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Pamr 1
1. The medical report analyzed the health condition of a 72-year-old man with diabetes, hypertension, and other issues. Laboratory tests found several biomarkers outside the optimal ranges, including high homocysteine, triglycerides, fasting insulin, and creatinine levels. 2. The report diagnosed specific risk factors and made recommendations, including nutritional supplements, a personalized diet plan limiting calories and carbohydrates, an exercise regimen, lifestyle changes, and repeating lab tests monthly. 3. Over six months of following the recommendations, the man's biomarkers and health improved significantly. His medications were reduced and stopped, his weight and blood pressure decreased, and he felt less pain and more energy.
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Pamr 1
- 1. Personalized Anti-aging MedicalReport Date : 17th Nov 2014 Zhang Y. from Hong Kong Age- 72 Sex- M Weight- 91 Height- 168 cm Symptoms/reason for consultation- Memory lapses, pain in the legs, tiredness in the evening, frequent infections, increased urinary frequency and urgency, decrease in visual acuity, frequent headaches, overweight. Medical history- Diabetes (type 2) since last 24 years, hypertension since last 10 years (BP in the range of 170 / 100 mmHg at the moment) Surgical history- Surgery for retinopathy 2 years ago. For prostate enlargement he has been advised by surgeon to undergo surgery. Family history- Younger brother has diabetes. Sister died of breast cancer 1 year ago at age 67. Dental history- Dental implants in 6 teeth ( 5 years ago). Allergy history- Allergic to nuts Current medicines- Name of medicine Strength BF Lunch Dinner 1 Tab. Metformin + Glicazide 500 mg Yes No No 2 Tab. Tamsulosin 0.4 mg No No Yes 3 Tab. Telmisartan 40 mg Yes No No 4 Tab. Rosuvastatin 10 mg No No Yes 5 Inj. Huminsulin 50/70 100 IU PF 18 U 8 U 10 U 6 Cap. Pregabalin 150 mg No No Yes 7 Tab. Furosemide 20 mg Yes No No 8 Tab. Ibuprofen 400 mg No Yes No Type to enter text
- 2. Laboratory report- Test ResultInterpretation LpA 11 mg/dL Optimal Homocysteine 42 mcmol/L High Triglycerides 185 mg/dL High Fasting insulin 18 ulU/mL High Fasting sugar 178 mg/dL High HbA1c 9.0 High Omega 3 index 8 % Optimal LDL 81 mg/dL Optimal Mg 1.5 mEq/L Low IGF-1 155 ng/mL Low 25-OH Vitamin D 80 Optimal Creatinine 2.8 mg/dL High PTH 35 pg/mL Optimal Uric acid 4/5 mg/dL Optimal Total cholesterol 250 mg/dL Optimal Total PSA 2.5 ng/mL Optimal Diagnosis of your current health condition from Anti-aging perspective Specific risk factors- 1. High Homocysteine- Homocysteine is an amino acid that is an intermediate in the production of two other amino acids, methionine and cysteine. Although homocysteine is naturally present in our bodies, too much homocysteine in the blood is responsible for an increased risk of Cardio- vascular diseases, including venous thrombosis, atherosclerosis, high blood pressure, coronary heart disease, and stroke. Target Homocysteine levels for you- 15-20 mcmol/L 2. High Triglycerides- Triglycerides are a type of fat found in your blood. Your body uses them for energy. You need some triglycerides for good health. But high triglycerides can raise your risk of heart disease and stroke. Target triglyceride levels for you- 90-100 mg/dL 3. High fasting insulin- Higher levels indicate insulin resistance. This means the cells in your body have become resistant to insulin’s effort to get sugar inside the body's cells where it gives energy. Insulin resistance takes root when your cells become less sensitive to the effects of insulin.
- 3. This requires thepancreas to produce more, which drives up your insulin levels. The pancreas tries to overcompensate by flooding the body with increasingly higher levels of insulin in order to force your cells to open up and take the sugar. Target fasting insulin level for you- 8-9 uuL/mL 4. Fasting sugar- Fasting blood sugar levels give vital clues about how a person's body is managing blood sugar. Blood sugar tends to peak about an hour after eating and declines after that. High fasting blood sugar levels point to insulin resistance or diabetes. Target fasting sugar level for you- 100-110 mg/dL 5. High HbA1c- A hemoglobin A1c (HbA1c) test measures the amount of blood sugar (glucose) attached to hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body. An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months. It's a three-month average because that's typically how long a red blood cell lives. If your HbA1c levels are high, it may be a sign of diabetes, a chronic condition that can cause serious health problems, including heart disease, kidney disease, and nerve damage. Target HbA1c for you- 5.5- 5.7 6. Low magnesium- Magnesium is one of the most abundant essential minerals in your body. It’s primarily stored in the bones of your body. A very small amount of magnesium circulates in your bloodstream. Magnesium plays a role in over 300 metabolic reactions in your body. Higher concentra- tions of blood glucose can cause the kidneys to excrete more urine. This also causes increased loss of magnesium. Mg deficiency is a risk factor for cardiovascular diseases and high blood pressure (hypertension). Target Mg level for you- 2.0 mEq/L 7. Low IGF-1- This test measures the amount of growth hormone in your body. Low IGF-1 in the elderly is linked to frailty and disease risk as well. Adequate IGF-1 levels are required for maintenance of bone mass, muscle mass and brain function. Decreased levels of IGF-1 also may be seen with nutritional deficiencies, chronic kidney or liver disease. Target IGF-1 level for you- 200-220 ng/mL 8. High creatinine- Elevated creatinine level signifies impaired kidney function or kidney disease. As the kidneys become impaired for any reason, the creatinine level in the blood will rise due to poor clearance of creatinine by the kidneys. Abnormally high levels of creatinine warn of possible
