10.1016/j.enzmictec.2004.07.023 Enzyme Microb

Colestipol (decrease cobalamin and folate absorption) Methotrexate (inhibits DHFR) Nitrous Oxide (inactivates MS) High Dose Niacin (depletes SAMe and limits pyridoxal kinase = active B6) Theophylline (limits pyridoxal kinase = active B6) Cyclosporin A (decreases renal function and increases Hcy) Metformin (decreases cobalamin absorption) Phenytoin (folate antagonist) Carbamazepine (folate antagonist) Oral Contraceptives (deplete folate) Antimalarials JPC-2056, Pyrimethamine, Proguanil (inhibits DHFR) Antibiotic Trimethoprim (inhibits DHFR) Ethanol Bactrim (inhibits DHFR) Sulfasalazine (inhibits DHFR) Triamterene (inhibits DHFR) Involving yourself with providers who are educated on MTHFR Take supplements that are methylation supportive L-5-MTHF Riboflavin (B2) Methylcobalamin or Hydroxocobalamin Zinc DHA Choline TMG (must be avoided in pregnancy) Magnesium Methyl- B6 NAC Vitamin E (natural forms only) Selenium Glutathione Vitamin C Vitamin D Potassium Probiotics Molybdenum Milk Thistle *****Avoid gluten as 20% of patients with MTHFR have gluten sensitivity and gluten is inflammatory

Patients with a history of thyroid tumors , including benign or malignant growths, should be thoroughly evaluated before beginning treatment
Kim WG, Kang GD, Kim HI, Han MJ, Kim DH
The patients comfort level, age, sex, physique, and health goals may also determine the injection location