SUMMARY: February 25th, 2013 Glucose 96 Cholesterol 205 HDL 48 Triglycerides 85 LDL 140 VLDL 17 Non HDL Cholesterol

157 NOVEMBER 12th, 2012 Glucose 96 Cholesterol 246 HDL 51 Triglycerides 122 LDL 171 VLDL 24 Non HDL Cholesterol 195 Hi Adam:

FEBRUARY 25th, 2013

The lab results are back and there has been some improvement- the total cholesterol is down to 205 and the "bad" LDL chol. is down to 140 (borderline high); You had normal blood sugar and HA1C (diabetes testing). So, keep up the good work with the dietary changes and plan to retest in 3 to 6 months. Regards, Ray N. Jarvis, PA-C

1000940 - GLUCOSE
Test Name GLUCOSE Result 96 Flag(s) Reference Range 65-110 mg/dL Reported Date 2/25/2013 11:16 AM Footnote EML

RANDOM GLUCOSE: 65 to 100mg/dL is normal Greater than or equal to 200mg/dL: Suspect Diabetes : . FASTING GLUCOSE: Less than 100mg/dL is Normal Greater than or equal to 100mg/dL to 126mg/dL indicates an impaired fasting glucose.
1004000 - CHEMISTRY PROFILE LIPID
Test Name CHOLESTEROL Result 205 Flag(s) H Reference Range < 200 mg/dL Reported Date Footnote 2/25/2013 12:00 EML PM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 200 mg/dl Desirable 200-239 mg/dl Borderline High Greater than or equal to 240 mg/dl High .
TRIGLYCERIDES 85 < 150 mg/dL 2/25/2013 12:00 EML PM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 150 mg/dl Normal 150-199 mg/dl Borderline High 200-499 mg/dl High Greater than or equal to 500 mg/dl Very High . .
HDL (HIGH DENS LIPO CHOLESTER) 48 > 40 mg/dL 2/25/2013 12:00 EML PM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 40 mg/dl Low Greater than or equal to 60 mg/dl High . HDL Cholesterol >/= 60 mg/dl counts as a negative risk factor: its presence removes one risk factor from the total count. . .
LOW DENSITY LIPOPROTEINS 140 H < 100 mg/dL 2/25/2013 12:00 EML PM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 100 mg/dl Optimal 100-129 mg/dl Near Optimal/Above Optimal 130-159 md/dl Borderline High 160-189 mg/dl High Greater than or equal to 190 mg/dl Very High . The LDL result included in the lipid profile is a calculated LDL which may be invalid when the triglyceride is greater than 400 mg/dl. A direct LDL is not affected by triglycerides or fasting state and may be ordered separately .
VERY LOW DENSITY LIPOPROTEIN NON HDL CHOLESTEROL 17 157 H < < 30 130 mg/dL mg/dL 2/25/2013 12:00 EML PM 2/25/2013 12:00 EML PM

IF LDL GOAL IS: < 160 mg/dL < 130 mg/dL < 100 mg/dL

NON-HDL < 190 < 160 < 130

GOAL SHOULD BE: mg/dL mg/dL mg/dL

< 70 .
CHD RISK FACTOR

mg/dL
FOOTNOTE

< 100 mg/dL

2/25/2013 12:00 EML PM

ATPIII Guidelines do not support the use of this risk estimate.

1700400 - HB A1C (HEMOGLOBIN A1C)
Test Name HBA1C (HEMOGLOBIN A1C) Result 5.4 Flag(s) Reference Range 4.3-6.1 % Reported Date 2/25/2013 12:29 PM Footnote EML

FOR DIAGNOSTIC USE: HbA1c >/= 6.5 %: ADA criteria for the diagnosis of diabetes. * *In the absence of unequivocal hyperglycemia, result should be confirmed by repeat testing. Point-of-care HbA1c assays are not sufficiently accurate at this time to use for diagnostic purposes. . HbA1c 5.7-6.4 %: ADA criteria for increased risk for diabetes (prediabetes). . FOR DIABETES MANAGEMENT: HbA1c <7 %: ADA recommendations for many nonpregnant adults with diabetes. . NOTE: Red cell survival directly influences HbA1c concentration: high values can be obtained when red cell turnover is low (e.g., post splenectomy) and low values when red cell turnover is high (e.g., hemolysis). High values may also be obtained when red cell mass is increased (e.g., polycythemia) and in iron deficiency anemia (mechanism not well described). Treatment of these disorders may result in a change in HbA1c concentrations that are unrelated to glucose control. Caution should be exercised when interpreting the HbA1c results from patients with these conditions. . Reference: American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. January 2011 34:S62-S69

Hi Adam:

