Raymond Ralph Marker · DOB 24 May 1973 · Weight 252 lb

Bilateral May-Thurner syndrome with 100% compression; stents implanted (patient report; procedure date not in lab packet).
ACL tear February 2026; diagnosed June 2026; ortho recommends reconstruction.
Training: daily movement. Zone 2 cardio 120 min/week. Resistance 2–3×/week. Run ¼–½ mile 4×/week. Sprint 2×/week. Sauna 2–3×/week.
Anticoagulation: Eliquis 2.5 mg twice daily + aspirin. Full meds/supplements list below.

For Dr. Rob Cywes — last 6 months of his core panel

Raymond Ralph Marker · DOB 24 May 1973 · Weight 252 lb. Eliquis 2.5 mg BID. Window 22 Mar 2026–22 Sep 2026. One row per assay = most recent in that window.

Glucose axis

Assay	Date	Value	Printed range / flag	Note
Fasting glucose (CMP)	2026-09-16	86 mg/dL	70–99 · Normal	Same CMP as BUN/Cr/electrolytes below. Earlier in window: 96 (11 Mar), 80 (28 May), 96 (11 Sep).
HbA1c	2026-05-28	5.1 %	<5.7 · Normal	Printed eAG 100 mg/dL.
Fasting insulin	2026-05-28	2.9 µIU/mL	2.6–24.9 · Normal	Low-normal. Only insulin in this window.
Fasting C-peptide	—	Not drawn in this window. Last in packet: 1.4 ng/mL on 1 Aug 2025.
Fasting glucagon	—	Not drawn in this window. Last in packet: 94 pg/mL on 9 Sep 2025.
Fructosamine	—	Never in packet.

Testosterone and homocysteine

Assay	Date	Value	Printed range / flag	Note
Total testosterone	2026-09-16	1012 ng/dL	264–916 · High	Most recent.
Free testosterone	2026-09-16	9.2 pg/mL	7.2–24 · Normal	Analog-scale assay. A 28 May 2026 free-T of 97.4 was a lab error and is excluded.
Homocysteine	2026-09-16	6.2 µmol/L	0.0–14.5 · Normal	Most recent. Same day as folate >20 and B12 >2000.

Standard lipid panel only

Assay	Date	Value	Printed range / flag	Note
Total cholesterol	2026-05-28	349 mg/dL	High	Alternate print 360. Only lipid panel in this window.
LDL-C (calc)	2026-05-28	238 mg/dL	High vs 0–99 sheet target	Alternate print 251.
HDL-C	2026-05-28	108 mg/dL	>39 · Normal	Alternate print 94.
Triglycerides	2026-05-28	41 mg/dL	0–149 · Normal	Alternate print 47.
VLDL	—	Not printed separately on that panel.

CBC with auto differential — most recent in window (11 Sep 2026)

Source: Result Trends CBC W/Auto Differential, table 6 (11 Dec 2025 – 11 Sep 2026). Earlier claim that indices and the differential were absent was wrong.

Assay	Date	Value	Printed range / flag	Note
WBC	2026-09-11	5.09 ×10E9/L	3.30–10.50 · Normal	11 Mar was 3.97.
Neutrophils, abs	2026-09-11	3.00 ×10E3/µL	1.20–6.80 · Normal	% lymphs 30.6, monos 7.3, eos 1.6, basos 1.2 same day.
Lymphocytes, abs	2026-09-11	1.56 ×10E9/L	1.20–3.20 · Normal
Monocytes, abs	2026-09-11	0.37 ×10E3/µL	0.20–0.80 · Normal	% 7.3 (1.0–12.0).
Eosinophils, abs	2026-09-11	0.08 ×10E3/µL	0.00–0.50 · Normal	% 1.6 (0.0–6.0).
Basophils, abs	2026-09-11	0.06 ×10E3/µL	0.00–0.10 · Normal	% 1.2 (0.0–2.0).
Immature granulocytes	2026-09-11	0.4 %	0.0–2.0 · Normal	Abs IG <0.04.
RBC	2026-09-11	4.27 ×10E6/µL	3.69–5.90 · Normal
Hemoglobin	2026-09-11	13.6 g/dL	11.7–16.7 · Normal
Hematocrit	2026-09-11	40.9 %	34.1–49.7 · Normal
MCV	2026-09-11	95.8 fL	80.0–97.0 · Normal
MCH	2026-09-11	31.9 pg	26.1–33.5 · Normal
MCHC	2026-09-11	33.3 g/dL	31.9–35.3 · Normal
RDW	2026-09-11	12.6 %	10.5–14.7 · Normal
Platelets	2026-09-11	170 ×10E9/L	140–440 · Normal
MPV	2026-09-11	8.9 fL	6.8–10.6 · Normal

CMP — most recent in window (16 Sep 2026 unless noted)

