Dustin Parker, D.O., FAAP

12/21/2025

Sunday schedule

Monday- Reelfoot
Tuesday-Reelfoot
Wednesday Christmas Eve 🎄- AM only ( out that Pm)
Thursday Christmas Day- entire office closed🎅
Friday- out of office

Please see I am in office the beginning of the week. After that I will not return until January 5th. If you need appts or medications in my absence then please call and our staff will get it handled.

I will still do my best to return messages as I always do when I am out.

Hope everyone has a Merry Christmas

12/16/2025

I had someone ask about MTHFR gene and vaccines and the gene in general. It's the in thing to talk about sometimes so here is some info about it. Talking about genes/enzymes and mutations can be complex so bear with me. It took me a little longer to get the data together but made time of it this morning before clinic. This is a very science based post but it's the only way to explain it.

The methylenetetrahydrofolate reductase (MTHFR) gene encodes a key enzyme in folate metabolism that catalyzes the conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, which is essential for homocysteine remethylation to methionine. However, there is no established relationship between MTHFR gene polymorphisms and vaccine response in the literature.

The MTHFR gene has been extensively studied in relation to numerous health conditions. The two most common polymorphisms, C677T (rs1801133) and A1298C (rs1801131), reduce enzyme activity and can lead to elevated homocysteine levels, particularly when folate status is impaired. These variants have been associated with cardiovascular disease, neural tube defects, certain cancers, autoimmune diseases, neurological disorders

The C677T polymorphism is particularly prevalent, with approximately 25% of Hispanics and 10-15% of North American Caucasians having this variant. This polymorphism results in a thermolabile enzyme with reduced activity at higher temperatures. The functional effects of these polymorphisms are modulated by folate status and ethnic background.

From a pharmacogenetic perspective, MTHFR polymorphisms have been shown to influence response to certain medications, particularly methotrexate in cancer and rheumatoid arthritis patients, as well as fluoropyrimidines and other antifolates. There is no current evidence that the gene can Change your response to vaccines. If that evidence arises I'll for sure update this.

So if you have cancer or autoimmune diseases your variant or lack thereof might be important. For children and vaccinations there's no documentation from a medical journal or literature perspective that says vaccines should be given different than the current AAP recs!

Dr. Parker

References

1. MTHFR Gene Polymorphisms: A Single Gene With Wide-Ranging Clinical Implications-a Review. Araszkiewicz AF, Jańczak K, Wójcik P, et al. Genes. 2025;16(4):441. doi:10.3390/genes16040441.
2. Methylenetetrahydrofolate Reductase: Biochemical Characterization and Medical Significance. Trimmer EE. Current Pharmaceutical Design. 2013;19(14):2574-93. doi:10.2174/1381612811319140008.
3. ACMG Practice Guideline: Lack of Evidence for MTHFR Polymorphism Testing. Hickey SE, Curry CJ, Toriello HV. Genetics in Medicine : Official Journal of the American College of Medical Genetics. 2013;15(2):153-6. doi:10.1038/gim.2012.165.
4. MTHFR Polymorphisms in Autoimmune Diseases: Mechanistic and Clinical Perspectives. Sun T, Wu Y, Kong L, et al. Autoimmunity Reviews. 2025;:103939. doi:10.1016/j.autrev.2025.103939.
5. MTHFR. National Library of Medicine (MedlinePlus).
6. Homocystinuria due to Deficiency of N(5,10)-Methylenetetrahydrofolate Reductase Activity. Umair M, Alfadhel M. GeneReviews® [Internet]. Updated 2025 Dec 4.
7. Functional Inference of the Methylenetetrahydrofolate Reductase 677C > T and 1298A > C Polymorphisms From a Large-Scale Epidemiological Study. Ulvik A, Ueland PM, Fredriksen A, et al. Human Genetics. 2007;121(1):57-64. doi:10.1007/s00439-006-0290-2.
8. Pharmacogenetic Relevance of MTHFR Polymorphisms. Toffoli G, De Mattia E. Pharmacogenomics. 2008;9(9):1195-206. doi:10.2217/14622416.9.9.1195.

