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Getting to Know the Relatives: The Importance of MTHFR Screening

Kayla Preece, ND
Shannyn Fowl, ND

Methyltetrahydrofolate reductase (MTHFR) enzyme deficiency due to a genetic polymorphism is frequently talked about these days. Studies are showing this polymorphism to be linked to many conditions, from depression to hypertension.1, 2 With the myriad conditions linked to MTHFR deficiency, it seems perhaps too easy to connect patient symptoms to this condition. However, a patient that seems to have more than his or her fair share of family history for specific conditions may warrant a genetic screening test. Additionally, appropriate treatment thereafter may help the patient’s condition, no matter if it is correlated with MTHFR deficiency or not. The objective of this article is to help identify those patients who should be tested, to both identify relative health risks and to improve outcome of care.

MTHFR Polymorphisms

Around 40 single nucleotide polymorphisms (SNP) in the MTHFR gene have been discovered, which can present as either homozygous or heterozygous genotypes. SNPs affecting enzyme function can affect the methylation of key proteins in the body. Many of these SNPS seem inconsequential to the proper functioning of the MTHFR enzyme. Two, however, have been shown to lower the efficiency of the enzyme enough to warrant looking at. The most severe change occurs with the C677T SNP (involving a thymine substitution for cytosine), which decreases enzyme activity by 35-60%, depending on whether the SNP is heterozygous or homozygous.3 In second place is the A1298C SNP, which is linked to a 30% decrease in enzyme activity in homozygotes.3 Frequencies of the homozygous genotypes range from approximately 2% to 23% (depending on the population and the specific polymorphism), with the highest percentages in Italian and Hispanic populations; frequency of the heterozygous MTHFR SNPs is much greater in all populations.4

In conventional medicine, the fact a patient has an MTHFR polymorphism is often considered an inconsequential finding, unless of course that patient presents with the most severe consequences of the SNP, such as hyperhomocysteinemia or neural tube defects. A growing body of research, however, is gradually raising awareness of clinical correlations with MTHFR SNPs, particularly homozygosity for 677TT, and naturopathic doctors are beginning to put this condition on their radar, testing more of their patients, and basing treatment plans on the results.

MTHFR Clinical Case Studies

The authors of this article gleaned clinical research from a practice in Southern California. The data were all derived from what patients self-reported in clinic visits, initial visit intakes, and doctor observations, as noted in the charts. Thirty-seven consecutive MTHFR-positive patients, confirmed with blood tests, were identified and used in this study, based on their positivity for MTHFR SNPs. Their charts were accessed for their chief complaint, family history, and past medical history in order to scan for a variety of characteristics. Patient data were then categorized by the genotypes present: 677CT, 677TT, 677CT/1298AC, 1298AC, and 1298CC.

Family history seemed frequently positive for clinical disorders in patients with MTHFR SNPs. Significant family history in this study required at least 2 of the 5 family history questions to be positive. Questions included a family history of diabetes mellitus (DM), cardiovascular disease (CVD), cancer, thyroid disease, and depression – the most common family histories that patients are asked about by clinicians. Many patients had more than 2 family members with these diseases. Specifically, among those patients with genotypes 677CT, 677TT, and 1298AC, more than 60% had a positive significant family history (Table 1). Table 2 shows family incidence found in each type of SNP.

Table 1. Prevalence of Family History* in 37 Patients with Specific MTHFR SNPs

Total number of patients (n=37)Patients with Zero Family HistoryPatients with 1 Family HistoryPatients with 2 Family HistoryPatients with 3 Family HistoryPatients with 4 Family HistoryPatients with 5 Family History% of patients with >2 Family History
677CT plus 1298AC721121057%

*Family History refers to CVD, cancer, depression, thyroid disease, and/or diabetes mellitus

Table 2: Incidence of Family History by Type in 37 Patients with Specific MTHFR SNPs

CVDCancerDepressionThyroid DiseaseDiabetes MellitusTotal Family History

As this was a retrospective observational study, patients were not contacted to clarify any other information. Similarly, the group with known MTHFR SNPs was not compared to a similarly numbered group of patients who were known to be MTHFR SNP-free. These observations can be used as a stepping point for clinical trials in the future.

The following case was chosen to illustrate the point that a significant family history may be another piece to an MTHFR SNP-positive patient’s health puzzle. 

Case Study 1

GG is a 50-year-old female who presents to the clinic for osteoarthritis. Reproductive history is significant, with G6 P0 TAB2 SAB4 (6 pregnancies, 0 term births, 2 therapeutic abortions, and 4 spontaneous abortions). Patient had recurrent miscarriages at 4.5-6 months due to an incompetent cervix causing premature rupture of membranes. Fetus with genetic kidney anomaly was also noted in pregnancy history. She has significant family history, including grandmother with diabetes, grandfather with heart disease, father and mother with arthritis, a relative with allergies, grandmother with stroke, grandfather with alcoholism, siblings with depression/anxiety, brother with unspecified mental illness, and father and brother with high blood pressure.

Her chief complaint is osteoarthritis pain. She states that at times the pain is debilitating in her shoulders, lower back, and hips. She states she has some pain during yoga but no long-lasting episodes.

Her diet history includes a 5-month liquid, high-protein diet prescribed by her doctor at a local HMO. She has been drinking 120 oz of water per day since beginning this diet. Her exercise includes yoga and dance class. She has a menstrual history of menorrhagia. Other pertinent past medical conditions include ankle fracture and reconstruction surgery, asthma, stomach ulcer, and gastroesophageal reflux disease.

Her vitals were WNL. Her review of symptoms was WNL. Her labs revealed she was homozygous for the MTHFR 677 SNP (677TT).


