Comprehensive Health Analysis Report

N1.Care Confidential
Generated
2026-02-27
Jean Yves Christian Sireau-80
ID 9ac16843-07fd-4d31-80a1-4c2261375ec2
1970-12-09
55 Years
Male
2024 - 2025
~2 Years

Executive Summary

Central Theme

A 55-year-old male with chronic multi-pathogen immune burden, HPA-SNS neuroendocrine uncoupling, and severe gut-pancreatic disruption driving a multi-system cellular energy crisis — with rapid kidney function decline, accelerated biological aging, and post-bariatric insulin resistance as the principal urgent threats.

Situation
  • eGFR declined >90 → 70 mL/min in 5 months [b1016]
  • Active Mycoplasma [b2619] and Bartonella IgM [b442] infections ongoing; untreated
  • Pancreatic insufficiency [d2] diagnosed; hyperoxaluria 173 mmol/mol creatinine [b842] threatening kidneys
  • Severe insulin resistance (HOMA-IR ~6.5); post-bariatric hyperinsulinemic hypoglycemia [b606]
  • Three body systems CRITICAL (GI/Pancreatic, Endocrine, Immunology) per assessment
Background
  • Bariatric surgery [p0] performed May 2025; persistent metabolic complications post-operatively
  • Biological age elevated; telomere age 72.7 years [b1457] at chronological 55
  • Cortisol excess [d5] and adrenal medullary catecholamine depletion [d6] diagnosed July 2025
  • Multi-pathogen infectious burden identified: VZV, EBV, HHV-6, Lyme, and Dientamoeba fragilis [b2549]
  • NAD critically low [b2085]; gut microbiome severely disrupted (Akkermansia 0.001% [b698])
Assessment
  • Kidney decline is acutely driven by hyperoxaluria, hyperinsulinemia, and infectious nephropathy risk [b1016] [b842]
  • HPA-SNS uncoupling is the master metabolic driver sustaining insulin resistance and immune senescence
  • EPI diagnosis may be overstated; likely functional/mild post-bariatric EPI [w463]
  • Adrenal medulla exhaustion [d6] doesn't match data; pattern is circadian uncoupling
  • CMV EliSpot 160 SI [b1081] reflects vigorous immune surveillance, not active disease
Recommendation
  • Nephrology referral within days; obtain uACR, urine microscopy, renal ultrasound urgently
  • Start PERT (Creon/Zenpep) immediately; co-prescribe calcium citrate to bind oxalate
  • Treat active Mycoplasma/Bartonella: doxycycline IR 100 mg BID × 3 months
  • Formal Cushing's workup (UFC, LNSC, DST) after reducing exogenous melatonin
  • Reduce high-dose melatonin; obtain blood CMV PCR, Strongyloides IgG, G6PD assay

Key Statistics

Total Conditions 11
4 high priority, 4 moderate priority, 3 low/surveillance
Data Span 2.0
~2 years (2024-01-03 to 2025-12-03)
Total Diagnoses 15
6 chronic, 9 acute
Total Procedures 1
Canonical Biomarkers 2,155
Total Biomarkers 2,970 399
Most Recent Assessment
2025-12-03

Key Metrics Dashboard

System Health Scores

Scores reflect current disease burden, trajectory, treatment effectiveness, and complication risk.

Multiple critical/concerning scores indicate need for urgent, coordinated multi-specialty care.

