With MTHFR and slow COMT, you may produce neurotransmitters inefficiently (MTHFR), but also break them down slowly (COMT). This can lead to fluctuating dopamine levels, periods of overstimulation or underperformance, and increased sensitivity to small biochemical changes.

In clinical practice, however, patterns often emerge before the research fully catches up. One such pattern I observe is a striking overlap between individuals with MTHFR gene variants and symptoms of ADHD or ADD. To be clear: this is not yet a fully established causal relationship. But there is enough emerging evidence—and strong biochemical plausibility—to warrant a closer look.