November 12th, 2012

The repeat fasing lipid testing is very similar to 2010; elevated total cholesteral and high LDL cholesterol. The blood sugar and HA1C are normal (diabetes check); plan to schedule an appointment with our nutritionist, Carol Kelly, then follow dietary guidelines and return for repeat testing. Make an appointment either via this system (Your Patient Portal; choose Appointments and follow the steps) or by calling (404) 727-7551, option 1. Regards,

Ray N. Jarvis, PA-C 1000940 - GLUCOSE

Test Name GLUCOSE Result 96 Flag(s) Reference Range 65-110 mg/dL Reported Date 11/12/2012 10:30 AM Footnote EML

RANDOM GLUCOSE: 65 to 100mg/dL is normal Greater than or equal to 200mg/dL: Suspect Diabetes : . FASTING GLUCOSE: Less than 100mg/dL is Normal Greater than or equal to 100mg/dL to 126mg/dL indicates an impaired fasting glucose.
1004000 - CHEMISTRY PROFILE LIPID
Test Name CHOLESTEROL Result 246 Flag(s) H Reference Range < 200 mg/dL Reported Date Footnote 11/12/2012 10:44 EML AM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 200 mg/dl Desirable 200-239 mg/dl Borderline High Greater than or equal to 240 mg/dl High .
TRIGLYCERIDES 122 < 150 mg/dL 11/12/2012 10:44 EML AM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 150 mg/dl Normal 150-199 mg/dl Borderline High 200-499 mg/dl High Greater than or equal to 500 mg/dl Very High . .
HDL (HIGH DENS LIPO CHOLESTER) 51 > 40 mg/dL 11/12/2012 10:44 EML AM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 40 mg/dl Low Greater than or equal to 60 mg/dl High . HDL Cholesterol >/= 60 mg/dl counts as a negative risk factor: its presence removes one risk factor from the total count. . .
LOW DENSITY LIPOPROTEINS 171 H < 100 mg/dL 11/12/2012 10:44 EML AM

According to NCEP ATPIII Guidelines, after a 9 to 12 hour fast: . Less than 100 mg/dl Optimal 100-129 mg/dl Near Optimal/Above Optimal 130-159 md/dl Borderline High 160-189 mg/dl High Greater than or equal to 190 mg/dl Very High . The LDL result included in the lipid profile is a calculated LDL which may be invalid when the triglyceride is greater than 400 mg/dl. A direct LDL is not affected by triglycerides or fasting state and may be ordered separately .
CHD RISK FACTOR FOOTNOTE 11/12/2012 10:44 EML AM

ATPIII Guidelines do not support the use of this risk estimate.

VERY LOW DENSITY LIPOPROTEIN NON HDL CHOLESTEROL 24 195 H < < 30 130 mg/dL mg/dL 11/12/2012 10:44 EML AM 11/12/2012 10:44 EML AM

IF LDL GOAL IS: < 160 mg/dL < 130 mg/dL < 100 mg/dL < 70 mg/dL .
1700400 - HB A1C (HEMOGLOBIN A1C)
Test Name HBA1C (HEMOGLOBIN A1C) Result 5.3 Flag(s)

NON-HDL GOAL SHOULD BE: < 190 mg/dL < 160 mg/dL < 130 mg/dL < 100 mg/dL

Reference Range 4.3-6.1 %

Reported Date 11/12/2012 12:18 PM

Footnote EML

FOR DIAGNOSTIC USE:

HbA1c >/= 6.5 %: ADA criteria for the diagnosis of diabetes. * *In the absence of unequivocal hyperglycemia, result should be confirmed by repeat testing. Point-of-care HbA1c assays are not sufficiently accurate at this time to use for diagnostic purposes. . HbA1c 5.7-6.4 %: ADA criteria for increased risk for diabetes (prediabetes). . FOR DIABETES MANAGEMENT: HbA1c <7 %: ADA recommendations for many nonpregnant adults with diabetes. . NOTE: Red cell survival directly influences HbA1c concentration: high values can be obtained when red cell turnover is low (e.g., post splenectomy) and low values when red cell turnover is high (e.g., hemolysis). High values may also be obtained when red cell mass is increased (e.g., polycythemia) and in iron deficiency anemia (mechanism not well described). Treatment of these disorders may result in a change in HbA1c concentrations that are unrelated to glucose control. Caution should be exercised when interpreting the HbA1c results from patients with these conditions. . Reference: American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. January 2011 34:S62-S69
EML Test Performed By EMORY MEDICAL LABORATORY (Angela M. Caliendo, MD, PhD, Director / 1364 Clifton Road NE, Atlanta, GA 30322) *** END OF FINAL LAB REPORT ***