Gastrointestinal & Pancreatic
20
Critical
Key Concerns
  • Severe EPI (elastase 85 mcg/g)
  • Methane SIBO
  • Proteus/Clostridium overgrowth
  • Akkermansia virtually absent
Endocrine / Neuroendocrine
25
Critical
Key Concerns
  • Chronic cortisol excess + adrenal medulla catecholamine exhaustion (2 formal diagnoses)
  • Severe EPI
Immunology & Infectious Disease
28
Critical
Key Concerns
  • Active Mycoplasma
  • Lyme IgG positive
  • CMV EliSpot 160 SI
  • CD28-negative senescent T-cells 58%
  • IgE 404 kU/L
Aging & Longevity
30
Concerning
Key Concerns
  • Telomere age 72.7 Years (17.7-year gap)
  • Pace of aging 1.2
  • SYMPHONY persistently elevated
Cellular Energy & Mitochondrial
32
Concerning
Key Concerns
  • Intracellular NAD 33.7 µM (below 40 µM threshold)
  • Blood NAD 15.2 nmol/ml (low)
  • NADPH 4.3
  • Mitochondrial efficiency 26
  • Improving
Kidney Function
35
Concerning
Key Concerns
  • eGFR declined >90 → 70 mL/min in 5 months (>20% KDIGO rapid-progression threshold)
  • Qualitative proteinuria
Metabolic & Glycemic Control
36
Concerning
Key Concerns
  • HOMA-IR ~6.5 (severe insulin resistance)
  • Post-bariatric hyperinsulinism
  • FIB-4 indeterminate zone
Toxicology
42
Concerning
Key Concerns
  • PFAS 96th percentile (worsening)
  • Glyphosate 89th percentile
  • Hair mercury 2.1 µg/g (blood confirmation pending)
Musculoskeletal
42
Concerning
Key Concerns
  • 10 formal diagnoses
  • Multilevel cervical disc prolapse C3–C7
  • Bilateral rotator cuff pathology
  • 25–50% supraspinatus tear
Cardiovascular
44
Concerning
Key Concerns
  • VO2 max 7th percentile (declining)
  • Systolic BP 91–93rd percentile
  • Heart biological age mildly elevated
Liver Function
50
Fair
Key Concerns
  • FIB-4 1.84–2.01 (indeterminate fibrosis zone)
  • FibroScan not yet performed
  • Hepatobiliary stress signal
Hematology
55
Fair
Key Concerns
  • Ferritin persistently low (17–19 µg/L)
  • Haptoglobin low (0.26 g/L)
  • Coagulation signals (D-Dimer 570, aPTT short)
Thyroid Function
58
Fair
Key Concerns
  • No validated quantitative thyroid abnormalities
  • Bioresonance signals only
  • Formal panel outstanding
Ophthalmology
72
Good
Key Concerns
  • Mild bilateral MGD (confirmed)
  • Very elevated genetic risk for exfoliation glaucoma (surveillance warranted)
Scoring Methodology
Critical: 0-29
  • Urgent issues requiring immediate attention
  • Life-threatening if untreated
Concerning: 30-49
  • Active issues requiring specialist management and close monitoring
Fair: 50-69
  • Some concerns requiring ongoing management
  • Moderate risk if unaddressed
Good: 70-89
  • Minor issues, well-managed
  • Low short-term risk
Optimal: 90-100
  • All markers normal or near-normal
  • Minimal concerns

Identified Conditions

11 Total
#1

Chronic Multi-Pathogen Infectious Burden & Immune Senescence

High
Active multi-pathogen burden immune senescence established and progressing
Related Diagnoses

Acute infection/inflammation [d7]

Key Evidence

*Active/recent pathogens:* Mycoplasma pneumoniae — IgG + IgA elevated + EliSpot 5 SI (ref 0–1) — triple positive pattern consistent with active or very recent infection [w157]; Bartonella IgM positive [b442][b1909] — indicates acute/recent Bartonella infection (sensitivity 43–71%; specificity 95–98%) [w166]

*Latent/reactivation:* VZV IgA 1.529 Ratio (ref ≤0.8) [b1522] + IgG 3702 IE/L (ref ≤80) [b1811] — consistent with subclinical VZV reactivation (Zoster Sine Herpete) [w85][w86]; EBV EA p54 IgG positive [b25] (reactivation-associated antigen); HHV-6 IgG 1:320 (ref <1:10) [b1372]

*Confirmed latent burden:* CMV EliSpot Lytic 61 SI + Latent 160 SI (ref 0–1) [b1756][b1081] — represents very robust CMV-specific protective T-cell memory consistent with prior CMV exposure and effective immune surveillance; high EliSpot values indicate immune competence rather than active CMV disease (CMV PCR recommended to rule out active viremia) [w107]; Lyme IgG ImmunoBlot positive [b2161] + screen indeterminate [b478] — constitutes a positive two-tier result per CDC 2024/IDSA 2020 [w167]; Toxoplasma IgG elevated 2.129 Ratio [b2621]

