---
created: 2026-05-10
source: topics/research-queue.md
status: archived-ledger
---

# Research Queue Completed Ledger Archive — through 2026-05-10

This archive preserves completed/de-prioritized research-queue entries that were removed from the active Health KB reading surface during the slimming pass. Canonical conclusions remain in the owner topic files; this ledger is for provenance and recovery, not active medical guidance.

## Removed / De-prioritized on 2026-04-25

Six outdated regional-logistics items were removed from the active queue because they no longer match the Phnom Penh-first plan or are already covered well enough in the medical-access material.

## Recently Completed

Full research conclusions live in the canonical articles below. This section is only a completion ledger so queue state does not duplicate active medical guidance.

| Date | Topic | Canonical owner(s) | Preserved note |
|---|---|---|---|
| 2026-05-10 | 24h / 48h / 72h fasting during the active 30-day experiment | `thirty-day-experiment.md`, `personal-knowledge-widening-roadmap.md` | Resolved as WATCH/optional-only. A 24-hour fast can be used once as a gut/motility signal test if stable, away from final labs, with careful logging of bloating/circumference/walk response/sleep/HR/HRV/BP/refeed response. 48-hour fasting is deferred unless the 24h signal is clearly useful; 72-hour fasting is skipped during the clean month. Practical decision: fasting is not a core cardiovascular, Lp(a), bleeding-risk, cancer-screening, inflammation, or longevity intervention for this profile; longer fasts would add avoidable lean-mass, sleep, mood, uric-acid, lipid/ApoB, inflammatory/platelet, bowel-output, and refeeding noise. |
| 2026-05-09 | External-audit consistency pass: dates, confidence language, emergency wording, and owner links | cross-KB maintenance | Resolved as INTEGRATE/minor patch pass. Reviewed `prove/proves/proven/proof`, `confirm/confirms/confirmed/confirmation`, `SHOULD`, `pristine`, `master regulator`, `emergency`, `ER`, `urgent`, `same-day`, `red flag`, `TBD`, `tomorrow`, `through 2025-12-31`, and `expired`. Patched exact contradictions/stale anchors/overconfident phrases; added owner-link lines for red flags and medication safety. No action needed for `SHOULD`, `pristine`, and `master regulator` outside the queue task text; negative confidence-limiters such as “not proof / not proven / does not prove” were intentionally preserved. No template standardization, Apple/Workout extraction, source refresh, or large merge/split performed. |
| 2026-05-08 | Phnom Penh logistics refresh with verified-date rows | `phnom-penh-medical-access.md` | Resolved as INTEGRATE. Public-source refresh added dated rows for Biomed FOB/stool direct exam/calprotectin/CBC/iron availability, confirmed no public Biomed FIT/SIBO/BAD/JAK2-CALR-MPL rows, and upgraded RPPH from vague “possible” to a real local route for 128-slice CT, CTA Coronary/echo heart packages, PSG/HSAT sleep testing, and FibroScan/upper-abdominal ultrasound liver package. Practical decision: use Biomed for cheap repeat stool/CBC/iron logistics; call RPPH before booking to confirm CAC vs CCTA, plaque-report fields, standalone FibroScan, and hematology send-out options. |
| 2026-05-08 | Medication/supplement reconciliation + safety-reference audit | `medication-avoid-list.md`, `recommended-supplement-adjustments.md` | Resolved as INTEGRATE. The medication owner now has a dated current-known table: 2026-05-04 confirms atorvastatin 20 mg, eczema cortisone cream for flare-ups, and no aspirin; eye drops, sildenafil timing, and exact supplement products still need product-level confirmation. Safety-reference audit tightened aspirin/NSAID/paracetamol/sildenafil/eye-drop/topical-steroid/fish-oil/turmeric/iron/B6 rows. Practical decision: no self-directed aspirin; avoid non-aspirin NSAIDs including pain patches/gels unless clinician-approved; paracetamol is default OTC only within product/alcohol/duplicate-APAP limits; identify the eye drops; keep turmeric+piperine stopped; avoid chronic high-dose B6. |
