Dr. Amy Nett: So this is talking probably a little bit more about methylation. I think that’s what you mean when you’re talking about the SNPs. I think I heard even again on Tuesday Chris was talking again about genetics and epigenetics and while the single-nucleotide polymorphisms (SNP) do give us some indication as to maybe whether or not people might need some form of methylation support, active forms of B vitamins like folate, the methyltetrahydrofolate or folinic acid. I don’t think we can actually use genetics alone to know who’s going to respond well to certain types of B vitamins, including both the different forms of B vitamins, like methyl B12, adeno B12, hydroxy B12, or different types of folate, like the methyltetrahydrofolate and folinic acid.
So when we see anxiety in people taking certain types of B12, most often this seems to be associated with over-methylation. We’ve talked about methylation. It can be a fine balance in terms of adequate methylation or over-methylation. So I would say if you’re seeing anxiety, some people again, they’re just sensitive, but I don’t know that we can use the SNPs to predict that, and most often it’s trial and error in terms of what patients can start with and we start them generally on, I believe we start people on hydroxo B12. I think most people tend to tolerate that a little bit better and sometimes switch people to adeno B12, and we also sometimes use a methyl B12. So a little bit of trial and error, but I don’t think you can use genes to predict that.