*Likely cross-reactive/uncertain:* Schistosoma IgG 2.2 INDEX [b1985] — highly likely false positive without endemic exposure [w137]; Chlamydia pneumoniae EliSpot 2 SI [b2535]; HSV 1/2 IgG elevated 31.92 U/mL [b949]; Coxsackie A7 IgG+IgA elevated [b1735][b1769]

*Gut pathogen:* Dientamoeba fragilis DNA positive [b2549]; Proteus Mirabilis 4+ [b1001]

*Immune senescence markers:* NK CD57+ low 70/µL (ref 100–360) [b488]; CD8 CD28-negative senescent T-cells 58% of CD8 (ref 4–51%) [b2005]; Memory CD8 T-cells persistently 96.8–98.5% [b1216][b1215]; Immune biological age 59.0–66.3 Years (ref 54.4) [cb1790]; IgE markedly elevated 404 kU/L (ref ≤100) [b796]; RF low-positive 22.7 IU/mL [b824] — likely viral-driven polyclonal B-cell activation [w154]

*Immune suppression:* WBC low (3.7 x10^9/L) [b177]; Lymphocytes low (1.3 x10^9/L) [b1262]; NK CD57+ low [b488]

Clinical Significance

This patient carries a high burden of both active/recent (Mycoplasma, Bartonella) and latent/reactivating (VZV, CMV, EBV, Lyme) pathogens alongside hallmark immune senescence markers. The expanded senescent CD8 T-cell pool (CD28-negative) and chronically elevated memory CD8 T-cells are consistent with "immunosenescence" driven by persistent antigen stimulation — a state that impairs vaccine responsiveness and pathogen clearance, and accelerates telomere attrition [w150][w152]. Elevated IgE 404 kU/L [b796] in this multi-pathogen context also warrants helminth screening (Strongyloides), particularly given the cross-reactive Schistosoma result.

#2

Adrenal & Neuroendocrine Axis Dysfunction

HPA Hyperactivation / Catecholamine Exhaustion

High
Active chronic — two formal diagnoses confirmed July 2025 [d5][d6]
Related Diagnoses

Chronic excess cortisol [d5]

Severe adrenal medulla exhaustion with inability to synthesize catecholamines [d6]

Key Evidence

*Cortisol excess:* Free Cortisol 1st Morning 51.14 µg/g Cr (ref 7.8–29.5) [b1327]; 2nd Morning 94.69 µg/g Cr (ref 23.4–68.9) [b300]

*Catecholamine collapse:* Norepinephrine 1st Morning 4.11 µg/g Cr (ref 9.4–22.0) [b2201], 2nd Morning 2.32 µg/g Cr (ref 12.6–38.2) [b1567], Night 10.2 µg/g Cr (ref 16.9–38.8) [b2545]; Epinephrine 1st Morning below detection limit [b2709] — flat across all timepoints, confirming adrenal medulla functional failure [d6]

*Very elevated morning melatonin:* 4,466 µg/g Cr (ref 10.1–26.0) — ~170× upper limit [b1797]; likely reflects exogenous high-dose supplementation; clinical correlation required; may paradoxically compound cortisol elevation and suppress sympathetic morning activation [w175][w173]

*Adrenal hormonal sequelae:* DHEA-S acutely low 1.9 µmol/L (ref 3.7–12.2) [b2397] — partially normalized to 3.9 [b2399]; Progesterone persistently low [b1127][b1128] — normalized only transiently [b2218]; Leptin worsening: 88th→94th percentile [b839][b838]

*Hormonal biological age:* Hormone organ system age 62.3 Years (ref 54.4) [b1709]; Biological Age (Hormone) increasing to 61.8 Years [cb1490]

Clinical Significance

The cortisol excess + catecholamine exhaustion dissociation represents a recognized neuroendocrine uncoupling pattern — selective HPA hyperdrive with relative SNS suppression [w129][w130]. The Endocrine Society (2022) designates this as "HPA Axis Dysfunction" rather than "adrenal fatigue" [w130]. This pattern is associated with metabolic syndrome amplification, immune dysregulation, and cardiovascular risk. Very elevated morning melatonin (likely supplementation) may be compounding the pattern. Formal endocrine evaluation may be warranted to exclude Cushing's syndrome, particularly after accounting for potential melatonin supplementation effects.