In December of 2013, following a thorough discussion of MTHFR, the patient was given the following instructions:

  • Avoid synthetic folate and folic acid in supplements and in fortified foods. Naturally-occurring folic acid (methyl-folate) is fine in moderation. No juicing of foods high in folate. Limit high-folate foods to 1-2 cups per day. A handout was given as a reference of high-folate foods (Table 3).
  • Methylcobalamin (vitamin B12): Take 1 capsule (1000 µg) daily with food. After 3 days, increase to 2 capsules, then to 3 capsules, or until symptoms such as headache, belly ache, or emotional changes are felt. Reduce capsule number to the last dose prior to symptoms.
  • Curcumin supplement (600 mg Curcuma longa rhizome extract, standardized to contain 90% curcuminoids): Take 1 capsule TID away from food for pain.


In February 2014 the patient is taking 3 tablets daily of the B12 supplement, and is switched to a different turmeric supplement (turmeric phytosome, containing 500 mg of 18% standardized curcuminoids). She reports some relief in her shoulders but feels there is a long way to go. She is not having to take daily NSAIDs as often as she was previously. Unrelated to her musculoskeletal complaints, she states that she has been less “grouchy.” She states no reactions to her vitamin B12 supplement.

By August 2014, the patient states that her pain issue is essentially gone.

In September 2014, she is given continued nutritional support including a B vitamin complex supplement. She is told to finish the bottle and switch to a multi-vitamin, alternating with another nutrient supplement, magnesium, and to eat an anti-inflammatory diet for maintenance.

Table 3: Food High in Naturally-Occurring Folic Acid5

FoodPortionFolate (µg)
Chicken liver3 oz654
Brewer’s yeast1 tbsp313
Orange juice1 cup136
Beef liver3 oz123
Black-eyed peas½ cup100
Romaine lettuce1 cup packed100
Cantaloupe½ medium80

This patient had a significant family history for chronic disease. Though the research is not robust for correlations between MTHFR SNPs and osteoarthritis,6 practitioners have anecdotally observed a link between these 2 conditions. The patient has a significant history for miscarriage. MTHFR has been linked with miscarriage7 and may have been a contributor to this patient’s reproductive history. Clearly, a confounding factor in this case example is that multi-modality medicine can make it difficult to determine if the improvement of symptoms is from the MTHFR support or turmeric supplementation.

Following is another case that had impressive results due to guidance based on MTHFR testing.

Case Study 2

T.S. is a 47-year-old male that presents to the clinic for hypertension. He has had high blood pressure for the last 4-5 years. Patient reports that his blood pressure runs 200/100 mm Hg without medication, and 160/90 mm Hg with medication. He has tried several pharmaceuticals and finds that his best response is a daily combination of amlodipine (10 mg) and benazepril (20 mg). Family history includes at least 2 members of the family dying in their 50s from myocardial infarction.

Patient reports that his doctor did a full work-up and prescribed a low-salt diet and to lose weight. He took this advice very seriously, losing 20 pounds and juice-fasting, which normalized his blood pressure. He felt good. This was the start of annual fasts of 30 days of juice, consisting mostly of greens, apple, watermelon, and water. After each fast, his blood pressure would return to normal, but then rise again. This year, his annual fast did not resolve his hypertension, which is why he is presenting to my office.

Review of systems was significant for a visual spot in his right eye that occurs when he has hypertension and which resolves when his hypertension is adequately managed. Palpitations are common with caffeine intake. He has been unable to get erections since he started medication, and is in a happy supportive relationship. The high blood pressure is felt first in his feet. He is vegetarian, having eaten a mostly raw-food diet for the last several years.

His blood pressure in the office was 154/92 mm Hg. Physical exam showed retinopathy with neovasularizations in the right eye, and was otherwise unremarkable. Labs revealed iron-deficiency anemia and low HDL-C.


While waiting on lab results, the patient was started on a liquid iron supplement, red rice yeast for increasing HDL-C, probiotics for digestive complaints, Crataegus (hawthorn) in liquid form (50 gtt daily), and deep breathing exercises. Patient refused magnesium supplementation, so high-magnesium foods were encouraged.


Ten days later, the patient returned and reported a hypertensive crisis after breaking his juice fast. He presented to urgent care, where he was prescribed losartan; he discontinued this drug a couple days after starting, due to side effects of GI upset, shoulder pain, and erectile dysfunction. In fact, he decided to discontinue all pharmaceuticals since consulting me, against medical advice. His blood pressure was running 180/103 to 148/ 93 mm Hg on his home machine, and decreased to 123/76 to 103/65 mm Hg after implementing Crataegus. In the office, his blood pressure reading was 112/80 mm Hg in both arms.

MTHFR results revealed a 677 heterozygous genotype, which may explain the cardiac history on the paternal side of the family. Patient was educated on avoiding fortified folate in food and eating adequate food-source folate, as he prefers food over supplementation. He did agree to continue Crataegus and consider additional magnesium.

He returned 3 weeks later with a BP of 110/76 mm Hg, and reported that this has been consistent and that he has continued his treatment plan. His only complaint during this visit is hemorrhoids. He is attempting to convince his sister to get tested for the polymorphism, since it “has changed my life.”

The last contact with this patient was in a community function a year later; he reported he was doing well, without any hypertension reoccurrence. He has since moved out of the community and was lost to follow-up.

Closing Comments

The word “genetics” is becoming more commonplace. The ability to look into our patients’ genetics for answers, or at least for new leads regarding possible origins of their complaints and/or risk factors, fits perfectly into the naturopathic philosophy. However, it is hard to determine cause and effect. Many factors go into influencing the occurrence of diseases in a family, and attempting to attribute them to SNPs may seem like an oversimplification. However, as noted in this article, if it seems like a patient has more than his or her fair share of significant family history, consider MTHFR testing. Tailoring treatment plans based on the MTHFR SNPs helps doctors ensure that our patients have an environment most conducive to dealing with the genetic grab bag they were given.

