COMPENDIUM ON FUNCTIONAL MEDICINE - Flipbook - Page 221
physician was able to reduce her medication dosage under
medical supervision. Most notably, the patient reported feeling
"clear-headed" for the first time in years [48].
Case Study 2: COMT/MAO and Anxiety with Cognitive Issues
Patient Profile:
● 35-year-old male
● Severe anxiety and panic attacks
● Executive function difficulties and attention problems
● Insomnia and racing thoughts
● High-stress corporate job
Genetic Testing Results:
● COMT V158M (+/+) homozygous (slow COMT)
● MAO-A R297R (+/+) homozygous (slow MAO-A)
● MTHFR A1298C (+/-) heterozygous
Intervention Approach: The practitioner recognized that the
patient's genetic profile suggested impaired catecholamine
metabolism, likely exacerbated by high stress. The treatment plan
included:
● Structured stress management program including breathing
techniques and cognitive behavioral therapy
● Diet modifications to reduce stimulants (coffee, chocolate)
and balance protein intake
● Supplementation with magnesium, B-complex vitamins with
emphasis on riboflavin
● Adaptogens including ashwagandha to modulate stress
response
221
