Total years in practice: 10

Publish Date
November 25, 2018
Patient
58 Years, Male, White
Medical Condition
High Blood Pressure, High Cholesterol, Obesity
Therapies
Nutrition,Diet Therapy
Medical History

Medications for lipids, blood pressure, bacterial infections on skin and  bleeding gums

Case Management

3/2017 - initial consultation and CMP review

Data: weight = 250 lbs.  Labs from 2/2017 show

    HIGH:  MCV (but liver, B12 and folate are ok) K+, Hcy slightly high.

     LOW: Chol  HDL is very low  (Simvistatin Rx) , TSH, Ft4 , BUN,  P


Discussed paleo type diet , portion control, sugar cravings and carbohydrate effect on blood sugar and insulin.

Therapy -  recommended, digestive enzymes and HCL, wellness formula, Multistrain Prob for possible dysbiosis. Carbohydrate substitutions and upgrades. Cut back on caffeine and alcohol.


6/2018 - follow up

Data: weight = 234 lbs.  
 Tim is reducing refined CHOs, has cookies on occasion, tries to opt for fruit, no alcohol, purchased paleo wraps and coconut clusters for upgrades. Will work on smoking cessation once diet is under new habit control
Under his own guidance, Tim has stopped simvastatin Rx
Tim is on the right track with behavior change and is very excited to see his weight at 234.I recommended new lab work in 3- 6 months to monitor lipid levels
Recommended APEX energetics Ultra D to improve HDL and Vit D

9/2018 - follow up and CMP review
Data: weight = 228 lbs
  1. fat weight loss has leveled out, discussed portion sizes as caloric intake may exceed energy expenditure needs. high MCV could be dehydration. elevated chol and LDL - need liver support. Monocytes are still elevated.  ele monocytes and Hb- could be lung repair. Ultra D has increase HDL to 37 and vit D to 50.
Nutrition  Therapy : will measure out nuts to consume ½ cup which =~ 350 cal.
 will reduce honey to 1 tsp from 1 tbs, have either and egg or turkey at breakfast, not both with coconut wrap, kale and avocado.
1 tsp of coconut oil instead of 1 TBS on weekends with green tea. will skip oil m-f breakfast to reduce calories.
Will do 14-16 hr TRF during weekend and daily 12 hour fast M-F
Will increase water intake and start morning off with 20 oz




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