, have only one copy of the defective gene. If you already know that you have an MTHFR gene mutation, consider having your children’s status tested.

MTHFR testing is offered several ways at our facility (prices are subject to change):

  • Saliva test kit that you do yourself at home and mail into the lab. This test is $125 and tests for C677T and the A1298C mutations as well as for another mutation called COMT which is also associated with mood disorders and dementia.
  • Add-on test at Spectracell Laboratories when ordering a nutrient analysis. The add-on price is $40 and tests for C677T and A1298C.
  • MTHFR can also be ordered through Quest lab who will attempt to bill your insurance; however, we’ve found that many insurance companies will not cover the test and this would result in Quest billing you, the patient, ~$400.


BMS Neurology, Effect of MTHFR
US National Library of Medicine National Institute of Health
Genetics Home Reference, Your Guide to Understanding Genetic Conditions
National Center for Advancing Translational Sciences
American Heart Association
Clinical Neurology and Neurosurgery
New England Journal of Medicine
Journal of Human Genetics
By |2017-03-01T17:36:12-06:00November 4th, 2015|Articles, General|

Supplement of the Month: Help with Depression and Anxiety

happyThere are a number of supplements that can be very helpful in supporting our mental health and function. Combined with improving the diet, getting regular exercise, balancing hormones, controlling chronic pain, getting adequate sleep, balancing gut flora (microorganisms), and other non-pharmaceutical approaches to treating depression and anxiety, here is a list of several supplements we frequently use at The Woodlands Institute:

 L-Theanine is an amino acid compound found in green tea and is noted for its ability to relax and calm, while improving focus without causing drowsiness.

 5-HTP is extracted from the seeds of the Griffonia plant, a shrub principally found in West African countries, and is an amino acid derivative that’s an immediate precursor to serotonin. Serotonin is a neurotransmitter (brain chemical) produced both in the intestinal tract and the brain and is important for promoting calmness and sleep in addition to alleviating depression. It can also be helpful in reducing carbohydrate cravings and supporting healthy eating patterns. 5-HTP should not be taken with antidepressants without medical supervision.

 L-Tyrosine is also an amino acid found in the human body that is a precursor for both thyroid hormones and neurotransmitters such as dopamine, noradrenaline and adrenaline. These neurotransmitters are needed to support stress response mechanisms, mood, and our ability to concentrate.

Other important supplements we commonly recommend to support mental/brain health include fish oil or krill oil, vitamin D, magnesium, and B-complex.

Discuss with your healthcare provider which supplement(s) may benefit you. We highly recommend medical supervision for use with all of these supplements.

*The product information provided is for educational purposes and is not intended as either diagnosis or treatment of any disease, nor does it replace professional medical advice.  (The FDA makes us say that)
*Warning: Please consult a health care professional before using these products.









By |2015-01-03T08:31:45-06:00January 2nd, 2015|Articles, General|

depression testimonial from JM

from J.M.

You were right, and after doing some serious thinking, I’m mad at a lot of doctors. I feel better than I have felt in my whole life, I think due to the diet, supplements, and testosterone injections. I was in bed for 30 years with double depression. In and out of institutions for years. I’m down to 10mg on the Celexa and 750 on the Depakote.  If this keeps up, I’m thinking about writing a book, really!

“The missing link”- already have the name picked out. I always was depressed even as a young very sick child. Doctors gave me shots and antibiotics since the day I was born. And never stopped!

I feel great but somewhat confused because I don’t know what normal feels like.

God bless and God speed…

By |2014-06-16T09:47:54-06:00June 16th, 2014|General|

Depressed? Need a lift?

Depression comes in many forms and has many possible causes. Rather than band-aiding your depression with an anti-depressant medication, The Woodlands Institute aims to detect and correct the underlying causes of your depression. Causes may be anything from a simple nutritional deficiency or hormonal imbalance to a reaction to a food. We’ll help you understand common depression signs so that you may identify depression symptoms in yourself, a family member or a friend. Then, we can also help you determine the best depression treatment for you.

We invite you to read our online article “Depression Symptoms & Treatments” for details on how depressed feelings affect all types of people and can be easily addressed with the right attention. Talking to a trained professional about your depressed feelings or those of a loved one is critical to resolving these feelings. Whether you’re a teen struggling with depression, a new mom who may be challenged with postpartum depression or a father who just isn’t energized about the things he once was, The Woodlands Institute is here for you.

