# SHEEHAN GREGG – MASTER HEALTH SUMMARY
**Last Updated**: 2025-06-11 | **DOB**: 1954-04-24 | **Diet**: Strict Carnivore (10+ years, 1-2yr lapse pre-MI)
---
## 🩺 ACTIVE CONDITIONS
### **Cardiovascular**
- **Post-PCI** (Mar 2025): RCA stent (90% stenosis, rotablation).
- **LVEF 62%**, mild-moderate mitral regurgitation.
- **Prolonged morning nosebleed** (30+ minutes; historically lasted only minutes).
### **Hyperthyroidism (Likely Graves’)**
- **Labs**: TSH <0.01 mIU/L, FT4 31.0 pmol/L, FT3 8.3 pmol/L, TRAb 1.1 IU/L (borderline).
- **Symptoms**: Fatigue, reduced motivation (since mid-2023).
### **Gout**
- **Uric Acid**: 0.57 mmol/L [Ref: <0.42].
- **Flares**: Managed with colchicine PRN.
---
## 💊 CURRENT MEDICATIONS
| Medication | Dose | Purpose | Notes |
|--------------|-------------|-----------------------------|------------------------|
| Aspirin | 100mg daily | Antiplatelet (lifelong) | Post-PCI protocol. |
| Ticagrelor | 90mg BID | Antiplatelet (1yr post-PCI) | Avoid CYP3A4 inhibitors.|
| Bisoprolol | 2.5mg daily | Heart rate/BP control | Monitor HR <60 bpm. |
| Carbimazole | 5mg BID | Hyperthyroidism | Repeat TSH/FT4 in 4w. |
| Doxazosin | 4mg nightly | BP/prostate | Orthostatic caution. |
| GTN spray | PRN | Angina relief | Max 3 doses/15 mins. |
| Colchicine | PRN | Gout flares | Early flare use only. |
---
## 🌿 SUPPLEMENTS & ELECTROLYTES
| Supplement | Dose | Purpose | Notes |
|---------------------|---------------|----------------------------------|---------------------------|
| Vitamin D3 | 5000 IU daily | Maintains 25(OH)D ~170 nmol/L | Synergizes with K2/Mg. |
| Vitamin K2 (MK-7) | 100 mcg daily | Prevents arterial calcification | Enhances D3 benefits. |
| Magnesium Glycinate | 2 caps daily | Supports D3/K2 metabolism | Prevents cramps/twitches. |
| Sodium Chloride | 1 tsp/L water | Prevents muscle cramps | Long-standing practice. |
| Vitamin C | 1000 mg daily | Antioxidant | General support. |
**Key Interactions**:
- D3 + K2 + Mg work together for calcium metabolism (avoids soft tissue calcification).
- Na + Mg prevent cramps (electrolyte balance).
---
## 📊 KEY LABS & METABOLIC MARKERS
| Test | Value (Updated) | Target | Notes |
|-----------------|-----------------|--------------|------------------------|
| **Fasting Glucose** | 4.8 mmol/L | <5.4 | 2025-06-10, pre-meal. |
| **Ketones** | 2.1 mmol/L | 0.5-3.0 | Nutritional ketosis. |
| **Weight** | 72.8 kg | - | Down from 73.5 kg. |
| Fasting Insulin | 78 pmol/L | <60 | ❗ Insulin resistance. |
| Ferritin | 1100 μg/L | 20-300 | ❗ Iron overload? |
| Uric Acid | 0.57 mmol/L | <0.42 | Gout risk. |
| CRP | 5 mg/L | <3 | Mild inflammation. |
---
## 🍖 LIFESTYLE & METABOLIC CONTEXT
- **Weight**: 72.8 kg (down from 77kg post-MI).
- **Electrolytes**: Sodium (optimal), Mg (PRN), K (dietary).
- **Sleep**: 7-8 hrs/night (excellent architecture).
- **Exercise**: Golf, riding E-scooter.
- **Alcohol/Smoking**: None (ceased beer Aug 2023, smoking age 32).
---
## 🎯 PRIORITIES & OPEN QUESTIONS
1. **Thyroid**: Optimize carbimazole dose (repeat TSH/FT4 in 4w).
2. **Gout**: Start allopurinol? (pending uric acid/renal labs).
3. **Cardiac**: Monitor ferritin/glucose, continue rehab.
4. **Nosebleeds**: Track frequency/duration; check BP/coagulation if recurrent.
**Questions for Team**:
- *"Is my insulin (78 pmol/L) improving on carnivore?"*
- *"Should I trial berberine for insulin sensitivity?"*
---
## 🚨 RED FLAGS TO REPORT
- Glucose >8.0 mmol/L post-meal.
- Recurrent/prolonged nosebleeds (>10 minutes).
- Chest pain unrelieved by GTN.
- Unexplained weight loss >2kg.
---
## 🔄 VERSION HISTORY
- **2025-06-11**: Added glucose (4.8), ketones (2.1), weight (72.8 kg).
- **2025-04-05**: Added nosebleed history, updated red flags.
- **2025-04-10**: Added full meds/supplements, refined lab targets.