Assay	Date	Value	Printed range / flag	Note
Glucose	2026-09-16	86 mg/dL	70–99 · Normal
BUN	2026-09-16	15 mg/dL	6–24 · Normal	28 May was 17 (7–25).
Creatinine	2026-09-16	0.83 mg/dL	0.76–1.27 · Normal
eGFR (no race)	2026-09-16	105	>59 · Normal	28 May 95; 11 Mar 105; 11 Sep 104.
BUN/Creat ratio	2026-09-16	18	9–20 · Normal
Sodium	2026-09-16	138 mmol/L	134–144 · Normal	28 May also 138.
Potassium	2026-09-16	4.5 mmol/L	3.5–5.2 · Normal	11 Sep printed 5.9 High (3.5–5.1) — possible hemolysis; not the latest.
Chloride	2026-09-16	102 mmol/L	96–106 · Normal
CO2	2026-09-16	20 mmol/L	20–29 · Normal	At the floor of that range.
Calcium	2026-09-16	9.4 mg/dL	8.7–10.2 · Normal	28 May 9.0.
Protein, total	2026-09-16	5.9 g/dL	6.0–8.5 · Low	28 May 6.2 (6.1–8.1).
Albumin	2026-09-16	4.4 g/dL	3.8–4.9 · Normal
Globulin	2026-09-16	1.5 g/dL	1.5–4.5 · Normal	At the floor. 28 May 2.0.
Total bilirubin	2026-09-16	0.5 mg/dL	0.0–1.2 · Normal	28 May 0.8.
ALP	2026-09-16	75 IU/L	47–123 · Normal	28 May 62.
AST	2026-09-16	22 IU/L	0–40 · Normal
ALT	2026-09-16	28 IU/L	0–44 · Normal
GGT	2026-05-28	60 IU/L	3–95 that day · Normal	Not on the 16 Sep CMP print; latest GGT in window.

Inflammation / nutrients — most recent

Assay	Date	Value	Printed range / flag	Note
hs-CRP	2026-05-28	0.8 mg/L	0–3 · Normal	Only hs-CRP in window.
Uric acid	2026-09-16	6.0 mg/dL	3.8–8.4 · Normal
Vitamin B12	2026-09-16	>2000 pg/mL	High	Supplemented; above assay.
Folate (serum)	2026-09-16	>20.0 ng/mL	High / replete	He prefers RBC folate. RBC folate was never drawn.
Vitamin D 25-OH	2026-05-28	67 ng/mL	30–100 · Normal	Only Vit D in window.
Magnesium (serum)	2026-09-16	2.0 mg/dL	1.6–2.3 · Normal	No RBC magnesium in packet.
TSH	2026-05-28	1.40 mIU/L	0.40–4.50 · Normal
Ferritin / iron / TIBC	—	Not drawn in this window. Last ferritin 189 on 9 Sep 2025.
RBC folate	—	Never drawn.

Still not in this 6-month window (draw tomorrow if he wants them, early AM after 12–15 h fast):

Fasting C-peptide and fasting glucagon (glucose + insulin + A1c are present; those two are not)
Ferritin ± iron/TIBC
RBC folate

Factual pattern from the latest paired set, not a diagnosis: glucose 86 with insulin 2.9 and A1c 5.1; TG 41 and HDL 108 with calculated LDL 238. No C-peptide or glucagon after Mar 2026, so insulin-resistant vs insulin-suppressed cannot be read from this page alone. Patient is on Eliquis. Transcription for one visit, not medical advice.

Medications and supplements

Patient-reported 22 Sep 2026. Doses not listed except Eliquis. This is not a reconciled med list from a pharmacy.

Class	Item	Dose / frequency	Note
Prescription	Eliquis (apixaban)	2.5 mg twice daily	Post-VTE; prior Xarelto stopped May 2025
OTC / antiplatelet	Aspirin	not specified
Supplement	Vitamin B12	not specified	Serum B12 >2000 on 16 Sep 2026
Supplement	Folate	not specified	Serum folate >20 on 16 Sep 2026
Supplement	NAC	not specified	N-acetylcysteine
Supplement	Glycerine	not specified	Listed as reported
Supplement	Creatine	not specified
Supplement	Electrolyte powder	not specified
Supplement	Trimethylglycine (TMG)	not specified
Supplement	Magnesium gluconate	not specified	Serum Mg only in packet; no RBC Mg
Supplement	Nattokinase	not specified	On anticoagulation — flag for the clinician
Supplement	Aged garlic	not specified
Supplement	Boron	not specified
Supplement	Zinc	not specified
Supplement	Vitamin D3 / K2	not specified
Supplement	Vitamin K2 (additional)	not specified	Also in the D3/K2 combo

Imaging & procedures

Date	Study	Finding

Private chart book

Raymond Marker · Dr. Cywes visit brief + full chart book