Kayla Preece, ND, is a recent graduate of the National College of Natural Medicine, and will soon be licensed as a naturopathic physician and midwife. She is excited to begin her private practice in a rural community as a truly family doctor. She enjoys spending time with her husband, dog, chickens and honeybees.

Shannyn Fowl, ND, began her service to the medical community by exploring midwifery and working as a nurse aid for 13 years. When she learned of naturopathic medicine, she pursued a Bachelor’s of Biomedical Sciences at Western Michigan University and was privileged to participate in their neuroimmunoendocrinology lab. She earned her Doctorate from National College of Natural Medicine and continued to be active in research during medical school. Dr Fowl has a private practice and is adjunct faculty at San Diego Community College. She resides in San Diego with her husband and son.


  1. Wu YLDing XXSun YH, et al. Association between MTHFR C677T polymorphism and depression: An updated meta-analysis of 26 studies. Prog Neuropsychopharmacol Biol Psychiatry. 2013;46:78-85.
  2. Wilson CPMcNulty HWard M, et al. Blood pressure in treated hypertensive individuals with the MTHFR 677TT genotype is responsive to intervention with riboflavin: findings of a targeted randomized trial. Hypertension. 2013;61(6):1302-1308.
  3. Gilbody S, Lewis S, Lightfoot T. Methylenetetrahydrofolate reductase (MTHFR) genetic polymorphisms and psychiatric disorders: a HuGE review. Am J Epidemiol. 2007;165(1):1-13.
  4. Botto LD, Yang Q. 5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: a HuGE review. Am J Epidemiol. 2000;151(9):862-877.
  5. Marz R. Medical Nutrition from Marz, 2nd Portland, OR: Marz; 1992.
  6. Inanir A,Yigit STural S, et al. MTHFR gene C677T mutation and ACE gene I/D polymorphism in Turkish patients with osteoarthritis. Dis Markers. 2013;34(1):17-22.
  7. Nair RR,Khanna ASingh RSingh K. Association of maternal and fetal MTHFR A1298C polymorphism with the risk of pregnancy loss: a study of an Indian population and a meta-analysis. Fertil Steril. 2013;99(5):1311-1318.e4.

What is the MTHFR Gene Mutation?

Is there hope for MTHFR polymorphs?

These conditions are associated with MTHFR genetic mutation in research: Several can be considered a genetic disorder since treating the mutation will resolve the illness. There continues to be correlations of health problems with MTHFR that are not mentioned here. You may also visit this website for information: 

Atrial Fibrillation ALS Alzheimers Anemia
Anxiety Arthritis Autism Bipolar disorder
Blood clot Breast Cancer Chronic Fatigue Syndrome Colorectal Cancer
Connective Tissue Disease Diabetes Down Syndrome DVT
Epstein Barr Virus Fibromyalgia Gluten intolerence Heart attack
Heart Murmurs Heavy metal toxicity Hemolytic anemia High homocysteine
Homocystinuria Hunnington’s Infertility in both men and women Insulin resistant diabetes
Leukemia Lupus Meniere’s Disease Migraine
Miscarriages MMA Multiple Chemical Sensitivity Multiple Sclerosis
Myalgic encephalomyelitis Neural tube defects Neuralgia Non Hodgkin Lymphoma
Panic Attacks Parkinson’s Post eclampsia Pre eclampsia
Pulmonary Embolism Retinal Vascular Occlusive Disease Schizophrenia Spina bifida
Stroke Thyroid disease Tongue Tie Vaccine Injury

Explanations for MTHFR can get very complex so let’s try to keep it simple.

The –ase tells us that it is an enzyme. This enzyme is at the center of the activity of so much of your biochemistry, from turning homocysteine into methionine, making the most important antioxidant in your body, glutathione and converting neurotransmitters like dopamine that will affect your mood. The enzyme also makes the active form of folate, called methylfolate. The active form of folate is able to get around the body better and it the only form that is absorbed in the gut properly and can adequately be used in the brain. As you can see, being able to make methyl-folate is very important for nervous system function, growing babies and much, much more.

The two little sections that code for the enzyme are known as MTHFR c677t and MTHFR a1298c. If we remember back to biology class, there are two letters that determine outcome of a particular trait in the punett square. Capital letters general indicate the wild type or normal variant of a gent. Little letters indicate a mutation. Two of the same letters indication homozygous and one of each indicates heterozygous.

  • AA Homozygous
  • Aa Heterzygous
  • aa Homozygous

The MTHFR section of the chromosome in a gene test with normal variants of amino acids should looks like this: C677C A1298A

What does it mean?

Simply, this genetic mutation decreases the ability for your biochemistry wheels to spin. Throughout our bodies we have ferris wheels that are used to turn one molecule into another. The enzyme is like the worker who loads the ferris wheel. Without adequate enzymes the ferris wheel doesn’t turn or gets clogged up and you can end up with a crowd of people in one section of the ferris wheel or a crowd of metabolites who cannot go the next step. This crowd of metabolites can cause symptoms- a myriad of symptoms that are endless.

MTHFR is at the center of your biochemistry wheels and interact in so many wheels conIf you are positive for a MTHFR mutation or polymorphism, it means that your body has less enzyme to help those biochemistry wheels turn and less active folate or methylfolate being made. If you are not able make active folate, it can clog up the gears causing many of the common symptoms of MTHFR.