12/15/2025

PSA 🚨

I have had several people message today about wait times recently and had families upset today about the waits. Although 1-2 hour waits are standard at many places it's usually not that way with me.

I promise you nobody cares as much about your time as I do. I am super conscientious of wait times but I assure you we were doing the best we can. I was even bringing back patients myself. We are in the middle of sick season with an entire new EMR.

Please give us some grace and before you feel the need to go on social media and say something shoot me a message on here. I literally give time to clinic and a ton of time answering messages every single day ( morning/night/holidays etc). If your med didn't make it to the pharmacy with our new system reach out here. If you have a concern reach out to me here. I am very responsive but I can't handle issues I don't know about.

Dr. Parker

12/14/2025

Sunday schedule

Monday- Reelfoot
Tuesday-Reelfoot
Wednesday- out of office
Thursday- Reelfoot
Friday- out of office AM. In office at 1

Reminder if you leave a message for refills, questions etc and don't hear back within a reasonable amount of time please call or reach out to me here. Our new system is syncing up with pharmacies etc so things could get lost! Also if any issues even if I didn't see your kid that day before you go to social media to complain reach out to me here. If you mention Reelfoot on social media whether I saw you that day or take care of your child it reflects on me 😊. I go above and beyond every single day ( weekends and holidays) and I will make sure your issue is handled. I care a lot about our clinic and our patients.

See everyone tomorrow

Dr. Parker

*pic from lights at Discovery park!

12/11/2025

I appreciate everyone's patience today as we were running behind on Day 3 of our new EMR with full sick season volume of patients. I know my patients have not got accustomed to 1 hour waits ( although that's normal doctor time 🤣). I try to be way more prompt than that. I appreciate everyone's understanding and I know I apologized a ton today for the delay.

If anyone had any check in issues let us know. It's a learning curve but I think it will be better in the long run!

Reminder flu is here! Wash your hands and don't go around people if you are feeling ill. Appreciate each and everyone!

Dr. Parker

12/10/2025

I wanted to touch on the literature for aluminum exposure as it's commonly brought up and I personally wanted to refresh my own knowledge. For those worried about "heavy metal exposure" here is some data.

Aluminum is ubiquitous in the environment, with exposure occurring primarily through food and drinking water. The European Food Safety Authority (EFSA) established a tolerable weekly intake (TWI) of 1 mg/kg body weight/week, while the Joint FAO/WHO Expert Committee on Food Additives set a provisional tolerable weekly intake (PTWI) of 2 mg/kg body weight/week.For vaccines, the FDA limits aluminum content to 0.85 mg/dose, with currently licensed vaccines containing 0.125-0.85 mg/dose. So let's for instance base this on a 10kg child. Say the child gets 4 vaccines ( injections) with max aluminum per the FDA. That ends up being 3.4mg. If we base that on the European guidelines we are 6.6mg away from the weekly recommended dose. 🤷‍♂️

Aluminum is cleared primarily by the kidneys, with efficient renal excretion in individuals with normal kidney function. Pharmacokinetic studies demonstrate that aluminum from intramuscular vaccines is slowly absorbed from the injection site and efficiently eliminated through glomerular filtration.After a single vaccine dose, aluminum contributes minimally to systemic levels and is rapidly cleared

Environmental aluminum exposure is extensive. Aluminum is the third most abundant element in Earth's crust and is released naturally through volcanic activity and rock weathering.Humans encounter aluminum through multiple routes: food (the primary source), drinking water, antacids, buffered analgesics, cosmetics, cookware, and occupational exposures. Recent data show that airborne aluminum represents an underestimated exposure source, with high concentrations found in lung and hilar lymph node tissues, suggesting inhalation of urban fine dust particles contributes significantly to total body burden. So us as humans are exposed significantly to aluminum as it is. One could infer that our environmental exposure greatly exceeds any vaccine exposure in our lifetime.

Average weekly aluminum exposure from food alone can reach approximately 50% of the TWI in adults, with infants and young children potentially exceeding the TWI when relying on specialized diets. When accounting for all sources (food, cosmetics, pharmaceuticals, and food contact materials), the TWI can be significantly exceeded, particularly in adolescents.