#3

Severe Gut Dysbiosis, SIBO & Pancreatic Insufficiency

High
Active pancreatic insufficiency formally diagnosed November 2025 [d2] dysbiosis ongoing and confirmed on multiple assessments
Related Diagnoses

Pancreatic insufficiency [d2]

Acute infection/inflammation [d7]

Key Evidence

*Severe exocrine pancreatic insufficiency:* Pancreatic Elastase 85 mcg/g (ref ≥200) [b705] — classified as severe EPI (<100 mcg/g threshold; sensitivity 88–100% [w141][w142]); associated with fat-soluble vitamin malabsorption and risk of Type 3c diabetes

*Structural gut disruption:* Methane SIBO positive 16.0 ppm (ref ≤10) [b2477]; Proteus Mirabilis 4+ in stool [b1001]; Clostridium species markedly elevated 82.08 x10^7 CFU/g (ref 5–50) [b2871]; Dientamoeba fragilis DNA positive [b2549]

*Severely depleted beneficial microbiota:* Akkermansia 0.001% (ref 0.02–3.0) [b698]; Bifidobacterium 0.108% (ref 2.5–5.0) [b638]; Lactobacillus 0.005% (ref 0.01–0.5) [b677]; Roseburia 2.284% (ref 5.0–11.0) [b795]; Oxalobacter 0.0% (ref 0.001–0.2) [b704] — multiple species confirmed depleted on culture [b99][b105][b2117][b2647][b2020]

*Pathobiont overgrowth:* Proteobacteria 7.615% (ref 0–4.0) [b2559]; Bacteroides 27.476% (ref 5–20) [b933]; D-Lactate elevated 1.69% (ref ≤1.0) [b2653]

*Downstream metabolic signals:* Phenylacetylglutamine persistently elevated (82nd percentile) [b1781][b1782] — gut dysbiosis metabolite; Urine oxalate markedly elevated 173.0 mmol/mol creatinine (ref 8.9–67.0) [b842] — consistent with absent Oxalobacter formigenes; 5-Hydroxyindoleacetic Acid elevated 9.1 mmol/mol creatinine (ref ≤2.9) [b1279]; Dopamine producer level severely low [b2946]; Arabinose elevated [b2379]

*Nutritional sequelae of severe EPI:* Iron low in hair [b633]; Ferritin low 17.7–19.0 µg/L [b2495][b1280]; multiple mineral deficits (Zinc, Chromium, Phosphorus, Silicon) [b399][b2548][b1948][b1855]; Vitamin C in urine 0.0 mmol/mol creatinine (ref 10–200) [b794]; Pyridoxic acid below mean [b2878]

Clinical Significance

Severe EPI (elastase 85 mcg/g) is a clinically significant finding that warrants urgent gastroenterology evaluation. It compounds the already severely disrupted gut microbiome — fat malabsorption contributes to altered bile acid metabolism that further disrupts beneficial bacteria. The Akkermansia depletion (0.001% — virtually absent) is particularly significant, as Akkermansia is a critical gut barrier-protective species. Methane SIBO on breath test, Proteus mirabilis 4+ overgrowth, and Clostridium excess represent multiple simultaneous pathogenic processes. The absent Oxalobacter directly explains marked urinary oxalate elevation, raising kidney stone risk — particularly relevant given the concurrent eGFR decline.

#4

Rapidly Declining Kidney Function

CKD Stage G2 with Accelerated Progression

High
Active rapidly worsening urgent nephrology evaluation warranted given rate of decline
Key Evidence

*eGFR trajectory:* >90 mL/min (Jun 2025) [b1174] → 87 mL/min (Sep 2025) [b1175] → 70 mL/min (Nov 2025) [b1016] — decline of ~20 mL/min in 5 months (annualized ~40 mL/min/year; ~23% reduction from baseline >90), exceeding the KDIGO 2024 rapid progression threshold of >20% eGFR change [w114]; classifies as Stage G2 CKD

