IFMCP Test with all Correct & 100% Verified
Answers |Actual Complete Update |Already
Graded A+ (just released)
What are the coenzymes needed for desaturase metabolism of omega 3 PUFAs ✔Correct Answer-
zinc, magnesium, ascorbate, niacin, and
pyridoxine
List the steps in the Omega-3 pathway ✔Correct 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 ✔Correct 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. ✔Correct 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? ✔Correct
Answer-Vitamin D
list natural treatments that are insulin sensitizers ✔Correct Answer-Vanadium, Chromium, Alpha
Lipoic Acid, Cinnamon, Magnesium (not citrate)
Homocysteine needs a methyl group to eventually become what? ✔Correct Answer-SAMe The
body's methyl donor
Tyrosine is methylated and becomes what? ✔Correct Answer-Dopamine and norepinephrine
Tryptophan is methylated and eventually becomes what ✔Correct Answer-Serotonin and
melatonin
Why does histamine need a methyl group? ✔Correct Answer-To get broken down
Which vitamins are involved in folate metabolism to 5MTHF ✔Correct 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? ✔Correct Answer-
BH4 (Tetrahydrobiopterin)
What does methionine synthase recycle? ✔Correct Answer-Methionine synthase is needed to
recycle homocysteine to Same
What is methionine synthase blocked by and what is a clue to dysfunction ✔Correct Answer-
Blocked by alcohol and a clue to dysfunction is elevated MCV
,What are the clinically elevated SNPs involved in methionine synthase ✔Correct Answer-MTRR
A66G and MTRRC524T
What mineral is a carrier of homocysteine ✔Correct Answer-Zinc
What vitamins need to be supported in a person with methionine synthase SNP defects ✔Correct
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 ✔Correct Answer-Betaine in the form of TMG
What are the two functions of COMT ✔Correct Answer-Breakdown catecholamines, takes part in
estrogen metabolism
What is the clinically relevant SNP for COMT ✔Correct Answer-COMT V158M
How does the Val/Val allele affect COMT function ✔Correct Answer-Up regulated so it will break
down catecholamines faster
How does the Val/Met allele affect COMT function ✔Correct Answer-This is normal
How does the met/met allele affect COMT function? ✔Correct 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 ✔Correct 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? ✔Correct
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? ✔Correct 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?
✔Correct 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 ✔Correct Answer-Quercetin and EGCG
Review the considerations for a patient who has the met/met COMT allele which means it is down
regulated. ✔Correct 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
✔Correct Answer-Hold methylated supplements. Consider magnesium. Consider SAMe
,supplementation which 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? ✔Correct Answer-Estrogen increases
TSH secretion
How do high doses of glucocorticoids affect the thyroid? ✔Correct Answer-High doses of
glucocorticoids inhibit thyroid hormone section
Steroid hormones are synthesized from what dietary intake? ✔Correct Answer-Cholesterol (LDL)
from the diet is required for steroid hormone synthesis.
The steroid pneumonic PTSD stands for what? ✔Correct Answer-Production, Transport, Sensitivity,
Detoxification
How does stress affect 17,20 lyase? ✔Correct Answer-Decreases anabolism by slowing down 17,20
lyase
How does inflammation affect 17,20 lyase? ✔Correct Answer-Inflammation inhibits 17,20 Lyase
How does inflammation affect estrogen? ✔Correct Answer-Stimulates aromatase to increase E
(estrogen) formation
How does inflammation affect the testosterone to DHT pathway? ✔Correct Answer-Increases 5α
reductase to increase formation of DHT. This can cause hair loss.
How does weight gain affect SHBG? ✔Correct Answer-SHBG is decreased by body weight
How does visceral adiposity affect SHBG? ✔Correct Answer-SHBG decreased by VAT , independent
of weight
How does insulin resistance affect SHBG? ✔Correct Answer-SHBG decreased by insulin resistance
and hyperinsulinemia. SHBG is a marker for insulin resistance and Low SHBG is a predictor for
development of Type II DM
What is the cortisol and DHEA pattern in Selye's stage 1 arousal? What is the clinical presentation?
✔Correct Answer-Both cortisol and DHEA increase with episodic stress, but recovery occurs to
baseline.
