Full Optimization Panel
Includes everything in Tier 1 (Methylation), Tier 2 (Metabolic and Inflammation), and Tier 3 (Hormone Panel), plus the additional markers below.
Every reference range on this panel is cited to a named study, a named researcher, and a named funder. You can read the same papers we did. That is what separates evidence from optimization marketing.
This panel answers the question most people never get to ask: why do two people following identical protocols get different results? COMT, VDR, APOE, and the advanced oxidative stress markers are the answers to that question.
Additional genetic markers
Genetic results are permanent. These variants do not change with intervention. They change what interventions are appropriate.
COMT
Catechol-O-methyltransferase. Determines how quickly you clear dopamine and estrogen. Slow COMT means higher stress sensitivity, stronger caffeine response, slower estrogen clearance. Fast COMT means the opposite. Affects supplement choices, stimulant tolerance, and hormonal support approach. Tyndale et al. and subsequent research established the clinical significance of COMT variants.
VDR
Vitamin D receptor variant. Two people taking identical vitamin D doses get different serum levels because of this gene. VDR determines how effectively your body responds to vitamin D regardless of what you put in. Explains some of the variance in vitamin D supplementation outcomes across populations.
APOE
Apolipoprotein E variant. APOE e4 status increases cardiovascular risk and Alzheimer's risk independently of lifestyle. Most people who carry e4 do not know it. This result requires a pre-acknowledgment step at purchase. ATH provides dedicated content explaining what each status means and what the research supports as intervention. APOE e4 is not a sentence. It is information.
Advanced optimization markers
Omega-3 Index
EPA and DHA as a percentage of total fatty acids in red blood cells. The most accurate measure of omega-3 status. Linked to cardiovascular and cognitive outcomes in Harris et al. and the REDUCE-IT trial. Most Americans are deficient. Supplementation without testing is guessing.
Glutathione
Master antioxidant. Depleted by chronic stress, heavy metal exposure, alcohol, acetaminophen, and age. Low glutathione impairs phase 2 liver detoxification regardless of what other interventions are in place.
CoQ10
Mitochondrial energy production. Depleted by statin medications. If you are on a statin and have never had your CoQ10 tested, this is the marker that explains the fatigue and muscle pain that your prescribing physician may have attributed to the drug's therapeutic effect.
Zinc
Required for over 300 enzymatic reactions. Essential for testosterone production, immune function, wound healing, and DNA synthesis. Deficiency is common and the serum test underestimates tissue deficiency.
Copper
Copper and zinc are antagonistic. Supplementing zinc without knowing copper status can worsen copper deficiency and vice versa. Collagen synthesis, iron metabolism, and neurological function all require adequate copper.
Selenium
Required for thyroid hormone conversion. The enzyme that converts T4 to active T3 (type I deiodinase) is selenium-dependent. Deficiency impairs conversion independently of iodine status and explains some cases of low free T3 with adequate T4.
SAM/SAH Ratio
S-adenosylmethionine to S-adenosylhomocysteine ratio. SAM is the universal methyl donor. SAH is its inhibitor. The ratio shows whether your methylation cycle is actually producing output given your inputs. You can have adequate B12 and folate and still have poor methylation output if SAH is elevated from other causes.
APOE requires a separate pre-acknowledgment
APOE e4 status has implications for Alzheimer's risk and cardiovascular risk that are meaningfully different from other genetic variants on this panel. Before purchasing Tier 4, you will be asked to confirm that you want to receive APOE results and that you understand what the result may indicate. ATH provides dedicated educational content for each APOE variant at the results page. Receiving this information is your choice.