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✓ 4 Category-Embedded Patient Calculators + 6-Tool Live API Suite • Zero Login Wall • NIH RxNorm + CMS NADAC + NIH DSLD v9
★ 100% Free Public Utility Suite

Interactive Clinical, Rx Wholesale Price, Supplement Elemental Math & Lab Cutoff Calculators

100% free forever with zero login walls. Every dotMD interactive calculator is embedded directly inside the category hub where you need it most—and indexed here for instant access. Audit multi-drug and supplement CYP450/mineral chelation conflicts, compare CMS Medicaid NADAC wholesale pill costs against retail pharmacy markups, decode true elemental supplement weights from compound bottle labels, and translate standard Quest/LabCorp lab ranges into optimal clinical cutoffs.

Lane 1 • /conditions Hub

MyChart Lab & Cuff Translator

Compare Quest/LabCorp bell-curve “Normal” against optimal Ferritin, HbA1c, ApoB, TSH, and BP cutoffs.

Launch on /conditions →
Lane 2 • /meds Hub

24-Hour Pill, Supplement & Coffee Clock

Build a conflict-free daily schedule around 4-hour Levothyroxine mineral blocks and CMS NADAC cash prices.

Launch on /meds →
Lane 3 • /supplements Hub

Bottle Label Elemental Dose Decoder

Expose why “1,000 mg Magnesium Glycinate” yields 141 mg elemental Mg and spot hidden Oxide fillers.

Launch on /supplements →
Lane 4 • /doctors Hub

60-Second Doctor Visit & CPT Builder

Generate your 10-second opening script (PMID 29972200) and in-office CPT procedure checklist.

Launch on /doctors →
Clinical Systems Engineering: dotMD-ClaimAudit v4.2 , CMS Part B Specialist CPT Volume & GreatDoc™ Auditor • Pharmacokinetic & Stoichiometry Audit: dotMD-PharmAudit v4.2 , FDA DailyMed, RxNorm & NIH DSLD Stoichiometry Auditor
Updated: • Primary Federal Datasets
ⓘ How Our Patient Calculators Work — NIH RxNorm, CMS NADAC Wholesale Ledger & NIH DSLD Stoichiometry (Click to Verify) ▾
1. CYP450 + GI Mineral Chelation Auditing

Cross-references FDA DailyMed and NIH RxNorm to flag both liver enzyme conflicts and stomach mineral binding (such as Magnesium or Iron blocking Levothyroxine absorption unless separated by 4 hours).

2. CMS Medicaid NADAC Wholesale Price Math

Exposes the exact per-tablet acquisition cost pharmacies pay wholesalers (CMS NADAC) alongside Cost Plus Drugs cash prices so you never overpay $50+ for a $5.40 generic prescription.

3. Stoichiometric Elemental Weight & Lab Cutoffs

Calculates true elemental mineral yield from compound supplement labels (NIH DSLD v9) and compares standard Quest/LabCorp reference intervals against ADA / ACC / AHA / Endocrine Society targets.

Interactive MyChart Lab & Cuff Translator • Lab Bell-Curve “Normal” vs. Physiological Optimal

Why Your Portal Says “Normal” When You Still Feel Awful: Enter Your Number

Quest and LabCorp “Normal” ranges are 95% population bell curves—not physiological optimums. Select a marker and type your result below:

3-Zone Clinical Cutoff Audit • Serum Ferritin (Iron Storage)

18 ng/mL = Marked "Normal" by Lab, Yet Clinically Depleted (< 30–50 ng/mL)

Default Sample: 18 ng/mL
Zone 1 • Clinical Cutoff
< 15 ng/mL • Overt Deficiency
< 15 ng/mL (Absolute Depletion)
Zone 2 • Portal “Normal” Gray Zone
15–49 ng/mL • "Normal" Yet Depleted
15–150 ng/mL (Quest/LabCorp Bell Curve)
Zone 3 • Physiological Optimal
50–100 ng/mL • Clinical Optimal
50–100 ng/mL (Physiological Optimal)
What This Number Means in Plain English

Commercial labs only flag Ferritin below 15 ng/mL, but clinical trials confirm fatigue, restless legs, diffuse telogen hair shedding, and impaired T4-to-T3 thyroid conversion begin whenever Ferritin drops below 30–50 ng/mL.

Action Plan: Take 25–28 mg elemental Iron Bisglycinate on alternate mornings (Mon/Wed/Fri) with Vitamin C to bypass the 24-hour hepcidin block, then re-test in 8–12 weeks.