- 4. malfunction or failureof the kidneys. Target creatinine level for you- 1.0- 1.2 mg/dL Summary- Analysis of above tests indicates that because of long standing diabetes your kidneys, eyes, nerves in legs are getting affected. There is a high possibility of presence of atherosclerosis ( blockage of blood vessels). It is important to address all issues simultaneously and in a comprehensive manner. The following regimen is recommended for next 6 months. Monitor fasting blood sugar and blood pressure twice a week. Maintain a written record(chart) of the same. 1. NUTRITIONAL SUPPLEMENTS IN ORTHOMOLECULAR DOSAGE Name Dose/Strength Breakfast Lunch Dinner Duration 1 Vit C- ER XXX mg Yes No No 6 months 2 Magnesium XXX mg No No Yes 6 months 3 B-cplx. forte XXX mcg Yes No No 6 months 4 TGM XXX mg No Yes Yes 6 months 5 Chromium XXX mcg Yes No Yes 6 months 6 ALA XXX mg No No Yes 6 months Note: The names of recommended brands will be given in your PAMR. You may use any other reputed brand but make sure that the specific dosages mentioned above are taken ( check quantity of active ingredients before buying any product). Specific dosages in above table have been blacked out to discourage self medication without physician's involvement 2. PERSONALIZED DIET Your daily caloric intake from all sources of food (Carbohydrates, Fats and Protein) should not exceed XXX kcal with exact ratio of 15 % calories from Carbohydrates, 20 % calories from Protein and 65 % calories from Fats. 1 gram of Carbohydrate gives 4 calories, 1 gram of Protein gives 4 calories and 1 gram of Fat gives 9 calories. Accordingly, your daily caloric consumption from all food sources should consist of XXX grams of fat, XXX grams of protein and XXX grams of carbohydrates. Do not eat more than 3 meals in a day (Breakfast, lunch, dinner) Do not eat anything in between the meals Avoid all kinds of fruits Avoid grain, rice and wheat products in any form Do not routinely nibble on sugar/ carbohydrates to 'regulate' blood glucose level. Take glucose to raise the low blood glucose level only in an extreme medical emergency. Seek emergency medical treatment immediately for blood glucose abnormalities.
- 5. 3. PERSONALIZED EXERCISEPROGRAM Graduated exercise program is advised as follows- A) First 2 weeks - Brisk walking for 25 minutes every day. B) From week 3 onwards - Graded resistance exercise on every alternate days. Resistance training is recommended at moderate intensity and slow velocity. Depending on your level of comfort you can increase the resistance to 50 % of maximum capacity. Each exercise session should not last more than 30 minutes. Exercising with cable machines is preferred to free weights in your specific case. This is to avoid any injuries while doing exercise.(N.B.- Always keep Glucometer and some sugar cubes handy just in case if your sugar levels fall too low) Anulom vilom also called the alternate nostril breathing technique- Repeat 60 times or for 5 minutes every day. You can do this any time of the day. After 1 month, increase the duration to 10 minutes/day. 4. LIFESTYLE ADVICE Controlling mental stress (stress management) is very important Avoid alcohol in any form. 5. REPEAT LAB TESTS- Do the blood tests as per below-mentioned schedule exactly at each month end. 1st month 2nd month 3rd month 4th month 5th month 6th month Fasting sugar Fasting sugar Fasting sugar Fasting sugar Fasting sugar Fasting sugar Triglycerides Hcy Triglycerides Hcy Fasting insulin Fasting insulin Mg Mg IGF-1 IGF-1 Creatinine Creatinine HbA1c HbA1c Dr. Shams Scheik M.D., ABAARM (USA), Dip. Orthomolecular Med. (Germany) American Board Certified in Anti-Aging & Regenerative Medicine
- 6. Physician comments- There wasgradual improvement in both subjective and objective parameters. Mr. Zhang’s blood sugar and blood pressure became optimal after following the recommended protocol for 6 months. Other blood parameters also changed towards optimal levels. Therefore the insulin dosage was reduced to minimum necessary and rest of the pharmaceutical medications were stopped altogether except Pregabalin. Objective improvement- Clinical Para- meters 1st Mo 2nd Mo 3rd Mo 4th Mo 5th Mo 6th Mo Weight 87.5 kg 85.0 kg 86.2 kg 83.4 kg 83.0 kg 83.5 kg Blood pressure 160/95 155/90 135/85 130/90 115/85 115/80 Hcy 22 16 TG 162 135 110 Fasting sugar 161 145 137 122 110 97 Fasting insulin 14 9 HbA1c 7.5 5.8 Mg 1.7 2.0 IGF-1 178 205 Creatinine 2.2 1.8 Current pharma medicines 1.Insulin dose reduced 2.Rosuva- statin stopped 1.Insulin dose reduced further 2.Furosemide dose reduced 3.Ibuprofen was stopped 1.Telmisartan dose reduced 2.Tamsulosin dose reduced 3. Metformin +Glicazide reduced 1.Metformin +Glicazide stopped 2. Furosemide Stopped 3. Insulin dose reduced further 1.Tamsulosin stopped 2.Telmisartan stopped 3. Insulin dose reduced further All meds stopped except Pregabalin Dose of insulin reduced to 4U- 0U-2U Subjective improvement- 1. Lost 7.5 kgs specifically from around the belly area 2. Leg pain decreased by 75% 3. Did not suffer from any infections since last 2 months 4. Energy levels and walking capacity increased significantly 5. Memory lapses decreased For prostate issue he has taken an appointment with his surgeon. He is maintaining his blood sugar and blood pressure by following the recommended protocol. Has been advised to do Myocardial perfusion studies to evaluate cardiac function.