Ameet Shah — Health Story

1 · Thyroid — the longest-running thread

TSH has swung between 0.85 and 6.28 since 2017 while TPO antibodies stayed positive — a classic Hashimoto's picture. Synthroid was added (~2021), then T3 (Cytomel) layered in, and low-dose naltrexone was started (early 2025) specifically to try to bring antibodies down. Note the late-2025 dip: free T4 fell to 0.74 and TSH rose to 4.28, then recovered by Feb 2026.

Today: TSH 3.03, free T4 0.91 (low-normal), TPO 241 — antibodies down from the Oct-2025 peak (347) but still ~7× the upper limit. Ask: is current T4/T3 dosing right given the low-normal free T4? Is LDN doing enough?

2 · Testosterone & estrogen — treated low-T, now managing the ceiling

In Jan 2020 total testosterone was 327 with real symptoms. TRT started (~2022): currently Xyosted weekly + HCG. Levels responded strongly — recent draws run 1,100–1,400, at or above the top of range. On TRT, estradiol climbed (58–65) so anastrozole 1 mg weekly was added; DHT also runs high (67–92) even on finasteride 1 mg. PSA is low and stable (0.7–0.8).

Today: T 1,282 (high), estradiol 61 (still above range on anastrozole), DHT 92 (high). Ask: is the dose right, and is the anastrozole dose/timing actually moving estradiol?

3 · Inflammation & the AS diagnosis — from mystery pain to a biologic

Years of hip / SI-joint / hamstring pain (PT, SI injections, PRP in late 2024) finally converged: HLA-B27 positive (twice, 2025) plus MRI evidence → ankylosing spondylitis. The imaging is unusually clear-cut: the pelvis MRI (Jul 2024) showed bilateral sacroiliitis, left worse than right, and the lumbar MRI (Dec 2024) found a new "Andersson lesion" at L4–L5 with enthesitis changes T11–L4 — both classic active-AS findings. Managed first with celecoxib + LDN; the Humira biosimilar started spring 2026, with hydroxychloroquine alongside. Separately, umbilical-cord stem-cell therapy in Panama (Jan 2026) targeted the AS-affected joints, SI joints and spine directly (following earlier rounds in 2018 & 2019 for old orthopedic injuries). A third imaging look agrees: the Nov 2025 Prenuvo whole-body MRI again showed bilateral sacroiliac bone-marrow edema (called "low-risk appearance"), plus multilevel degenerative disc disease down the cervical, thoracic and lumbar spine — see the whole-body screen thread below.

Today: hsCRP 4.71 — its highest recorded value, drawn ~2 weeks before the biologic began; sed rate has stayed low (1–6). Ask #1: my Resilience Code portal shows the Humira script "expired 4/5/2026" — please confirm whether I'm actively on it or holding on hydroxychloroquine alone. Ask #2: recheck CRP now that treatment has changed; the new L4–L5 Andersson lesion is worth a direct look. Ask #3: hep B surface antibody <4 (non-immune) — discuss vaccination while on an immune-suppressing drug.

4 · Cholesterol & coronary plaque — the numbers, and what they did to my arteries

From 2017–2020 LDL ran 163–198 untreated. Rosuvastatin was prescribed (Jan 2023), then replaced by Repatha (evolocumab, a PCSK9 injectable) 140 mg every 2 weeks. LDL fell to 74–95 through 2025. The Feb 2026 draw popped back to 123.

The payoff shows up on imaging, not just the lab sheet. Two coronary CT scans (Cleerly, ordered by Dr. Prusmack) bracket the treatment: total plaque volume actually fell from 107 mm³ (Jun 2024) to 73 mm³ (Nov 2025), calcium score is minimal (Agatston 5, CAD-RADS 2), and overall burden is low (~3% atheroma volume). The one spot to watch: a branch of the LAD (the D2 diagonal) went the other way — stenosis 25% → 28% with a new low-density (softer, higher-risk) plaque component appearing in 2025.

Today: LDL 123 with HDL 66 and triglycerides 64; overall plaque regressing but one soft-plaque branch progressing. Ask: why the LDL rebound — injection timing vs. the draw, or a dose question? Given the D2 soft-plaque, is the LDL target tighter than 100 for me (Dr. Prusmack has aimed for <70)?

5 · Blood sugar — a quiet win

A1c flagged at 5.7–5.8% (prediabetic borderline) repeatedly from 2019–2025. With berberine, tesamorelin, and training changes it came down to 5.4% on the last two draws, with fasting insulin low (3.8–5.0). The A1c chart is above, paired with LDL.

Today: A1c 5.4%, fasting glucose 99, insulin 3.8. Keep doing: current plan; berberine supply gap noted (out of stock ~3 months — replacement queued).

6 · Vitamin D — low, overshot, now dialed in

Vitamin D was 19–21 (deficient) in 2019–2022 → supplementation began → overshot to 133 (above range) by Sep 2024 → dose reduced → now steady at 51–80.

Today: Vit D 80 — upper-mid range. Watch: uric acid crept to 7.1 (top of range) — started a uric-acid support supplement; recheck next draw. Liver enzymes (ALT/AST) spiked Sep–Oct 2025 (77/58) and normalized by Feb 2026 — worth one follow-up look.

