Expert Add-on: One-Carbon Metabolism Depth, Methylation & Micronutrient Absorption Panel (Quest)

What this panel includes

This panel should be paired with the full Women’s Fertility Expert Panel and adds markers focused on methylation metabolism and micronutrient absorption.

Expert hormonal and metabolic assessment

• Reproductive and ovarian health: Estradiol, progesterone, total testosterone, free testosterone, DHEA S, FSH, LH, SHBG, prolactin, and Anti Müllerian hormone (AMH). Evaluates ovulation, ovarian reserve, androgen balance, hormone availability, and brain to ovary signaling.

• Thyroid function and immune regulation: TSH, free T4, free T3, TPO antibodies, thyroglobulin antibodies, and ANA panel. Assesses thyroid performance and screens for autoimmune patterns that may influence hormonal balance, metabolism, and fertility.

• Metabolic and cardiometabolic health: Comprehensive Metabolic Panel, fasting glucose, fasting insulin, hemoglobin A1c, leptin, lipid panel with ratios, lipoprotein(a), high sensitivity CRP, uric acid, and homocysteine. Provides insight into insulin sensitivity, metabolic regulation, inflammation, and cardiovascular risk factors that intersect with hormonal health.

• Blood health and systemic function: CBC with differential. Evaluates red and white blood cells and overall hematologic status.

• Nutrient and micronutrient status: Vitamin D, vitamin B12, folate, iron with TIBC, ferritin, magnesium (RBC), zinc, and selenium. Assesses nutrient levels essential for hormone production, thyroid conversion, ovulation, immune balance, and energy metabolism.

Additional markers for methylation and micronutrient absorption

• MTHFR C677T and A1298C genotype: Genetic variants that influence methylation cycle efficiency and folate metabolism.

• Methylmalonic acid (MMA): A functional marker of vitamin B12 activity that helps detect tissue level B12 deficiency.

• Vitamin B6 (pyridoxal 5 phosphate, PLP): A key cofactor in transsulfuration and homocysteine metabolism.

• Serum folate: Helps evaluate folate status and supports interpretation of methylation related biomarkers.

• Vitamin A (retinol, plasma): A fat soluble vitamin involved in immune signaling, cellular differentiation, and reproductive tissue function.

• Vitamin E (alpha tocopherol, plasma): A lipid soluble antioxidant that supports cellular membrane protection and oxidative balance.

• Omega 3 index (EPA and DHA percent of RBC): Reflects long term omega 3 fatty acid status and cellular membrane composition.

• Copper (serum): A trace mineral involved in antioxidant enzyme systems and micronutrient balance.

• Iodine (spot urine): Evaluates iodine status, an essential micronutrient required for thyroid hormone synthesis.

Together, these markers provide a deeper view of methylation cycle function, micronutrient status, and absorption pathways that support metabolic and hormonal health.

Biomarkers tested

Why patients choose this

• A deeper draw that adds targeted markers for methylation cycle function and micronutrient absorption on top of the Women's Fertility Expert Panel.
• Provides deeper insight into biochemical patterns that may influence hormonal balance, energy metabolism, and cellular health.
• Evaluates methylation efficiency, vitamin-dependent metabolic pathways, and micronutrient absorption together.
• Especially useful for women with elevated homocysteine, unexplained fatigue, a history of micronutrient deficiencies, restricted diets, or malabsorption risk.
• Schedule your lab test seamlessly and complete it at a lab near you.

Before your test

This panel should be paired with the full Women's Fertility Expert Panel.

Cycle timing matters more for this panel than most. It is recommended that you schedule your lab draw on day 2 or 3 of a standard 28-day cycle.

Cycle timing is not always predictable. You may reschedule your lab appointment if needed, though same-week availability may be limited.

It is recommended to fast for at least 8 hours before your draw.

Important information

Why it matters: one-carbon metabolism regulates methylation, DNA synthesis, detoxification pathways, and homocysteine metabolism, and disruptions from genetic variants, micronutrient deficiencies, or impaired absorption may contribute to elevated homocysteine, impaired methylation capacity, and broader metabolic or reproductive challenges.

Who it's for: especially useful for women with elevated homocysteine, unexplained fatigue, a history of micronutrient deficiencies, restricted diets, malabsorption risk, or clinical suspicion of impaired methylation pathways.

This panel should be paired with the full Women's Fertility Expert Panel.

It is recommended to fast for at least 8 hours before your draw.