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[DOI] [PMC free article] [PubMed] [Google Scholar] 157.Galdi F., Pedone C., McGee C.A., George M., Rice A.B., Hussain S.S., Vijaykumar K., Boitet E.R., Tearney G.J., McGrath J.A., et al

Diagnosis therefore depends on a convergence of evidence from history, examination, and complementary investigations

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DD methylation analysis or plasma methionine/SAM/SAH panels reveal: methylation efficiency SAM/SAH ratio methionine sufficiency oxidative stress burden zinc/copper ratios presence of inflammation affecting the methylation cycle Treatment may include: methylcobalamin methylfolate (in appropriate cases) P5P TMG or betaine methionine support zinc correction gentle titration of SAMe Because undermethylation is closely linked to OCD-like presentations, supporting methylation improves OCD and undermethylation symptoms when paired with mitochondrial stabilization