⚠ Lab Assay & Cuff False-Alarm Check

Acute inflammation, viral illness, or fatty liver artificially elevates Ferritin (it is an acute-phase reactant). Always pair Ferritin with Fasting Transferrin Saturation (TSAT) and hs-CRP.

Read Low Ferritin & Iron Deficiency Clinical Guide → Find a Hematology / Iron Specialist →
Interactive 24-Hour Pill, Supplement & Coffee Clock • FDA DailyMed Spacing + CMS NADAC Cash Price Check

“Can I Take These Together?” Build Your Conflict-Free Daily Schedule

Toggle your prescriptions and supplements below to see stomach mineral absorption blocks, CYP450 conflicts, and your exact 24-hour clock:

1. Select Your Daily Prescriptions & Supplements (Click to Toggle):
⚠ Active Chelation & Co-Factor Audit (FDA DailyMed + NIH RxNorm)
6 Active Items Scheduled Across 4 Conflict-Free Windows
  • 4-Hour Chelation Block (Levothyroxine + Magnesium / Iron): Magnesium and Iron bind to Levothyroxine in the stomach, cutting thyroid absorption by 30%–45%. We automatically moved Iron to 10:30 AM and Magnesium to 9:30 PM.
  • 60-Minute Coffee & Espresso Rule: Brewed coffee sequesters oral T4 tablets inside the intestinal lumen. Wait 45–60 minutes after 6:30 AM Levothyroxine before drinking coffee (or ask about Tirosint gelcaps).
  • Metformin ER + Vitamin B12 Depletion: Long-term Metformin impairs calcium-dependent ileal B12 uptake. Take Metformin ER mid-dinner (6:30 PM) and verify Serum B12 + MMA annually.
  • Atorvastatin / Rosuvastatin + CoQ10 Synergy: Statins inhibit mevalonate synthesis, lowering endogenous CoQ10. Pairing 100–200 mg Ubiquinol with lunch/dinner supports muscle ATP.
6:30 AM • Fasting Water Only
Levothyroxine (Synthroid / Euthyrox)

Take 30–60 min before coffee/breakfast; keep 4 hours away from Iron, Calcium & Magnesium.

Iron Bisglycinate (25–28 mg Elemental)

Alternate-day morning dosing with 200 mg Vitamin C avoids the 24h hepcidin block and protects Levothyroxine.

12:30 PM • Lunch With 15g Fat
Vitamin D3 (2,000–5,000 IU) + MK-7 + CoQ10

Fat-soluble D3, K2 (MK-7), Omega-3 rTG, and CoQ10 Ubiquinol absorb 32%–50% better with dietary fat.

6:30 PM • Mid-Dinner GI Buffer
Metformin ER (500–1,000 mg)

Taking Extended-Release (ER) mid-dinner cuts GI nausea/diarrhea by >60%. Check Vitamin B12 + MMA yearly.

Atorvastatin (20 mg) or Rosuvastatin (10 mg)

Pairs cleanly with dinner alongside CoQ10 Ubiquinol (100–200 mg) to support muscle mitochondrial ATP.

9:30 PM • Bedtime 60m Pre-Sleep
Magnesium Bisglycinate (200–300 mg Elemental)

Safely separated 15 hours from morning Levothyroxine; glycine + Mg2+ support GABAergic deep sleep.

Verified 30-Day Generic Cash Price Check (Cost Plus & CMS NADAC Benchmark)

Never pay a $45–$68 retail pharmacy walk-in markup for pennies-per-pill generics:

Metformin ER: $5.40/mo Atorvastatin: $5.40/mo Rosuvastatin: $5.40/mo Losartan: $5.10/mo
Interactive Bottle Label “True Elemental Dose & Filler” Decoder • NIH DSLD v9 Stoichiometry Audit

Why a “1,000 mg” Bottle Often Delivers Only 141 mg: Decode Your Label

Supplement front labels print total compound weight (mineral + carrier). Pick your supplement form and enter the mg on your bottle:

Instant Label Presets:
NIH DSLD Molecular Stoichiometry • Magnesium Bisglycinate Chelate (14.1% Elemental)

"1,000 mg Magnesium Glycinate" (2 Capsules) = 141 mg True Elemental Magnesium (70.5 mg/capsule)

Fair Benchmark: ~$18/mo (USP / TRAACS)
True Active / Elemental Yield
141 mg active (70.5 mg/cap)
14.1% active weight • 85.9% carrier weight
Capsules Needed for RCT Target
3 capsules/day
Human RCT target: 200–300 mg active/day
Estimated GI Bioavailability
~80% Relative Uptake
Always verify USP / NSF / IFOS 3rd-party CoA
⚠ Hidden Filler & Label Math Warning

BUFFERED OXIDE TRAP: If a single capsule claims "400 mg Elemental Magnesium from Magnesium Glycinate," it is chemically impossible—pure bisglycinate is 85.9% glycine by weight. That bottle is spiked with cheap Magnesium Oxide (4% absorption, osmotic laxative).