Elevated Cortisol
Elevated or normal DHEA
Asymptomatic, stimulated
What is the cortisol and DHEA pattern in Selye's stage 2 adaptation? What is the clinical
presentation? ✔Correct Answer-Cortisol chronically elevated, (cortisol can also be normal) but
DHEA declines. Elevated cortisol/DHEA ratio
"Stressed," anxiety attacks, mood swings, depression
What is the cortisol and DHEA pattern in Selye's stage 3 exhaustion? What is the clinical
presentation? ✔Correct Answer-Adrenal insufficiency / low cortisol and DHEA
Depression and fatigued. Generally, the cortisol/DHEA ratio is no longer useful
, What are the basic supplements needed to support adrenal hormone production? ✔Correct
Answer-B-Complex (especially B5, B6, Biotin, Folate), Vitamin C, Magnesium, Omega-3s, Zinc
What are the foundational "alarm" stage 1 interventions for transiently elevated catecholamines and
cortisol? ✔Correct Answer-Ashwagandha, Holy Basil. L-theanine, 5-HTP, Passion Flower, Valerian
Root, Kava Kava, Rehmannia, Schisandra, Polygala
What are the foundational stage 2 (resistance/early decompensation) interventions for
hypercortisolism ✔Correct Answer-Ashwagandha, Rhodiola, Cordyceps, Siberian ginseng, St. Johns
Wort, Phosphatidylserine, Dark chocolate
What are some conditions associated with insufficient HPA activity - Low Cortisol? ✔Correct
Answer-Atypical depression, Seasonal affective disorder, Postpartum depression, Panic attacks,
Generalized anxiety disorder, Bipolar II disorder, Chronic Fatigue Syndrome
What are some foundational interventions for Stage 3 - exhaustion phase/late decompensation -
hypocortisolism? ✔Correct Answer-Ashwagandha, Licorice, Rehmannia, Cordyceps, Asian ginseng
What are nutrients that contribute to proper production of thyroid hormones? ✔Correct Answer-
Iron, Iodine, Tyrosine, Zinc, Selenium, Vitamins E, B2, B3, B6, C, D
What are factors that inhibit proper production of thyroid hormones? ✔Correct Answer-Stress,
Infection, Trauma, Radiation, Medications, Flouride, Toxins - pesticides, mercury, cadmium, lead,
autoimmune disease like Celiac
What are factors that increase conversion of T4 to T3? ✔Correct Answer-Selenium, Zinc
What are factors that increase the conversion of T4 to RT3? ✔Correct Answer-Trauma, Stress, Low-
calorie diet, Inflammation, Toxins, Infections, Liver/kidney dysfunction, Certain medications
What factors improve celluar sensitivity to thyroid hormones? ✔Correct Answer-Vitamin A,
Exercise, Zinc
What enzyme converts testosterone to DHT? ✔Correct Answer-5a-reductase
Does pregnancy increase or decrease SHBG? ✔Correct Answer-increase
Does hyperthyroidism increase or decrease SHBG? ✔Correct Answer-increase
Does exogenous estrogen administration (like HRT or OCP) increase or decrease SHBG? ✔Correct
Answer-increase
Does obesity increase or decrease SHBG? ✔Correct Answer-decrease
Do androgens increase or decrease SHBG? ✔Correct Answer-decrease
Does insulin increase or decrease SHBG? ✔Correct Answer-decrease
Does IGF-1 increase or decrease SHBG? ✔Correct Answer-decrease
Does hypothyroidism increase or decrease SHBG? ✔Correct Answer-decrease
Answers |Actual Complete Update |Already
Graded A+ (just released)
What are the coenzymes needed for desaturase metabolism of omega 3 PUFAs ✔Correct Answer-
zinc, magnesium, ascorbate, niacin, and
pyridoxine
List the steps in the Omega-3 pathway ✔Correct 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 ✔Correct 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. ✔Correct 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? ✔Correct
Answer-Vitamin D
list natural treatments that are insulin sensitizers ✔Correct Answer-Vanadium, Chromium, Alpha
Lipoic Acid, Cinnamon, Magnesium (not citrate)
Homocysteine needs a methyl group to eventually become what? ✔Correct Answer-SAMe The
body's methyl donor
Tyrosine is methylated and becomes what? ✔Correct Answer-Dopamine and norepinephrine
Tryptophan is methylated and eventually becomes what ✔Correct Answer-Serotonin and
melatonin
Why does histamine need a methyl group? ✔Correct Answer-To get broken down
Which vitamins are involved in folate metabolism to 5MTHF ✔Correct 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? ✔Correct Answer-
BH4 (Tetrahydrobiopterin)
What does methionine synthase recycle? ✔Correct Answer-Methionine synthase is needed to
recycle homocysteine to Same
What is methionine synthase blocked by and what is a clue to dysfunction ✔Correct Answer-
Blocked by alcohol and a clue to dysfunction is elevated MCV
,What are the clinically elevated SNPs involved in methionine synthase ✔Correct Answer-MTRR
A66G and MTRRC524T
What mineral is a carrier of homocysteine ✔Correct Answer-Zinc
What vitamins need to be supported in a person with methionine synthase SNP defects ✔Correct
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 ✔Correct Answer-Betaine in the form of TMG
What are the two functions of COMT ✔Correct Answer-Breakdown catecholamines, takes part in
estrogen metabolism
What is the clinically relevant SNP for COMT ✔Correct Answer-COMT V158M
How does the Val/Val allele affect COMT function ✔Correct Answer-Up regulated so it will break
down catecholamines faster
How does the Val/Met allele affect COMT function ✔Correct Answer-This is normal
How does the met/met allele affect COMT function? ✔Correct 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 ✔Correct 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? ✔Correct
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? ✔Correct 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?
