THAIS-HLTH-2026-W37 Verified

SHA-256: 8f4b...c92a • Signed Dr. Rajiv Verma, MD

Comprehensive Clinical Blueprint

Health Blueprint

Authoritative metabolic evaluation recalibrated weekly for treating physicians.

Week 37, 2026 (Current) Effective: Sep 13 – Sep 19, 2026

Ajay Sharma (Patient Core Phenotype)

DOB: 14-Aug-1984 • Male • Blood Group: O+ Rh+

NKDA Levine PhenoAge Verified

Chronological Age 42 yrs Calendar Age

Biological PhenoAge 37.4 yrs -4.6 yrs Rejuvenated

Body Weight & BMI 76.4 kg BMI 24.1 (-11.8kg total)

Waist-to-Height 0.47 Visceral Safe (<0.50)

DEXA Body Fat % 17.8% Down from 26.4%

Skeletal Muscle Mass 34.2 kg 100% Lean Preserved

Visceral Adipose (VAT) 68 cm² Optimal (<100 cm²)

Resting Metabolic Rate 1,740 kcal / day (Katch-McArdle)

🛡️ Physiological Reserve Index

84 / 100 Metabolic Reserve

Allostatic Load: 1.4 / 10 (Minimal Systemic Strain)

Delta +1.8 vs Wk 36

Endocrine 82% Insulin restored

Cardiovascular 88% Endothelial high

Hepatorenal 89% Steatosis cleared

Immune / Gut 79% Quiet mucosal barrier

🥞

1. Endocrine & Glycemic Homeostasis

Pancreatic Beta-Cell Integrity, Glucose Flux & Insulin Sensitivity

Score: 82/100

Fasting Plasma Glucose (FPG) LOINC: 1558-6

Ref: 70–99 mg/dL • Baseline: 138 mg/dL

94 mg/dL -3 mg/dL this wk

Glycated Hemoglobin (HbA1c) LOINC: 4548-4

Ref: <5.7% (Optimal), 5.7–6.4% (Pre-DM) • Baseline: 8.4%

5.9% -2.5% Absolute Drop

Fasting Serum Insulin LOINC: 2498-4

Ref: 2.6–10.0 μIU/mL • Baseline: 26.2 μIU/mL

8.4 μIU/mL Optimal Euglycemic

HOMA-IR & HOMA-β Beta Function LOINC: 90538-0

Ref: HOMA-IR <2.0 • HOMA-β >80% • Baseline IR: 5.4

1.9 • 98.4% Beta-Cell Rest Reached

CGM Time In Range (70–140 mg/dL) LOINC: 97509-4

Mean: 104 mg/dL • %CV: 16.2% (Target <20%) • 0% Hypo (<70)

96.4% TIR Near Flatline Glycemia

Clinical Summary: Substantial recovery of first-phase pancreatic insulin secretion. Hyperinsulinemic drive resolved. Metformin successfully halved from 1000mg to 500mg daily without glycemic rebound.

❤️

2. Cardiovascular & Vascular Endothelial Reserve

Arterial Compliance, Nitric Oxide, ApoB & Lipoprotein Subfractions

Score: 88/100

Office Resting Blood Pressure LOINC: 85354-9

Target: <120/80 mmHg • Baseline: 142/90 mmHg

121/78 mmHg Stage 1 Hypert. Cleared

Resting HR & RMSSD HRV LOINC: 8867-4 / PPG

Ref: HR 50–70 bpm • HRV >50 ms • Baseline: 72 bpm, 38 ms

56 bpm • 68 ms +4 ms HRV this wk

Triglycerides / HDL Ratio LOINC: 2571-8 / 2085-9

Ref: <2.0 (Zero Small Dense LDL) • Baseline: 4.8

1.64 (112/68) Atherosclerosis Shield

Apolipoprotein B (ApoB) & Lp(a) LOINC: 1884-6 / 43583-4

Ref: ApoB <80 mg/dL • Lp(a) <75 nmol/L • Baseline ApoB: 118

64 mg/dL • 18 nmol/L Minimal Particle Burden

High-Sensitivity Cardiac Troponin I LOINC: 89579-7

Ref: <6.0 ng/L • Non-HDL-C: 94 mg/dL (Target <100)

<2.5 ng/L Zero Myocyte Strain

Clinical Summary: Endothelial eNOS coupling confirmed by robust nitric oxide vasodilation. Triglyceride clearance complete (112 mg/dL). Statin therapy successfully discontinued with cardiology consensus.

🧪

3. Hepatic Function & Steatosis Clearance

Intra-Hepatocyte Lipid Clearance, FibroScan & Transaminases

Score: 89/100

Alanine Aminotransferase (ALT) LOINC: 1742-6

Ref: 9–36 U/L (Optimal <25) • Baseline: 58 U/L

22 U/L 100% Normalized

AST & AST/ALT (De Ritis Ratio) LOINC: 1920-8

Ref: AST 10–35 U/L • Ratio <1.0 • Baseline AST: 46

19 U/L (0.86) Optimal Hepatocyte

Gamma-Glutamyl Transferase & Bilirubin LOINC: 2324-2 / 1975-2

Ref: GGT 9–48 U/L • Total Bili 0.2–1.2 mg/dL • Baseline GGT: 64

18 U/L • 0.7 mg/dL Biliary Stress Zero

FibroScan CAP Steatosis & VCTE Stiffness Elastography

Ref: CAP <238 dB/m (S0) • Stiffness <6.0 kPa (F0) • Baseline: 312 dB/m (S3)

182 dB/m • 4.2 kPa S0/F0 (Full Remission)

Clinical Summary: Total resolution of hepatic steatosis via nocturnal 16-hour fasting and liquid fructose elimination. Serum Albumin at 4.6 g/dL (LOINC 1751-7) confirms robust hepatic protein synthesis.

