Medusa Metabolic Health Approach

Introduction

The following report is intended to assess the effectiveness of the Medusa Metabolic Healthcare Approach on patient health outcomes. The study is based on Dr. Emily Cooper’s patients with data spanning over 20 years. Dr. Cooper is the Medical Director and Founder of Seattle Performance Medicine (SPM) and the Cooper Center for Metabolism (CCM) and has developed care approach. The study involves extensive data collection on 2,290 patients with varying treatment durations and pre-existing conditions. For each test outlined below, only those patients that initially measured outside of the normal range as defined by Quest and/or Labcorp were included in the analysis of that specific lab.

The Medusa Metabolic Healthcare Approach

Metabolic medicine is a field of medicine that focuses on understanding and managing metabolic disorders and imbalances in the body. It involves the study and treatment of various metabolic conditions, including but not limited to diabetes, obesity, metabolic syndrome, hormone imbalance, heart disease, kidney disease, thyroid disorders and lipid disorders.

Metabolism refers to the biochemical processes that occur within the cells of the body to convert food into energy and support various bodily functions. Metabolic disorders occur when there are abnormalities or dysfunctions in these processes, leading to health issues and an increased risk of chronic diseases.

The Medusa Metabolic Approach aims to identify the underlying causes of metabolic disorders and develop personalized treatment strategies to improve metabolic health. This may involve lifestyle modifications such as dietary changes, exercise programs, weight management, and stress reduction techniques. Additionally, medications or therapeutic interventions may be used to target specific metabolic pathways or address hormonal imbalances.

Diabetes

In this study, a patient is defined to have Diabetes if they have an HBA1C level 6.5% and above. Pre-diabetic is defined as having HBA1C levels between 5.7-6.4%.

According to the CDC:

• 25% of people with pre-diabetes will develop diabetes within three to five years
• 50% of people with pre-diabetes will develop diabetes within five to ten years

In this study the percent of individuals who developed diabetes over the time horizon was 1%

Overall number of patients by duration of treatment (in years):

	Under 6 months	6 - <12 months	1 - 2 years	2 - 4 years	5 - 7 years	8+ years
Developed Diabetes	0	1	1	0	2	2
Developed Pre-Diabetes	4	10	8	12	19	8
Diabetic to Non-Diabetic	0	2	1	5	2	1
Diabetic to Pre-Diabetic	7	4	5	4	8	4
Pre-Diabetic to Non-Diabetic	11	32	41	36	65	67
Remained Diabetic	7	10	7	12	15	2
Remained Pre-Diabetic	20	29	26	28	39	44

As a percentage:

	Under 6 months	6 - <12 months	1 - 2 years	2 - 4 years	5 - 7 years	8+ years
Developed Diabetes	0.0%	1.1%	1.1%	0.0%	1.3%	1.6%
Developed Pre-Diabetes	8.2%	11.4%	9.0%	12.4%	12.7%	6.2%
Diabetic to Non-Diabetic	0.0%	2.3%	1.1%	5.2%	1.3%	0.8%
Diabetic to Pre-Diabetic	14.3%	4.5%	5.6%	4.1%	5.3%	3.1%
Pre-Diabetic to Non-Diabetic	22.4%	36.4%	46.1%	37.1%	43.3%	52.3%
Remained Diabetic	14.3%	11.4%	7.9%	12.4%	10.0%	1.6%
Remained Pre-Diabetic	40.8%	33.0%	29.2%	28.9%	26.0%	34.4%

Fasting Glucose

Fasting Glucose change by gender:

Gender	Average % Fasting Glucose Change	Median % Fasting Glucose Change
Female	-11.10%	-11.50%
Male	-9.00%	-8.53%

Fasting Glucose change by Age:

Age Group	Average % Fasting Glucose Change	Median % Fasting Glucose Change
20 - < 40	-10.54%	-11.76%
40 - < 60	-11.01%	-11.27%
>= 60	-9.61%	-9.35%

Fasting Glucose Change by Duration

Treatment Duration	Average % Fasting Glucose Change	Median % Fasting Glucose Change
Under 6 months	-9.52%	-9.04%
6 - <12 months	-10.35%	-9.13%
1 - 2 years	-13.71%	-13.34%
2 - 4 years	-9.24%	-9.00%
5 - 7 years	-8.64%	-9.82%
8+ years	-12.10%	-12.02%

