WOODSON C. MERRELL, M.D.
44 EAST 67th STREET
NEW YORK, NEW YORK 10065
Telephone:
Far
Date: November 23, 2010
Patient: Jeffrey Epstein (Email: & jeevacation(4mail.com)
• Because of very high cholesterol and triglycerides, and abnormal coronary CT
angiogram, it is very important for you to be maintained on a cholesterol
regimen to keep: LDL below 80, triglycerides below 120, and HDL above 40;
none of which is the case now
• To begin with the above, start Niacin. The prescription sustained release SR
form is more easily tolerated, but plain is OK if you can tolerate it. Begin
with 500 mg twice a day. If well tolerated after one week, double the dose to
1,000 mg twice a day
• Have your pharmacy call if you need sustained release form of the niacin
• Recheck you blood work (cholesterol, triglycerides, CRP, and liver enzymes)
one month after being on full dose, and call me to review
• Consider seeing cardiolo .st, Dr. Rony Shimony 425 East 61st Street 4h1 Floor
NY NY 10021 - - if you'd like to review your cardiovascular
regimen in more detail. You are due for a stress test (stress-echocardiogram)
which he can do during a consultation. If you do see him, call us to send a
copy of your test results (which we did once before with a note)
• Your folic acid enzyme test (MTHFR) was low. This means you do not utilize
folic acid well. To counter this, begin MTHF form of folic acid; FolaPro by
Metagenics is excellent, 1 three times a week.
• Your vitamin D is low-normal (35); but do to the hyperparathyroidism, I
would keep it at this level so as to not raise your calcium level (which is
currently normal at 9.4)
• Contact your parathyroid specialist at Yale to review present blood test
• See attached pdf of your current lab results (only estradiol and testosterone
are pending)
All supplements are available at
Willner Chemists
100 Park Avenue
NYC, NY 10017
EFTA00727369