FRIDAY &MIDDOT; MAY 15, 2026

Good morning, Stewart.

Today's mission

Do your first strength session - even a 20-minute lower-body workout.

Green recovery is a green light. Starting from zero, any session counts.

PUSH HARD

HRV 20 ms · RHR 63 bpm · Sleep 7h 37m

OUT OF KETOSIS

GLU 138 mg/dL

KETONES LO (0.0) mmol/L

DAILY NUTRITION

138%

33%

92%

20%

WEEKLY ACTIVITY

43%

88%

67%

Today's checklist

Strength session

Pending

✓

Protein≥ 162 g

223 / 162 g

Hit

—

Hydration≥ 3.5 L

—

Source not configured. Enable dietary_water in Health Auto Export or log manually.

No data

Glucose + Ketones test

Pending

Steps≥ 7,500

2,417 / 7,500

Pending

Yesterday score

Score: 86 / 100

✅ Best: Protein 210g (≥130g target)

❌ Drag: Steps 4,668 (target ≥7,500 — 37% under)

Macros yesterday

Macro	Yest	Goal	Δ
Protein	210 g	162 g	+48g
Net Carbs	97 g	≤35 g	+62g
Fat	146 g	188 g	-42g
Sugar	22 g	≤25 g	OK

Lean / fat loss

Since Mounjaro start (May 4, 2026) (153.4 kg / 33.5% BF est.):

Weight-6.9 kg (146.51 today vs 153.4 pre-Mounjaro)

Fat mass<pending post-Mounjaro body scan>

Lean mass<pending post-Mounjaro body scan>

Lean loss ratio<pending post-Mounjaro body scan>

iDay 12 on Mounjaro 2.5 mg. Down 6.8 kg from baseline - primarily water/glycogen. Sustained fat-loss begins ~week 3.

iLatest Keto-Mojo: glucose 138 mg/dL · BHB 0.0 mmol/L · logged May 13.

+Recovery 88% (green). Ideal day for first strength session.

!HRV averaging 18 ms. Low for adults but in line with 8-week baseline.

PROGRESS · SCORE 31/100

Long-term arc.

Today 148.8 kg → M6 122 kg by Nov 13, 2026 → M9 114 kg → M12 107 kg → M15-18 102 kg. Body fat 33.5% → <20%. Strength + protein floor are the muscle-preservation levers on GLP-1.

out of 100 · weighted across 7 goals

Milestone trajectory · Withings history + projected curve through M6 -> M15-18

Stars mark the four named milestones: M6 (Nov 13, 2026 · 122 kg · 28% BF), M9 (Feb 13, 2027 · 114 kg · 25% BF), M12 (May 13, 2027 · 107 kg · 22% BF), M15-18 (mid-2027 · 102 kg · <20% BF). Dashed line is the projected path from today; reassess every 4 weeks.

30-day habit streaks

Protein

≥130g

Steps

≥7.5k

Sugar

≤25 g

Ketones

0.5-2.5

Milestone strip · M6 -> M15-18

May 15, 2026

146.51 kg

NOW · 33.5% BF

Nov 2026 · M6

122 kg

+26w · 28% BF

Feb 2027 · M9

114 kg

+39w · 25% BF

May 2027 · M12

107 kg

+51w · 22% BF

Sep 2027 · M15-18

102 kg

+71w · 20% BF

~1.0 kg/wk to M6 (Mounjaro dose escalating), tapering to ~0.5 kg/wk by M12 and ~0.3 kg/wk to M15-18 (realistic floor). Real curves bend - reassess every 4 weeks.

Goal cards

Weight

Behind

146.51kg

M6: 122 kg by Nov 13, 2026 · long-term 102 kg by M15-18

21.7% to M6 · need ~24.5 kg over ~26 weeks.

Body fat

Awaiting reweigh

33.5%

M6: 28% · M12: 22% · long-term <20%

Last reading Sep 2025. Reweigh on Body Scan to refresh.

