IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
What are the coenzymes needed for desaturase metabolism of omega 3 PUFAs - (ANSWER)zinc,
magnesium, ascorbate, niacin, and
pyridoxine
List the steps in the Omega-3 pathway - (ANSWER)ALA to Stearidonic acid to Eicosatetranoic acid to
Eicosapentaenoic acid (EPA) to Docosapentaenoic acid to Docosahexaenoic acid (DHA)
List the steps in the Omega-6 pathway - (ANSWER)Linoleic acid (LA) to GLA to Dihomogamma-linolenic
acid to AA to Adrenic acid to Docosopentaenoic acid
What vitamin deficiency leads to food intolerance because it is essential for maintaining integrity and
function of all mucosal surfaces. - (ANSWER)Vitamin A. It can be corrected with dietary supplements,
10,000+ international units a day
What vitamin enhances host defenses against cancer, enhances host defense against infection, up
regulates antimicrobial peptides, and dampens inflammatory cytokines production? - (ANSWER)Vitamin
D
list natural treatments that are insulin sensitizers - (ANSWER)Vanadium, Chromium, Alpha Lipoic Acid,
Cinnamon, Magnesium (not citrate)
Homocysteine needs a methyl group to eventually become what? - (ANSWER)SAMe The body's methyl
donor
Tyrosine is methylated and becomes what? - (ANSWER)Dopamine and norepinephrine
Tryptophan is methylated and eventually becomes what - (ANSWER)Serotonin and melatonin
Why does histamine need a methyl group? - (ANSWER)To get broken down
,IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
Which vitamins are involved in folate metabolism to 5MTHF - (ANSWER)Pyridoxine (B6) and riboflavin
(B2)
Which cofactor which uses 5MTHF to synthesize, is involved in the tryptophan to serotonin pathway and
the tyrosine to dopamine pathway and the arginine to nitric oxide pathway? - (ANSWER)BH4
(Tetrahydrobiopterin)
What does methionine synthase recycle? - (ANSWER)Methionine synthase is needed to recycle
homocysteine to Same
What is methionine synthase blocked by and what is a clue to dysfunction - (ANSWER)Blocked by alcohol
and a clue to dysfunction is elevated MCV
What are the clinically elevated SNPs involved in methionine synthase - (ANSWER)MTRR A66G and
MTRRC524T
What mineral is a carrier of homocysteine - (ANSWER)Zinc
What vitamins need to be supported in a person with methionine synthase SNP defects - (ANSWER)Zinc,
B12, 5-MTHF
If a patient has a methionine synthase SNP and their high homocysteine is not budging what supplement
should be considered - (ANSWER)Betaine in the form of TMG
What are the two functions of COMT - (ANSWER)Breakdown catecholamines, takes part in estrogen
metabolism
What is the clinically relevant SNP for COMT - (ANSWER)COMT V158M
,IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
How does the Val/Val allele affect COMT function - (ANSWER)Up regulated so it will break down
catecholamines faster
How does the Val/Met allele affect COMT function - (ANSWER)This is normal
How does the met/met allele affect COMT function? - (ANSWER)It is down regulated so it will not break
down catecholamines as well
should you give a woman with the Val/Val snp aspirin for CVD protection - (ANSWER)No, there is an 85%
increase risk of CVD with aspirin
Should you give a woman with the Val/Val COMT allele vitamin E for CVD protection? - (ANSWER)No,
there is an increase risk of CVD with vitamin E in a woman with the Val/Val SNP
Should you give a woman with the met/met allele aspirin for CVD protection? - (ANSWER)Possibly, there
is a 40% decrease risk of CVD with ASA
Should you give a woman with the met/met allele for COMT vitamin E for CVD protection? -
(ANSWER)Possibly, there is a decreased risk of CVD with vitamin E and women with the met/met allele
Which polyphenols can block the COMT enzymewhen it is up regulated in somebody with the Val Val
allele - (ANSWER)Quercetin and EGCG
Review the considerations for a patient who has the met/met COMT allele which means it is down
regulated. - (ANSWER)Stress management, avoid caffeine and other stimulants, caution with EGCG and
quercetin, consider Sam E supplementation which is a cofactor, consider magnesium optimization,
support the MS enzyme, consider creatine as the body uses a lot of creatine to make SAMe, optimize
estrogen levels with DIM and sulpforaphane, in women, use ASA and vitamin E when appropriate
Review the management of a patient with MTHFR dysfunction with a COMT met/met allele -
(ANSWER)Hold methylated supplements. Consider magnesium. Consider SAMe supplementation which
, IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
is a cofactor. Consider creatine. Slowly introduce methyl folate at lower doses. Consider hydroxy
cobalamin. Consider glutathione and/or NAC.