- **2025-03-15**: Post-PCI baseline created.
**Last Updated**: 2025-06-11 | **DOB**: 1954-04-24 | **Diet**: Strict Carnivore (10+ years, 1-2yr lapse pre-MI)
---
## 🩺 ACTIVE CONDITIONS
### **Cardiovascular**
- **Post-PCI** (Mar 2025): RCA stent (90% stenosis, rotablation).
- **LVEF 62%**, mild-moderate mitral regurgitation.
- **Prolonged morning nosebleed** (30+ minutes; historically lasted only minutes).
### **Hyperthyroidism (Likely Graves’)**
- **Labs**: TSH <0.01 mIU/L, FT4 31.0 pmol/L, FT3 8.3 pmol/L, TRAb 1.1 IU/L (borderline).
- **Symptoms**: Fatigue, reduced motivation (since mid-2023).
### **Gout**
- **Uric Acid**: 0.57 mmol/L [Ref: <0.42].
- **Flares**: Managed with colchicine PRN.
---
## 💊 CURRENT MEDICATIONS
| Medication | Dose | Purpose | Notes |
|--------------|-------------|-----------------------------|------------------------|
| Aspirin | 100mg daily | Antiplatelet (lifelong) | Post-PCI protocol. |
| Ticagrelor | 90mg BID | Antiplatelet (1yr post-PCI) | Avoid CYP3A4 inhibitors.|
| Bisoprolol | 2.5mg daily | Heart rate/BP control | Monitor HR <60 bpm. |
| Carbimazole | 5mg BID | Hyperthyroidism | Repeat TSH/FT4 in 4w. |
| Doxazosin | 4mg nightly | BP/prostate | Orthostatic caution. |
| GTN spray | PRN | Angina relief | Max 3 doses/15 mins. |
| Colchicine | PRN | Gout flares | Early flare use only. |
---
## 🌿 SUPPLEMENTS & ELECTROLYTES
| Supplement | Dose | Purpose | Notes |
|---------------------|---------------|----------------------------------|---------------------------|
| Vitamin D3 | 5000 IU daily | Maintains 25(OH)D ~170 nmol/L | Synergizes with K2/Mg. |
| Vitamin K2 (MK-7) | 100 mcg daily | Prevents arterial calcification | Enhances D3 benefits. |
| Magnesium Glycinate | 2 caps daily | Supports D3/K2 metabolism | Prevents cramps/twitches. |
| Sodium Chloride | 1 tsp/L water | Prevents muscle cramps | Long-standing practice. |
| Vitamin C | 1000 mg daily | Antioxidant | General support. |
**Key Interactions**:
- D3 + K2 + Mg work together for calcium metabolism (avoids soft tissue calcification).
- Na + Mg prevent cramps (electrolyte balance).
---
## 📊 KEY LABS & METABOLIC MARKERS
| Test | Value (Updated) | Target | Notes |
|-----------------|-----------------|--------------|------------------------|
| **Fasting Glucose** | 4.8 mmol/L | <5.4 | 2025-06-10, pre-meal. |
| **Ketones** | 2.1 mmol/L | 0.5-3.0 | Nutritional ketosis. |
| **Weight** | 72.8 kg | - | Down from 73.5 kg. |
| Fasting Insulin | 78 pmol/L | <60 | ❗ Insulin resistance. |
| Ferritin | 1100 μg/L | 20-300 | ❗ Iron overload? |
| Uric Acid | 0.57 mmol/L | <0.42 | Gout risk. |
| CRP | 5 mg/L | <3 | Mild inflammation. |
---
## 🍖 LIFESTYLE & METABOLIC CONTEXT
- **Weight**: 72.8 kg (down from 77kg post-MI).
- **Electrolytes**: Sodium (optimal), Mg (PRN), K (dietary).
- **Sleep**: 7-8 hrs/night (excellent architecture).
- **Exercise**: Golf, riding E-scooter.
- **Alcohol/Smoking**: None (ceased beer Aug 2023, smoking age 32).
---
## 🎯 PRIORITIES & OPEN QUESTIONS
1. **Thyroid**: Optimize carbimazole dose (repeat TSH/FT4 in 4w).
2. **Gout**: Start allopurinol? (pending uric acid/renal labs).
3. **Cardiac**: Monitor ferritin/glucose, continue rehab.
4. **Nosebleeds**: Track frequency/duration; check BP/coagulation if recurrent.
**Questions for Team**:
- *"Is my insulin (78 pmol/L) improving on carnivore?"*
- *"Should I trial berberine for insulin sensitivity?"*
---
## 🚨 RED FLAGS TO REPORT
- Glucose >8.0 mmol/L post-meal.
- Recurrent/prolonged nosebleeds (>10 minutes).
- Chest pain unrelieved by GTN.
- Unexplained weight loss >2kg.
---
## 🔄 VERSION HISTORY
- **2025-06-11**: Added glucose (4.8), ketones (2.1), weight (72.8 kg).
- **2025-04-05**: Added nosebleed history, updated red flags.
- **2025-04-10**: Added full meds/supplements, refined lab targets.
- **2025-03-15**: Post-PCI baseline created.
