Basically COMT is a system to reduce or eliminate (metabolize away) neurotransmitters. (removes methyl groups from them to inactivate them).

MTHFR is a methylating system which will MAKE the same neurotransmitters, by adding a methyl group to the substrates.
So these two systems work to balance things out in the long run.

I really haven't had time to find the other variants of the MTHFR's listed.

This stuff is really new and complex and how it shakes out in vivo may be very subtle. Your mixed mutation in the major MTHFR variant means you will have to use methylfolate instead of folic acid, and avoid folic acid if possible, (because it is in alot of foods in the US), because it competes for folate for transport into the brain, it is thought.

I was hoping you'd get the Cytochrome P-450 test DNA evaluation too, to see how you metabolize the drugs you take.

So you tapered off the Cymbalta? I didn't know you did that.

I still believe you have some kind of iatrogenic (doctor caused) problem. You didn't have this before, and only acquired it after quite of bit of invasive procedures.

Some of the COMT information revolves around too much dopamine (since with the mutation the body can't get rid of excess)...and that is something to look into when you have time. Too much dopamine is connected to addictive behaviors, and some forms of mental illness.

Have you been tested for heavy metals load? The MTHFR mutation appears to be very significant for heavy metal toxicity to build up in the body because they can't be methylated and excreted. That one link I gave stressed that possibility.

Also the dietary suggestions for lots of veggies as sources of natural folate, seems important. Methylfolate is now again available OTC. Solgar makes it, and you might start with it to see what happens... 800mcg a day.

I would avoid however, SAMe, as this is a methyl donor and you can't remove methyl groups adequately.