EFTA Document EFTA01733957

WOODSON C. MERRELL, M.D. 44 EAST 67th STREET NEW YORK, NEW YORK 10065 Telephone: (212) 535-1012 Fax: (212) 535-1172 csmithadocmerrelcom Date: September 19, 2016 Patient: Jeffrey Epstein (Email: ieevacation(algmail.com ) • Have a consultation about treatment for your spinal stenosis with expert endoscopic , minimally-invasive neurosurgeon Saad Chaudhary, MD: PACC Bldg, 10 Union Sq East, Suite 5P, NYC 10003, 212-844-8680; www.saadchaudharvmd.com • I have sent in the prescriptions to your pharmacy: o atorvastatin 10 mg for cholesterol once daily o Metformin S00 mg twice daily for blood sugar and metabolism (and some stusies show anti-aging potential) • A cystoscopy is pending for hematuria • Your PTH remains normal—no need to see the endocrinologist for this • See Jeffrey Mechanick, MD (now running a new center for Eva) for discussion of testosterone treatment. • Supplements: o If you go with clomiphene use it with an aromatase-inhibitor. A good natural one is Aromat 8-PN from VitaHealth natural pharmacy below (non-Rx)—rather than some rx such as tamoxifen you must take an activated form of folic acid due to missing some of the folic acid-converting enzymes (MTHFR): Folapro by Metagenics one daily o Niacel form of B vitamin one daily---key nutrient for mitochondria] energy production o B12 1,000 mcg sublingually (low blood level with Rony) o Vit D3: the tablets were not working well so try a liquid form (often absorbed better): Design for Health has one; 2,000 units/drop: take 3 drops/day in liquid: most important vitamin for immune system (and many physiological processes) o Two adaptogens that can help energy: o Rhodiola Force by New Chapter, one in AM *Russian) o Cordyceps by JHS Natural Products, one twice daily (TCM) o For sleep you can try Cortisol Manager by Integrative Therapeutics two at bedtime (Ayurvedic ashwaganda-based) o Use magnesium citrate 400 mg (Solgar makes a good 200 mg tablet) at bedtime: this relaxes muscles, promotes better sleep and helps protect against kidney stones (the citrate reduces chance of them) • Recheck labs in 4-6 weeks (cholesterol/triglycerides, CRP, Vit D and B12) • I will send labs to Rony and Mechanick. • Have full body MRI report sent to me (and reports in general when you see specialists to keep a master record) • Follow-up with me after lab recheck late Oct/early November---or anytime of course EFTA_R1_00010880 EFTA01733957 All supplements are available at: Willner Chemists VitaHealth 100 Park Avenue 1235 1st Avenues (41•t Street) (Between 66th & 67th Street) NYC, NY 10017 New York, NY 10065 212-682-2817 212-628-1110 800-633-1106 866-628-5255 www.willner.com Pharmacist: David Restrepo EFTA_R1_00010881 EFTA01733958