7 · The root-cause workup — infections, gut & environment (Dr. Prusmack / Resilience Code)

Alongside the mainstream care, Dr. Prusmack's functional-medicine workup chased what might be driving the inflammation. The picture is mixed and worth a clinician's read:

• Tick-borne: the Igenex panel (Nov 5, 2024) ordered by Dr. Prusmack is the source the July 2025 note was citing. It shows Babesia duncani IgG immunoblot positive (Babesia FISH and IgM negative; B. microti negative), Bartonella FISH positive (Bartonella immunoblot IgM and IgG negative), and Anaplasma (HGA) IgG borderline at 80 (equivocal zone; ≥160 = active). Lyme / Borrelia was fully negative — immunoblot, PCR and screen — as were relapsing-fever Borrelia, Ehrlichia and Rickettsia. Hydroxychloroquine does triple duty here (antibabesial + anti-inflammatory + immunomodulator). The same-month TLab FISH panel called Borrelia, Bartonella and Babesia all "Not Detected" — so the two labs disagree, but the positives Dr. Prusmack acted on are real Igenex results. Worth a clinician's read on which lab to trust.
• Gut / yeast: rising Candida antibodies (dubliniensis, tropicalis), organic-acid markers of fungal overgrowth, and elevated anti-CdtB (a marker Vibrant links to IBS) — the reason for itraconazole (replacing nystatin) and the AIP / elimination diet.
• Environment: a urine organophosphate-pesticide metabolite (DMTP) came back high and sharply rising (2.4 → 74; ref <34); mold (ochratoxin A) and arsenic were mild-moderate. Several IgG food sensitivities (dairy peptide, walnut, cocoa, several fruits).

Ask: the Igenex positives (Babesia duncani IgG, Bartonella FISH) vs. the same-month TLab negatives — which lab do we trust, and does it change the plan? And the rising DMTP (pesticide) reading is the kind of environmental exposure worth a source-hunt. Thyroid antibodies (TPO 177 on the Vibrant panel) echo the Hashimoto's thread above.

8 · Brain & cognition — a normal MRI with two footnotes

The May 2024 brain MRI was structurally normal (normal volume, hippocampus at the 47th percentile, no acute findings), with two things noted for the record: 16 small white-matter FLAIR lesions (5.5 cm³ total, right-side predominant — the scan was run through "NeuroQuant MS" software), and mild cerebellar tonsillar ectopia (a slight low-lying position of the cerebellar tonsils — not quantified against the Chiari-I threshold). Cognitive testing (CogniFit, Mar 2026) scored moderate-to-strong overall — reasoning, attention and memory strong — with perception the one weaker domain, and I self-reported memory/focus concerns even though objective scores held up. As a cross-check, the Nov 2025 Prenuvo brain screen was unremarkable — no worrisome mass or lesion, no aneurysm (it screens the major arteries down to ~3 mm), and no evidence of prior stroke or injury; a screening MRI won't necessarily flag small nonspecific white-matter spots, so it neither confirms nor contradicts the 16 FLAIR lesions.

Ask: the 16 white-matter lesions deserve a neurologist's eye — most likely nonspecific, but worth naming a cause and setting a baseline for future comparison. Context from my problem list: prior concussion (postconcussional syndrome), migraine, and obstructive sleep apnea — all plausible contributors.

9 · The whole-body screen — a clean cancer baseline (Prenuvo, Nov 2025)

In November 2025 I had a Prenuvo comprehensive whole-body MRI (ordered by Dr. Prusmack, read by Dr. Jason Itri). The headline is reassuring: ONCO-RADS Category 2 — no oncologically concerning or high-risk findings across head, neck, chest, abdomen and pelvis; a 12-month follow-up scan is suggested. Everything it flagged was incidental and low-risk:

• Sinusitis — mucosal thickening in the maxillary and ethmoid sinuses (usually self-resolving).
• 6 mm right thyroid cyst — small, typically benign (MRI is less sensitive here than ultrasound).
• Normal-size prostate at 28.3 mL; no suspicious lesion.
• Multilevel degenerative disc disease — cervical (C3–4 through C6–7), thoracic, and lumbar (L3–4 through L5–S1), with bilateral neuroforaminal narrowing.
• Bilateral sacroiliac bone-marrow edema — the AS finding, seen a third time (Thread 3).
• Mild bilateral shoulder and knee degeneration, plus a small left-knee joint effusion (low-risk).
• Anatomical variant: 11 thoracic vertebrae (instead of 12) — worth flagging before any future spine procedure.
• Clear elsewhere: brain, liver (no fatty liver), kidneys, pancreas, spleen, adrenals, bowel, no enlarged lymph nodes.

Note the blind spots: a Prenuvo screen does not evaluate the heart or coronary vessels (my Cleerly CT covers those) and does not replace colonoscopy or dedicated breast/lung screening. Ask: nothing here is urgent — it's a clean baseline for the 12-month re-scan, and the SI edema is one more independent confirmation of the AS.