| 2026-05-07 | OTC topical mupirocin genital exposure before the August 2025 bleeding incident | `medication-avoid-list.md`, `occult-stool-blood-workup.md`, `diverticular-disease.md` | Resolved as INTEGRATE/REJECT-as-bleeding-cause. Product identity remains preserved under archive ID `topical-mupirocin-prebleed-2025-08`: 康立邦 莫匹罗星软膏, matching listings 2% × 5 g / 20 mg/g. FDA/DailyMed/UK label review supports topical small-area skin use only and avoidance of mucosal/genital self-use because of local irritation/sensitization, PEG/open-wound/renal cautions, and antibiotic-associated diarrhea/CDAD class warnings. PubMed found no mupirocin-specific hematochezia/GI-bleeding case reports; FAERS/openFDA bleeding reports are nonspecific and heavily confounded. Practical decision: preserve/disclose the exposure if reconstructing the event, but treat it as low-plausibility/temporal-only and do not let it displace the diverticular/stool-blood/iron/endoscopy framework. |
| 2026-05-05 | Coke Zero / diet-soda trigger after same-day stomach-ache worsening | `sibo-mmc.md`, `abdominal-spot-pain-map.md`, `thirty-day-experiment.md` | Resolved as INTEGRATE/avoid-during-signal-finding. Coke Zero is not treated as a proven bleeding/diverticulitis danger, but it is a plausible personal symptom trigger through carbonation volume, cola acid/caffeine, and non-caloric sweeteners. Evidence is mixed: carbonated beverages can cause gastric mechanical distress especially by volume; carbonated-drink intake is associated with IBS in observational data; NCS GI/microbiome evidence is mixed, with one functional-GI RCT supporting an NCS-free diet but small aspartame microbiome trials showing minimal short-term effects. Practical decision: avoid Coke Zero/diet colas during the clean month and log any slip/rechallenge with volume and symptom timing. |
| 2026-05-04 | Sept 2024 colonoscopy report retrieval and quality abstraction | `occult-stool-blood-workup.md`, `post-30-day-noninvasive-exam-plan.md`, `diverticular-disease.md` | Report obtained from email and archived locally in a private VPS directory; images remain local/private and are not embedded in the public report. Quality gap resolved: BBPS 9, terminal ileum reached/examined 15 cm beyond valve, normal terminal ileum/colon/rectal retroflexion, no inflammation, no polyps, no malignancy, diverticulosis from right flexure to sigmoid. Decision change: repeat colonoscopy is not automatic if repeat stool/iron/Hb normalize, but persistent FOB/RBC or iron/Hb drift still warrants GI-source review despite the adequate prior exam. |
| 2026-05-04 | MASLD / liver–immune–cardiometabolic hidden-risk triage | `post-30-day-noninvasive-exam-plan.md`, `phnom-penh-medical-access.md`, `inflammatory-thrombotic-axis.md`, `elevated-iga-workup.md` | Resolved as INTEGRATE/mostly DROP unless triggered, not a standalone liver page. Current pattern has normal AST/ALT/GGT/bilirubin, good insulin sensitivity, normal HbA1c, modest triglycerides, high-not-low platelets, and FIB-4 about 0.51, so advanced fibrosis is unlikely and liver disease is a weak explanation for ESR/IgA/WBC/platelets/CVD risk. Re-open only if FIB-4 rises >=1.3, liver enzymes/ALP/GGT become persistently abnormal, ultrasound shows steatosis/chronic-liver signs, metabolic risk worsens, or clinician exam points liver. RPPH publicly lists a FibroScan + upper-abdominal ultrasound liver-screening package poster, but the offer date is expired, so phone confirmation is needed. |
