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Clinical trend Which symptoms improved, resolved, worsened or appeared newly Whether the dominant biotype score changed Whether mood, sleep, energy, cognition and stress tolerance are moving together Whether adverse effects suggest excessive dosage or incorrect sequencing Laboratory and supplement trend Repeat copper, zinc, ceruloplasmin, homocysteine and other core markers Repeat SAM, SAH, methionine and related methylation markers when indicated Compare supplement dose changes with symptom and laboratory movement Adjust treatment priorities when the expected response does not occur Undermethylation, Detoxification and Chronic Inflammation Methylation and transsulfuration intersect with antioxidant defense and glutathione production

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Tolosa et al., 2013