Fasting Insulin

Fasting Insulin change by gender:

Gender	Average % Insulin Glucose Change	Median % Insulin Glucose Change
Female	-15.16%	-15.20%
Male	-15.14%	-14.34%

Fasting Insulin change by Age:

Age Group	Average % Fasting Insulin Change	Median % Fasting Insulin Change
20 - < 40	-18.17%	-19.32%
40 - < 60	-13.63%	-13.00%
>= 60	-16.18%	-17.32%

Fasting Insulin Change by Duration

Treatment Duration	Average % Fasting Insulin Change	Median % Fasting Insulin Change
Under 6 months	-4.20%	-2.29%
6 - <12 months	-1.30%	0.00%
1 - 2 years	-10.34%	-9.84%
2 - 4 years	-14.06%	-13.81%
5 - 7 years	-18.88%	-21.55%
8+ years	-22.30%	-24.17%

HBA1C

HBA1C change by gender:

Gender	Average % Insulin Glucose Change	Median % Insulin Glucose Change
Female	-5.77%	-5.26%
Male	-3.83%	-3.51%

HBA1C change by Age:

Age Group	Average % HBA1C Change	Median % HBA1C Change
20 - < 40	-6.09%	-5.26%
40 - < 60	-5.38%	-5.17%
>= 60	-5.03%	-5.08%

HBA1C Change by Duration

Treatment Duration	Average % HBA1C Change	Median % AST Change
Under 6 months	-4.10%	-3.51%
6 - <12 months	-5.52%	-3.51%
1 - 2 years	-5.52%	-4.55%
2 - 4 years	-4.87%	-5.13%
5 - 7 years	-5.11%	-5.08%
8+ years	-5.91%	-6.90%

Metabolic Syndrome

Metabolic Syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and diabetes. Indicators of Metabolic syndrome include high blood pressure, high blood sugar, excess body fat, and abnormal cholesterol levels.

In this study, a patient is defined to have metabolic syndrome if they have three or more of the following:

• Elevated BMI
• Elevated Blood Pressure
• Elevated Fasting Glucose
• Abnormal Glucose/Insulin Ratio
• Elevated HBA1C
• Low HDL Cholesterol
• Elevated Triglycerides
• Elevated ALT

Of the patients that were initially diagnosed with metabolic syndrome, 20% recovered and are no longer considered to have metabolic syndrome.

Overall number of patients by duration of treatment (in years):

	Under 6 months	6 - <12 months	1 - 2 years	2 - 4 years	5 - 7 years	8+ years
Status Unchanged	85	132	133	147	212	175
Never had Meta. Syndrome	222	69	63	61	62	33
Developed Meta. Syndrome	20	24	24	24	28	16
No Longer Meta. Syndrome	13	18	38	39	63	53

As a percentage:

	Under 6 months	6 - <12 months	1 - 2 years	2 - 4 years	5 - 7 years	8+ years
Status Unchanged	25.0%	54.3%	51.6%	54.2%	58.1%	63.2%
Never had Meta. Syndrome	65.3%	28.4%	24.4%	22.5%	17.0%	11.9%
Developed Meta. Syndrome	5.9%	9.9%	9.3%	8.9%	7.7%	5.8%
No Longer Meta. Syndrome	3.8%	7.4%	14.7%	14.4%	17.3%	19.1%

Body Composition

Weight

To assess change weight, only patients with an obesity level BMI (30+) are included in the analysis.

Weight change by gender:

Gender	Average % Weight Change	Median % Weight Change
Female	-7.39%	-4.85%
Male	-5.97%	-4.48%

Weight change by Age:

Age Group	Average % Weight Change	Median % Weight Change
20 - < 40	-4.39%	-3.28%
40 - < 60	-6.56%	-3.98%
>= 60	-10.06%	-7.96%

Weight Change by Duration

Treatment Duration	Average % Weight Change	Median % Weight Change
Under 6 months	-0.72%	-0.11%
6 - <12 months	-2.97%	-2.99%
1 - 2 years	-5.54%	-4.25%
2 - 4 years	-7.86%	-7.97%
5 - 7 years	-11.96%	-12.32%
8+ years	-13.63%	-13.93%

BMI

To assess change in BMI, only patients with an obesity level BMI (30+) are included in the analysis.