Ketosis (BHB)

Just starting

0.0mmol/L

Band 0.5-2.5 mmol/L · 5+ days/wk

In-band 0/2 logged days (30d). Pending Dr. Kanjanee SGLT2+keto safety review.

Strength

Restart pending

0/3

3 sessions per week

Dr. Muscle program restart pending.

Protein floor

On track

132g avg

≥130 g daily floor

71% of logged days hit floor.

Weekly steps

Behind

23423

55,000-80,000 weekly range

Aerobic base is the HRV lever.

Sleep 7-9 h

On track

57%

Nights in 7-9 h band

4/7 nights in band.

Hydration

On track

3.5L+

≥3.5 L daily · electrolytes after sweat

Habitual. SGLT2 increases water loss.

BODY COMPOSITION

146.51 kg · 33.5% body fat

BMI 36.3 · healthy at 201 cm is 75-101 kg. Body fat reading is stale from Sep 2025 · reweigh on Body Scan to refresh.

Weekly progress photos

Drop into Health Dashboard/05 Progress Photos/YYYY-MM-DD/front.jpg · same time, same lighting, same pose.

Week 1

drop front.jpg

Week 2

drop front.jpg

Week 3

drop front.jpg

Week 4

drop front.jpg

Once 2+ weeks of photos exist, a slider/morph component (v2.2) will populate this section. Optional side.jpg and back.jpg for multi-angle morph.

Muscle WatchWhere you stand on muscle preservation — the #1 risk factor on GLP-1 therapy

Lean mass stale · reweigh due

93.8kg

From Withings body comp scan

Reading: Sep 2025

Lean loss ratio

—

Awaiting fresh scan. Two body-comp readings 2+ weeks apart needed.

Target: keep <15%

Fat mass stale · reweigh due

49.7kg

Baseline reading Sep 2025

Reading: Sep 2025

Hydration stale · reweigh due

67.1kg

Watch on SGLT2 — fluid loss

Reading: Sep 2025

Walking speed

2.48 mph

Target ≥ 3.0 mph · last 30 days

Walking step length

28.1 in

Target ≥ 26 in · last 30 days

Walking asymmetry

0.0%

Target < 5% · last 30 days

Double support

32.5%

Target < 25% · last 30 days

Protein adherence (7-day avg)

132g/day

vs 162 g target · 5/7 days ≥130 g this week

Last 14 days

Strength sessions this week

0/ 3 target

Whoop activities: Weightlifting / Strength / Crossfit / Functional

Week of May 08–May 14

Recovery quality (7-day avg)

72%

3/7 days in green (≥67%)

From Whoop daily recovery

Weight trajectory · Withings history

Body composition

Last reading Sep 2025 · Reweigh due

Fat mass

49.7 kg

Muscle

93.8 kg

Hydration

67.1 kg

Bone

3.5 kg

BMI

36.3

Healthy range 75-101 kg at 201 cm

Current vs start

-6.8kg

Since Mounjaro start (May 4) - mostly water in week 1

To M6 milestone

24.5kg

Remaining to 122 kg by Nov 13, 2026

Blood pressure · Beurer BM Elite 950

127/80mmHg

Latest May 13, 2026 10:03 AM · pulse 73 bpm · MAP 95.7

ACTIVITY · LAST 14 DAYS

Build the base.

Strength 0/3 this week. Steps 23,423 vs 55k floor. Exercise 71 min vs WHO 150 min/wk.

Recent workouts

Date	Activity	Duration	Strain	kcal	Avg HR	Max HR
Fri May 15	Walking	46 min	0.0	87	84 bpm	105 bpm
Wed May 13	Walking	13 min	4.6	64	108 bpm	140 bpm
Wed May 13	Walking	25 min	5.9	168	113 bpm	153 bpm
Sun May 03	Walking	22 min	3.2	44	96 bpm	108 bpm
Sat May 02	Walking	15 min	4.9	98	116 bpm	130 bpm

Recovery · HRV · RHR · last 14 days

Strain vs Sleep · last 14 days

Steps · last 14 days

Daily exercise minutes (WHO 150/wk = ~21/day)

FUEL

Protein-first · sugar-low.

