One Health Direct Primary Care

One Health Direct Primary Care Dr. Osei is a Board Certified Family Physician providing high quality and personalized healthcare at affordable cost.

04/15/2026

Rapid rounds for this week: 73-year-old with progressive, length-dependent neuropathy over several months, now extending proximally with associated gait instability.

✅What are you missing in your workup?
✅And what test would you send next
that could completely change the direction of this case?

04/10/2026

🗣️ Before starting testosterone therapy—take a step back.
Low testosterone is not always a primary testicular issue.

If LH is low or inappropriately normal, think secondary hypogonadism—and that shifts your entire workup.

✅One key lab that is often overlooked: PROLACTIN.

Elevated prolactin can suppress GnRH, leading to low LH/FSH and low testosterone. In some cases, this is due to a prolactinoma—a treatable brain tumor condition.

Treating the underlying cause can restore endogenous testosterone—without replacement.

➡️➡️ A complete evaluation should include:
✔️ Two morning total testosterone levels
✔️ LH/FSH
✔️ Prolactin (if LH low or normal)
✔️ Sleep study if clinically indicated
✔️ Baseline safety labs (hematocrit, PSA as appropriate)

Testosterone can be powerful—
but only when you’re treating the right problem because keep in mind no medication is without adverse effects.

PMID: 29562364, 30916608, 24832108

04/09/2026

➡️➡️ CASE ANSWER REVEAL: Isolated mild bilirubin elevation with normal labs.

Think pattern first. Indirect bilirubin + no hemolysis + normal liver enzymes = Gilbert syndrome. Benign. Common. Often missed.

Gilbert syndrome is a benign condition caused by reduced activity of the UGT1A1 enzyme, which is responsible for bilirubin conjugation. You see mild elevation in bilirubin, usually less than 3, predominantly indirect,
with normal liver enzymes and normal CBC. Levels of indirect bilirubin can increase with fasting, illness, stress, or exercise.

04/08/2026

➡️➡️ What are your thoughts?? Everything looks normal… except one thing. Would you catch it?

04/07/2026

✅Low ferritin is not the diagnosis—it’s a clue.
If your iron stores are low, the real question is: why?

Ask:
➡️ Am I losing blood?
➡️ Am I absorbing iron properly?

Educational purposes only, not medical advice.
PMID: 22549084, 30895872, 32735339

03/30/2026

These are some of the key labs I often check when evaluating fatigue:

• CBC – helps identify anemia or signs of infection that can drain energy
• Iron (Ferritin) – shows your iron stores; low levels are a very common cause of fatigue
• Vitamin B12 – important for energy, focus, and nerve function
• Vitamin D – low levels can contribute to fatigue, low mood, and muscle aches
• Thyroid (TSH, Free T4) – regulates metabolism; imbalance can slow everything down
• Glucose & A1C – helps assess blood sugar patterns that may cause energy crashes
• CMP – evaluates liver, kidney function, and electrolytes that impact overall energy

Discuss sleep and stress….very important!!!

Fatigue is a signal from your body — not a final diagnosis.
A thoughtful, complete evaluation can make a difference.

PMIDs: 25848084, 21705493, 18451362, 23844091, 28564623, 20350913

🚫medical advice. Consult your physician

03/14/2026

Evidence supporting iron deficiency without anemia and associated symptoms: PMID: 17344500 PMID: 28413760 PMID: 22549084

01/30/2026



✅Longevity care isn't about waiting for abnormal labs. It's about optimization, prevention, and actually listening to what your body is telling us.

✅If you've been told your labs are normal but you don't feel well - that's your sign to ask for a deeper review.

➡️➡️➡️➡️Your body deserves more than 'normal.

01/30/2026


✅Longevity care isn’t about waiting for abnormal labs.
It’s about optimization, prevention, and actually listening to what your body is telling us.
✅If you’ve been told your labs are normal but you don’t feel
well - that’s your sign to ask for a deeper review.
➡️➡️➡️Your body deserves more than ‘normal.

11/09/2025

FREE COMMUNITY PANTRY AT RETRO COFFEE AVL!
For those in need, Retro Coffee AVL has set up a free community pantry in their shop, and they would love to see more people utilizing it! There are wipes, baby food, feminine hygiene products, shampoo, conditioner, tooth paste and tons of shelf stable food. This pantry is for everyone and will be permanent. Per the owner: “We would love to erase the stigma of what “food insecurity” may look like. Cheers ☕️”

⏰ They are open daily from 8:00am-3:00pm, but if you need to meet at a specific time please let them know and they will try to accommodate. 828-490-7608

👍 No purchase necessary.

👝 Bags are available or bring your own reusable.

📕 They also have a great selection in their free little library if you need a good book.

♥️ And they have a period pantry in the bathroom!

🗺️ 2619 Sweeten Creek Rd, Asheville NC

🚨🚨 FOR EVEN MORE FOOD RESOURCES AVAILABLE IN OUR AREA, PLEASE SEE OUR COMPREHENSIVE POST (Make sure to read the comment of that post, too!) HERE: https://www.facebook.com/share/p/17MwY6QcHH/?mibextid=wwXIfr 🚨🚨

11/09/2025

GET HELP WITH THE HOLIDAYS!
If you’re in need of a little extra help this holiday season, or hoping to spread some cheer, check out these local programs offering holiday assistance and ways to give back, put together by Buncombe Partnership for Children! (Act soon, spots fill up quickly!)

Saint Nicholas Project – Eblen Charities
https://signup.com/client/invitation2/secure/119298092609/false #/invitation

Operation Santa – The Arc of Buncombe County
www.arcofbc.org/operationsanta

Hope for the Holidays - Hearts with Hands
https://www.heartswithhands.org/holidays

Christmas Angel – ABCCM
https://www.abccm.org/christmas-angel/

Angel Tree – The Salvation Army of Buncombe County
Call 929-253-4723 Mon-Fri 8:30a-4p to schedule appointment

United Way of Asheville/Hands On

Toys for Tots (WNC)
https://wnctft-nc.toysfortots.org/local-coordinator-sites/lco-sites/default.aspx?nPageID=0&nPreviewInd=0&nRedirectInd=3

USPS Operation Santa
https://www.uspsoperationsanta.com/

Swannanoa Valley Christian Ministry – Christmas Cheer
https://www.svcmblackmountain.org/johnny-raines-christmas-program

Save and share this post to get the information to those in need and comment below with any community programs we have missed!

10/18/2025

With costs due to rise sharply next year, look for coverage that protects your wallet as well as your health.

Address

1095 Hendersonville Road, Suite G
Asheville, NC
28803

Opening Hours

Monday 8:30am - 4pm
Tuesday 8:30am - 1pm
Wednesday 8:30am - 4pm
Thursday 8:30am - 1pm
Friday 9am - 1pm

Telephone

+18283608359

Website

https://linktr.ee/onehealthdpc

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