💧

4. Renal Filtration & Fluid Homeostasis

Glomerular Filtration, Cystatin C & Electrolyte Balance

Score: 92/100

Estimated GFR (CKD-EPI 2021) LOINC: 33914-3

Ref: >90 mL/min/1.73m² (Stage 1 Normal) • Stable trajectory

104 mL/min Pristine Filtration

Creatinine, BUN & Cystatin C LOINC: 2160-0 / 33863-2

Ref: Creat 0.7–1.2 mg/dL • BUN 7–20 • Cystatin C 0.53–0.95 mg/L

0.88 mg/dL • 0.74 mg/L BUN: 12 (Ratio 13.6)

Urine Microalbumin / Creatinine (uACR) LOINC: 14959-1

Ref: <30 mg/g (Zero Diabetic Nephropathy) • Normoalbuminuria

6.0 mg/g Podocyte Intact

Serum Electrolytes (Na / K / Cl) LOINC: 2951-2 / 2823-3

Ref: Na 135–145 • K 3.5–5.0 mEq/L • Osmolality: 288 mOsm/kg

140 • 4.6 • 102 Euvolemic Balance

Clinical Summary: Zero evidence of diabetic nephropathy or glomerular hyperfiltration. Intracellular hydration and sodium-potassium balance optimal.

🛡️

5. Systemic Inflammation & Immune Resilience

Vascular Inflammatory Tone, Methylation & Micronutrient Stores

Score: 86/100

High-Sensitivity CRP (hs-CRP) LOINC: 30522-7

Ref: <1.0 mg/L (Lowest Vascular Risk Stratum) • Baseline: 3.4

0.7 mg/L Lowest Risk Tier

Neutrophil-to-Lymphocyte Ratio (NLR) Calculated

Ref: 1.0–2.5 • Baseline: 3.8 (Chronic Immune Activation)

1.6 Immune Equilibrium

Homocysteine & Serum Uric Acid LOINC: 13965-9 / 3084-1

Ref: Hcy 5–10 μmol/L • Uric Acid 3.5–6.0 mg/dL • Baseline Hcy: 14.8

7.4 μmol/L • 4.2 mg/dL Optimal Methylation

25-OH Vitamin D3 & Serum Ferritin LOINC: 62292-8 / 2276-4

Ref: Vit D 40–70 ng/mL • Ferritin 30–200 ng/mL • Baseline Vit D: 19

58 ng/mL • 110 ng/mL Replete Micronutrients

Clinical Summary: Complete quenching of metabolic endotoxemia and vascular inflammation. High sulforaphane and polyphenol antioxidant reserve active. B12 at 680 pg/mL.

🦠

6. Gastrointestinal Transit & Mucosal Barrier

Microbial Resilience, Prebiotic SCFA Tolerance & Mucosal Barrier

Score: 94/100

Bristol Stool Scale Consistency Clinical Scale

Target: Type 3–4 (Smooth sausage) • Colonic Transit Time: 22h

Type 4 Optimal Transit

Acid Reflux / Heartburn Flares Symptom Log

Baseline: 4x weekly antacid use • Off all PPIs / H2 blockers

0 in 90 Days 100% Cured

Fiber Tolerance & Fecal Calprotectin LOINC: 38445-3

Target: >35g prebiotic fiber • Calprotectin <50 μg/g (Intestinal health)

38g / day • <15 μg/g Zero Gut Dysbiosis

Secretory IgA (sIgA) Mucosal Barrier Stool Biomarker

Ref: 100–200 mg/dL • Postprandial Satiety Index: 9.2 / 10

142 mg/dL Intact Barrier Shield

Clinical Summary: Restoration of lower esophageal sphincter competence via 3-hour pre-bed fast. 38g daily diverse prebiotic fiber tolerated with zero gas or bloating. High butyrate synthesis verified.

💊

Weekly Clinical Prescription Rx

Week 37 Mandate

Net Carb Ceiling 125g / day Insulin-calibrated

Protein Floor 122g / day 1.6g / kg lean mass

Potassium Target 3,800 mg Endothelial eNOS

Feeding Window 12:30 – 8:30 PM 16:8 Autophagy

Prescription Tapering Status Metformin 500mg (Halved) • Statin Ceased Next clinical titration review: Day 60

Supervising Clinical Reviewer: Reg #DMC-48291

"I have reviewed the metabolic trajectory, LOINC blood biomarkers, and home telemetry data for Patient Ajay Sharma for Week 37/2026. The biochemical reversal of Type-2 diabetes and fatty liver steatosis is clinically verified. Pharmaceutical deprescribing is proceeding safely under active observation."

Dr. Rajiv Verma, MD (Internal Medicine) Signed Sep 13, 2026 00:00 UTC

Official Tovelu Medical Blueprint • Complete 6-Organ Clinical Evaluation, PhenoAge Epigenetics, LOINC Markers & Attested Signature.

TOVELU CLINICAL HEALTH BLUEPRINT