A genetic report can tell you the tendencies your child was born with. It cannot tell you what is happening in them today — and confusing the two leads families badly astray.
Two children with identical MTHFR results can have completely different homocysteine, completely different symptoms, and need completely different support. The blood is what tells you which one you have.
*Genetics inform the style of support. Labs and symptoms set the dose.* A slow-COMT child may need a gentler hand with methyl donors — but whether they need any, and how much, comes from measuring, not from the report.
This is exactly where families get hurt: a report says "MTHFR" and a protocol of methyl donors follows, without anyone checking whether that child is already replete. Over-supplementing a replete child produces irritability, agitation and aggression.
Consumer genotyping arrays only test the positions on the chip. Newer chip versions dropped a substantial share of the variants that older methylation panels ask for — so a report can come back with half the boxes simply empty.
If you are going to sequence, whole-genome sequencing covers everything and never becomes obsolete, so you never have to re-test to answer a new question. If you already have consumer data, it is still useful — just know what is missing.
Different frameworks read the same SNP differently, and they disagree in useful ways. A result is more trustworthy when several frameworks point the same direction — and when a marker in the blood agrees with them.
If a genetic report and your child’s bloodwork disagree, believe the bloodwork.
Want this answered for your own child? A Plan B synthesis reads every lab and note you have — together — and tells you what is driving the picture, what has never been checked, and what to ask for next.
The first one is free, and you keep the list either way. Phone photos of labs are fine.
Plan B for PANS is written by a parent, not a physician. Nothing here is medical advice or a substitute for your child's clinicians — it is meant to make you the best-informed person in the room when you talk to them.