| 2026-05-04 | Lp(a) therapy trial/access map for Southeast Asia + Norway | `lpa-therapy-watchlist.md` | Resolved as WATCH/no active sourcing action. No Lp(a)-specific drug is approved for routine use. Norway had pelacarsen HORIZON and olpasiran OCEAN(a)-Outcomes sites in Oslo/Skedsmokorset, but both are active-not-recruiting and established-ASCVD oriented; OCEAN(a)-PreEvent is primary-prevention-relevant but currently lists Australia/Canada/US, not Norway. Thailand has no active Lp(a) drug-treatment trial found; Singapore has completed lepodisiran early-phase work and Lp(a) education/screening signals, not a suitable treatment trial. Current move remains imaging/BP/smoking/ApoB readiness and PCSK9 discussion only if plaque/risk tier justifies it. |
| 2026-05-04 | Aortic-valve + vascular-aging module for very high Lp(a) | `aortic-valve-vascular-aging.md`, `lp-a.md`, `ldncp-advanced-imaging.md`, `ct-scan-screening.md` | Created a focused cardiovascular owner separating the aortic-valve/BP/vascular-aging branch from coronary CAC/CCTA logic. Current call: baseline transthoracic echo is reasonable because Lp(a) 838.6 mg/L is linked to calcific aortic-valve disease; CAC=0 would reassure calcified coronary plaque only, not valve disease or pulse-pressure/LV response. Use the 7-day BP profile for average BP and pulse pressure; avoid standalone arterial-stiffness gadgets unless cardiology uses them. Echo follow-up is severity-based: normal valve by symptom/murmur/BP trigger or clinician-selected multi-year check, mild AS roughly 2-3 years in ESC-style guidance if low calcification, moderate at least annually, severe at least 6-monthly. Corrected bad legacy Lp(a)-valve PMIDs in the imaging owner. |
| 2026-05-04 | Personal knowledge-widening tests and experiments | `personal-knowledge-widening-roadmap.md` | Added a ranked roadmap for tests/experiments that reveal genuinely new personal information rather than repeating routine panels. Highest yield: 7-day BP profile, baseline echo, CAC/CCTA route clarification, true SPEP for IgA patterning, and triggered smear/JAK2/stool/iron branches. Parked broad tumor markers, broad autoimmune panels, broad microbiome tests, full-body CT, and untargeted endocrine panels as low-yield novelty. |
| 2026-05-04 | Bile-acid dysregulation as a SUDD/bloating subphenotype | `sibo-mmc.md`, `phnom-penh-medical-access.md` | Integrated as a conditional symptom branch, not a new standalone page. BAD matters mainly if stool logs show persistent watery/urgent diarrhea, high frequency, or toilet-proximity burden; bloating/distension alone is too weak. Guidelines favor objective testing where available (SeHCAT, fasting serum C4, or fecal bile acids), but Biomed's public tariff has no BAD-testing rows and Phnom Penh public pages do not confirm access. A bile-acid sequestrant trial belongs only with clinician supervision because it can worsen bloating/constipation and bind other medications/supplements. Drop the branch if the clean experiment does not show repeated watery urgency. |
| 2026-05-04 | Gut-heart-skin microbiome actionability | `eczema-diverticular-connection.md`, `probiotics.md`, `sibo-mmc.md` | Integrated as a useful-vs-noisy filter, not a standalone microbiome page. Current call: keep tolerated fiber/plant diversity, optional fermented foods, and one probiotic only if gut/skin logs justify it; consider SIBO/bile-acid branches only by symptom pattern. Broad commercial microbiome sequencing, fecal SCFA panels, TMAO chasing, and histamine narratives are not core next steps. Microbiome language must not explain away positive FOB/stool RBC, iron drift, or Lp(a)/BP/plaque decisions. |