Mounjaro suppresses appetite. Floor: 130 g protein, <30 g sugar, ≥30 g fiber. Front-load 40 g protein at breakfast - afternoon nausea common in early weeks.

Macro targets · 2,600 kcal

Strict keto

160 g protein

≤30 g net carbs

200 g fat

Moderate low-carb (start)

160 g protein

75 g carbs

180 g fat

Safety: Pending Dr. Kanjanee review of SGLT2 (Jardiance) + keto safety. Start with moderate low-carb; escalate to strict keto only after sign-off.

Calories · in vs burned

Macros vs targets · last 14 days

Protein · target: 162 g

Net Carbs · target: ≤35 g

Fat · target: 188 g

Sugar · target: ≤25 g

Fiber (g) · target ≥30 g/day

Glucose (mg/dL) · Keto-Mojo · last 30 days

Week averages (MFP days)

Cal in2017

Protein132 g

Burn2869

Deficit852

Protein adh71%

Daily nutrition · last 7 days

Date	Calories	Protein	Carbs	Fat	Sugar	Fiber
Sat May 09	1995	146 g	156 g	78 g	18.0 g	9.0 g
Sun May 10	1839	162 g	78 g	91 g	0.0 g	1.0 g
Mon May 11	2463	137 g	219 g	116 g	137.0 g	31.0 g
Tue May 12	1814	89 g	96 g	104 g	18.0 g	8.0 g
Wed May 13	1989	134 g	121 g	105 g	7.0 g	8.0 g
Thu May 14	2578	210 g	108 g	146 g	22.0 g	11.0 g
Fri May 15	2596	223 g	27 g	173 g	5.0 g	2.0 g

NINJA CREAMI DELUXE · 14 RECIPES

Dessert without the damage.

No/low sugar, dessert-sweet, 200–250 cal per serving with 25–32 g protein. Each pint = 2 servings. Allulose stays scoopable; xanthan gum is the secret to creaminess. Run Lite Ice Cream, respin once if powdery, add mix-ins after the first spin.

Avg cal/serv

222

Avg protein

28 g

Avg sugar

2.8 g

Recipes

Base ratio

1 cup Fairlife skim + ½ cup unsweetened almond milk + 1 scoop protein + ¼ tsp xanthan + 3 tbsp allulose.

Freeze time

Minimum 24 hours flat. Skip the rush — partial freeze ruins texture.

Mode

Lite Ice Cream for protein bases. Respin once if powdery. Mix-ins always after first spin.

Sweetener stack

Allulose is the bulk (doesn’t refreeze hard). 5 drops liquid stevia boosts perceived sweetness.

All recipes

Peanut Butter Fudge Swirl

220 cal32 g protein3 g sugar

Ingredients

1 cup Fairlife skim milk
½ cup unsweetened almond milk
1 scoop chocolate protein
3 tbsp PB2 / peanut butter powder
3 tbsp allulose + 5 drops stevia
¼ tsp xanthan, pinch salt, 1 tsp vanilla
Mix-in: 1 tbsp SF hot fudge + 1 tsp natural PB

Directions

Blend base, freeze 24h. Run Lite Ice Cream, respin if needed. Drizzle fudge + PB into the well and run Mix-In.

Salted Caramel Macadamia

245 cal26 g protein2 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop unflavored protein
3 tbsp allulose
1 tsp SF caramel syrup (Jordan’s Skinny)
½ tsp vanilla, ¼ tsp xanthan, ¼ tsp flaky salt
Mix-in: 2 tbsp chopped macadamias + 1 tbsp ChocZero caramel

Directions

Blend, freeze 24h. Lite Ice Cream, respin once. Add nuts + caramel sauce, run Mix-In. Finish with extra flaky salt.