How does the addition of exogenous estrogen affect TSH? - (ANSWER)Estrogen increases TSH secretion
How do high doses of glucocorticoids affect the thyroid? - (ANSWER)High doses of glucocorticoids inhibit
thyroid hormone section
Steroid hormones are synthesized from what dietary intake? - (ANSWER)Cholesterol (LDL) from the diet
is required for steroid hormone synthesis.
The steroid pneumonic PTSD stands for what? - (ANSWER)Production, Transport, Sensitivity,
Detoxification
How does stress affect 17,20 lyase? - (ANSWER)Decreases anabolism by slowing down 17,20 lyase
How does inflammation affect 17,20 lyase? - (ANSWER)Inflammation inhibits 17,20 Lyase
How does inflammation affect estrogen? - (ANSWER)Stimulates aromatase to increase E (estrogen)
formation
How does inflammation affect the testosterone to DHT pathway? - (ANSWER)Increases 5α reductase to
increase formation of DHT. This can cause hair loss.
How does weight gain affect SHBG? - (ANSWER)SHBG is decreased by body weight
How does visceral adiposity affect SHBG? - (ANSWER)SHBG decreased by VAT , independent of weight
WITH COMPLETE SOLUTION
What are the coenzymes needed for desaturase metabolism of omega 3 PUFAs - (ANSWER)zinc,
magnesium, ascorbate, niacin, and
pyridoxine
List the steps in the Omega-3 pathway - (ANSWER)ALA to Stearidonic acid to Eicosatetranoic acid to
Eicosapentaenoic acid (EPA) to Docosapentaenoic acid to Docosahexaenoic acid (DHA)
List the steps in the Omega-6 pathway - (ANSWER)Linoleic acid (LA) to GLA to Dihomogamma-linolenic
acid to AA to Adrenic acid to Docosopentaenoic acid
What vitamin deficiency leads to food intolerance because it is essential for maintaining integrity and
function of all mucosal surfaces. - (ANSWER)Vitamin A. It can be corrected with dietary supplements,
10,000+ international units a day
What vitamin enhances host defenses against cancer, enhances host defense against infection, up
regulates antimicrobial peptides, and dampens inflammatory cytokines production? - (ANSWER)Vitamin
D
list natural treatments that are insulin sensitizers - (ANSWER)Vanadium, Chromium, Alpha Lipoic Acid,
Cinnamon, Magnesium (not citrate)
Homocysteine needs a methyl group to eventually become what? - (ANSWER)SAMe The body's methyl
donor
Tyrosine is methylated and becomes what? - (ANSWER)Dopamine and norepinephrine
Tryptophan is methylated and eventually becomes what - (ANSWER)Serotonin and melatonin
Why does histamine need a methyl group? - (ANSWER)To get broken down
,IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
Which vitamins are involved in folate metabolism to 5MTHF - (ANSWER)Pyridoxine (B6) and riboflavin
(B2)
Which cofactor which uses 5MTHF to synthesize, is involved in the tryptophan to serotonin pathway and
the tyrosine to dopamine pathway and the arginine to nitric oxide pathway? - (ANSWER)BH4
(Tetrahydrobiopterin)
What does methionine synthase recycle? - (ANSWER)Methionine synthase is needed to recycle
homocysteine to Same
What is methionine synthase blocked by and what is a clue to dysfunction - (ANSWER)Blocked by alcohol
and a clue to dysfunction is elevated MCV
What are the clinically elevated SNPs involved in methionine synthase - (ANSWER)MTRR A66G and
MTRRC524T
What mineral is a carrier of homocysteine - (ANSWER)Zinc
What vitamins need to be supported in a person with methionine synthase SNP defects - (ANSWER)Zinc,
B12, 5-MTHF
