I think its the group of defects you have with the acat, shmt, and full mthfr a1298c These are big guns and if you can get a doc on board, it would help. I know thats hard since there are only a handful of people who do this stuff. Your comt +\- is probably ok with some methyl groups but I would be careful with that acat since its a big gut enzyme and is also connected to mito problems. Since Yasko always starts with the SHMT you should start there.Her spray has folinic and nucleotides along with some other stuff so would be a good start. But overall, I'm not sure how you would do if you don't get the gut part stable. I would really research what you can to see whats right for you. Caledonia has a great signature for basic methylation info and I finally added some below that people ask me about alott.