MTHFR disorders are treatable. I find 80% of patients improve immediately with the right treatment. MTHFR is one of the most satisfying conditions that I treat because patients get so well when their treatment is focused. There are a number of other mutations, such as COMT, CBS, MAO that can complicate treatment. Some patients are so sick that we have to address other health problems before they are able to tolerate treatment.

How is it treated?

Many people believe only homozygous MTHFR needs to be treated. I beg to differ and find that even heterozygous MTHFR will find that their health problems can be resolved by treating MTHFR. Treatment of MTFHR is often very hopeful.

In general, treatment is nutritional. The goal is to work toward lifestyle changes and a maintenance dose of a multi-vitamin with methyl-folate in it and avoidance of synthetic forms of folate. It can take some stepping stones to get to the maintenance dose as we tweak your body’s ability to spin biochemistry wheels and make the gears more efficient. We want to spin them at the right speed, not too slow and not too fast causing detox. Some patients see immediate life changing results while others see results consistently but more slowly especially if things have been going on for a very long time.

Any medications that involve folate pathways are generally contraindicated with a decrease in your enzyme.

Who should be screened?

If there is a family history of MTHFR or methylation defects in your family, you should be screened. It is estimated that 30-40% of the population has this mutation depending on ethnicity, therefore it is wise to screen for it whenever there is chronic disease, infertility, or in pregnancy. Growing a baby involves adequate active folic acid so screening in pregnancy MTHFR is essential.

There is a very long list of chronic diseases that are linked to MTHFR but in short, I often screen for it in my office if there is some family history of heart disease, cancer, diabetes, any clots, depression and/or addiction. I also screen in more unusual conditions such as sensitivity to caffeine, a feeling of something creeping up such as a panic attack, estrogen dominance such as fibroids and autoimmune conditions. In the first patient visit, we are creating a painting of the person’s well being and if the picture fits MTHFR, a screening is well worth it.

Screening can be done in our office by blood test. There are kits offered online for blood and saliva testing. I do counsel patients on the best option for them depending on their finances, health goals and concern for genetic testing and data mining of the information.

Published Work

California Naturopathic Doctors: An Effective Solution for Chronic Disease Prevention

The Value of Naturopathic Medicine

Healthcare Expenditures Among Users and Nonusers of Alternative Medicine

Childhood Depression and Chocolat 200C

Treating Pneumonia: When Antibiotics Fail

Getting to Know the Relatives: The Importance of MTHFR Screening

About Journey of Health in Arizona

Journey of Health in Arizona

About the Arizona practice:

Journey of Health has been based in California for more than 12 years and has expanded to Arizona. We help patients find access to alternative care. There is a huge shortage of primary care physicians in Arizona. Reports such as this news article show that 50% of Arizonian are unable to find physicians to work with and yet Arizona is rapidly growing and is the 4th largest growing state. This means that many individuals are delaying appropriate care or screening because they cannot find someone comfortable to work with or someone to meet their needs. It is not just that options for healthcare are limited when you go to your insurance based doctor, but you may also feel like you are not heard or even compartmentalized so your symptoms do not integrate even though you are one body.

What makes us different:

At Journey of Health, our passion is to revitalize care plans using old medicine to treat our modern illnesses. It is important for you to have safe and natural options, but it is crucial to learn how to use them so you can thrive! Preventing disease and feeling empowered are added bonuses that our patients find too.

The demand for alternative medicine and complimentary options is increasing but educated and qualified professionals are limited. If you are looking for safe and effective options, we may be a good fit for you.

In our office, we talk about using natural options whenever possible. One in three Americans are seeking for alternative medicine options. There is a growing sense that some old-fashioned black bag options like the old apothecary of herbs and homeopathy and nutrition have some answers! Now when we mix that with some modern-day science to understand the mechanisms of why and when they are safe and most effective, patients win.

We are naturopathic medicine tailored to your needs. Not everyone’s symptoms look the same. Your health goals and concerns will be explored so we can find answers in your journey toward wellness and better balance. We are a primary care office since the body’s imbalance manifests in many ways, and we specialize in matching natural options to the individual.

Contact us today to schedule your appointment or to learn more!

About the Doctor:

Dr. Shannyn Fowl, NMD is licensed in both Arizona and California. She works best with patients who are serious about finding answers to their health problems and finding long term balance. Dr. Shannyn takes a holistic approach in her own personal life and often tries treatments personally. If applicable, before asking a patient to follow through on a change. Balancing her life with hobbies, interests along with the work of good nutrition, exercise and appropriate supplementation has empowered her to find answers on her own health journey. Her thrill in life is to see patients on their own journey to health.

Medical experience:

Dr. Shannyn started her health experience quite young as an herbalist reader and applied it to animal husbandry. She partially trained as a midwife before becoming a nurse aide working in setting from emergency to restorative to hospice. This really allowed her to have hands on experience with diverse pathology and understanding of patients that should would take into her medical career. Her experience in medicine is over 25 years.


She taught continuing education for nurses for ten years at the community college for classes such as Introduction to Naturopathic Medicine, The Natural First Aide Kit and Homeopathy and Hydrotherapy for the Family. Some of these classes are being converted to online classes accessible to families. See my upcoming classes to keep updated on these offerings.

Dr. Shannyn also taught pediatrics at a naturopathic medical school for a couple of years while the faculty was in transition.


Dr. Shannyn is also an ongoing principal investigator for a research company overseeing the compliance of research collections.

What is a Naturopathic Physician?

Naturopathic physicians attend federally accredited 4-year postgraduate level medical schools and are trained in the same medical sciences and treatment options as other physicians such as pharmaceuticals, imaging, lab, gynecology, psychology, immunology, etc. The added benefit of additional natural and old fashioned treatments are also part of the curriculum such as nutrition, physiotherapy, IV therapy and so much more.