If a patient has a methionine synthase SNP and their high homocysteine is not budging what supplement
should be considered - (ANSWER)Betaine in the form of TMG
What are the two functions of COMT - (ANSWER)Breakdown catecholamines, takes part in estrogen
metabolism
What is the clinically relevant SNP for COMT - (ANSWER)COMT V158M
,IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
How does the Val/Val allele affect COMT function - (ANSWER)Up regulated so it will break down
catecholamines faster
How does the Val/Met allele affect COMT function - (ANSWER)This is normal
How does the met/met allele affect COMT function? - (ANSWER)It is down regulated so it will not break
down catecholamines as well
should you give a woman with the Val/Val snp aspirin for CVD protection - (ANSWER)No, there is an 85%
increase risk of CVD with aspirin
Should you give a woman with the Val/Val COMT allele vitamin E for CVD protection? - (ANSWER)No,
there is an increase risk of CVD with vitamin E in a woman with the Val/Val SNP
Should you give a woman with the met/met allele aspirin for CVD protection? - (ANSWER)Possibly, there
is a 40% decrease risk of CVD with ASA
Should you give a woman with the met/met allele for COMT vitamin E for CVD protection? -
(ANSWER)Possibly, there is a decreased risk of CVD with vitamin E and women with the met/met allele
Which polyphenols can block the COMT enzymewhen it is up regulated in somebody with the Val Val
allele - (ANSWER)Quercetin and EGCG
Review the considerations for a patient who has the met/met COMT allele which means it is down
regulated. - (ANSWER)Stress management, avoid caffeine and other stimulants, caution with EGCG and
quercetin, consider Sam E supplementation which is a cofactor, consider magnesium optimization,
support the MS enzyme, consider creatine as the body uses a lot of creatine to make SAMe, optimize
estrogen levels with DIM and sulpforaphane, in women, use ASA and vitamin E when appropriate
Review the management of a patient with MTHFR dysfunction with a COMT met/met allele -
(ANSWER)Hold methylated supplements. Consider magnesium. Consider SAMe supplementation which
, IFMCP EXAM (QUESTIONBANK) | 526 QUESTIONS AND ANSWERS | 2025/2026 UPDATE |
WITH COMPLETE SOLUTION
is a cofactor. Consider creatine. Slowly introduce methyl folate at lower doses. Consider hydroxy
cobalamin. Consider glutathione and/or NAC.
How does the addition of exogenous estrogen affect TSH? - (ANSWER)Estrogen increases TSH secretion
How do high doses of glucocorticoids affect the thyroid? - (ANSWER)High doses of glucocorticoids inhibit
thyroid hormone section
Steroid hormones are synthesized from what dietary intake? - (ANSWER)Cholesterol (LDL) from the diet
is required for steroid hormone synthesis.
The steroid pneumonic PTSD stands for what? - (ANSWER)Production, Transport, Sensitivity,
Detoxification
How does stress affect 17,20 lyase? - (ANSWER)Decreases anabolism by slowing down 17,20 lyase
How does inflammation affect 17,20 lyase? - (ANSWER)Inflammation inhibits 17,20 Lyase
How does inflammation affect estrogen? - (ANSWER)Stimulates aromatase to increase E (estrogen)
formation
How does inflammation affect the testosterone to DHT pathway? - (ANSWER)Increases 5α reductase to
increase formation of DHT. This can cause hair loss.
How does weight gain affect SHBG? - (ANSWER)SHBG is decreased by body weight
How does visceral adiposity affect SHBG? - (ANSWER)SHBG decreased by VAT , independent of weight
