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Whole blood histamine for undermethylation and histamine patterns Plasma zinc, serum copper, and ceruloplasmin for copper-zinc imbalance and free copper patterns Urinary pyrroles / HPL for pyroluria and zinc/B6 depletion patterns Homocysteine, SAM, SAH, and SAM/SAH ratio when methylation efficiency needs clarification Vitamin D, CBC, CMP, B12, folate, glucose, and inflammatory markers for general metabolic context Organic acids, gut, mold, or toxic burden testing when history suggests oxidative stress or environmental load How these mechanisms integrate within the Walsh Approach OCD symptoms often arise from a biochemical constellation rather than one isolated neurotransmitter defect

This does not change the total amount of medication (10 mg), but it does change how much liquid you have to draw up for a specific dose

Lynch, T