Dr.Garielle Wagnac, Dr.Aarti Patel Dr.Kimberley Hausheer, Dr.Pankhuri Garg • 42 year-old male • No major health issue to date • Notable increase in weight over past month— gain of 17 pounds • Recent lethargy • Patient is on a new eating regimen—every meal is from a ‘fast-food’ restaurant Physical Examination • Enlarged Liver • Muscle Weakness Laboratory Results • Negative for hepatitis • Excessive glycogen granules in liver • High levels of fat in liver – abnormal fat metabolism • Low testosterone levels • Abnormal cell calcium balance Diagnosis Smooth ER not properly functioning! Smooth Endoplasmic Reticulum What it isn’t doing! Leads to……! (Uh Oh) • Regulations of calcium concentration • Steroid metabolism • Metabolism of carbohydrates • Abnormal levels of calcium • Muscles are getting weaker instead of being strong • Low levels of testosterone • Excessive glycogen granules present • Presence of fat in liver past normal levels What caused it? • The new diet contained a lot of fat. The liver could not metabolize all of the fat and as a side effect fat begins to build hurting the liver, which takes care of fat metabolism. • Once the smooth ER is down then everything goes south. • The gain of weight is due to diet and lethargy is caused because of the poor diet that the patient is undergoing.