✔Correct 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 ✔Correct Answer-Quercetin and EGCG
Review the considerations for a patient who has the met/met COMT allele which means it is down
regulated. ✔Correct 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
✔Correct Answer-Hold methylated supplements. Consider magnesium. Consider SAMe
,supplementation which 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? ✔Correct Answer-Estrogen increases
TSH secretion
How do high doses of glucocorticoids affect the thyroid? ✔Correct Answer-High doses of
glucocorticoids inhibit thyroid hormone section
Steroid hormones are synthesized from what dietary intake? ✔Correct Answer-Cholesterol (LDL)
from the diet is required for steroid hormone synthesis.
The steroid pneumonic PTSD stands for what? ✔Correct Answer-Production, Transport, Sensitivity,
Detoxification
How does stress affect 17,20 lyase? ✔Correct Answer-Decreases anabolism by slowing down 17,20
lyase
How does inflammation affect 17,20 lyase? ✔Correct Answer-Inflammation inhibits 17,20 Lyase
How does inflammation affect estrogen? ✔Correct Answer-Stimulates aromatase to increase E
(estrogen) formation
How does inflammation affect the testosterone to DHT pathway? ✔Correct Answer-Increases 5α
reductase to increase formation of DHT. This can cause hair loss.
How does weight gain affect SHBG? ✔Correct Answer-SHBG is decreased by body weight
How does visceral adiposity affect SHBG? ✔Correct Answer-SHBG decreased by VAT , independent
of weight
How does insulin resistance affect SHBG? ✔Correct Answer-SHBG decreased by insulin resistance
and hyperinsulinemia. SHBG is a marker for insulin resistance and Low SHBG is a predictor for
development of Type II DM
What is the cortisol and DHEA pattern in Selye's stage 1 arousal? What is the clinical presentation?
✔Correct Answer-Both cortisol and DHEA increase with episodic stress, but recovery occurs to
baseline.
Elevated Cortisol
Elevated or normal DHEA
Asymptomatic, stimulated
What is the cortisol and DHEA pattern in Selye's stage 2 adaptation? What is the clinical
presentation? ✔Correct Answer-Cortisol chronically elevated, (cortisol can also be normal) but
DHEA declines. Elevated cortisol/DHEA ratio
"Stressed," anxiety attacks, mood swings, depression
What is the cortisol and DHEA pattern in Selye's stage 3 exhaustion? What is the clinical
presentation? ✔Correct Answer-Adrenal insufficiency / low cortisol and DHEA
Depression and fatigued. Generally, the cortisol/DHEA ratio is no longer useful
, What are the basic supplements needed to support adrenal hormone production? ✔Correct
Answer-B-Complex (especially B5, B6, Biotin, Folate), Vitamin C, Magnesium, Omega-3s, Zinc
What are the foundational "alarm" stage 1 interventions for transiently elevated catecholamines and
cortisol? ✔Correct Answer-Ashwagandha, Holy Basil. L-theanine, 5-HTP, Passion Flower, Valerian
Root, Kava Kava, Rehmannia, Schisandra, Polygala
What are the foundational stage 2 (resistance/early decompensation) interventions for
hypercortisolism ✔Correct Answer-Ashwagandha, Rhodiola, Cordyceps, Siberian ginseng, St. Johns
Wort, Phosphatidylserine, Dark chocolate
What are some conditions associated with insufficient HPA activity - Low Cortisol? ✔Correct
Answer-Atypical depression, Seasonal affective disorder, Postpartum depression, Panic attacks,
Generalized anxiety disorder, Bipolar II disorder, Chronic Fatigue Syndrome
What are some foundational interventions for Stage 3 - exhaustion phase/late decompensation -
hypocortisolism? ✔Correct Answer-Ashwagandha, Licorice, Rehmannia, Cordyceps, Asian ginseng
What are nutrients that contribute to proper production of thyroid hormones? ✔Correct Answer-
Iron, Iodine, Tyrosine, Zinc, Selenium, Vitamins E, B2, B3, B6, C, D
What are factors that inhibit proper production of thyroid hormones? ✔Correct Answer-Stress,
Infection, Trauma, Radiation, Medications, Flouride, Toxins - pesticides, mercury, cadmium, lead,
autoimmune disease like Celiac
What are factors that increase conversion of T4 to T3? ✔Correct Answer-Selenium, Zinc
What are factors that increase the conversion of T4 to RT3? ✔Correct Answer-Trauma, Stress, Low-
calorie diet, Inflammation, Toxins, Infections, Liver/kidney dysfunction, Certain medications
What factors improve celluar sensitivity to thyroid hormones? ✔Correct Answer-Vitamin A,
Exercise, Zinc
What enzyme converts testosterone to DHT? ✔Correct Answer-5a-reductase
Does pregnancy increase or decrease SHBG? ✔Correct Answer-increase
Does hyperthyroidism increase or decrease SHBG? ✔Correct Answer-increase
Does exogenous estrogen administration (like HRT or OCP) increase or decrease SHBG? ✔Correct
Answer-increase
Does obesity increase or decrease SHBG? ✔Correct Answer-decrease
Do androgens increase or decrease SHBG? ✔Correct Answer-decrease
Does insulin increase or decrease SHBG? ✔Correct Answer-decrease
Does IGF-1 increase or decrease SHBG? ✔Correct Answer-decrease
Does hypothyroidism increase or decrease SHBG? ✔Correct Answer-decrease
