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Integrative Psychiatry

Introduction to Methylation by Shelese Pratt, ND

By February 9, 2021No Comments

Watch our short video as Dr. Shelese Pratt discusses “What are signs your patient needs methylation support?” in her video, Introduction to Methylation.



Why use genomics?

Because, you know, it’s a hot topic, it has been a hot topic for several years now.

Your patients are going to ask about it. They’re hearing about 23andMe on TV. They’re hearing from buzzwords, or they’re seeing a Goop article or Mindbodygreen article, and they need to know about MTHFR. So, you guys need to know what that means and how to use it in your practice most successfully.


Single nucleotide polymorphisms

Only the studied genes should be looked at for health purposes.

Changes in alleles or base pairs create a variant and change the expression and the function of the genotype, right? And there are 10 million snips in the human genome, only a percentage of these snips have been found to be relevant, which I want to underline and underscore that point, that there’s a lot of snips that you get on a Prometheus lab. I don’t know if you’ve ever run any of those that we just don’t know enough about. So, we can’t make assumptions until the research supports it.

Therefore, only the studied gene should be looked at for health purposes.


What is Methylation?

Methylation is the addition of a methyl group (CH3) to another molecule.                   

Okay, so what is methylation? Like at the very basis what is methylation?

Methylation is the addition of a methyl group, which is a carbon and three hydrogens into another molecule. And the body’s main methyl donor is SAM-e. Okay, and SAM-e activates other enzymes by donating its methyl group. And this either turns on or off some kind of process. And it happens in all cells of the body. Every cell methylates. But we specifically think about it a lot in the liver and phase two of liver detoxification.


What are signs your patient needs methylation support?

So, what are signs that your patient needs some support?

Well, mood fluctuations and irritability, depression, anxiety, those conditions that we’re going to cover today, bipolar pregnancy has an incredible demand for methylation.

If you get really red faced after exercising, that’s a sign of histamine. And it’s just a sign that something in methylation is not going well, maybe you don’t have enough SAM-e. Intolerance to alcohol, low energy and toxic feeling. Just so you know, nitrous oxide makes them feel awful. That’s at the dentist when they get dental work. People with MTHFR, specifically that gene mutation, we know do not tolerate nitrous oxide at all, as well as other medications.


Prenatal Supplement with Methylfolate

Treatment and prevention of depression in women trying to conceive and during pregnancy

Let’s talk about pregnancy for a minute here. The ability to make and generate as much tissue as well as for the mother, as well as the baby takes a tremendous amount of choline, a lot of choline.

Choline is a major nutrient that you need in order to methylate correctly. The need for phosphatidylcholine is exceptionally high in pregnancy, or somebody wanting to get pregnant. So, phosphatidylcholine is, I think, deficient in 90% of women that are trying to get pregnant or have gotten pregnant. So, you want to make sure that you’re giving them some sort of choline.


Genetic Testing

  • You take a detailed history
  • You know what symptoms they are struggling with
  • You have to run testing

So again, take your detailed history, know the symptoms that they’re struggling with, so you have an idea of what you’re trying to treat, because a lot of times people go down rabbit holes, and they miss their patient, right?

I don’t want you to do that. In functional medicine, it can be a big problem that you run all these labs and you forget what they came in for. Try not to chase after all the other things and relate back to why they came in, what are they wanting help with? And it may be that you have to go several feet deep within all of this, but we should always remain in the scope of what are they looking for solutions for.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.