BMI change by gender:

Gender	Average % BMI Change	Median % BMI Change
Female	-7.36%	-5.00%
Male	-5.91%	-3.98%

BMI change by Age:

Age Group	Average % BMI Change	Median % BMI Change
20 - < 40	-4.36%	-3.03%
40 - < 60	-6.50%	-3.33%
>= 60	-10.07%	-8.11%

BMI Change by Duration

Treatment Duration	Average % BMI Change	Median % BMI Change
Under 6 months	-0.75%	0.00%
6 - <12 months	-3.09%	-2.90%
1 - 2 years	-5.37%	-3.33%
2 - 4 years	-7.71%	-7.69%
5 - 7 years	-11.93%	-12.20%
8+ years	-13.60%	-13.89%

Body Fat

To assess change in body fat, only patients with an obesity level BMI (30+) are included in the analysis.

Body Fat change by gender:

Gender	Average % Body Fat Change	Median % Body Fat Change
Female	-9.09%	-8.30%
Male	-3.31%	-4.63%

Body Fat change by Age:

Age Group	Average % Body Fat Change	Median % Body Fat Change
20 - < 40	-13.29%	-17.65%
40 - < 60	-7.04%	-6.06%
>= 60	-5.94%	-5.98%

Body Fat Change by Duration

Treatment Duration	Average % Body Fat Change	Median % Body Fat Change
Under 6 months	-0.87%	0.00%
6 - <12 months	-1.20%	0.00%
1 - 2 years	-7.90%	-5.47%
2 - 4 years	-5.39%	-5.96%
5 - 7 years	-7.49%	-7.71%
8+ years	-9.28%	-9.52%

Blood Pressure

Blood Pressure is assessed using Mean Arterial Pressure (MAP) which is defined as [Diastolic BP + (Systolic BP - Diastolic BP)/3]

MAP change by gender:

Gender	Average % MAP Loss	Median % MAP Loss
Female	-6.43%	-6.31%
Male	-4.16%	-4.22%

MAP change by Age:

Age Group	Average % MAP Change	Median % MAP Change
20 - < 40	-3.94%	-3.30%
40 - < 60	-5.85%	-5.93%
>= 60	-6.82%	-6.35%

MAP Change by Duration

Treatment Duration	Average % MAP Change	Median % MAP Change
Under 6 months	-2.80%	-3.08%
6 - <12 months	-2.75%	-3.14%
1 - 2 years	-4.62%	-5.04%
2 - 4 years	-6.39%	-5.74%
5 - 7 years	-7.92%	-7.97%
8+ years	-9.66%	-10.69%

Liver

Liver health is measured by ALT and AST that help monitor fatty liver and diagnose liver disease.

ALT

ALT change by gender:

Gender	Average % ALT Change	Median % ALT Change
Female	-35.66%	-40.96%
Male	-19.71%	-22.86%

ALT change by Age:

Age Group	Average % ALT Change	Median % ALT Change
20 - < 40	-21.47%	-26.25%
40 - < 60	-28.01%	-31.58%
>= 60	-34.55%	-36.39%

ALT Change by Duration

Treatment Duration	Average % ALT Change	Median % ALT Change
Under 6 months	-14.23%	-16.06%
6 - <12 months	-21.28%	-21.42%
1 - 2 years	-28.73%	-29.03%
2 - 4 years	-15.44%	-25.00%
5 - 7 years	-33.95%	-40.54%
8+ years	-38.15%	-44.68%

AST

AST change by gender:

Gender	Average % AST Change	Median % AST Change
Female	-48.30%	-53.56%
Male	-33.21%	-36.84%

AST change by Age:

Age Group	Average % AST Change	Median % AST Change
20 - < 40	-40.28%	-38.89%
40 - < 60	-43.07%	-49.53%
>= 60	-49.14%	-51.77%

