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Elevation in homocysteine is expected with cobalamin deficiency due to reduced methionine synthase activity even in the face of extreme cobalamin deficiency

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Serotonin Syndrome Counteraction A 2005 study in the European Journal of Pharmacology (PMID: 15840402) induced severe serotonin syndrome using pargyline (MAO inhibitor) plus L-tryptophan (serotonin precursor), producing forepaw treading, hindlimb abduction, wet dog shake, and hyperthermia mediated primarily through 5-HT2A receptors

PlexusDx offers both Compounded Semaglutide Injection (starting at $189/mo (or $149/mo on the 6-month plan)) and Oral Semaglutide ($289/mo), and your care team can help you test which formulation suits you best