I understand people worry about ingredients in food, vaccines and what we intake every single day. It's okay to question things. It's okay to have conversation. Again we all can learn from each other. This above isn't some made up personal opinion about aluminum. It's science with references to back it up.

Hope you all learned something. I can touch on another ingredient another day. Appreciate the commentary and appreciate those wanting to learn.

Dr. Parker

References

1. The Role and Safety of Aluminum Adjuvants in Childhood Vaccines. Nirenberg E, Maldonado YA, Hoffman SA. Pediatrics. 2025;:205757. doi:10.1542/peds.2025-074874.
2. Aggregated Aluminium Exposure: Risk Assessment for the General Population. Tietz T, Lenzner A, Kolbaum AE, et al. Archives of Toxicology. 2019;93(12):3503-3521. doi:10.1007/s00204-019-02599-z.
3. Aluminum Salts in Vaccines--Us Perspective. Baylor NW, Egan W, Richman P. Vaccine. 2002;20 Suppl 3:S18-23. doi:10.1016/s0264-410x(02)00166-4.
4. Updated Aluminum Pharmacokinetics Following Infant Exposures Through Diet and Vaccination. Mitkus RJ, King DB, Hess MA, Forshee RA, Walderhaug MO. Vaccine. 2011;29(51):9538-43. doi:10.1016/j.vaccine.2011.09.124.
5. Overview of the Relationship Between Aluminum Exposure and Health of Human Being. Niu Q. Advances in Experimental Medicine and Biology. 2018;1091:1-31. doi:10.1007/978-981-13-1370-7_1.
6. Aluminum Effects in Infants and Children. Corkins MR. Pediatrics. 2019;144(6):e20193148. doi:10.1542/peds.2019-3148.
7. Airborne Aluminum as an Underestimated Source of Human Exposure: Quantification of Aluminum in 24 Human Tissue Types Reveals High Aluminum Concentrations in Lung and Hilar Lymph Node Tissues. Ganhör C, Mayr L, Zolles J, et al. Environmental Science & Technology. 2024;58(26):11292-11300. doi:10.1021/acs.est.4c01910.
8. Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts. Willhite CC, Karyakina NA, Yokel RA, et al. Critical Reviews in Toxicology. 2014;44 Suppl 4:1-80. doi:10.3109/10408444.2014.934439.

12/10/2025

We appreciate everyone's patience as we move to the new EMR. It's a lot for us in the middle of sick season but the next few days we should be back to running full capacity albeit a tad slower. Appreciate all of yall!

Dr. Parker

12/09/2025

I am sure many of you have seen the below graphic. First it's a little misleading nobody gets 7 injections at once but I digress....

People are sharing this to promote fear and hype of the anti vaccine movement ( which is very strong). I am going to do my best ( with evidence based references) to explain why we do what we do. I'll preface this whole post with I am pro vaccine but also pro parents choice on their decision for their child. Much like anything I recommend getting professional advice from a professional. I don't turn to social media when I need an electric job done-----I go to a trusted electrician or deal with potential real world consequences if I didn't.

The fundamental difference in food vs vaccines lies in the distinct purposes and risk profiles of the two.

Vaccines are administered together because they protect against immediate infectious disease threats, and the infant immune system can safely handle multiple antigens simultaneously. Infants encounter thousands of antigens daily through normal environmental exposure, and studies demonstrate that multiple vaccinations do not overwhelm the immune system—rather, they prompt appropriate immune development without interference when given according to tested schedules.Each vaccine in the infant series (hepatitis B, DTaP, pneumococcal, rotavirus, poliovirus, Haemophilus influenzae type b) is timed to provide protection when infants face real exposure risks. The main reason I don't recommend delaying them.

The traditional recommendation to introduce one food at a time with 3-5 day waiting periods was intended to monitor for allergic reactions. However, this practice is increasingly questioned. Most IgE-mediated food reactions occur within 2 hours of ingestion, making a 3-5 day waiting period inconsistent with the actual timeline of allergic responses. Additionally, over 90% of food allergies involve just 8 major allergens (peanut, tree nuts, egg, milk, soy, wheat, fish, shellfish) rather than the typical first foods like cereals, fruits, and vegetables.

