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Writer's pictureNancy Mullan, MD

Depression, MTHFR+, Chronic Fatigue Syndrome and Fibromyalgia

If you have chronic fatigue syndrome (CFS) or fibromyalgia (FM), you are likely to be miserable. You may have body pain, fatigue, insomnia, headaches, difficulty concentrating and poor digestion, among other symptoms. Any degree of exercise can just wipe you out. Your mainstream doctor may try to help, but he is likely to be confused and directionless about how to do that. Drugs meant to suppress symptoms do not work well for a multi system disorder. He may send you to a laundry list of specialists who don't help that much either. The problem can go on for years. You may end up being shunned by doctors. They may see you, but they don't come close to fixing your issues. After many failed treatments, you start feeling totally hopeless about recovering or even improving. Three quarters of CFS/FM patients are women between the ages of 30 and 50, although it may start earlier. You loose functional capacity and may not be able to work, so you get financially underwater. Your family may get tired of the whole thing and their sympathy wear thin. The situation is depressing, to say the least. This is psychological depression, depression caused by situational factors. But CFS/FM are multi system disorders affecting at minimum your nervous, endocrine (hormonal) and immune systems. Any factors impacting these systems also produce mental states that look like psychological depression, but they aren't psychological. They are caused by the underlying physiological disorder.  Ground zero for these illnesses are the mitochondria, a critical part of your cell. Mitochondria not only produce energy for your cells, they have connections to methylation and genetics that determine how well your cells function. The nucleus of the mitochondria have structures called histones that need to be methylated to function correctly. If you have an MTHFR mutation, MTHFR+, your capacity to make methyl groups will be limited and you may not be able to methylate the histones. The mitochondria then can start to send your cell into a programmed cell death called apoptosis. That is what CFS and FM feel like, as if your body were shutting down. Electron microscope studies of muscle cells of people with CFS/FM have shown damage. The mitochondria can not function properly. When the energy production in your cells declines, you become physiologically, and very likely psychologically, depressed. The factors that make your problem genetics worse and additionally lead to mitochondrial damage are known to be poor nutrition, chronic physical or mental stress, sedentary lifestyle, chronic inflammation, certain prescription drugs, and environmental toxins. A short list of the prescription drugs that damage mitochondria include acetaminophen (Tylenol), tricyclic antidepressants, statins, certain anti-viral drugs, certain antibiotics and chemotherapy.

Improving and restoring mitochondrial health is critical to getting back on your feet. Treating your mitochondria has been shown to have a very positive impact on these disorders. Clearly, if your nutrition is poor, that has to be corrected. Beyond that, you need to find out what your genetics are and nutritionally bypass any roadblocks you have to methyl group production. You need to decrease oxidative stress in your mitochondria by taking anti-oxidants and other supportive nutrition. Important mitochondrial restoration supplements are n-acetyl-cysteine (NAC), acetyl-L-carnitine, alpha lipoid acid, and CoQ10. These detoxify the interior of the mitochondria and increase their function. It is a rising tide that lifts all ships. It improves the health and function of all of your organ systems, especially your heart, skeletal muscles and brain. When these improve, so does the depression that came with your depleted mitochondrial state.


If you want expert help personalized to your genetics and your own particular biochemistry, you can start with an Exploratory Conversation with me. I offer this service so that you can check out how I work, get to know what I am like as a human being, see what I have to say and decide if you would like to take whatever further steps may be involved in improving your symptoms. This is a 30-minute conversation in which I listen to your health issues, review what test results you have, and make recommendations about what I think you should do. You can tell me all of the things you have tried and I will give you my input about what you can consider next.

The fee for this service is $129. It is easy to set a time for this conversation, and it can save you weeks or months of doing the wrong thing, lurching around in the dark with a clinician who doesn’t know anything about the genetics or molecular biology of MTHFR+ and its connections to CFS/FM. You are dealing with conditions in your body that are confusing and difficult to understand. I can help you cut through all of that and give you clarifying input that moves you in the right direction.

I have a free, downloadable ebook at NancyMullanMD.com that gives you further detail about methylation issues. Click here to download.

I look forward to being able to help,

Dr. Mullan


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What people are saying about my work:


I shudder at the thought of what my family would be like without Dr. Mullan. Thankfully, with her help, we have stopped my husband's chronic 30 year battle with kidney stones. He is no longer forming them and is stone free. My thyroid is now working normally, my body temperature is almost normal and my hair has grown back. My oldest daughter's Autism is in the process of being reversed and her hair pulling has stopped. The greatest blessing from our good health is the birth of my second daughter Ava, now one-year-old. At 50 years old I carried her to term.  One of my doctors commented to me saying “ you are carrying this baby like a 22-year-old.” Yes, I am because of Dr. Mullan and working on my methylation pathway.  One by one she is knocking off symptoms and bringing us back to health. The future is bright! Thank you, Dr. Mullan, for the work you do.   - JVW Wow.  I feel great.  Thank you for your help.  It’s amazing really.  Like a light turned on.  Curious to see what the next tests show.   To ride this peak indefinitely is my goal.  Ha.  I have energy again.  Yay!  Really grateful. - DG I am so relieved. My daughter is doing SO WELL since we started with you!  We have been to so many doctors and tried so many things.  Now I can start working on my own program with you.... - GV So excellent!  I literally learn something with every single post and I get clarification on things that have been lingering on my mind… - VB You are giving people a huge gift by empowering them…It’s about helping the patient become their own healer by taking them to a higher level of consciousness… - AL Thank you so much, Dr. Mullan.  Thank you so, so much for everything you do. - MS Wow!  I have to tell you, it’s so nice to hear good news especially about a child.  Anxiety, OCD and a host of other mental/psychiatric symptoms have been a huge hurdle for me.  So to hear this story of all those awful symptoms totally going away is such a bright light for me!!!! - TR Fantastic, caring, smart, savvy doc.  I worked with Dr. Mullan for a couple of years to help MTHFR mutations and their associating expressions!  To say the least!  She's brilliant.  At that time she had weekly calls for her patients - free - where we could ask questions and she would reply.  What doctors do this?  She does.  She's also an animal lover and is right on about the way she practices medicine.  I highly recommend her.  In good health! - MG You're in good hands with Dr. Mullan. She is intelligent, caring and knowledgable, spending much time with you. She thinks outside the box to achieve wellness for you. She really knows what's going on inside your body. - MS Dr. Nancy Mullan is a beautiful person. She is an expert in her field and has helped our family so much. I am very grateful to her.  She came highly recommended and I know why. I would recommend her and her website for information re: healing from a genetic point of view. Thank you, Dr. Mullan, for everything. - GD Dr.Mullan has helped me with issues that I have struggled with for years.  She is knowledgable and practical.  I would recommend her to others. - BC



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