Butterscotch Pecan

235 cal25 g protein2 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop unflavored protein
1 tbsp SF butterscotch pudding mix (Jell-O)
3 tbsp allulose, 1 tsp vanilla
¼ tsp xanthan
Mix-in: 2 tbsp dry-toasted pecans

Directions

Toast pecans in a dry pan 3 min — transforms them. Blend base, freeze 24h, run Lite Ice Cream. Add pecans, Mix-In.

Strawberry Cheesecake

210 cal28 g protein4 g sugar

Ingredients

1 cup low-fat cottage cheese (blend smooth first)
½ cup Fairlife skim
2 oz fat-free cream cheese
3 tbsp allulose, ½ tsp lemon juice
¼ tsp xanthan
¼ cup crushed freeze-dried strawberries

Directions

Blend cottage cheese first until smooth (no curds), then add the rest. Freeze 24h, run Lite Ice Cream, respin once. Cheesecake density — you’d never know.

Chocolate Fudge Brownie

230 cal30 g protein2 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop chocolate protein
2 tbsp unsweetened cocoa (Dutch-process)
¼ cup allulose, ¼ tsp xanthan
Pinch salt, ½ tsp vanilla
Mix-in: 2 tbsp ChocZero chips + chopped Quest brownie (optional)

Directions

Whisk cocoa with hot water first to bloom it, then blend with rest. Freeze 24h, Lite Ice Cream. Add mix-ins, run Mix-In.

Vanilla Bean Bourbon

195 cal28 g protein3 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop unflavored protein
3 tbsp allulose, 5 drops stevia
1½ tsp pure vanilla extract
Scrape of vanilla bean if you have one
¼ tsp xanthan, pinch salt

Directions

The control recipe. Blend, freeze 24h, Lite Ice Cream. Scoops like premium vanilla. Pairs with anything you want to add later.

Mint Chocolate Chip

215 cal29 g protein2 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop unflavored or vanilla protein
3 tbsp allulose
¼ tsp peppermint extract (start with ⅛)
¼ tsp xanthan
Mix-in: 2 tbsp ChocZero mini chips

Directions

Peppermint is potent — underdose, you can always add more on respin. Freeze 24h, Lite Ice Cream. Add chips, Mix-In. Don’t blend chips into the base or they’ll seize.

Maple Walnut Praline

240 cal26 g protein2 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop unflavored protein
2 tbsp SF maple syrup (Lakanto)
2 tbsp allulose, ½ tsp maple extract
¼ tsp xanthan, pinch salt
Mix-in: 2 tbsp walnuts tossed with ½ tsp allulose + cinnamon

Directions

Toast the walnut/allulose mix in a dry pan until fragrant and glossy. Cool. Blend base, freeze 24h, Lite Ice Cream. Add candied walnuts, Mix-In.

Chocolate Peanut Butter Cup

250 cal32 g protein3 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop chocolate protein
2 tbsp PB2, 1 tbsp cocoa
3 tbsp allulose, ¼ tsp xanthan
½ tsp vanilla
Mix-in: 1 tbsp natural PB + 1 tbsp ChocZero chips

Directions

Blend, freeze 24h, Lite Ice Cream. Drop frozen-spoon dollops of PB into the well plus chips, run Mix-In. The PB stays in chunks for that Reese’s effect.

Raspberry Dark Chocolate

210 cal27 g protein3 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop chocolate protein
3 tbsp allulose, 1 tbsp cocoa
¼ tsp xanthan
¼ cup crushed freeze-dried raspberries
Mix-in: 1 tbsp ChocZero 70% chips

Directions

Crush the freeze-dried raspberries into a powder, stir into the base. Freeze 24h, Lite Ice Cream. Add chips, Mix-In. Raspberry/dark chocolate completely hides the protein flavor.

Banana Cream Pie

220 cal26 g protein4 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop vanilla or unflavored protein
1 tbsp SF banana cream pudding mix (Jell-O)
3 tbsp allulose, ½ tsp vanilla
¼ tsp xanthan
Mix-in: 2 crushed Quest vanilla cookies or 1 tbsp toasted pecans

Directions

No actual banana — keeps sugar minimal. The pudding mix carries the flavor. Blend, freeze 24h, Lite Ice Cream, then Mix-In.