*Supporting kidney damage markers:* Proteinuria (qualitative, undated) [b2959]; Glomerular Filtration Rate Low (qualitative) [b966]; Kidney biological age 60.2 Years (ref 54.4) [b2144]; Kidney biological age (blood) 57.8–60.3 Years over 2025 [cb1594]

*Contributing factors:* Hyperinsulinemia with HOMA-IR ~6.5 (insulin resistance is an independent CKD progression risk factor [w111]); Severe EPI with malnutrition; Hyperoxaluria (urine oxalate 173 mmol/mol creatinine [b842]) — oxalate nephropathy risk; Ferritin low 17.7–19.0 µg/L [b2495][b1280]; Haptoglobin low 0.26 g/L [b2790]; D-Dimer elevated 570 ng/mL [b1779] — possible hypercoagulable state amplifying nephropathy

*Note:* Formal CKD diagnosis per KDIGO 2024 requires confirmatory markers (urine ACR ≥A2 or structural abnormality) sustained ≥3 months [w112]. Given the rate of decline and eGFR of 70, this represents urgent clinical concern pending formal workup

Clinical Significance

An eGFR decline of ~23% over 5 months — exceeding the KDIGO 2024 rapid progression threshold of >20% eGFR change [w114] — is consistent with an acute-on-chronic process warranting urgent nephrology evaluation per KDIGO 2024 and UK Kidney Association guidelines [w112]. Key contributing mechanisms include hyperoxaluria (driven by absent Oxalobacter and Akkermansia depletion), hyperinsulinemia-driven glomerular hypertension, and possible malnutrition-related tubular injury. CKD also independently accelerates telomere attrition, creating a bidirectional vicious cycle [w149].

Medical Timeline: The Evolution of Disease

1-Year Disease Progression
2024 Genetic & Epigenetic Risk Profiling — Latent Dangers Mapped
2024 First Functional Deficits Identified — NAD and Cellular Energy
2025 Organ Aging Assessment + Bariatric Surgery + Musculoskeletal Diagnosis
2025 Multi-Pathogen Infectious Burden Revealed + Metabolic Dysregulation Emerges
2025 Metabolic Nadir — eGFR Plunges, NAD and NADPH Depleted
2025 Coagulation, Autoimmune & Hepatic Signals + Gut Culture Confirmed
2025 Stabilization Attempts — Partial Normalization, Ongoing Deficits
Click to expand detailed journey
Critical
Progressing
Emerging
🚨 Critical/Urgent
⚠️ Warning
✅ Normal/Positive

2024 (Jan–Jul): Genetic & Epigenetic Risk Profiling — Latent Dangers Mapped

Age 53-54 EMERGING
JANUARY Initial Aging Baseline
MARCH Inflammatory Aging Signal
JULY Genetic Risk Mapping
January — Initial Aging Baseline
✅ Chronological age 53 at testing
• SYMPHONY age 54.7 Years (normal) [b2941]
⚠️ OMICm biological age 59.0 Years (ref 54.4) — 4.6-year biological age gap present from earliest data point [b2604]
March — Inflammatory Aging Signal
⚠️ Symphony Age (Blood) 58.6 Years (elevated), Symphony Age (Inflammation) 58.0 Years [b2877][b1248]
July — Genetic Risk Mapping
⚠️ Tobacco addiction genetic risk 82nd percentile [b2914]
• BMI genetic predisposition Higher [b276]
⚠️ Genetic elevated risks:
• Colorectal cancer [b2667], Lung cancer [b2307], AAA [b1311]
• Exfoliation glaucoma Very Elevated [b2557]
• Fuchs' corneal dystrophy Elevated [b2752]
⚠️ IL-6 genetic predisposition Higher [b240]
• Von Willebrand Factor genetic predisposition Much Lower [b1678]
✅ Polygenic risk score for CAD:
• Reduced (protective) [b2837]
• Polygenic risk for T2DM: Reduced [b2666]
Clinical Significance

The patient entered the observation window with an already-elevated biological age and multiple genetic risk flags — particularly for inflammatory tone (IL-6 predisposition), pulmonary cancer, colon cancer, and ophthalmologic conditions. The reduced polygenic CAD risk is a notable protective counterpoint.

