Lab-guided Biotype Assessment for mood and behavior disorders.
Second Opinion Physician, led by David Epstein, D.O., applies the Walsh Approach within a functional-medicine framework to interpret measurable lab markers alongside a structured biotype questionnaire. The good news is that a small set of nutrients can strongly influence neurotransmitter activity; this evaluation provides a clear, lab-based explanation for mood and behavior symptoms grounded in methylation status, copper/zinc balance, oxidative stress, and detox pathways.
Testing is completed through LabCorp locations nationwide, and findings are delivered in a concise report with practical next steps. Based on the work of William J. Walsh, PhD, this approach is designed for people seeking an individualized, lab-based nutrient protocol—rather than a shotgun supplement regimen or medication-only plan.
Common concerns addressed: chronic depression, severe anxiety, OCD, ADHD, autism, oppositional defiant disorder (children), addictions, and dementia.
How It Works
Step 1: Complete the Biotype Questionnaire
Start with a simple, structured intake form designed around the Walsh Approach. This questionnaire identifies patterns in mood, behavior, and physical health that point to specific biochemical imbalances. It’s the first step in uncovering whether neurotransmitter activity, copper/zinc balance, or methylation may be playing a role in symptoms.
Step 2: Get Lab Testing at Your Nearest LabCorp
When needed, we order targeted labs through LabCorp or specialty panels. These tests measure key analytes such as histamine, copper, zinc, homocysteine, and vitamin D—markers that reveal methylation status, oxidative stress, and nutrient imbalances. With objective data, we can confirm patterns suggested by the questionnaire and refine the assessment.
Step 3: Receive a Personalized Walsh Protocol
During a one-on-one telemedicine consult, results are reviewed in detail and a personalized strategy is outlined. Supplement recommendations, diet and lifestyle adjustments, and enhancement therapies are tailored to restore balance. The goal is to reduce reliance on medications, optimize neurotransmitter activity, and support long-term mental and physical health.
The Walsh Approach: A Foundation for Nutrient-Based Care
The Walsh Approach grew out of decades of clinical research by Dr. William Walsh, who began his work alongside Dr. Carl Pfeiffer studying nutrient therapy in Cook County hospitals and prisons. His early research into the biochemical profiles of violent offenders and individuals with severe mental illness revealed patterns of neurotransmitter and nutrient imbalance that traditional psychiatry had overlooked.
This work led to the identification of what Dr. Walsh termed the Five Biotypes of Depression—distinct biochemical patterns linked to imbalances in methylation, copper, zinc, pyrroles, and inflammation. These biotypes provide a structured way to evaluate why depression, anxiety, OCD, ADHD, or cognitive decline may persist despite conventional treatment.
At Second Opinion Physician, this biotype framework forms the starting point for assessment, while also being expanded through functional medicine. Beyond copper, zinc, and histamine, the evaluation looks at gut dysbiosis, toxic overload, mitochondrial function, and hormone balance—factors that further shape brain chemistry and resilience. This integration provides a more complete picture, guiding nutrient therapy that is tailored, actionable, and sustainable.
The Five Biotypes of Depression
Undermethylation
Screened via the whole blood histamine test, and is clarified with a SAM:SAH methylation panel to pinpoint therapy. Undermethylation is highly correlated with symptoms and can be explained by low serotonin and dopamine activity in association with chronic depression, concentration fatigue and competitiveness.
Undermethylation
Presents with higher methyl group availability, leading to higher serotonin and dopamine activity. Management is significanlty different from undermethylation therapy. And it is often a cause of counterproductive results in SSRI and SNRI strategies that similarly increase serotonin, dopamine and norepinephrine activity.
Copper Overload
Elevated copper, elevated ratio of copper to zinc, and or an elevated free copper ratio (copper to ceruloplasmin) are calculated to identify copper overload per the Walsh Approach. This is a common cause of high stress due to the increased production of noradrenalin brough about by elevated free copper.
Pyroluria
Due to a stress induced error in hemaglobin metabolism, pyrroles spill into the urine, much like sugar in a diabetic. Because pyrroles are bound to B6 and zinc, these key nutrients are depleted. A simple urine test will determine if stabilizing blood levels of these nutrients can improve a vast number of unexplained symptoms.
Toxic Overload
Burden from gut dysbiosis, excessive medications, environmental exposure, heavy metals and chronic inflammation raise oxidative stress, impairing liver methylation and kidney detoxification. Optimizied supplement strategies, lifestyle changes and liver/kidney detox can help tremendously.
A Different Path from Prescription Drugs
While medications may provide temporary symptom relief, they often do not address the underlying biochemical issues. This can leave people cycling through side effects, dose adjustments, or persistent symptoms. Nutrient therapy—rooted in the Walsh Approach—works at the cellular level to optimize neurotransmitter activity and support detox pathways. This provides a sustainable alternative to medication, focusing on long-term brain health and overall well-being.
Why Nutrient Therapy (The Walsh Approach)
Also known as The Walsh Approach, this method identifies and corrects biochemical imbalances that drive mood, behavior, and cognitive problems. Instead of focusing only on symptoms, it examines nutrient levels and key markers like copper, zinc, histamine, and methylation status. These reveal how serotonin, dopamine, and norepinephrine are functioning, and whether activity is too high or too low. By tailoring nutrient therapy to each profile, the Walsh Approach helps restore balance at the source, leading to more stable mood, better focus, and long-term resilience.
Dr. David Epstein, D.O., is both a Walsh Protocol practitioner and a functional medicine doctor, uniquely blending the two approaches. While the Walsh Protocol provides a foundation for assessing methylation, copper overload, and pyroluria, functional medicine expands the scope to include toxic overload, gut health, kidney and liver detox capacity, mitochondrial energy, and hormonal balance.
His approach is not about trading one pill for another. Instead, it’s about identifying what blocks the body’s natural ability to regulate mood, detoxify, and repair. For some, this means addressing excess copper or restoring zinc and B6. For others, it means improving methylation with SAMe, creatine, or mitochondrial support. In every case, the goal is the same: to reduce unnecessary medications, restore biochemical balance, and build lasting resilience.
Ordering Supplements
Biotype Nutrients is a physician-directed supplement platform designed specifically for patients evaluated through Second Opinion Physician. Products are selected to align with Dr. Walsh’s Five Biotype model and tailored nutrient strategies.
While you may purchase from any source, this platform ensures
competitive pricing, and availability of the exact nutrients</em> used in your plan.
Patients who complete a Biotype Assessment receive a discount code for all Biotype Nutrients orders—making long-term support more accessible.