Birthday Cake

225 cal28 g protein2 g sugar

Ingredients

1 cup Fairlife skim, ½ cup almond milk
1 scoop vanilla protein
3 tbsp allulose
1 tsp butter extract, 1 tsp vanilla, ¼ tsp almond extract
¼ tsp xanthan, pinch salt
Mix-in: 1 tbsp sprinkles + 1 tbsp crushed SF vanilla wafer

Directions

Butter + vanilla + a touch of almond extract is the “cake batter” trinity. Blend, freeze 24h, Lite Ice Cream, then Mix-In.

Lemon Cheesecake

200 cal27 g protein4 g sugar

Ingredients

¾ cup nonfat Greek yogurt
½ cup Fairlife skim
2 oz fat-free cream cheese
1 scoop unflavored protein
3 tbsp allulose, zest of 1 lemon, 1 tbsp lemon juice
½ tsp vanilla, ¼ tsp xanthan

Directions

Blend everything until completely smooth, freeze 24h, Lite Ice Cream, respin once for that cheesecake density. Best after a heavy meal.

Toasted Pecan Praline

240 cal25 g protein3 g sugar

Ingredients

1 cup Fairlife skim, ½ cup half-and-half (or all skim)
1 scoop unflavored protein
2 tbsp SF maple syrup, 2 tbsp allulose
½ tsp vanilla, ¼ tsp cinnamon
¼ tsp xanthan
Mix-in: 3 tbsp pecans toasted with ½ tsp allulose + salt

Directions

Toast pecans + allulose + salt in a dry pan until they smell candy-like and the allulose has melted onto them. Cool, then add at the Mix-In step.

DATA · SOURCE OF TRUTH

Where the numbers come from.

Seven data streams. Re-export weekly. Empty-state cards below show what's still pending - blood work, glucose/ketones, BP, PWV.

Source-of-truth policy

WHOOPRecovery · Strain · HRV · RHR · Sleep stages

WITHINGSWeight · Body composition · Hydration

APPLESteps · Exercise minutes · Active energy

MFP via APPLECalories · Protein · Carbs · Fat · Sugar · Fiber · Net carbs

KETO-MOJOGlucose · Ketones (BHB) - GK+ meter device readings

BEURER BM Elite 950Systolic · Diastolic · Pulse · MAP

MANUALBloodwork PDFs · PWV · Mounjaro log

Refresh cadence

Re-export Whoop from app, Withings from Health Mate, Apple Health via HealthAutoExport to 02 Stew/ weekly. Scheduled rebuild runs every 6 hours.

Data Quality

✓

QC PASS

? pass · ? warn · ? fail

Last run: -

View report

Pending data streams

Bloodwork

Pending

Waiting for April panel PDF. Drop it in 02 Stew/06 Bloodwork/ when ready.

Lipid panel (total chol, LDL, HDL, triglycerides)
HbA1c, fasting glucose
Kidney function (creatinine, eGFR, BUN)
B12, vitamin D, ferritin

Glucose & Ketones

Active

Keto-Mojo GK+ meter export now ingesting. Latest reading shown on Today tab. Drop new CSV in 02 Stew/05 Keto-Mojo/ after each batch of readings.

Fasting AM glucose target < 100 mg/dL (ideal), < 130 OK
Ketosis band 0.5-2.5 mmol/L BHB

Blood Pressure

Active

Beurer BM Elite 950 export ingesting from HealthManager Pro. Charted on Body tab. Drop fresh CSV in 02 Stew/06 Beurer/.

Target band 110-130 / 70-85 mmHg
Morning + evening readings preferred

Vascular Age (PWV)

Manual

PWV is not in the Withings export - read it from the Withings Health Mate app and log manually.