| 2026-05-04 | Dental/periodontal inflammation audit | `inflammatory-thrombotic-axis.md`, `phnom-penh-medical-access.md` | Integrated as a source-cleanup checklist, not a new standalone section. No dental/gum symptom history is recorded in the cloud document, so status is unknown. If WBC/platelets/CRP/ESR persist after clean-month exposure cleanup, a periodontal screen with pocket depths, bleeding on probing, recession/attachment loss, mobility, and X-rays if indicated is a low-friction check. Periodontal therapy can improve IL-6/SBP and probably CRP when disease exists, but CVD-event prevention evidence is very low-certainty; dental care is source control and tooth preservation, not a substitute for BP/ApoB/imaging/smoking control. Roomchang/Malis/Pagna are local Phnom Penh leads. |
| 2026-05-04 | Legacy supplement/probiotic cluster audit | `recommended-supplement-adjustments.md`, `probiotics.md`, `clostridium-butyricum.md`, `omega-3.md` | Replaced the scattered supplement logic with a smaller keep/conditional/defer/stop router. Current call: keep D3/K2 maintenance and modest fish oil; use probiotics, B12/B-complex, magnesium, zinc, psyllium, and iron only when a logged symptom/lab branch justifies them; stop turmeric+piperine and avoid indefinite probiotic stacking. Corrected a bad S. boulardii PMID and kept CBM588 as an exact-strain, symptom-only trial with Cambodia stock still unconfirmed. |
| 2026-05-03 | Calcium-PTH-Vitamin D/K2 overlap refresh | `calcium-parathyroid-vitamin-d.md`, `vitamin-d-k2.md`, `recommended-supplement-adjustments.md` | Replaced the unsourced physiology owner with a smaller guideline/source-anchored router. Current pattern remains monitoring, not PHPT or vitamin-D toxicity: high-normal stable total calcium, normalized PTH, sufficient 25(OH)D, and no reason to push D/K2 higher. Biomed public tariff lists serum calcium/albumin/phosphorus/PTH/25(OH)D but not ionized calcium or vitamin K; Lp(a)-valve reassurance belongs to baseline echo, not K2 speculation. |
| 2026-05-03 | Legacy PSA kinetics guideline refresh | `psa-kinetics.md`, `planned-blood-tests.md` | Replaced the unsourced PSA page with a smaller AUA/SUO + EAU anchored router. PSA 2.85 ug/L is not an emergency or biopsy trigger; repeat standardized PSA first, ideally with free PSA if trying to resolve the branch. PSA velocity is background only, not a stand-alone escalation rule; persistent near/above-3 or rising PSA moves to DRE/risk-calculator/prostate-volume/PSA-density/urology/MRI logic. |
| 2026-05-03 | Legacy CT/CAC/CCTA screening refresh | `ct-scan-screening.md`, `ldncp-advanced-imaging.md`, `phnom-penh-medical-access.md` | Replaced the unsourced first-commit CT screening page with a smaller sourced decision table. CAC remains the low-friction coronary anchor; CAC=0 is reassuring but not a full high-Lp(a) all-clear because CCTA can show non-calcified plaque. LDCT stays USPSTF pack-year conditional; abdomen CT is symptom/complication-triggered; full-body CT remains rejected. RPPH now has an official CT coronary-screening package, but exact CAC-vs-CCTA/report contents and pricing still need phone confirmation. |
| 2026-05-03 | Legacy antithrombotic / aspirin refresh | `antithrombotic-strategy.md`, `lp-a.md`, `occult-stool-blood-workup.md` | Replaced the unsourced high-confidence aspirin page with a size-neutral sourced router. High-Lp(a) aspirin signals exist (WHS/ASPREE genetic subgroups, MESA measured Lp(a), 2024 review), but bleeding data are thin and general primary-prevention guidelines require low bleeding risk. With diverticular hemorrhage + positive FOB/stool RBC, default remains no self-directed aspirin; documented ASCVD would make it cardiology + GI balancing, not an automatic yes. |
