When you fill out the forms and return them to the clinic, Dr. Lowe will evaluate them. The outcome of the evaluation will tell him whether metabolic rehab is likely to benefit you. If it appears that the treatment will benefit you, we'll let you quickly let you know. If it appears that you're not a candidate for metabolic rehab, Dr. Lowe may suggest the type of clinician you should consult.

Medical Records. Please send copies of all your relevant medical records prior to your appointment with  Dr. Lowe. He'll review the records before your evaluation.

Lab Tests. The basic lab tests necessary to begin your evaluation include:

1. CBC (complete blood count).

2. Chemistry (fasting blood sugar, electrolytes, liver and kidney enzymes. Fasting means that you abstain from eating for 12 hours before the blood is drawn.) Some labs call the Chemistry by different names, such as a "SMAC" or "comprehensive  metabolic profile."

3. Lipid panel (total cholesterol, triglycerides, LDL, and HDL levels). The lab results must be "fasting" levels.

4. AM serum cortisol. It's important to go to the lab in the early morning, within one-to-three hours after you've awakened.

5. Thyroid profile (TSH, free T4, and Free T3).

6. Anti-thyroid antibody profile (thyroid microsomal [peroxidase] antibodies, and thyroglobulin antibodies). If you’re not now taking thyroid hormone (and have never had a diagnosis of hypothyroidism), to complete your evaluation, you will need to have the tests in numbers 5 and 6 tests.

7. Male Sex Hormone Panel (Total and free testosterone levels).
8. Insulin-like Growth Factor-1 (also called "somatomedin-C").

8. Electrocardiogram (ECG or EKG). Dr. Lowe prefers to do the ECG/EKG himself for standardized skin preparation and electrode placement.

If you have profiles 5 and 6 (see above) done before you come to Boulder, please have the results faxed or mailed to us. If you can't get the tests done in your hometown, Dr. Lowe will order them for you either in Boulder or long distance. For current charges for the profiles, please phone us at (603) 391-6061, or e-mail us at Tammy@drlowe.com.

Preparing for Your Metabolic Evaluation. Please print out and read our detailed instructions on preparing for your metabolic evaluation. The instructions explain how to take your basal body temperature and basal pulse rate. They also explain how to prepare for blood testing at the medical laboratory, and how to prepare for measurement of your resting metabolic rate and body composition. Only by you properly preparing can Dr. Lowe be sure to get accurate measurements. Accuracy is of the utmost importance, in that the measurements will weigh heavily in Dr. Lowe's conclusions about your metabolic status and his recommendations for your treatment.

You will begin preparing for your metabolic evaluation the week before you come to the clinic. During that week, you'll need to take your body temperature and pulse rate when you first wake up in the morning, before you get out of bed. These two measurements are important for Dr. Lowe to comprehensively evaluate your metabolic status. If you have any questions about how to properly take your temperature and pulse rate, be sure to phone us at 603-391-6061.

The lab tests that Dr. Lowe requires are necessary for him to accurately evaluate of your metabolic status. Before going to the lab, be sure to fast for twelve hours, and avoid undue physical and emotional stress, if at all possible.

Dr. Lowe will also do a physical exam for tissue signs consistent with impaired metabolism. He may also do select  neurological tests and evaluate your musculoskeletal status. If he does a fibromyalgia exam, he'll  measure the tenderness of your fibromyalgia tender point sites with an algometer. An algometer is a pressure gauge that enables Dr. Lowe to precisely measure the amount of pressure needed to cause the perception of discomfort.

You must have an ECG (EKG, or electrocardiogram) before you begin metabolic treatment. If Dr. Honeyman performs the ECG during your initial evaluation, the cost will be $70.00. In most cases, an ECG performed by another physician within the past six months will suffice. If you've had an EKG during the past six months, please bring a high-quality copy of the tracing or have it sent to Dr. Lowe.

Dr. Lowe will spend considerable time with you during your visit. You and he will get to know one another, as he considers this important to a collaborative patient/doctor relationship. The time is also important for him to gain an understanding of your health problems. He’ll give you detailed instructions about how you can begin to improve your metabolism and, as a result, reduce and hopefully eliminate your symptoms. He'll continue to counsel and guide you as needed while you’re under his care.

After your evaluation, you can begin treatment. If you choose to use over-the-counter medications, Dr. Lowe will directly advise you in their use. If you choose to use prescription medications, he'll advise the prescribing doctor in which medications and dosages are appropriate for you.