File: 02 Stew/03 Withings/pwv_manual.csv
Columns: date, pwv_ms (and optional vascular_age)

Daily snapshot · last 7 days

Date	Recovery	Strain	HRV	RHR	Sleep	Cal in	Protein	Steps
Sat May 09	-%	-	- ms	- bpm	-	1995	146 g	541
Sun May 10	52%	9.2	15 ms	68 bpm	8h 59m	1839	162 g	472
Mon May 11	81%	8.8	19 ms	66 bpm	7h 41m	2463	137 g	3,874
Tue May 12	-%	-	- ms	- bpm	-	1814	89 g	4,467
Wed May 13	67%	5.6	18 ms	64 bpm	8h 33m	1989	134 g	9,111
Thu May 14	-%	-	- ms	- bpm	-	2578	210 g	4,668
Fri May 15	88%	4.5	20 ms	63 bpm	7h 37m	2596	223 g	2,417

Medications & supplements (active)

Name	Type	Dose	Schedule	Started	Purpose
Mounjaro (tirzepatide)	medication	2.5 mg	weekly Sunday ~12:00	2026-05-04	GLP-1/GIP agonist for diabetes + weight
Jardiance Duo	medication	5/1000 mg (empagliflozin/metformin)	2x daily after breakfast and dinner	2026-05-04	SGLT2 + metformin for diabetes
Trilipix	medication	135 mg	1x daily after breakfast	2026-05-04	fenofibrate for hyperlipidemia
Vitamin D3 + K2 (XTRA FUEL)	supplement	20000 IU D3 + 200 mcg K2	1 cap every 3 days x 8 wks then 1 cap weekly	2026-05-11	severe vitamin D deficiency replenishment
Omega-3 Triple Strength	supplement	~900 mg EPA/DHA	daily	-	lipid + anti-inflammatory
Curcumin Phytosome (CurCare Meriva)	supplement	250 mg	daily	-	anti-inflammatory
Selenium (Vitamaze Selen)	supplement	200 mcg	daily	-	micronutrient
Zinc (Vitamaze Zink Aktiv)	supplement	TBD - confirm from label	daily	-	micronutrient
Acetyl-L-Carnitine (NOW)	supplement	500 mg	daily	-	fat metabolism + nerve support
Ashwagandha KSM-66 (natural elements)	supplement	TBD - confirm from label	daily	-	stress / cortisol
L-Glutamine (NOW)	supplement	500 mg	daily	-	amino acid
L-Arginine 4500 (Vitamaze)	supplement	4500 mg	daily	-	NO precursor / vascular
CoQ10 Bio-Quinone (Pharma Nord)	supplement	100 mg	daily	-	cardiac / energy
Alpha-Lipoic Acid (MEGA Lipo-X)	supplement	50 mg	daily	-	glucose / antioxidant / neuropathy

Pill organizer · daily bands

Your container's columns are days, rows are AM / Noon / PM. Each band below = one row's contents, duplicated across every day-column. Only Vitamin D3 differs day-to-day.

AMwith breakfast11 supplements / day + 2 prescription pills

Omega-3Triple Strength softgel

CoQ10 Ubiquinol 100 mgLife Extension

Curcumin Phytosome 250 mgMEGA CurCare

Acetyl-L-Carnitine 500 mgNOW

L-Arginine 4500 mgVitamaze

Lion's Mane ExtractZENement - NGF support

L-Carnosine 1000 mgJarrow - anti-glycation

Tongkat Ali 500 mgTen Percent Club

NAC 1000 mgVegavero

Green Tea Extractnatural elements

Alpha-Lipoic Acid 50 mgMEGA Lipo-X

+ Prescriptions: Trilipix 135 mg · Jardiance Duo 5/1000 mg

Sun + Thu only: Vitamin D3 20,000 IU + K2 200 mcg - drop a 12th cap into the AM compartment on those two days for 8 weeks (loading), then Sunday-only maintenance.