| 2026-05-03 | Sleep apnea / nocturnal hypoxia / autonomic BP phenotype | `sleep-apnea-nocturnal-hypoxia.md`, `blood-pressure-profile.md`, `apple-health-signals.md` | Integrated as a trigger-based sleep/BP router: known baseline STOP-BANG points are only age >50 + male with BMI ~24 and no documented classic symptoms, so no blind test. Finish home BP and symptom check first; repeated morning BP elevation, supported-watch breathing-disturbance notification, repeated nocturnal SpO2/breathing abnormality, or classic snoring/apnea/sleepiness triggers RPH HSAT/PSG discussion. Confirmed OSA changes BP/autonomic-risk handling but does not replace CAC/CCTA/echo. |
| 2026-05-03 | Celiac + autoimmune gastritis + malabsorption cluster | `malabsorption-celiac-autoimmune-gastritis.md`, `ferritin-iron-workup.md`, `b12-functional-deficiency.md`, `elevated-iga-workup.md` | Integrated as a small trigger-based screen: tTG-IgA while eating gluten if iron/TSAT, chronic non-bloody diarrhea/weight loss, or persistent unexplained bloating makes it actionable; total IgA is already not deficient; broad autoimmune-gastritis/pernicious panels are deferred unless B12/iron response, gastrin, upper-GI symptoms, or gastroscopy triggers them. |
| 2026-05-03 | FOB/FIT assay-quality audit and stool-blood decision science | `occult-stool-blood-workup.md`, `diverticular-disease.md` | Integrated as the stool-blood algorithm quality layer: Biomed lists FOB + Stool Direct Exam but no FIT; local FOB is a pragmatic guaiac-style bridge, not a FIT-equivalent rule-out. Best cheap repeat is 2-3 separate spontaneous stools with FOB + direct exam, paired with CBC/iron trends. Persistent positivity, iron/Hb drift, visible blood, melena, or uncertain colonoscopy quality moves toward GI-source review rather than endless retesting. |
| 2026-05-03 | CHIP / clonal hematopoiesis as marrow-inflammation-CVD bridge | `thrombocytosis-lpa-thrombosis.md` | Integrated as a boundary inside the platelet pathway: repeat CBC/differential, smear, reactive-cause cleanup, and focused JAK2/CALR/MPL logic still come before broad CHIP sequencing. CHIP, if found, is a gene/clone-size risk modifier that should intensify conventional prevention and specialist interpretation, not trigger routine screening, aspirin, or anti-inflammatory self-treatment. |
| 2026-05-03 | Reducing systemic inflammation — practical intervention hierarchy | `inflammatory-thrombotic-axis.md` | Resolved as a ranked intervention table: stop smoking; keep alcohol out while gut/BP/stool-blood questions are live; measure/control BP and ApoB/plaque risk; exercise consistently; use diet/fiber/iron timing, sleep/OSA screening, gut/iron/CBC, skin/oral cleanup only by trigger; supplements/anti-inflammatory drugs are lowest priority in this primary-prevention + GI-bleed context. |
| 2026-05-03 | Chronic systemic inflammation — damage, aging, lifespan, and quality-of-life impact | `inflammatory-thrombotic-axis.md` | Resolved as a concise outcome-impact layer: the strongest durable evidence is vascular risk amplification, especially relevant with very high Lp(a); mortality/healthspan and metabolic/frailty/cancer links are mostly observational and not personal years-lost calculators. Current markers show mild/moderate inflammatory-thrombotic context, not proven severe systemic inflammatory disease; clean-month CBC/differential, platelets, CRP/hsCRP, ESR, fibrinogen, iron/stool markers decide persistence. |
| 2026-05-03 | Post-experiment treatment-priority plan | `post-experiment-treatment-priority-plan.md` | Added treatment router: after day-30/31 data, rank durable smoking/alcohol abstinence, BP/imaging-guided cardiovascular prevention, stool-blood/iron and CBC branches if objective signals persist, then bloating/SUDD, skin/oral inflammation, and fear-management supports. Separates clinician-led decisions from safe self-management trials. |