You can find more about the training of naturopathic physicians here.

Modalities Where You May Find Help

Clinical Nutrition

Let food be thy medicine and medicine be thy food- Hippocrates

Dr. Shannyn firmly believes that one of your greatest tools to finding optimal health is by understanding that food is a most powerful medicine. Discovering food intolerances and understanding the challenges of today’s food sources can help shape the right diet for your individual needs. Choosing the right foods and finding what you need to avoid is a key part of treatment. Every modern disease can be helped by an optimal diet, including diabetes, hypertension, high cholesterol, heart disease, autoimmune disease, arthritis, anxiety, and obesity. Food is medicine. The right choice of foods can help address hormone problems and digestive complaints as well as give you more energy, less brain fog, and better sleep.

Anti-Aging and Prevention of Disease

Aging well is all about preventing the damage of long-term inflammation. This is an important part of regular care. Understanding where the risks for an individual are and nourishing the system before it becomes a disease process. This also means screening and learning about the new updated ways to screen and what makes the most sense for the individual. For example, knowing your heart risk by measuring the thicknesses of the layers of the heart when you have family heart history can be a huge way of assessing whether the prevention plan is working. Why guess when you can know? Research is exploding in new labs and screening options.

Environmental Medicine and Emunctorology

This includes strategies to avoid and eliminate toxins in everyday life and diet. It also means knowledge of the symptoms that common toxins can cause. Avoidance is key, and learning to choose the safest foods, personal care, and home cleaning products is the first step.

Emunctorology is the art of opening up elimination pathways in the body or detoxing in the absence of a better term. Bringing the body back to Balance. The attempt to shift back to normal Physiology. We know so much about normal physiology, but pathology is constantly changing. The need for emunctorizing, eliminating, detoxing, etc, is a great need in our population.

Forever Chemicals are a great example of this. PFAs and PFOAs are being found everywhere, from the rain in Brazil to leaching out of waste management systems into the soil. Known to cause cancers of all sorts, the immune system cannot seem to keep up. These chemicals do not break down, so the need to eliminate them and prevent confusion in the immune system is higher in patients with autoimmune diseases as well.


Dr. Shannyn is trained in classical homeopathy, which takes into account the whole of a person, physically, mentally, and emotionally to guide in the selection of the correct remedy to stimulate the person’s vital force to heal itself. She uses homeopathy throughout her practice for acute conditions, first aid, surgery recovery, and complicated cases. It is very gentle, safe, and often very effective. Dr. Shannyn also teaches families how to use homeopathy in their family life.

Can you afford naturopathic care?

It is about the outcome and the lasting outcomes of staying on track with your health goals. Not only do healthy lifestyles predict a decrease in chronic disease, but when there is a hiccup, they greatly mitigate the potential side effects and improve recovery. Prevention is very much a part of Naturopathic Medicine. So that is a question you will need to ask yourself, can you afford the risk of going it alone and the potential outcomes of disease?

Becoming an Arizona Patient:

Step 1: The first step in becoming a patient in Arizona is filling out patient paperwork, reading over the new patient paperwork, and asking any questions that may not have been answered.

Email us for patient paperwork

Step 2: After you get the paperwork in, your patient portal will be created where you can schedule an appointment.

Step 3: Bring your goals and questions to your appointment and create a plan for wellness.

Clinical Publications

“Treating Pneumonia: When Antibiotic Fail” Oct 2018

Naturopathic Doctor News and Review,

Cardiopulmonary Medicine Issue

“Getting to Know the Relatives: The Importance of MTHFR Screening” Aug 2015

Naturopathic Doctor News and Review, Vol 11: Issue 8.

“Childhood Depression and Chocolat 200C” ~Oct 2012

Naturopathic Doctor News and Review


Aging Gracefully with Natural Medicine

Our goal is aging gracefully. We want to be as youthful as possible both inside and outside. Using our knowledge of normal physiology and what know about our tools can help us shape some key points.

The Basics of Aging Gracefully

Eating right for you. Veggies are always a good idea- as many servings and colors as you can get in. Fruits are important too. Beans are a common denominator among the oldest living populations in the world and likely that is related to feeding the diverse microbiotic world of the gut. Protein sources and healthy fats are important. Avoid those foods you know don’t agree. They just aren’t worth the trouble.

Exercise should include balance exercises and for those at risk for osteoporosis- weight bearing exercises. Moving is key to vitality and feeling strong.

Antioxidants are imperative to aging well. The sooner we incorporate them in our routine, the sooner they can protect your tissues from oxidation or aging. It is never too late to start. Work with your naturopathic doctor who is especially trained in antioxidant ratios and can pick out the multivitamin that you will see results on.  Lutein/Zeanthinin are protective for the eyes while we are seeing an increase in macular degeneration and retinal detachment.  Curcumin is anti-inflammatory helping health lipid protection and joints.  The right B’s are important for methylation challenges especially in MTHFR.

Mental workouts are important to keep that brain working. Whether you are taking a cooking class or doing puzzles or learning a new language; new learning helps to keep the brain active.

Be Aware of YOUR Particular Health Problems

Knowing your risk factors gives you the power to prevent worse damage. This is where your naturopathic doctor is especially important. They are looking out for ways to prevent and to make your susceptible areas stronger. It is a completely different way of looking at healthcare but patients are refreshed to feel they can be empowered and do something about their health risks instead of waiting for things to happen.

Whether your risk factors include dementia or arthritis, both of which impact your life and your loved ones, you can nourish your brain or joints and give it the tools it needs to prevent damage as well as preventing the damage from taking place. It seems like a simply novel idea and it really is with patients showing much appreciation in the simplicity.

