| Description |
Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that breaks down the amino acid homocysteine. When folic acid is ingested, MTHFR assists in its breakdown, resulting in LMethylfolate, the only form of folic acid that can cross the blood brain barrier. L-Methylfolate assists in the production of serotonin, dopamine, and norepinephrine. There are two main polymorphisms of MTHFR that have been linked to depression, C677T and 1298A. These variants cause reduced folic acid conversion, causing elevated homocysteine levels and reducing the amount of L-Methylfolate available to the brain. Since L-Methylfolate is needed to assist in neurotransmitter production, these variants have been linked to depression and treatment resistance. The C677T variant allele occurs most frequently in Hispanics (20% to 25%), Asians (up to 63%), and Caucasians (8% to 20%), and is relatively uncommon in African Americans (<2%) (Lipp, et al., 2020). Symptoms can be present from one copy (heterozygous) and more severe with two copies of C677T (homozygous). Many providers are not aware of this mutation and the availability of gene testing that can determine if a patient has it. The purpose of this project is to educate providers in family practice settings about MTHFR variants, reduced folic acid conversion, and their role in treatment resistant depression, specifically. Increasing provider adherence to evidence supported genetic testing will improve MTHFR polymorphism detection and potentially help improve treatment of depression. An online educational tool addressing MTHFR polymorphism prevalence and testing methods with an emphasis on genetic testing was created and offered to family practice healthcare providers participating in the study. A pretest and posttest were used to assess knowledge and intent to change practice. Data received from these tests were statistically analyzed and tables showing results were formulated. |