AST Change by Duration

Treatment Duration	Average % AST Change	Median % AST Change
Under 6 months	-39.53%	-36.84%
6 - <12 months	-41.75%	-53.06%
1 - 2 years	-46.32%	-52.27%
2 - 4 years	-35.06%	-40.56%
5 - 7 years	-43.22%	-44.44%
8+ years	-52.36%	-58.93%

Cholesterol

Total Cholesterol

Total Cholesterol change by gender:

Gender	Average % Total Cholesterol Change	Median % Total Cholesterol Change
Female	-11.70%	-9.68%
Male	-24.58%	-24.80%

Total Cholesterol change by Age:

Age Group	Average % Total Cholesterol Change	Median % Total Cholesterol Change
20 - < 40	-8.68%	-7.46%
40 - < 60	-13.53%	-10.83%
>= 60	-15.85%	-12.82%

Total Cholesterol Change by Duration

Treatment Duration	Average % Total Cholesterol Change	Median % Total Cholesterol Change
Under 6 months	-10.20%	-7.39%
6 - <12 months	-12.88%	-9.52%
1 - 2 years	-13.56%	-9.40%
2 - 4 years	-11.71%	-11.37%
5 - 7 years	-14.83%	-12.08%
8+ years	-14.47%	-12.93%

HDL Cholesterol

HDL Cholesterol change by gender:

Gender	Average % HDL Cholesterol Change	Median % HDL Cholesterol Change
Female	8.92%	8.16%
Male	3.59%	2.63%

HDL Cholesterol change by Age:

Age Group	Average % HDL Cholesterol Change	Median % HDL Cholesterol Change
20 - < 40	7.94%	5.51%
40 - < 60	5.90%	4.88%
>= 60	8.62%	7.14%

HDL Cholesterol Change by Duration

Treatment Duration	Average % HDL Cholesterol Change	Median % HDL Cholesterol Change
Under 6 months	1.29%	0.00%
6 - <12 months	2.50%	2.04%
1 - 2 years	3.67%	0.00%
2 - 4 years	6.36%	4.26%
5 - 7 years	8.37%	7.61%
8+ years	10.71%	10.20%

LDL

LDL change by gender:

Gender	Average % LDL Change	Median % LDL Change
Female	-13.52%	-10.78%
Male	-25.82%	-22.81%

LDL change by Age:

Age Group	Average % LDL Change	Median % LDL Change
20 - < 40	-7.86%	-7.69%
40 - < 60	-15.27%	-12.25%
>= 60	-20.18%	-16.00%

LDL Change by Duration

Treatment Duration	Average % LDL Change	Median % LDL Change
Under 6 months	-9.10%	-6.67%
6 - <12 months	-13.68%	-10.53%
1 - 2 years	-15.08%	-11.93%
2 - 4 years	-12.84%	-9.26%
5 - 7 years	-16.90%	-13.28%
8+ years	-18.24%	-16.31%

LDL Particles

LDL Particles change by gender:

Gender	Average % LDL Particles Change	Median % LDL Particles Change
Female	-9.43%	-11.00%
Male	-18.54%	-22.08%

LDL Particles change by Age:

Age Group	Average % LDL Particles Change	Median % LDL Particles Change
20 - < 40	-5.28%	-8.03%
40 - < 60	-10.99%	-12.33%
>= 60	-15.15%	-16.39%

LDL Particles Change by Duration

Treatment Duration	Average % LDL Particles Change	Median % LDL Particles Change
Under 6 months	-9.66%	-12.17%
6 - <12 months	-9.89%	-9.66%
1 - 2 years	-11.32%	-12.01%
2 - 4 years	-7.49%	-7.46%
5 - 7 years	-10.68%	-13.30%
8+ years	-14.98%	-18.73%

HSCrp

HSCrp change by gender:

Gender	Average % HSCrp Change	Median % HSCrp Change
Female	-30.95%	-32.53%
Male	-29.58%	-28.00%

HSCrp change by Age:

Age Group	Average % HSCrp Change	Median % HSCrp Change
20 - < 40	-23.37%	-15.54%
40 - < 60	-31.93%	-33.17%
>= 60	-32.56%	-36.43%