3. Decrease Overall Inflammation
Inflammation is a normal part of aging so if we can ramp up the tools to slow it down, we can notice that a number of factors can improve from mood to libido to memory and focus. Many primary concerns such as gastrointestinal, cardiovascular, rheumatic is brought on by inflammation. We have to treat the cause and not the symptom. Natural solutions are in demand so there may be many protocols that you have never heard of that are working in your naturopath’s office.

4. Money is an Investment
Money is an object for health and happiness. Yes, good health costs money. Alzheimer’s disease is a high cost to a family and society. Investing in your brain, especially if you are at risk, with high-quality products specified for you does no harm and may actually help. Many diseases cost an incredible amount of money but a maintenance plan of health habits and a regimen of individualized products that do not interfere with essential medications can help combat the risks and live healthier, happier, full lives.

Consider your options for aging gracefully.

What Is The Best Medication for PMS?

Premenstrual syndrome (PMS) is the most common period related complaints of women in their reproductive years.  They can have PMS irritability and anger, nausea, cramping, pain and bloating.  PMS can also cause anxiety, depression, swelling, headaches and breast tenderness.  The best medication for treating PMS is considered oral contraceptives, however some patients have adverse effects usually because of a methylation defect, MTHFR.  Another treatment considered successful is the Serotonin selection re-uptake inhibitors (SSRIs), however these can have side effects too and women don’t feel like themselves.  The lack of resolutions of the symptoms without drugs or side effects often leaves women asking ‘what vitamins are good for PMS?’ or ‘how to stop PMS naturally?’

Integrative medicine has included Chaste Tree Berry as an effective herbal medicine to balance the cycle out and minimize symptoms associated with premenstrual syndrome and even PMDD.  Naturopathic Doctors have found the research for Chaste Tree Berry, otherwise known as Vitex, as effective as oral contraceptives for PMS mood swings and PMS pain but without the side effects many women experience from oral contraceptives.  While this herbal supplement shows great promise, holistic medicine allows your Naturopathic Doctor to consider what other alternative medicine options may fit you as well.  Magnesium may benefit you for PMS cramps and may be an appropriate natural remedy if you have other signs of magnesium deficiency.  Evening primrose oil or progesterone may also be a goos fit. Assessing your overall health and body symptoms can help a integrative doctor fit the right tools to eventually be close to symptom free around your period.

There is a natural rise and fall to estrogen and progesterone during a women’s cycle that is important to understand and balance out.  When the estrogen is higher, a woman is more likely to be decisive and motivated.  This is the best time of the month to make decisions or work on a large project.  This is the time of doing.  Right around the time PMS shows up, there is a time of reflection and being and part of the natural cycle and big decisions are not best made here.  Just understanding this about your body can empower you.  The more you are able to create balance, the less symptoms or vitamins and medications you will need for PMS symptoms.  This is the natural rhythm of the menses cycle.  This is surely an alternative view but a holistic treatment protocol for PMS.  Our Naturopathic Doctors understand that your body has been through a lot and may have cellular memory contributing to your symptoms of PMS.  We are all about problem solving.

We specialize in this kind of thing so PMS or cramps is not a new idea for us. Getting the right care tailored for you, your specific body and situation is key to success in your health.  At Journey of Health Naturopathic Clinic we are dedicated to finding the right integrative solutions for each patient. We proudly serve the San Diego area, providing some of the best service in Naturopathic medicine. If you wish to further your own journey of health with Naturopathic solutions and Alternative medicine, give us a call at (619) 772-1164.  We offer free 10 minute consults so you can see if we are the right fit for you and you family.  Reach out and learn more about your holistic medicine options today!

Hypothyroidism Causes

Hypothyroidism causes are on many patients’ minds. Are they at risk?  Are their symptoms related? What if their labs are normal? Trying to find answers through your insurance based doctor can be challenging.  If your symptoms don’t fit perfectly inside the box of the medical description for hypothyroid then the search for the cause of your symptoms usually stops here- all normal.  Even treatment is not one size fits all.  Varying degrees of treatment work for different people.  Often a medical doctor may not know what else to do. Naturopathic doctors understand that you are an individual and one size does not fit all.  There are many things to consider when treating hypothyroidism, therefore we must take an integrative approach.

Let’s talk about symptoms first.  Fatigue, hair loss, dry skin are common but if we look at you from a holistic view including the whole body; symptoms can include so many things that may not even make sense such as painful periods, brain fog or even depression.   Many patients who have come to me for painful periods or perimenopausal symptoms have had them completely resolve when on the proper form of thyroid medication and hormone support. It is very holistic thing to see when the body readjusts as the hormones are back in balance. Alternative medicine is all about including odd and unusual symptoms as part of the whole problem and the solution.

Finding hypothyroidism causes is an important part of treating hypothyroid in a naturopathic fashion.  Your case likely has a different collection of causes than the next person.  In addition, often the thyroid gets blamed for not functioning properly when it is other systems that have been taxed and cannot provide adequate support. For example, adrenal fatigue is a fairly common cause that is recognized among integrative practitioners particularly in a patient who has had to push through school or motherhood with young children.  This patient needs a holistic treatment plan to support her adrenals, her thyroid function throughout the body not just her thyroid and lifestyle adjustments to allow her body to heal.  Menopause is another key time when the liver is taxed and overwhelmed with keeping up with the hormonal changes so the thyroid’s requests may be interpreted as not important.  This patient may need some menopausal or hormonal support, sleep support and some simple detox methods to get her back on a natural rhythm.  These are all simple but targeted natural treatments that your naturopathic doctor can recommend.