| 2026-05-03 | Diverticular disease, bloating, and new spot-pain map | `abdominal-spot-pain-map.md`, `bloating-vs-bleeding-risk.md`, `sibo-mmc.md`, `occult-stool-blood-workup.md` | Resolved: brief low-grade migrating spot pains belong primarily to the symptom/motility/visceral-sensitivity branch, not the bleeding branch. Track location/duration/meal-walk-toilet-gas links and circumference; persistent focal/systemic pain triggers clinician/imaging logic; stool blood/iron drift stays separate. |
| 2026-05-03 | Long-running population cohorts and life-course risk translation | `longitudinal-cohort-risk-translation.md` | Added expanded cohort atlas: Copenhagen/ERFC/US pooled/MESA/EPIC directly inform Lp(a) ASCVD/mortality risk; Framingham and British Doctors translate BP/smoking into life-course risk; HPFS/NHS/EPIC-Oxford/Million Women/UK Biobank/Swedish/Danish cohorts add diverticular disease, fibre, activity, smoking, obesity, and bleeding/diverticulitis context. |
| 2026-05-03 | 7-day home BP profile + Phnom Penh/Grab Mart sourcing | `blood-pressure-profile.md`, `phnom-penh-medical-access.md` | Resolved: the profile can be started alone at home with a validated upper-arm cuff; hospital/pharmacy comparison is optional QC, not a prerequisite. Buy through Grab Mart/UCare-style channels only when the exact model and cuff range can be verified; avoid generic unvalidated CK-A156-style listings for decision-grade data. |
| 2026-05-03 | Post-30-day non-invasive examination plan | `post-30-day-noninvasive-exam-plan.md` | Router added: finish paired blood/stool/log/BP first; use echo/CAC for high-Lp(a) cardiac risk; trigger ultrasound, H. pylori, celiac, liver-gallbladder-pancreas, smear, PSA, or SIBO tests only when results/symptoms justify them; endoscopy becomes hard to avoid with persistent stool blood/RBC, iron/Hb drift, alarm symptoms, or uncertain colonoscopy quality. |
| 2026-05-03 | Whole-profile seriousness triage | `whole-profile-seriousness-triage.md` | Forest-before-trees router added: red-flag overrides first; silent Lp(a)/ASCVD/valve risk is the largest permanent-harm branch; stool-blood/iron and CBC/smear trends decide near-term escalation; bloating/spot pains are tracked as symptom burden unless objective red flags appear. |
| 2026-04-27 | SIBO breath-test availability + CBM588 sourcing | `sibo-mmc.md`, `clostridium-butyricum.md`, `phnom-penh-medical-access.md` | No public Phnom Penh hydrogen/methane SIBO provider confirmed; CBM588/Miyarisan Cambodia stock remains unverified; Thailand/Bangkok is fallback, not default. |
| 2026-04-27 | Smoking + alcohol relapse impact | `smoking-alcohol-relapse-risk.md`, `thirty-day-experiment.md` | Lp(a) is mostly genetic; smoking/alcohol matter by stacking endothelial, BP, sleep, gut, HRV, inflammatory, and experiment-quality effects. |
| 2026-04-27 | Medication / avoid-list standardization | `medication-avoid-list.md`, `antithrombotic-strategy.md` | Atorvastatin remains the lipid anchor; NSAIDs and primary-prevention aspirin remain avoided while bleeding risk is live; PDE5 safety depends on nitrate/BP/symptom context. |
| 2026-04-27 | B12 / vegetarian brain-fog follow-up | `b12-functional-deficiency.md` | Low-normal B12 plus vegetarian diet and upper-normal homocysteine justify oral B12 or homocysteine/folate follow-up; MMA was not found on Biomed tariff. |
| 2026-04-27 | Oral iron repletion | `oral-iron-repletion.md`, `ferritin-iron-workup.md` | Iron is a repletion tool, not a diagnostic shortcut; use conservative alternate-day dosing only if trends/symptoms justify it. |