Current evidence suggests that introducing a diverse diet early may actually reduce allergy risk. Studies show that dietary diversity in the first year is associated with decreased risks of atopic dermatitis, asthma, and food allergies. Many doctors now recommend shorter waiting periods, with only 55.6% believing the traditional 3-5 day recommendation is helpful. Early introduction of allergenic foods like peanut (between 4-11 months) can reduce peanut allergy risk by 86%.

Do vaccines have risks? Certainly, but so does driving a car, flying in a plane or any thing we do as humans every day. Life has risks. The issue is many of us in our generations now haven't seen polio, hepatitis B, HiB meningitis etc. People think since they haven't seen it it's not a risk....but guess what?! The reasons we don't see those terrible diseases is because we found a way to prevent 😊.

My children are vaccinated and I wouldn't recommend anything for my patients that I wouldn't do for my own but support others decisions to do as they please. Those conversations are never to make someone feel bad and I have many people who see me both vaccinated and unvaccinated.

But please do me a favor and get your medical info from real world medical professionals, not social media or the government. Some of us trained a long time to do what we do. We are only trying to help. If evidence changes we will adapt but as of now the evidence says vaccines 💉 work but I never fault a parent for wanting to learn more and understand or choosing not to. They are not my children!

Thank you,

Dr. Parker

References

1. Routine Childhood Vaccines Given in the First 11 Months of Life. Jacobson RM. Mayo Clinic Proceedings. 2020;95(2):395-405. doi:10.1016/j.mayocp.2019.06.007.
2. Immunological Considerations Regarding Parental Concerns on Pediatric Immunizations. Nicoli F, Appay V. Vaccine. 2017;35(23):3012-3019. doi:10.1016/j.vaccine.2017.04.030.
3. Recommendations on Complementary Food Introduction Among Pediatric Practitioners. Samady W, Campbell E, Aktas ON, et al. JAMA Network Open. 2020;3(8):e2013070. doi:10.1001/jamanetworkopen.2020.13070.
4. Complementary and Allergenic Food Introduction in Infants: An Umbrella Review. Soriano VX, Ciciulla D, Gell G, et al. Pediatrics. 2023;151(2):e2022058380. doi:10.1542/peds.2022-058380.
5. The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Greer FR, Sicherer SH, Burks AW. Pediatrics. 2019;143(4):e20190281. doi:10.1542/peds.2019-028

12/09/2025

🚨 reminder for patients we are moving to Athena Health today! Please be patient as there will be new registration paperwork, we will be running lower volume and learning an entire new system. It will be better in the end but please do your best to be patient! 😊

Dr. Parker

12/07/2025

Sunday schedule ( on "67" weekend per my oldest)

Monday- Reelfoot
Tuesday-Reelfoot
Wednesday- Reelfoot
Thursday- Reelfoot
Friday- out of office

🚨 reminder we will be moving to Athena with launch for Tuesday this week. Please be patient with us as we will be running slower with lower volume to accomodate for a new system and check in process. You also should be receiving emails in regards to patient portal access. This will be great for our patients but will have some growing pains as we transition over!

See everyone tomorrow

Dr. Parker

*pic from lights at Discovery park!

12/04/2025

I have had several questions about taking new patients. The answer is yes! The question came from the fact it's hard to get in for well checks with me for new patients due to me being booked several months out.

However, that does not affect my ability to see new patients ( newborns, new sick patients who are moving their care to me, or second opinions). If you are new and just need a well check feel free to schedule it with me when I have availability!

If you are new and need an immediate well check one of our NPs are happy to see you sooner!

We will also be moving to Athena ( our new EMR) with launch plan next week. Please be patient during this time. We are going to have to run a little slower due to the new system and us becoming accustomed but once we get the hang of it I can assure you it will be better for our patients!

Everyone have a great day!

Dr. Parker

12/02/2025

https://m.facebook.com/story.php?story_fbid=1280296200798604&id=100064547089621

A new study in Pediatrics found that twelve-year-olds who owned smartphones were more likely to experience depression and obesity and not get enough sleep than their peers without one. Consistent communication with children and teens about smartphones and screen time can help make sure that phones don’t crowd out important activities like exercise, sleep, and quality time with friends and family. Learn more in AAP News: https://bit.ly/3KvYJkB