What is MTHFR?
MTHFR is a gene that codes for a very important enzyme. This enzyme helps make neurotransmitters and is a part of many other very important biochemical processes in our body.
If you suffer from fatigue, brain fog, depression, have high homocysteine or other problems, it may because you have an MTHFR gene mutation. These mutations are termed Single Nucleotide Polymorphism (SNP), and we pronounce the abbreviation SNP as "snip".
There are two clinically significant MTHFR snps: the 677C>T and 1298A>C or T>G. The first letter before the ">" is the normal allele, and the letter after is the abnormal allele.
MTHFR problems are fairly easy to treat.
There are other genes that interact with MTHFR, and it is worth testing via 23andme to get the complete genetic picture, especially if you have health issues, or if you do not improve with methylfolate, or if methylfolate does bad things to you.
For more information on MTHFR, please visit my Blog
However, MTHFR is just one gene out of many, and is often the least significant of someone's SNPs. I also like to look at COMT, CBS, MTR/MTRR, GST, GSS, GSR, and many more.
Also, genetics are just one piece of the diagnostic pie; alone, they are unlikely to give you the solutions you seek..More important than SNPs are your symptoms and history, as well as lab testing, which should be comprehensive and include vitamins and minerals.
Conditions treated includeHypothyroidism, hyperthyroidism, functional hypothyroidism, Hashimoto's, adrenal fatigue, fibromyalgia, fatigue, depression, anxiety, mold toxicity, heavy metal toxicity, vitamin deficiencies, ADHD, etc.
One of my special areas of focus is helping hypothyroid pregnant women adjust their thyroid medication throughout their pregnancy, and also assist with specialized nutrient supplementation, in order to have the best pregnancy outcome possible.
I am also familiar with Lyme, Celiac and gluten sensitivity.
Congratulations to Alliance Integrative Medicine, Herndon VA on winning the 2015 Patients' Choice Awards for Family Doctor in Herndon, VA
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My practice might perhaps be best described as "Genomic and Orthomolecular Integrative Medicine".
I deliver personalized care largely by looking at your genes and by testing your individual levels of vitamins, minerals, and hormones. Whatever your current level of health, I aim to make it better.
Currently, I am licensed in and actively practice in 4 States (PA, VA, OH, WV). Due to insurance issues, new WV patients have to use the VideoMedicine platform for appointments, but can still e-mail, call, message or text me as needed outside of appointments. Everyone else should use doxy.me/aim for video.
I hold Fellowship level training in Integrative Medicine. My Board certifications are in Integrative Medicine and Family Medicine. I have, however, decided that continued certification with the American Board of Family Medicine is not a good use of my financial resources or time, and have switched this certification to NBPAS.
I see patients primarily by telemedicine (video or phone). This saves you from having to drive to an office.
However, I do appreciate that video cannot fully replace a good face-to-face meeting, and should people decide to come visit or be local enough to me, will do housecalls during spring and fall.
Low patient volume:
In order to have unhurried and high quality patient visits, I keep a very low patient volume, and usually try to give you all the time you need.
Deal directly with the physician:
I function solo with no office staff, so if you call, expect me to pick up the phone personally (the office number rings to my cell phone). If I am busy I will not pick up, so please be prepared to leave a message, or better yet, also send me an email (please include a signed E-Mail Communication Consent), or contact me via the other options listed below.
The downside is if I get busy or go on vacation, there can be some delay before I get back to you.
The other downside is that I will tend not to chase after you with appointment reminders, lab work reminders, or bug you for updates; you will need to take the initiative. I am also not able to handle a high volume of administrative tasks that are routine for other offices, such as pre-auths, filling out insurance forms, etc. I may also charge a small administrative fee if asked to perform these tasks, or I may in certain situations partially fill out the form and let you fill in the rest. Insurance reimbursement forms are only provided for full service in-person or video medical consultations - I will fill out the first form for you as an example, so that you will know how to fill out subsequent forms yourself.
People who occasionally do not receive my return emails tend to be those using hotmail or yahoo (gmail seems to work just fine). If my inbox gets suddenly swamped, it is also possible for me to occasionally miss seeing something. So, if for any reason you do not hear back from me within 72 hrs, please feel free to message, call or text. On occasion, as I am getting busier, there can be a lag of 4 days, especially over weekends.
If your need is semi urgent and just needs a very short quick answer, I encourage you to contact me via any number of HIPAA compliant free secure messaging apps including MedTunnel, or ohMD.
Before contacting me, please read through at least some of my blog and/or this website first, as many answers are already directly or indirectly there, and it will give you a better feel for whether or not I am right for you.
My practice is not heavily advertised, as I prefer to have only a limited number of patients in order to provide personalized quality care to everyone. I am usually found by referral, word of mouth, or by people who need help and are motivated enough to search the internet.
