The dosage number also includes a 15 mg tablet of AOR mb12 that I make into a homemade transdermal solution. I know it's not as affective as the oils so that makes the dose seem higher than it likely actually is. It seems to be about as potent as three squirts of the oil so that 15 mg is more like 5-7 but some days I do it twice.
I have multiple homozygous MTR, MTRR, MTHFR, MTHFD and MTHFS SNPs. The multiple MTR SNPs are an upregulation so I waste a lot of b12 with the conversion from HCY to methionine but in order to get a central nervous system penetrating dose and get neurological healing going I need that much and I need to take it many times throughout the day. No matter how big a dose of b12 I take, I feel the need for more usually within about 4-5 hours. Again, this is due to the MTR upregulation.
Since starting low dose lithium and getting my oxalates under control I am seeing a reduction in my b12 needs. I also have SNPS in the intrinsic factor, methylmalonic acid, transcobalamin and cobalamin transport pathways which exasperates my functional b12 deficiency.
I agree that nutrient and supplements need to change as you heal and progress and the SNPs certainly don't tell the whole story but the SNPS are absolutely critical to get the initial healing happening for some people due to treatment conflicts and inadequate dosages.
Oxalates is a perfect example in my case. If I had paid attention to that set of SNPs in the beginning, I would have realized years ago that I needed to go low oxalate and I would have healed even faster. I also would never have been able to do the Fredd protocol and heal my neurology without understanding my issues around glutamate and CBS upregulation.
I don't do any testing anymore. I never learned anything useful and I can't afford to waste money on them. Blood levels tell you nothing because they are either extremely transient minute to minute or tightly controlled by the body through homeostasis. Even my doctor admitted that urine oxalate testing isn't reliable because this status changes hour to hour. Again, it was the symptoms coupled with the SNPs that revealed the most information. Kidney stones are also pretty hard to ignore and are definitive diagnostically to say the least.
I did HTMA years ago, but that was too slow to be useful on methylation protocols because the healing and detox create rapid physiological changes over the course of days or weeks. HTMA is useful for long term trends and revealed my initial heavy metal problem but wasn't useful on methylation protocols.
I did test my sulfates early on to monitor my CBS upregulation but that problem is gone with the Fredd protocol. Once I started healing enough to create a potassium deficiency, mineral testing also became useless and I had to go by symptoms because they change by the hour.
I've had my TSH tested during bouts of hyperthyroid symptoms and when I was hypothyroid. They revealed nothing as it was always within range but the iodine thyroid protocols I did were vital to helping me heal. Not supported whatsoever by testing or doctors.
It's certainly not everyone's experience but doctor's and testing never helped me in any way shape or form when it came to this disease. I'm in Canada and our public health care system doesn't fully acknowledge CFS/ME as real disease.
As far as detoxing goes, it's just as important as any other factor for healing and you are right you need to pay attention to those pathways but testing for me was useless. Unless you live like a native in the jungle, far removed from pollution and food and water additives etc. and you don't have any SNPs affecting your detox pathways my assumption is you're toxic and need to detox I don't need a test to tell me this. I have looked closely at all of the SNPs in my Phase I and Phase II detox pathways and I supplement for that and I do coffee enemas regularly. My liver has never been healthier. Functioning methylation is the most important factor for liver detox in my experience. Before I started this protocol, my liver enzymes were elevated (duh).
My diet consists of any non-processed fresh or frozen meat except farmed fish, low oxalate fruit and vegetables and that's it. I use organic extra virgin olive and coconut oil for cooking. I don't eat anything processed, and I try to stay ketogenic as my brain seems to work much better burning fat. I cook all of my own food. This is all mainly because of my hyper sensitivity to gluten and synthetic folic acid. Also, the food "industry" is a major racket driven by profit and they don't have your health interests at heart so processed food is neither clean nor healthy.
My supplement regimen is ridiculous and I won't list them all here but trust me, I've got my cofactors covered in spades. One that often gets missed in addition to the ones you list is iodine. B12 doesn't work properly without it.
Cysteine and glutamine can be very problematic for someone with CBS and GAD SNPs and glycine can upregulate endogenous oxalate production and also reverse convert to glutamate with certain SNPs so you have to be careful and tailor your program accordingly.