Test yourself for hormonal imbalances that may be causing or contributing to your depressed moods. One culprit of your depression could be low thyroid, which we can also help address.

Contact us at now for a free consultation with one of our wellness consultants.

Click here to read a testimonial from a real patient of TWIHW who suffered with depression for many years.

By |2014-06-25T10:45:04-06:00June 13th, 2014|Articles, General|

Depression testimonial

Depression testimonial

from J.M.

You were right, and after doing some serious thinking, I’m mad at a lot of doctors. I feel better than I have felt in my whole life, I think due to the diet, supplements, and testosterone injections. I was in bed for 30 years with double depression. In and out of institutions for years. I’m down to 10mg on the Celexa and 750 on the Depakote.  If this keeps up, I’m thinking about writing a book, really!

“The missing link”- already have the name picked out. I always was depressed even as a young very sick child. Doctors gave me shots and antibiotics since the day I was born. And never stopped!

I feel great but somewhat confused because I don’t know what normal feels like.

God bless and God speed…

By |2014-05-21T09:38:21-06:00May 21st, 2014|General, Testimonials|


5-HTP (5-Hydroxytryptophan) is extracted from the seeds of the Griffonia plant, a shrub principally found in West African countries.5-htp 5-HTP is an amino acid derivative and the immediate precursor to serotonin. Serotonin is a neurotransmitter produced both in the intestinal tract and in the brain and is important for mood, promoting calmness, and sleep.  It can also be helpful in reducing carbohydrate cravings and supporting healthy eating patterns.  5-HTP should be taken under medical supervision.

By |2014-05-07T12:39:03-06:00May 4th, 2014|Articles, General|

Overcoming Depression Is A Balancing Act

Overcoming Depression

by Nancy Mehlert, MS

We often refer to the Standard American Diet as “SAD” and it really is – it is a very depressing diet!  The suggested food plate and previous food pyramid have led Americans into eating a very inflammatory and congesting diet of fast and processed foods, sugar, artificial sweeteners, chemical preservatives and dyes, MSG, grains, and grain fed meats. We live fast and don’t take time to figure in fresh vegetables, fruits, and undamaged, healthy fats which should make up the largest part of our diet and benefit our overall health more than any other foods.  And layer on top of that the toxic nature of our water, another fundamental aspect of our nutrition, and we are in depression trouble. Eating this SAD diet quickly leads to nutrient depletion and inflammatory diseases.  Our body is no longer in balance; it becomes overwhelmed with a lack of nutrients and an excess of inflammation. Nutrient depletion in and of itself is a known cause of depression.

The human body needs balance.  It is made to function optimally when everything is working in proper balance.  Depression occurs when there is an inadequate supply of our “happy” brain chemical called serotonin.  Many aspects of our dietary habits can inhibit the successful production of serotonin.  Sugar in general and high fructose corn syrup specifically is one such culprit.  Fructose and high sugar diets have been shown to degrade the availability of tryptophan, the precursor to serotonin.  As a result, there is barely any tryptophan available to the body for the production of serotonin.  Sugar, especially fructose has also been shown to suppress activity of a key growth hormone called BDNF (brain derived neurotrophic factor) that promotes healthy brain neurons.  BDNF levels are consistently low in depressed individuals.

A more complex issue arises with aspartame (eg. Nutrasweet and Equal) and monosodium glutamate.  These neurotoxins interrupt the balance between neurotransmitters in the brain, thus promoting depression.

There is something out of balance about 6-11 servings a day of grain.  At a minimum, if you happen to be able to make time to eat three times a day, you’d need to eat two servings of grain at every meal in order to meet the minimum recommendation.  Gluten, found in the grains wheat, rye and spelt, is another food that can block the production of critical brain neurotransmitters including serotonin and has been demonstrated to be especially problematic for those with gluten allergies or sensitivities.

More recent research into the balance of healthy bacteria in the small and large intestines has also revealed that in truth, more of our serotonin is made in the gut lining than in the brain.  This critical neurotransmitter, which we usually call a “brain chemical” is actually a “gut chemical”!  But this fact reveals that having a healthy gut full of favorable bacteria and not overcome by yeast, parasites or pathogens is mission critical to resolving depression.  The gut is the human body’s second brain and its health is highly correlated to brain health.  A healthy gut is a healthy brain.  Balancing gut flora, sealing a leaky gut and addressing unwelcomed inhabitants is a primary step in resolving depression.  Unwelcome gut inhabitants prosper and grow well on processed and sugary foods, but are not especially fond of fresh vegetables and healthy fats!