Physical Treatment. An advantage to returning to the clinic in Boulder is that Dr. Lowe can provide your physical treatment. This won't be necessary, of course, if you're receiving effective treatment from another practitioner.

Physical treatment is especially important if you have a diagnosis of fibromyalgia. Metabolic rehab can't completely relieve most patients' fibromyalgic pain until they undergo effective physical treatment for trigger points and vertebral subluxations. But most patients with abnormally slow metabolism—even those who don't meet the criteria for fibromyalgia—benefit from physical treatment.

As Your Metabolic Treatment Progresses. Throughout your treatment, Dr. Lowe will counsel you at intervals and work closely with you, as you require. The focus of your communications with him will be on what you must do to further improve your health and how to do it. If you are local to the Boulder area, you're welcome to come to the clinic to see him. If not, your communicates with him can be by telephone.

At intervals during your treatment, Dr. Lowe will reevaluate your health status and recommend changes in your treatment regimen. Any changes he recommends will be based your scores on objective measures of your health status. It will be optimal if you can come to the Center in Boulder for reevaluations. If you do, Dr. Lowe can perform physical exams and remeasure  your resting metabolic rate and body composition. The measures will show how you're metabolism is responding to your current treatment regimen, and they'll make clear whether changes in your treatment regimen are needed.

If you can't come to the clinic, however, Dr. Lowe can evaluate your response to treatment long distance. You may be able to get your resting metabolic rate measured in your home town. If so, that will be helpful. However, Dr. Lowe can guide you long distance without remeasuring your metabolic rate and body composition. For many years, Dr. Lowe guided long-distance patients to improvement or recovery without these measurements. To do so, they used another method involving systematic monitoring of the intensity of patients' symptoms, resting body temperature, and resting pulse rate, and graphing the scores to lines graphs at intervals. This method is essential if patients are to recover their  health, even if they come to the clinic at intervals to have their metabolic rate measured. Because of that, it is important that you read the section below titled "Systematic Monitoring."

Systematic Monitoring. The backbone of metabolic rehab is periodic monitoring of the intensity of your symptoms and posting of the intensities to one or more line graphs. The monitoring and graphing are absolutely essential to metabolic rehab; without it, you won't be doing metabolic rehab. Monitoring and graphing will make your treatment intelligence-based and precise. A pilot has the greatest chance of landing in the desire location when he/she uses the gauges on the dash of the cockpit; similarly, you'll have the greatest chance of fully recovering when you systematically monitor how you respond to each change in your treatment regimen. It's well worth emphasizing that few patients fully recover when they decline to monitor and graph the intensity of their symptoms. Declining to monitor and graph, then, will be to sabotage your own efforts to get well through metabolic rehab. 

Two Options for Monitoring and Graphing. You have two options for systematic monitoring and graphing. Either (1) Dr. Lowe can take part in your monitoring and graphing, or (2) you can do your own monitoring and graphing.

(1) Dr. Lowe can take part in your monitoring and graphing. When he does so, you fill out his interim evaluation forms at appropriate intervals and fax or mail them to the clinic. The forms will be scored and the scores posted to several line graphs. We will provide you with a copy of the resulting line graphs and schedule a consultation with Dr. Lowe. During your consultation, Dr. Lowe will discuss your progress with you and recommend any indicated changes to your treatment regimen. The fee for this service is $75.00 for each monitoring session. The fee includes a 15-minute consultation at no additional charge. Any time beyond the 15 minutes will be charged at the usual $4.25 per minute rate.

(2) The other option is for you to do your own systematic monitoring. Dr. Lowe encourages patients to use this option. They do so because it engages the person more so in his/her rehab process; it also heightens the person's awareness of the health benefits of lifestyle changes and treatments. 

If you prefer to do your own monitoring, you should get a copy of Dr. Lowe's book titled Your Guide to Metabolic Health. In Chapters 2 and 3 of the book, they explain how to do your own monitoring in a highly user-friendly manner. They encourage patients to use the book as a by-the-numbers guide to achieving metabolic health. The book contains the necessary symptom-severity scales and a line graph that you can copy and use. However, the scales and graph are also available free of charge on our webpage of evaluation forms (you'll need to print the third set of forms). If you do your own monitoring and graphing, Dr. Lowe will need to see your scales and graphs at intervals. By looking at them and then talking with you briefly on the phone, he can help you decide how best to tweak your treatment regimen. Tweaking it at intervals will enable you to improve as quickly as possible. The cost of the telephone consultations with the doctor is the usual $4.25 per minute rate.