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 - (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
,[Type here]
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
,[Type here]
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
, [Type here]
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
2025/2026 UPDATE | WITH COMPLETE SOLUTION
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
,[Type here]
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
,[Type here]
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
, [Type here]
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