HSCrp Change by Duration

Treatment Duration	Average % HSCrp Change	Median % HSCrp Change
Under 6 months	-23.30%	-23.08%
6 - <12 months	-27.00%	-26.11%
1 - 2 years	-37.22%	-42.88%
2 - 4 years	-34.79%	-43.52%
5 - 7 years	-32.33%	-36.36%
8+ years	-26.28%	-20.00%

Metabolic Hormones

AGRP

AGRP change by gender:

Gender	Average % AGRP Change	Median % AGRP Change
Female	1.72%	0.00%
Male	-3.42%	-4.85%

AGRP change by Age:

Age Group	Average % AGRP Change	Median % AGRP Change
20 - < 40	4.36%	3.57%
40 - < 60	1.00%	0.00%
>= 60	-8.03%	0.00%

AGRP Change by Duration

Treatment Duration	Average % AGRP Change	Median % AGRP Change
6 - <12 months	0.00%	0.00%
1 - 2 years	-6.80%	-5.79%
2 - 4 years	8.10%	13.04%
5 - 7 years	-4.07%	0.00%
8+ years	2.03%	0.00%

Ghrelin

Ghrelin change by gender:

Gender	Average % Ghrelin Change	Median % Ghrelin Change
Female	-3.60%	-2.11%
Male	-7.40%	-6.21%

Ghrelin change by Age:

Age Group	Average % Ghrelin Change	Median % Ghrelin Change
20 - < 40	-3.95%	-3.00%
40 - < 60	-4.64%	-3.29%
>= 60	-2.64%	-0.62%

Ghrelin Change by Duration

Treatment Duration	Average % Ghrelin Change	Median % Ghrelin Change
Under 6 months	-16.47%	-19.69%
6 - <12 months	-10.84%	-9.22%
1 - 2 years	-2.50%	-3.18%
2 - 4 years	-1.15%	1.11%
5 - 7 years	-0.88%	0.28%
8+ years	-4.44%	-3.42%

NPY

NPY change by gender:

Gender	Average % NPY Change	Median % NPY Change
Female	-15.88%	-16.80%
Male	-21.52%	-20.14%

NPY change by Age:

Age Group	Average % NPY Change	Median % NPY Change
20 - < 40	-16.42%	-17.05%
40 - < 60	-16.22%	-16.82%
>= 60	-18.54%	-20.48%

NPY Change by Duration

Treatment Duration	Average % NPY Change	Median % NPY Change
Under 6 months	-14.98%	-16.18%
6 - <12 months	-13.42%	-9.37%
1 - 2 years	-14.90%	-12.63%
2 - 4 years	-10.98%	-9.61%
5 - 7 years	-17.61%	-19.74%
8+ years	-19.73%	-20.68%

ACTH

ACTH change by gender:

Gender	Average % ACTH Change	Median % ACTH Change
Female	-8.11%	-7.14%
Male	-0.54%	1.17%

ACTH change by Age:

Age Group	Average % ACTH Change	Median % ACTH Change
20 - < 40	-9.69%	-8.77%
40 - < 60	-6.57%	-5.26%
>= 60	-6.77%	-6.48%

ACTH Change by Duration

Treatment Duration	Average % ACTH Change	Median % ACTH Change
Under 6 months	-10.93%	-12.68%
6 - <12 months	-3.43%	-1.17%
1 - 2 years	-7.95%	-4.14%
2 - 4 years	-6.22%	-3.95%
5 - 7 years	-7.15%	-7.14%
8+ years	-7.49%	-5.56%

MSH

MSH change by gender:

Gender	Average % MSH Change	Median % MSH Change
Female	-1.33%	0.00%
Male	1.78%	0.00%

MSH change by Age:

Age Group	Average % MSH Change	Median % MSH Change
20 - < 40	0.31%	0.00%
40 - < 60	-1.21%	0.00%
>= 60	-0.49%	0.00%

MSH Change by Duration

Treatment Duration	Average % MSH Change	Median % MSH Change
Under 6 months	-0.71%	0.00%
6 - <12 months	-0.46%	0.00%
1 - 2 years	-2.40%	0.00%
2 - 4 years	-0.40%	0.00%
5 - 7 years	0.57%	0.00%
8+ years	-1.66%	0.00%