Active unresolved questions are kept here so the KB does not sprawl randomly. The active queue now includes platelet persistence / reduction strategy, a deep unifying gut-mechanism review, and a narrower stool-fragment / mixed-consistency triage item, because platelets, bloating, stool/spot-pain changes, occult blood/bleeding, ferritin/iron shifts, inflammatory/reactive markers, and intermittent visible undigested material may share upstream drivers even though current owner pages keep the bleeding, platelet, and symptom branches separate for safety.
planning · future work
Research Queue
Research topics queued for investigation. Items are prioritized by clinical relevance. When you ask me to "do some research" or "research N items", I work through this list top to bottom.
Priority 1 — High Clinical Urgency
No active Priority 1 item after the medication/supplement safety-reference audit was completed on 2026-05-08.
Priority 2 — Actionable Soon
Platelet persistence: cause attribution and reduction strategy
decision target: research why platelet counts have stayed borderline/high over years in Dag's profile, which explanations are most likely after the clean-month improvement, and which actions can realistically lower platelets versus only reduce thrombotic risk.
why it matters: platelets improved but remain above Biomed's reference range and near the common thrombocytosis threshold, while WBC normalized and stool/iron signals cooled. The unresolved question is whether this is residual reactive thrombocytosis, a persistent source such as iron loss/inflammation/smoking/oral-skin-gut disease, lab/physiologic baseline, or a clonal/myeloproliferative branch that needs focused testing.
research scope: review reactive thrombocytosis algorithms, expected platelet response after smoking cessation, iron repletion, bleeding resolution, infection/inflammation control, skin/oral/gut source cleanup, exercise/weight/BP/ApoB risk reduction, medications/supplements that do or do not lower platelet counts, antiplatelet boundaries with GI-bleed risk, and thresholds for smear, JAK2/CALR/MPL, BCR-ABL1, hematology, marrow, or myeloid/CHIP sequencing.
integration threshold: integrate only if the research changes the current platelet pathway: repeat-test timing, which reactive sources to prioritize, what counts as a meaningful fall, what not to self-treat, when to ask hematology for mutation testing, or how to separate platelet-lowering from cardiovascular-risk lowering.
stop condition: owner pages give a practical "what lowers platelets / what only lowers risk / what requires hematology" table, with triggers for watch-only, reactive-source cleanup, smear/molecular workup, and urgent escalation.
decision target: deep-research whether the apparently parallel gut problems are better explained by one connected model or by separate branches that only cluster through shared exposures.
why it matters: Dag's lived pattern is that extreme bloating, stool/spot-pain changes, bleeding/occult blood concern, iron recovery, and CBC/inflammatory markers seem to move in the same broad period. The current KB separates symptom/motility and bleeding mechanisms to avoid unsafe inference; this item asks whether a higher-level synthesis can connect them without erasing the red-flag boundaries.
research scope: review diverticular disease/SUDD, post-diverticular visceral hypersensitivity, dysbiosis/SIBO/MMC, gut-barrier injury, alcohol/smoking effects, occult bleeding/iron physiology, calprotectin-negative bleeding, mast-cell/eczema/allergic gut links, autonomic/stress mechanisms, and inflammatory-thrombotic marker coupling; map each candidate against Dag's timeline and objective data.
integration threshold: produce a compact connected-mechanism model only if it changes decisions, for example test sequencing, symptom logging, exposure priorities, or escalation thresholds; otherwise preserve the current separated-branch safety model with clearer cross-links.
stop condition: owner pages explicitly state which symptoms can plausibly share upstream drivers and which findings still require independent evaluation: visible/occult blood, ferritin/TSAT/Hb drift, melena, persistent focal pain, or CBC abnormalities.
Undigested-food fragment and mixed-consistency stool triage
decision target: determine whether an occasional visibly undigested pale food fragment plus one same-sample mix of hard/dark stool and pale/liquid stool should change the current GI interpretation, stool logging, or post-experiment test router.
why it matters: a single larger fragment found only while preparing a stool sample may be benign food identity / chewing / high-fiber or rapid-transit noise, but in Dag's profile it sits near open questions about bloating, motility/SUDD-SIBO, occult stool blood, iron recovery, and possible malabsorption. The research should prevent over-reading one observation while defining the threshold where recurrence becomes meaningful.
research scope: review normal visible food remnants versus pathologic steatorrhea/maldigestion; rapid transit, IBS/SUDD, bile-acid diarrhea, pancreatic exocrine insufficiency, celiac disease, small-bowel disease, and diet/meal-size/chewing contributors; map which stool features are visually useful versus unreliable; define logging prompts and test triggers such as weight loss, persistent diarrhea/greasy floating stool, recurrent large undigested fragments, worsening iron/B12/ferritin patterns, or persistent stool-blood positivity.
integration threshold: integrate only if the evidence changes practical rules in the motility/malabsorption/stool-blood owners, such as when to escalate from observation to celiac/pancreatic/BAD evaluation or how to tag mixed-consistency stools in the tracker/photo protocol.
stop condition: owner pages state whether this pattern is watch-only after a one-off observation, which recurrence/red-flag features would make it clinically useful, and how it interacts with the existing occult-blood/iron branches.
decision target: ensure CEA is not treated as routine CRC screening or a reflex stool-blood add-on.
why it matters: prior CEA history is real, but CEA has poor screening/diagnostic performance and should not distract from stool blood, iron, symptoms, imaging, or endoscopy-quality logic.
integration threshold: keep CEA only as clinician-directed follow-up in context of prior CEA trend, symptoms, imaging, or endoscopy planning.
stop condition: no active plan text recommends routine CEA because FOB remains positive.
Priority 4 — Parking Lot / Only If It Becomes Actionable
decision target: keep pelacarsen, olpasiran, lepodisiran, muvalaplin, zerlasiran, PCSK9-bridge logic, and Norway/SE Asia access status current without bloating the page.
trigger: new phase-3 outcome readout, regulatory filing/approval, new Southeast Asia/Norway recruiting site, or next scheduled watchlist review.
integration threshold: update approval/trial/access status only if it changes practical readiness, clinician discussion, or sourcing; otherwise add a one-line reviewed/no-change note.
stop condition: next_review date set in the owner topic after each refresh.
Completed research
Completed and de-prioritized research items are no longer part of the active reading surface. Current conclusions should live in the owner topics above; this queue should stay small: unresolved decision-changing questions, watch triggers, and no large completion ledger. The migration manifest tracks the preservation file/checksum for the completed ledger.
2026-05-24: daily cannabis / dry-herb vaping risk at 20 g/week researched and folded into Daily Cannabis / Dry-Herb Vaping Risk; active queue item closed immediately after integration.