Provider Summary — Metabolic dysfunction + dysautonomia — draft

{
  "components": [
    {
      "name": "Tesamorelin",
      "evidence": [],
      "dosingText": null,
      "safetyNotes": "Contact the clinic with concerns.",
      "dosingSource": null,
      "componentType": "peptide",
      "dosingReviewed": null,
      "monitoringNotes": "Monitor tolerance.",
      "providerRationale": null,
      "providerInstruction": "As directed by your provider."
    }
  ],
  "lab_snapshot": {
    "systems": {
      "immune": 0,
      "hormonal": 0,
      "metabolic": 77,
      "nutritional": 6,
      "inflammatory": 0,
      "mitochondrial": 0,
      "detoxification": 0,
      "connective_tissue": 5,
      "neuroinflammatory": 0
    },
    "confidence": 0.32,
    "missingMarkers": [
      "crp",
      "hscrp",
      "esr",
      "ferritin",
      "fibrinogen",
      "wbc",
      "neutrophils",
      "lymphocytes",
      "monocytes",
      "eosinophils",
      "basophils",
      "igg",
      "iga",
      "igm",
      "lactate",
      "pyruvate",
      "ck",
      "free_t3",
      "free_t4",
      "reverse_t3",
      "testosterone",
      "estradiol",
      "progesterone",
      "dhea_s",
      "am_cortisol",
      "b12",
      "folate",
      "iron",
      "iron_saturation",
      "magnesium",
      "zinc",
      "copper",
      "ast",
      "alt",
      "ggt",
      "bilirubin",
      "albumin",
      "creatinine",
      "egfr"
    ],
    "abnormalMarkers": [
      {
        "flag": "high",
        "value": 116,
        "marker_name": "fasting glucose"
      },
      {
        "flag": "high",
        "value": 24,
        "marker_name": "fasting insulin"
      },
      {
        "flag": "high",
        "value": 6.4,
        "marker_name": "hba1c"
      },
      {
        "flag": "high",
        "value": 220,
        "marker_name": "triglycerides"
      },
      {
        "flag": "low",
        "value": 38,
        "marker_name": "hdl"
      },
      {
        "flag": "high",
        "value": 150,
        "marker_name": "ldl"
      },
      {
        "flag": "low",
        "value": 26,
        "marker_name": "vitamin d"
      }
    ]
  },
  "signed_off_at": "2026-06-14T00:42:53.888+00:00",
  "safety_snapshot": {
    "highFlags": [],
    "criticalFlags": [],
    "overallRiskLevel": "Moderate Review Priority",
    "overallRiskScore": 26,
    "missingInformation": [
      "current_medication_list_confirmed",
      "pregnancy_status_confirmed",
      "infection_status_confirmed"
    ],
    "monitoringConsiderations": [
      "Cardiac monitoring",
      "Metabolic monitoring",
      "Medication review",
      "Physician review before protocol selection"
    ]
  },
  "outcome_snapshot": {
    "trends": {
      "pem": [],
      "pain": [
        {
          "date": "2026-01-10T09:00:00+00:00",
          "value": 3
        },
        {
          "date": "2026-02-09T09:00:00+00:00",
          "value": 3
        },
        {
          "date": "2026-03-11T09:00:00+00:00",
          "value": 2
        }
      ],
      "sleep": [
        {
          "date": "2026-01-10T09:00:00+00:00",
          "value": 4
        },
        {
          "date": "2026-02-09T09:00:00+00:00",
          "value": 5
        },
        {
          "date": "2026-03-11T09:00:00+00:00",
          "value": 7
        }
      ],
      "fatigue": [
        {
          "date": "2026-01-10T09:00:00+00:00",
          "value": 6
        },
        {
          "date": "2026-02-09T09:00:00+00:00",
          "value": 5
        },
        {
          "date": "2026-03-11T09:00:00+00:00",
          "value": 3
        }
      ],
      "brain_fog": [],
      "functional": [
        {
          "date": "2026-01-10T09:00:00+00:00",
          "value": 50
        },
        {
          "date": "2026-02-09T09:00:00+00:00",
          "value": 60
        },
        {
          "date": "2026-03-11T09:00:00+00:00",
          "value": 75
        }
      ]
    },
    "baselineVsCurrent": [
      {
        "metric": "fatigue_score",
        "current": 3,
        "baseline": 6
      },
      {
        "metric": "brain_fog_score",
        "current": null,
        "baseline": null
      },
      {
        "metric": "pain_score",
        "current": 2,
        "baseline": 3
      },
      {
        "metric": "sleep_quality_score",
        "current": 7,
        "baseline": 4
      },
      {
        "metric": "pem_score",
        "current": null,
        "baseline": null
      },
      {
        "metric": "work_capacity_percent",
        "current": 75,
        "baseline": 50
      }
    ],
    "clinicalImprovementScore": 62,
    "functionalImprovementScore": 64
  },
  "protocol_plan_id": "742510aa-39a0-4591-ab16-d4b9de919086",
  "phenotype_snapshot": {
    "scores": {
      "gut_immune": 0,
      "dysautonomia": 48,
      "babesia_pattern": 0,
      "connective_tissue": 0,
      "mold_cirs_pattern": 0,
      "neuroinflammation": 0,
      "bartonella_pattern": 0,
      "immune_dysregulation": 0,
      "metabolic_dysfunction": 52,
      "mitochondrial_dysfunction": 13
    },
    "primary": "metabolic_dysfunction",
    "secondary": "dysautonomia",
    "recoveryStage": "improving"
  },
  "provider_instructions": [
    {
      "name": "Tesamorelin",
      "instruction": "As directed by your provider."
    }
  ],
  "dosing_references_used": [],
  "evidence_references_used": []
}