First functional deficit identified →

2024 (Nov–Dec): First Functional Deficits Identified — NAD and Cellular Energy

Age 54 EMERGING
November — Cellular Energy Deficit
🚨 Intracellular NAD critically low: 20.3 µM (ref 40.0–100.0) — half the lower reference limit [b2085]
December — Metabolic Screening
⚠️ Vitamin D3 High
• Calcium elevated (bioresonance screening, non-validated methodology) [b2884][b2210]
✅ Sleep impairment low (favorable)
• Exercise and fat loss response Low genetic trait [b1397][b2341]
Clinical Significance

The NAD deficit — identified over a year before most clinical diagnoses — suggests long-standing mitochondrial and cellular energy compromise. This may be the earliest measurable functional deficit in the record.

Global organ aging acceleration →

2025 (Jan–May): Organ Aging Assessment + Bariatric Surgery + Musculoskeletal Diagnosis

Age 54-55 PROGRESSING
JANUARY Multi-Organ Aging Acceleration
FEBRUARY Dysbiosis Onset
MAY Surgical & Pathogen Convergence
January — Multi-Organ Aging Acceleration
⚠️ All organ system biological ages above reference (54.4 Years):
• Hormone 62.3 [b1709]
• Kidney 60.2 [b2144]
• Immune 59.0 [b1375]
• Blood 58.6 [b2465]
• Metabolic 58.2 [b2394]
• Lung 57.9 [b1728]
• Liver 57.1 [b487]
⚠️ Phenylacetylglutamine dysbiosis marker: 82.1 percentile (ref >80) — first signal of gut dysbiosis [b1781]
⚠️ Memory CD8 T Cell Percentage: 96.8% (elevated) — first evidence of immune senescence [b1216]
February — Dysbiosis Onset
⚠️ Gut microbiome assessment:
• Akkermansia 0.001% (ref 0.02–3.0) [b698], Bifidobacterium 0.108% (ref 2.5–5.0) [b638], Lactobacillus 0.005% (ref 0.01–0.5) [b677], Roseburia 2.284% (ref 5.0–11.0) [b795]
• Proteobacteria elevated 7.615% (ref 0.0–4.0) [b2559]
• Bacteroides elevated 27.476% (ref 5.0–20.0) [b933]
May — Surgical & Pathogen Convergence
⚠️ Telomere biological age:
• 72.7 Years (ref ≤54.4) — a 17.7-year gap [b1457]
• OMICm Fit Age 62.2 Years [b2829]
⚠️ VO2 Max:
• 17th percentile (low) [b2233]
• Grip Strength: 39th percentile (ref ≥50) [b767]
⚠️ Bariatric surgery performed [p0]
• Post-operative: Mitochondrial Efficiency 26 (low, ref 46–65 optimal) [b805]
• Glycan Median Index 86.0 (elevated) [b451]
⚠️ Bilateral shoulder pathology diagnosed:
• Right supraspinatus tendinosis/partial tear [d8]
• Infraspinatus partial tear [d14]
• Bilateral subacromial bursitis [d9][d11]
• Cervical disc bulge C5/6 and C6/7 [d12]
⚠️ Lyme IgG ImmunoBlot positive (IGX criteria) [b2161]
• Bartonella IgM positive [b442][b1909] — first tick-borne serology panel
Clinical Significance

This era reveals a patient with globally accelerated organ aging (all organ systems above chronological reference), severely compromised gut microbiome architecture, critically low physical fitness, and active/recent tick-borne pathogen serology positivity — all converging around the time of bariatric surgery.

Infectious and neuroendocrine crisis →

2025 (Jun–Jul): Multi-Pathogen Infectious Burden Revealed + Metabolic Dysregulation Emerges

