@Maurice Daher i typically do more jujitsu/lifting/crossfit but occasionally other kinds of events. There is a 100 mile relay race (teams of 4-6 people in March (so i would end up running about 20-25 miles give or take). Given being carb sensitive and now eating more of a real food keto/carnivor-ish diet do you have suggestions or insight on how to fuel for this? I would like to test somethings out prior in training and just need some ideas to get started.

Hi everyone, I want to give you a simple assignment for the weekend. The goal is not to chase one lab number or one symptom. I want you to start thinking the way I think when I look at someone’s health. I want you to build your own **personal biology pattern**. Take 20 to 30 minutes this weekend and write down the following: 1. Your **top 3 health goals** right now. 2. Your **top 3 symptoms or concerns** you are still trying to understand. 3. Your most recent important labs, if you have them. Focus on things like fasting glucose, A1C, fasting insulin, triglycerides, HDL, LDL, ApoB, blood pressure, thyroid, hs-CRP, vitamin D, ferritin, or anything else relevant to you. 4. What has improved over the last 3 to 6 months? 5. What has not improved? 6. What are the **3 biggest things you are currently doing every day** that you believe are helping you? 7. What is one habit, food, supplement, medication, stressor, sleep issue, or lifestyle pattern that you think may still be working against you? 8. Most importantly, write down what you think the **main driver** of your current pattern may be. Do not worry about being right. That is the point of the exercise. I want you to practice connecting the dots. *For example: High fasting glucose + high insulin + high triglycerides may point us toward one pattern. High ApoB + low triglycerides + high HDL may point us toward a different pattern. Fatigue + high TSH + low free T3 may point us somewhere else. The goal is to stop looking at every marker as a separate problem. Think: **What connects these things together?** Then post your answers below. Next week I will go through some of them with you and show you where I agree, where I would look deeper, and what I would test next. Keep it simple. Do not write a medical textbook. Just give me your pattern. **Symptoms → Labs → Possible Driver → What You Would Do Next** That is the skill I want everyone practicing. Have a great weekend everyone. I’m looking forward to seeing what you come up with.

@Maurice Daher Here is my follow up bloodwork Overall sleeping better getting 7 hours most nights trying to work on increasing that -dreaming again -waking up more rested -still struggling getting meals at same times due to schedule -walking as much as i can after meals but sometimes it’s more right in to working on patients -holding caffeine at least 90 minutes and definitely after food -minimal anxiety although stress and moods can still be up and down -added back in vitamin D but not until after lab work -not fully carnivore but mostly, still some veggies and berries I was wondering if i should cut down on dairy, was having a bit of cheese and heavy cream? Also given the numbers that have gone up are there suggestions for changes that I should make in my protocol? Happy to give more information if it’s needed. My biggest challenges are trying to eat my last meal earlier and at constant times. And stress management (needing to add in breath work still) Blood work RBC Mg 5 (up from 4.4) Glucose: 96 (down from 97) Urea Nitrogen(BUN): 19 (down from 23) Creatinine: 1.08 (up from 1.04) EGFR: 66 (down from 69) BUN/Creatinine ratio: 18 (down from 22) Sodium: 136 (down from 138) Potassium: 4.1 (stayed the same) Chloride: 105 (down from 104) Carbon Dioxide: 26 (up from 24) Calcium: 8.9 (down from 9.0) Protein, Total: 6.3 (down from 6.6) Albumin: 4.4 (down from 4.5) Globulin: 1.9 (down from 2.1) Albumin/Globulin Ratio: 2.3 (up from 2.1) Bilirubin, Total: 0.5 (down from 0.6) Alkaline Phosphatase: 68 (up from 67) AST: 31 (down from 41) ALT: 25 (down from 40) ApoB: 123 (up from 93) LP PLA2 * for some reason missed on retest, was 135 Oxidized LDL: 79 (up from 48) Cystatin C: 0.88 (down from 0.91) eGFR: 92 (up from 88) Vitamin D, 25-OH, Total: 59 (down from 110) Vit D, 25-OH, D2: <4 (same) HS CRP: 0.6 (down from 0.8) Insulin: 3.8 (down from 3.9) A1c: 5.6 (down from 5.7) F2-Isoprostane: <0.2 (same)

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@Maurice Daher I have a patient who I am considering referring to you. He has suffered with vertigo and dizziness that has remained consistent. It typically hits at 4-6am and especially if laying on his back or Left side to the point he has anxiety about it and has to avoid those positions in his everyday life. He has had bloodwork, CT scans, and your standard various Epleys maneuvers with no improvement. We are trying a few things out but if that doesn’t work would this be a situation that could help with some extra testing?? He is running out of options. From what he sent me they did not seem to look for vitamin deficiency and he has a few markers he has been working on improving. I was going to message privately but thought it was a good opportunity for the group to learn more from (including me). Thank you for your time