| 2026-04-27 | Blood pressure profile | `blood-pressure-profile.md` | BP is the missing major cardiovascular risk variable; use validated home BP/ABPM protocol before guessing. |
| 2026-04-27 | Lp(a) therapy watchlist | `lpa-therapy-watchlist.md` | Pelacarsen/olpasiran/lepodisiran/muvalaplin/zerlasiran remain outcome/access watchlist items; no current management change until approvals/results/access. |
| 2026-04-27 | Next Biomed/result framework | `planned-blood-tests.md`, `elevated-iga-workup.md`, `thrombocytosis-lpa-thrombosis.md` | Do not pre-order a generic Round-2 panel; use result-triggered branches for IgA/SPEP, CBC/smear/molecular workup, stool/iron, fibrinogen, and PSA. |
| 2026-04-27 | Recurrence action plan | `recurrence-action-plan.md` | Recurrent epigastric/upper-abdominal pain with sweating/dizziness/arm symptoms belongs in ECG + high-sensitivity troponin / possible ACS rule-out logic, not GI speculation. |
| 2026-04-27 | Persistent thrombocytosis + leukocytosis | `thrombocytosis-lpa-thrombosis.md`, `inflammatory-thrombotic-axis.md` | Reactive causes remain likely, but persistent WBC/platelet abnormalities trigger CBC differential, smear, iron/inflammation context, then JAK2/CALR/MPL or CML-style workup if unexplained. |
| 2026-04-27 | Primary vs secondary prevention status | `prevention-status-cvd-burden.md`, `ldncp-advanced-imaging.md`, `ct-scan-screening.md` | Current label is high-risk primary prevention until imaging or clinical ASCVD documents otherwise; CAC/CCTA/echo define the boundary. |
| 2026-04-25 | Elevated IgA | `elevated-iga-workup.md`, `planned-blood-tests.md` | IgA is a moderate isolated abnormality; normal IgG/IgM/urine and normal hemoglobin electrophoresis are reassuring, but hemoglobin electrophoresis is not SPEP. |
| 2026-04-25 | Ferritin / iron / TSAT | `ferritin-iron-workup.md`, `oral-iron-repletion.md` | Not iron-deficiency anemia now; positive stool blood plus borderline TSAT keeps trend-based GI/iron monitoring active. |
| 2026-04-24 | Positive FOB + stool RBC with normal calprotectin | `occult-stool-blood-workup.md`, `bloating-vs-bleeding-risk.md` | Current state is yellow -> low-orange; repeat local FOB/direct exam is a bridge, but persistent blood or Hb/ferritin/TSAT drift escalates the GI-source branch. |
| 2026-04-22 | Bloating relief vs bleeding risk | `bloating-vs-bleeding-risk.md`, `sibo-mmc.md`, `diverticular-disease.md` | Symptom-control strategies may help bloating, but they are not validated diverticular-rebleeding prevention tools. |

## Open Questions from Topic Files

The following open questions surfaced in individual research topics and remain worth tracking:

- **Lp(a) units / assay handling**: Raw lab value is clearly reported as mg/L. Should future re-testing prioritize an nmol/L assay rather than rough conversion? (from lp-a.md)
- **Smoking timeline for CBC interpretation**: Older WBC dates need smoking-status back-labeling before historical WBC spikes are used for/against smoking-related leukocytosis: 2018-02, 2020-10, 2021-07, 2024-01/02/03, and exact 2025-2026 quit/relapse boundaries. (from smoking-alcohol-relapse-risk.md / inflammatory-thrombotic-axis.md)
- **HDL fluctuation**: Did the Dec 2025 HDL peak represent noise/variation, or does a return above ~2.3-2.6 still deserve deeper workup? (from hdl.md)
- **TSH normalization meaning**: Was the 3.61 result transient or reversible, and does TPO testing still add useful signal once the higher-priority GI questions are settled? (from tsh-thyroid-trend.md)
- **CAC-zero reassurance threshold**: If CAC is zero, is that sufficiently reassuring in this Lp(a) profile, or should echo / CCTA logic still escalate on symptoms or other findings? (from ldncp-advanced-imaging.md)