NOONwith lunch3 supplements / day

Selenium 200 mcgVitamaze Selen

ZincVitamaze Zink Aktiv

Potassium 99 mgNaturesPlus - cramps

PMwith dinner3 supplements / day + 1 prescription pill

Ashwagandha KSM-66natural elements

L-Glutamine 500 mgNOW

Magnesium-3 ComplexVitamaze - cramps + sleep

+ Prescription: Jardiance Duo 5/1000 mg (second daily dose)

Mounjaro injection: 2.5 mg subcutaneous, Sundays ~12:00 - not in the organizer (injection, not pill).

QUESTIONS FOR DR. KANJANEE

Running list for Samitivej visits.

Mark each as 'asked' when discussed, then 'answered' when you have a decision. State persists locally in your browser.

pending

0 asked · 0 answered

Cardiovascular & ED

Cialis (tadalafil) 5 mg daily as Viagra alternative — ED + sildenafil headaches

ED in diabetic men is often vascular; tadalafil has a different side-effect profile and may be tolerated where sildenafil isn't.

Latest lipid panel result from April bloodwork — is Trilipix moving triglycerides down?

High trigs drive endothelial dysfunction → ED + CV risk. Trilipix is prescribed specifically to address this.

Strength training clearance — any contraindications with current med stack (Mounjaro + Jardiance + Trilipix)?

Confirm clearance before ramping up resistance work.

Cramps & Electrolytes

Cramps workup: request serum magnesium, potassium, sodium levels

Empagliflozin (SGLT2) dumps electrolytes via urine; cramps developed during therapy. Need labs to confirm.

Keto + Medication Safety

Keto + SGLT2 safety: pause/reduce Jardiance Duo if pursuing nutritional ketosis?

Euglycemic DKA risk is 5-7× baseline on SGLT2 + low-carb. Need explicit clearance + ketone ceiling.

Diabetic Neuropathy

High-dose B6 in Re-B Forte (500 mg/day) — long-term neuropathy risk?

Pyridoxine UL is 100 mg/day; chronic excess can paradoxically cause peripheral neuropathy.

Restart Milgamma Mono (benfotiamine) alone — without the Re-B Forte?

Safer half of December prescription; evidence-based for diabetic neuropathy at this dose.

Prescription-strength alpha-lipoic acid (600 mg/day) for diabetic neuropathy?

Current 50 mg supplement is sub-therapeutic. Clinical dose is 600 mg/day.

Bionic Gym EMS device safety with diabetic neuropathy?

EMS in compromised nerve tissue is "consult physician." Stewart has the device; wants to use for cardio adjunct.

Vitamin D

Confirm Vitamin D3 protocol: 20,000 IU every 3 days for 8 wks, then weekly maintenance?

Severe deficiency at last bloodwork ("practically zero"); BMI 36+ needs higher doses than standard maintenance.

Re-test 25(OH)D at week 10-12 of D3 loading?

Confirm replenishment is working and adjust frequency if hypercalcemia signs.

Labs to Request

A1c trend from April bloodwork → next checkpoint?

Tracking Mounjaro + Metformin + SGLT2 cumulative effect on glycemic control.

Kidney function (eGFR, creatinine) — on Metformin + SGLT2?

Both medications require periodic renal monitoring; SGLT2 in particular can affect GFR.

B12 level?

Chronic Metformin use depletes B12. Independent of the discontinued Re-B Forte.

Tracking Tools

Continuous glucose monitor prescription — FreeStyle Libre 3?

Bumrungrad/Samitivej carries Abbott; with three glucose-lowering meds + keto attempt, CGM gives invaluable real-time data.

DEXA scan referral at next milestone (target Nov 2026 check-in)?

Body composition ground-truth for tracking Mounjaro muscle-preservation outcomes.

InBody clinical scan availability at Samitivej?

Quarterly body comp tracking between DEXAs — does Samitivej have one in-house?

Treatment Plan

Mounjaro titration timeline — when to step from 2.5 mg → 5 mg → 7.5 mg → 10 mg?

Sets realistic expectations for the weight-loss curve through M6 / M9 / M12 milestones.

Auto-refresh every 6h · Source: 02 Stew/ · v2.3