Evidence-Audited Dosing Rule

To hit the human RCT sleep & anxiety target of 200–300 mg true elemental magnesium, you need 3 to 4 capsules (1,420–2,130 mg compound bisglycinate) 60 minutes before bed.

Open Magnesium Glycinate Flagship Audit → Check Rx Spacing Clock →
Interactive 60-Second “Show This to Your Doctor” Visit & CPT Builder • Defends Against the 11-Second Interruption Rule (PMID 29972200)

Walk Into Your 15-Minute Appointment With Exact Labs, CPT Codes & Opening Words

Clinicians interrupt patients after a median of 11 seconds (J Gen Intern Med, PMID 29972200). Select your appointment reason below to generate your 1-page script:

15-Minute Exam-Room Agenda • High-Volume Endocrinology

Hypothyroidism, Subclinical TSH Drift (2.5–8.0 mIU/L) or Thyroid Nodule

Filter High-Volume Endocrinology Doctors → Hypothyroidism & TSH Guide
1. Your 10-Second Opening Script (Read Verbatim Before the 11-Second Interruption)

"I have two specific goals for our 15 minutes today: first, my morning TSH is [X] mIU/L with persistent fatigue and cold intolerance, so I would like to evaluate Free T4, Free T3, TPO Antibodies, and Ferritin together; second, if we palpate any thyroid asymmetry, can we perform an in-office neck ultrasound (CPT 76536)?"

2. In-Office Medicare CPT Procedures to Verify Before Booking
CPT 76536 In-Office High-Resolution Thyroid & Neck Ultrasound

Confirms the endocrinologist images thyroid nodules themselves rather than sending you to a hospital radiology department.

CPT 60100 Ultrasound-Guided Fine-Needle Aspiration (FNA) Biopsy

Identifies structural thyroid specialists vs. general diabetes-only clinics.

3. Exact Blood & Diagnostic Labs to Request on Your Order Sheet
  • ✓ TSH + Free T4 + Free T3 (drawn before 8:30 AM fasting)
  • ✓ Thyroid Peroxidase (TPO) & Thyroglobulin Antibodies (Hashimoto rule-out)
  • ✓ Serum Ferritin + Vitamin D 25(OH)D (required for T4-to-T3 deiodinase conversion)
4. Day-1 Pre-Appointment Rule

Hold all Biotin (Vitamin B7) supplements for 72 hours before your blood draw so streptavidin assay interference does not create a false TSH/Free T4 reading.

NIH RxNorm • FDA DailyMed CYP450 • Mineral Chelation Spacing Engine

Multi-Drug, Supplement & Meal-Timing Conflict Checker

100% Free • Zero Login Required
Load common clinical regimen:
Audited Regimen (3 Entities): Levothyroxine Sodium (Synthroid) + Magnesium Bisglycinate + Iron BisglycinateHighest Conflict Tier: Moderate
Levothyroxine (T4) ↔ Magnesium Bisglycinate / Oxide / CitrateModerate Conflict

Divalent magnesium cations (Mg2+) form an insoluble chelate complex with levothyroxine in the upper gastrointestinal tract, reducing T4 intestinal absorption by 30% to 45% and causing rebound TSH elevation.

Actionable Spacing / Clinical Rule: Separate Levothyroxine and any magnesium, calcium, or iron supplement by at least 4 hours (e.g., take Levothyroxine at 6:30 AM fasting and Magnesium Bisglycinate at dinner or 60 minutes before bed). (FDA DailyMed SPL & Endocrine Society Pharmacokinetic Guidelines)

Levothyroxine (T4) ↔ Iron Bisglycinate / Ferrous SulfateMajor Conflict

Ferrous/ferric ions bind phenolic hydroxyl groups on thyroxine to form poorly soluble ferric-thyroxine complexes in the duodenum, blunting peak serum Free T4.

