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Clinical Findings and Laboratory Assessment Basic Labs: Fasting insulin: 10 IU/mL (elevated) Fasting glucose and A1c: normal Total cholesterol: 132 mg/dL (low) White blood cell count: 9.8 x10/L (mildly elevated) Vitamin B12: 384 pg/mL (low-optimal) Homocysteine: 13 (high) umol/L Homozygous MTHFR C677T polymorphism Zinc: 62 ug/dl (low) Hormone Panel (DUTCH Plus Test): Elevated free and total cortisol (especially AM) low estradiol with poor estrogen detox Normal testosterone Elevated progesterone Comprehensive Stool Test: Evidence of intestinal dysbiosis with low diversity of commensal bacteria Elevated markers of fungal overgrowth (Candida spp.) Mild elevation in fecal zonulin (suggestive of intestinal permeability) Slightly reduced secretory IgA, indicating compromised mucosal immunity Functional Interpretation Despite an outwardly clean Paleo diet, M.Z

for this reason, most people are better off taking sublingual B12 supplements, but shots are best because they allow for a 100% vitamin b12 absorption into the tissue