In addition to these adrenal and menopausal causes, your naturopathic doctor may find that food intolerances or food allergies may be contributing to your hypothyroid diagnosis. Gluten often is a culprit in irritating the thyroid but we can also test a wide range of foods to see if any of them are causing your Hashimoto’s. Many patients may not even know that they have Hashimoto Hypothyroid unless the Thyroid Perioxidase Antibody (TPO) lab is also run in their blood draw.  The food intolerance test is a simple finger stick at our Journey of Health Medical Clinic so no need to be concerned about another blood draw.  This is not the IgE that you have run for allergies.  (See my food intolerance blog to understand more about the differences here.)  We have done over 500 of these with one of the most reputable and reasonably priced companies in the business of food intolerances. has helped us take a holistic approach by identifying those often mysterious foods for patients.

As a holistic doctor, we are still considering that you may not even fit into these categories mentioned above as a cause for your hypothyroid or Hashimoto’s and there are still more causes that are less often part of the picture but still a potential instigator in your symptoms. Nutritional deficiencies are a possibility. MTHFR is a genetic change that can affect your methylation status.  That big word means utilizing hormones, vitamins, etc. properly and being able to detox our cells properly. (See my MTHFR blog.) By adjusting your methylation, we can often see shifts in your thyroid related symptoms as well.  Integrative medicine allows us to choose which treatment options work best for you and to address all the possible causes for hypothyroid challenges.

We specialize in this kind of thing and see it frequently in our office so it’s not a new idea for us. Getting the right care for your body is important and tailored for your specific body in mind. At Journey of Health we are dedicated to finding the right naturopathic solutions for each patient. We proudly serve the San Diego area, providing some of the best service in naturopathic medicine. If you wish to further your own journey of health with naturopathic solutions and alternative medicines, give us a call at (619) 772-1164.

Professional Affiliations

Dr. Shannyn Fowl has many professional affiliations. Read below to learn more about her connections.

Western Michigan University
B.S. , Cume Laude in Biomedical Sciences
Western Michigan University

National College of Natural Medicine
Doctorate of Naturopathic Medicine, Honors in Research
National University of Natural Medicine

Ongoing Research Efforts
While pursuing my bachelor’s degree, I was also active in research relating neurotrophic factors to blood pressure regulation. This research experience fueled my hunger for solutions. I continued research while in medical school, and was involved in projects at Helfgott Research Institute and Portland VA Medical Center.

Clinical and basic science research is instrumental in providing adequate health care for individuals. As a result, I keep up to date on new treatments and diagnostic protocol developments in research so I can provide the best care possible, focusing on holistic ideals and naturopathic medicine.

I am associated with the following organizations:

American Association of Naturopathic Physicians

California Association of Naturopathic Doctors

National University of Natural Medicine Alumni Association

Pediatric Association of Naturopathic Physicians

Homeopathic Association of Naturopathic Physicians

The VP (Vulvar Pain) Foundation

MTHFR Support 

American Association of University Women, El Cajon/La Mesa Chapter

PIDS- Pediatric Infectious Disease Society

La Mesa Chamber of Commerce


Have questions about Dr. Shannyn’s professional affiliations? Contact us today!

Are we more concerned with getting sunburned than with our Vitamin D status?

In this article, I want to take another look at Vitamin D and our epidemic of Vitamin D deficiency.

Vitamin D is a fat-soluble steroid that is used throughout the body for many processes. Some symptoms of deficiency are commonly known while others may be new concepts. We take Vitamin D to help balance calcium that is taken from and stored in the bones. Immune function relies on Vitamin D to keep infection at bay. The vitamin also plays an important role in mood, autoimmune disease, obesity, and likely, most chronic disease. It is also vital to brain development.

Vitamin D synthesis starts in the skin and concludes in the kidney with an endocrine transfer that distributes the vitamin to tissues throughout the body. With this mind, we can consider why so many people have Vitamin D deficiency. Sometimes, Vitamin D deficiency simply results from inadequate intake; other times, deficiency can be due to the body’s inability to utilize the Vitamin D it has absorbed. About half of the patients with the MTHFR mutation or methylation defect also have a defect in their Vitamin D receptors, which causes suppression of Vitamin D production in the body. Cytochrome P (CYP) in the liver can also activate receptors and deactivate the Vitamin D molecule. Even from the simplified biochemical explanation here, you can see that the body’s system of utilizing Vitamin D is rife with complexities and details.

Adding to Vitamin D deficiency issues is the trend of doctors instructing parents to keep their kids out of the sun. We smother our kids with sunscreen so they get very little sun absorption. This is not to suggest that we allow our kids to get sunburned during a long outing in the sun! Rather, we must reach a balance to ensure that little bodies adapt to tolerate the sun in regular doses from an early age – this way, our children are less likely to burn as they get older. In fact, we can reach our daily levels of recommended Vitamin D intake before we are even close to the sunburn level. It is estimated that it takes roughly half the time to reach satisfactory intake levels as it does to burn, which ranges from about 15 minutes for fair skin to two hours for dark skin. So save the strongest versions of sunscreen for the hours of 11 am to 3 pm, or the middle of the day, when children are in direct sunlight, and allow modest exposure otherwise. Even individuals with a history of skin cancer can increase the anti-oxidant levels in their skin, without increasing their risk for skin cancer reccurrence, through moderate sun exposure. For those times that do call for sunscreen, beware that some chemicals in poorly-formulated sunscreens can actually increase risk factors of skin cancer, as can sunscreens that only block UVB waves (and expose you to dangerous UVA radiation). Be sure to look for natural ingredients and make sure the product you buy protects against both UVA and UVB.