Actionable Spacing / Clinical Rule: Maintain a strict 4-hour minimum separation window between thyroid hormone replacement and oral iron repletion. (NIH RxNorm & JAMA Internal Medicine PK Crossover Data)
Instant Reference Cheat-Sheets • Grounded in FDA DailyMed, CMS NADAC & NIH DSLD v9

4 High-Impact Reference Tables Every Patient Should Bookmark

1. Critical Drug & Supplement Spacing Rules

FDA DailyMed PK
Levothyroxine + Magnesium / Iron / Calcium: Separate by 4+ hours (divalent cations chelate T4 in the stomach, cutting absorption by 30%–45%).
Lisinopril / Losartan + Spironolactone + Potassium: Avoid potassium-rich salt substitutes or supplements unless monitored; combined RAAS blockade risks hyperkalemia (>5.2 mEq/L).
Metformin ER + Vitamin B12: Long-term Metformin blocks calcium-dependent ileal B12 absorption; check Serum B12 + MMA annually.
Atorvastatin / Rosuvastatin + CoQ10 (Ubiquinol): Statins inhibit mevalonate synthesis (the shared pathway for endogenous CoQ10); 100–200 mg Ubiquinol with dinner supports mitochondrial ATP.

3. Supplement Elemental Yield vs. Compound Weight

NIH DSLD v9
Magnesium Bisglycinate Chelate 1,000 mg Compound (2 Caps) • Unbuffered
141 mg Elemental (14.1%) ~80% Relative Uptake
Magnesium Oxide (Buffered Salt) 500 mg Compound • Osmotic Laxative Filler
301 mg Label (60.3%) Only ~4% Absorbed (~12 mg)
Iron Bisglycinate (Ferrochel) 125 mg Compound • Alternate-Day Morning
25 mg Elemental (20.0%) 3.4x Uptake vs. Sulfate
Omega-3 Fish Oil (rTG vs. Standard) 1,200 mg Softgel • Check [EPA + DHA] Sum
850 mg rTG vs. 360 mg EE Target: 2,000 mg EPA+DHA/day

4. Commercial Lab “Normal” vs. Clinical Optimal Cutoffs

ADA / ACC / Endocrine
Serum Ferritin (Iron Storage) Quest/LabCorp Bell Curve: > 15 ng/mL
Optimal: 50–100 ng/mL <30 ng/mL triggers hair/fatigue
TSH (Morning Fasting Thyroid) Standard Lab Range: 0.45–4.50 mIU/L
Optimal: 0.80–2.20 mIU/L Hold Biotin 72h before blood draw
HbA1c & Fasting Insulin Prediabetes: 5.7%–6.4% • T2D: ≥ 6.5%
Optimal: 4.8%–5.3% A1C Fasting Insulin < 6 µIU/mL
Apolipoprotein B (ApoB) & LDL-C Portal Borderline LDL-C: 100–129 mg/dL
Optimal ApoB: < 80 mg/dL < 60 mg/dL if high Risk / Lp(a)
Methodology & Patient Safety Standards

Frequently Asked Questions About dotMD Clinical & Pharmacy Calculators

How does the dotMD Multi-Drug & Supplement Interaction Checker catch mineral absorption blocks?

Most online interaction checkers only flag severe liver enzyme (CYP450) conflicts while missing everyday gastrointestinal chelation blocks. Our engine audits both hepatic CYP450/P-gp pathways (NIH RxNorm & FDA DailyMed) and divalent cation chelation—such as Magnesium, Calcium, or Iron binding to Levothyroxine or fluoroquinolone/tetracycline antibiotics in the stomach—giving you the exact 2-to-4-hour spacing rule.

Where does the Rx Wholesale vs. Retail Cash Ledger get its medication prices?

We benchmark every generic medication against the federal CMS Medicaid NADAC (National Average Drug Acquisition Cost) per-unit ledger—the exact invoice price brick-and-mortar pharmacies pay wholesalers—alongside transparent Cost Plus Drugs wholesale cash prices and typical uninsured chain walk-in retail prices.

Why does a "1,000 mg Magnesium Glycinate" bottle only deliver ~141 mg of actual magnesium?

Supplement front labels often print the total compound weight (the mineral plus its heavy amino acid carrier) rather than the true elemental mineral weight. By molecular weight, pure unbuffered Magnesium Bisglycinate is 14.1% elemental magnesium, Magnesium Citrate is 16.2%, and Magnesium L-Threonate is 7.2%. Our Elemental Weight Decoder calculates both your true elemental dose and exact capsule count.

Why can a lab result marked "Normal" on my Quest or LabCorp portal still cause symptoms?

Commercial lab reference intervals are statistical 95% population bell curves derived from everyone who walked into the lab—not physiological optimums. For example, a Serum Ferritin of 18 ng/mL is marked "Normal" (>15 ng/mL), yet clinical studies show fatigue, restless legs, hair shedding, and impaired thyroid conversion begin whenever ferritin drops below 30–50 ng/mL.