Encrypted email or Secure Message encouraged:
Anyone wanting to be my patient is encouraged to contact me via e-mail or secure message, or phone followed by e-mail or secure message once I have agreed to accept you. I do not automatically accept all comers; I only accept those I reasonably think I can help.
|Secure email :|
(please hand copy)
|This e-mail address is HIPAA compliant and encrypted, and cannot be accessed on my phone.|
|Secure message:|| MedTunnel
||MedTunnel ID : doc@iAim|
Videomedicine's text function is free to use but can be buggy and I may not see the message.
|Phone:||570-391-0104||570-391-0104 is not text capable.|
No Primary Care:
I am technically a specialist, and cannot officially function as a primary care provider (PCP). My patients are encouraged to maintain their own primary care doctor, or obtain one if they do not have a PCP. I will do some things for my patients that a PCP would normally do, but I should not offically be anyone's PCP of record, as I cannot provide the full range of PCP services (eg, I do not stock or administer vaccines, and am not on call 24/7).
No sales pitch:
I do not stock any vitamins or supplements for sale, so if I recommend something it is because I think it may help you, not because I want to move my inventory. Similarly, when I order specialty lab testing, I pass on the cheapest price I can get to my patient, and refuse to pad the cost of the test in any way. The only situation where you will pay me for labs is if I can provide additional savings over the lowest listed price (this does not happen often).
I prefer to facilitate independence where possible for those who need IV's or injections, and instead of giving B12 shots in my office, prefer to teach my patients to self-administer at home, which saves both time and money. For those who need it, I encourage home nebulized glutathione, which while not quite as good as IV glutathione, is way more convenient, and cheaper. Similarly for magnesium, I teach self injection into muscle, which, while slightly less effective than an IV magnesium push, is more convenient and economical, and far more effective than oral magnesium. People with ports can easily administer IV vitamin C at home with some training. I will also teach people how to do oral chelation at home.
My entire goal when I accept someone as a patient is to get them improved to the point where they no longer need me, or need me only minimally.
No holding lab results hostage:
Your lab results belong to you, and I do not force anyone to make an appointment with me before releasing results.
However, unless otherwise stated, lab results are released unreviewed, so you will still need to make an appointment for me to go over the results with you and to plan the next steps. On occasion, if there are only one or two results that are fairly normal, lab review can take place by email. You also may have the option to have me produce a written lab review; charges for this are comparable to an appointment.
This also means I do not accept any insurance, as then I would have to do things their way. If you have insurance, you can in some cases submit the bill to your insurance for reimbursement according to your plan. Many insurances will not reimburse for phone or video visits, but some will.
I am opted out of Medicare in PA, so anyone with Medicare needs to inform me and sign a private contract with me. I am unable to see any Medicare patients in VA, WV or OH due to issues with opting out.
However, I am a participating provider with Liberty Direct for supplement prescriptions, which allows members to pay for supplements using their Health Savings account. Liberty Direct is not health insurance. Instead, it is health cost sharing.
I try to keep my office paperless. Documents can be sent by email, fax, or MedTunnel. My fax comes through my computer as a PDF. Please try not to mail any hardcopies to me. Any paper mailed has to get scanned, then shredded. This can take significant time, and will likely greatly delay your first appointment.
I try to run with low overhead and pass the savings on to my patients; my fees are about half that of comparable specialists on the east and west coast.
Billing is by time. New patient appointments are usually in the ballpark of $300-400 for visits around an hr long, and follow-up appointments are generally $80 to $180, again depending on duration.
Click for additional: Fee details .
May vary slightly from week to week.
Monday: 10:30 am through noon.
Tuesday: 10 am through 4 pm.
Wednesday: 10 am through 4 pm.
Thursday: 10 am through 2 pm.
Friday: Generally unavailable.
Not available during winter or July/August. Limited availability at other times.
Tuesday: 11 am through 3 pm
Wednesday: 11 am through 3 pm
Thursday: 11 am through 2 pm
Saturday: can be negotiated if absolutely needed.
How to schedule an appointment:
You schedule directly with me via e-mail (preferred) or secure message.
For new patients:
New patient form: Please download, complete, then email or fax back to me. In a pinch, a cell phone photo also works.
Email consent form: Please download, complete, then email or fax back to me.
Privacy notice: Please download, complete, then email or fax back to me
Medical Symptom Questionnaire: Please download, complete, then email or fax back to me.
Methylation and Mood Questionnaire [if applicable]: Please download, complete, then email or fax back to me.
Diet Log [optional]: Please download, complete, then email or fax back to me.
Herndon VA office : I am no longer there in person. Visits are now conducted by phone or video from the convenience of your home. However, you can still go there for speciality lab blood-draws; contact ArcPoint labs directly at 703-689-2721.
Bloomsburg PA Office: I do not have a local office. Please contact me to arrange a HouseCall (if in the local area) or a Telemedicine visit.
This website is hand-coded using notepad (I shun webpage editors), so if something is not working right, please let me know.
However, as my HTML programming skills are self-taught and rudimentary at best, and I have not taken the time to learn Java, this website is unlikely to get much fancier.
(I prefer to spend my time researching SNPs rather than become a better page-coder)