The founder of the Vitamin D Council has observed that three epidemics have started since our society has been taught to shelter kids from the sun: asthma, autism and autoimmune conditions. Parents put many resources into their children’s treatments for these serious conditions. As a naturopathic physician, I have been able to reverse the complications of these ailments in many of my patients. For instance, kids with asthma respond very quickly to natural treatment and often go off inhalers and steroids within the first month after visiting me. Autism, interestingly, is more common in households of higher socioeconomic status as parents with higher education tend to follow more strictly medical persuasion to keep kids out of the sun. Avoiding the sun altogether really is a new idea for the human race, as is sunscreen.

In countries with normal exposure to the sun, mean natural Vitamin D levels are 46 ng/mL of blood. The ideal concentration of Vitamin D in the blood depends on factors such as individual risk and illness, and can vary widely. In general, 46 ng/mL is a good number for which the already healthy should strive. Some studies show that Vitamin D can be washed off the skin within 12 hours of exposure simply by bathing. While sunbathing is the preferred method of getting Vitamin D, you can also get it from supplements and some limited food sources like reindeer meat, seagull eggs, lard, cold water fish, sun dried mushrooms, grass-fed meat, eggs and milk.

Finally, I’d like to address briefly the issue of medications and sun exposure. If you are in the sun while taking certain medications, you may experience a phototoxic reaction caused by interaction between the sunlight and the free radicals in the medication. This interaction may cause sunburn, rash or hives. There are several medications that can cause sun sensitivity. The most common are antibiotics such as tetracyclines and fluoroquinolones; anti-depressants acting as SSRIs or tricyclics; NSAIDs such as Advil, Aleve, Celebrex and Motrin; and diuretics. Your doctor will warn you to stay out of the sun for 48 hours after taking these medications. It is wise to avoid the sun when you have no choice but to take these particular pharmaceuticals.

Schedule a visit with your La Mesa naturopathic doctor for more information or if you are concerned about your vitamin D levels. For more articles on natural health, please subscribe to our newsletter here.

Vitamin D

Are we more concerned about getting sunburned or with our Vitamin D status? I want to take another look at Vitamin D and our epidemic of Vitamin D deficiency.

Vitamin D is a fat-soluble steroid that is used throughout the body for many processes. Some things are commonly known while other may be new ideas. We take it to help balance calcium that is taken from and stored in the bones. Immune function relies on Vitamin D to keep infection at bay. It is also important in the role of mood, autoimmune disease, obesity and likely most chronic disease. It is also widely used in brain development.

Vitamin D’s last step is an endocrine transfer in the kidney that then goes to over 200 tissues throughout the body that have the Vitamin D Receptor (VDR). So with this mind, we can consider why so many have people have Vitamin D deficiency. Sometimes it is that they are not getting the intake of Vitamin D but what if they are and are just not able to utilize it. Likely about half or the patients with the MTHFR mutation or methylation defect also have a defect in their VDR affecting their body’s ability to suppress the production. Cytochrome P (CYP) in the liver can also activate VDR and deactivate the vitamin D molecule. As you can see there are several challenges to ensuring that Vitamin D is present and accounted for in our simplified version of the biochemistry here alone. Sometimes deficiency can be caused by disease.

However, the deficiency has become a new problem and only since doctors have been telling parents to keep their kids out of the sun. We smother our kids with sunscreen so they get very little absorption of the sun. This is not a suggestion that we should allow our kids to get sunburned on a long outing in the sun. There is a balance of ensuring that little bodies and their skin learn how to tolerate the sun from an early age in regular doses and therefore less likely to burn as they get older. Save the safe versions of sunscreen for the hours of 11-3, the middle of the day, when you must be in direct sunlight. But really, this isn’t a pertinent part of the Vitamin D deficiency discussion. We can get plenty of daily levels of Vitamin D before we are even close to the sunburn level. It is estimated that you can get a daily dose of Vitamin D in half the time it takes to burn which can range from 15 minutes for those with fair skin or 2 hours for darker skin. Even individuals with a history of skin cancer can increase their anti-oxidant levels in their skin and tolerate moderate sun without increasing their risk factor for skin cancer reoccurrences. Often chemical ingredients in poorly formulated sunscreens can increase risk factors of skin cancer, as can blocking only UV waves. Look for natural ingredients and blocks for UVA and UVB.

The founder for the Vitamin D Council has observed that three epidemics have started since our society has been taught to shelter kids from the sun: asthma, autism, and autoimmune conditions. These are three very concerning conditions on which parents spend many resources in order to survive the complication of the condition. Kids with asthma respond very quickly to natural treatment and often go off inhalers and steroids within the 1st month’s visit to me. Autism is more common in households of higher socioeconomical status and a higher educated mom is more likely to listen to medical persuasion to keep her kids out of the sun. Avoiding the sun really is a new idea for the human race, as is sunscreen.

In countries with normal exposure to the sun, natural vitamin D levels are 46 ng/ml. Preference of blood levels depends on risk factors and present illness, sometimes double is preferred and for other patients, it is lower. In general, this is a good number for the already healthy to strive for. Some studies show that Vitamin D can be washed off the skin within 12 hours with any bathing. Sunbathing is the preferred method of getting Vitamin D; however, you can also get it from supplements and some limited food sources like reindeer meat, seagull eggs, lard, cold water fish, sun dried mushrooms, grass-fed meat, eggs, and milk.

Antibiotics and sun exposure is another concern that I want to address. There are several medications, not just antibiotics, that can cause sun sensitivity and your doctor will warm you to stay out of the sun for 48 hours after taking them. It is wise to avoid the sun when you have no other choice but to take these particular pharmaceuticals.

Have questions about vitamin deficiencies? Call Journey of Health today to find balance.

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