Overburden the body with anything and balance is lost.  What do water, toothpaste and anti-depressants all have in common? Fluoride!  It is added to over two-thirds of our nation’s water supply and is in all of our basic toothpaste products as well as found in anti-depressant drugs!  Yet it is a known endocrine (ie: hormone) disruptor and especially impacts the thyroid, which is essential to good mental health.  Depression is a common symptom of endocrine malfunction and we ingest considerable levels of fluoride through the water we drink and bathe in, to the toothpaste we put in our mouths, to the prescription drugs we take, and this imbalance creates havoc.

Bottom Line:  When it comes to nutrition and overcoming or avoiding depression:

  • Eliminate sugar from your diet and limit intake of fresh fruits
  • Avoid artificial sweeteners, especially Aspartame that is found in common brands such as NutraSweet and Equal.
  • Eliminate gluten from your diet especially if you are allergic to gluten or sensitive to it.  Regardless, we recommend trying a gluten elimination diet for several weeks to see if it helps you to feel better over all. Gluten is highly associated with many diseases.
  • Avoid monosodium glutamate normally found in fast foods and processed foods and also know as MSG.  Be careful to avoid other names for MSG which include hydrolyzed vegetable protein, textured vegetable protein, yeast extract, Torula yeast, just to name a few.
  • Be a detective and find out all the ways you are ingesting fluoride and begin to trade for fluoride free options.  Household water can be filtered to remove fluoride, many fluoride free toothpastes exist on the market today and try our supplement suggestion in this newsletter instead of an anti-depressant (be sure to consult a physician before stopping an antidepressant medication)

Pursuing a whole food diet, rich in vegetables, herbs, spices, undamaged natural fats such as those found in pastured eggs and butter, Pacific salmon, nuts and seeds, coconut oil, and olive oil can help to bring balance to the inner workings of the human body and ward off and overcome depression.

By |2014-05-02T11:39:59-06:00May 2nd, 2014|Articles, General, NANCY’S NUTRITIONAL NUGGET|

Overcoming Depression Testimonial

Overcoming Depression Testimonial

by Mila McManus MD

As I was my first wellness patient, and depression was one of my many issues, I thought it would be appropriate to share my story this month since this newsletter focuses on depression.

I remember feeling depressed when I was in high school, but seemed mostly situational. College years were good, but developed anxiety. Two yrs into medical school, life was rough. I was exhausted and emotional and anxious all the time. I started on antidepressants and boy did it help a lot.  I went from a lot of emotion to NO emotion. It helped anxiety as well.  I craved carbs terribly and continued to have issues with insomnia which I first noticed in my early teens.  I also had issues with terrible allergies, constipation, headaches, PMS, reflux, high blood pressure, unexplained 80 lb weight gain over a 5 year period, and eczema, just to name a few.

OK, so in retrospect, I had severe adrenal fatigue, low thyroid function, I was riddled with yeast, and was nutritionally bankrupt.  Keep in mind that my labs were ALWAYS perfectly normal (so it had to be all in my head, right?). Over the years I tried several times to wean my antidepressant to no avail.  Of course now I know that it’s because I wasn’t addressing the underlying causes of my depression and anxiety in the first place.  Skip ahead to my first year in private practice as a family physician.  I’ve now accumulated 12 prescription medications and I’m 30 years old, going on 90. I lived on diet soda and fast food. Nobody taught me in medical school that it wasn’t healthy to eat that way.  Seriously!

Thank Goodness I found wellness, which is everything we doctors don’t learn in medical school.  I was able to discover that the underlying causes of my depression and anxiety were due to nutritional deficiencies, abnormal gut flora, hormonal imbalance, and having toxic overload. Within 2 weeks of starting bio-identical hormones, changing my diet, and taking a handful of vitamins, I was well on my way to shedding all 12 of my medications.  It did take about 6 months, but my antidepressant was the first to go.

I often wonder where I would be today, almost 11 years later, if I had not found wellness.  My story is unfortunately a very common one, and I hope reading this story gives you hope.  I feel so blessed every day that I get to pay it forward by helping other people overcome what ails them!

By |2014-10-20T12:50:10-06:00May 2nd, 2014|Ask Dr McManus, General, Testimonials|