Age 55 PROGRESSING
June — Metabolic & Toxic Load
⚠️ First comprehensive blood panel:
• WBC low 3.7 x10^9/L [b177], Lymphocytes low 1.3 x10^9/L [b1262]
• Insulin elevated 28.0 uIU/mL (ref 3–25) [b2454]
• FIB-4 1.84 (indeterminate zone) [b117]
⚠️ Hair mineral analysis (non-validated test; requires blood/urine confirmation): Mercury 2.1 µg/g (ref ≤0.8) [b1661], Aluminum 18.0 µg/g (ref ≤7.0) [b2240], Cadmium 0.12 µg/g (ref ≤0.065) [b1245]
⚠️ Leptin elevated:
• 88th percentile [b839]
• Glyphosate elevated: 89th percentile [b301]
• PFAS borderline elevated [b2850]
⚠️ Acute infection/inflammation diagnosed [d7]
July — Immune & Adrenal Crisis
⚠️ IgE markedly elevated:
• 404.0 kU/L (ref ≤100.0) [b796]
• Triglycerides 2.1 mmol/L (ref ≤2.0) [b1889]
• FIB-4 worsening 2.01 [b116]
• DHEA-S acutely low 1.9 umol/L (ref 3.7–12.2) [b2397]
🚨 Viral EliSpot panel:
• CMV Lytic 61 SI, CMV Latent 160 SI (ref 0–1) [b1756][b1081]
• Mycoplasma EliSpot 5 SI (ref 0–1) [b2619]
• VZV EliSpot 3 SI [b563]
• Chlamydia pneumoniae EliSpot 2 SI [b2535]
⚠️ Full viral serology:
• EBV (all IgG including EA p54 reactivation marker [b25]), VZV IgA elevated 1.529 (ref ≤0.8) [b1522] + IgG 3702 IE/L (ref ≤80) [b1811] — consistent with subclinical VZV reactivation [w85]
• HSV 1/2 IgG elevated 31.92 U/ml [b949]
• HHV-6 IgG 1:320 (ref <1:10) [b1372]
• Mycoplasma pneumoniae IgG+IgA positive [b432][b1162]
• Toxoplasma IgG elevated [b2621]
• Schistosoma IgG elevated (likely false positive/cross-reactivity in non-endemic setting [w137]) [b1985]
🚨 Adrenal axis:
• Free Cortisol 1st Morning 51.14 µg/g Cr (ref 7.8–29.5) [b1327], 2nd Morning 94.69 µg/g Cr (ref 23.4–68.9) [b300]
• Norepinephrine all timepoints severely low: 1st Morning 4.11 µg/g Cr (ref 9.4–22.0) [b2201], 2nd Morning 2.32 (ref 12.6–38.2) [b1567], Night 10.2 (ref 16.9–38.8) [b2545]
• Melatonin 1st Morning 4466.06 µg/g Cr (ref 10.1–26.0, ~170× upper limit — likely exogenous supplementation) [b1797]
🚨 Chronic excess cortisol diagnosed [d5]
• Severe adrenal medulla exhaustion diagnosed [d6]
⚠️ Hematocrit elevated 52.5% (ref 40–51) [b1799]
• MCV elevated 112.7 fL (ref 80–96) [b1594]
• CD8 CD28-negative senescent T-cells 58% (ref 4–51) [b2005]
• NK CD57+ low 70/µL (ref 100–360) [b488]
Clinical Significance

This is the most acute and diagnostically dense period. It reveals simultaneous neuroendocrine dysfunction (HPA-SNS dissociation with adrenal medulla exhaustion), active/recent multi-pathogen immune burden (Mycoplasma active, VZV reactivation, CMV load), severe insulin resistance (HOMA-IR ~6.5), and immune senescence markers — all converging.

Renal and metabolic nadir →

2025 (Aug–Sep): Metabolic Nadir — eGFR Plunges, NAD and NADPH Depleted

Age 55 PROGRESSING
August — Aging Acceleration Confirmed
⚠️ OMICm Age normalizes to 54.0 Years [b2599] — partial improvement in epigenetic clock
🚨 Pace of Aging worsens to 1.2 (ref ≤1.0) — acceleration confirmed [b401]
• VO2 Max declines to 7th percentile [b2232]
September — Renal & Energy Collapse
🚨 eGFR acutely drops to 87 mL/min/1.73m² [b1175], then to 70 mL/min/1.73m² by Nov [b1016] — decline of ~20 mL/min in 5 months (~23% drop from baseline >90), exceeding KDIGO 2024 rapid progression threshold of >20% eGFR change [w114]
⚠️ Glucose low 3.0 mmol/L (ref 3.9–6.0) [b606]
• Insulin simultaneously elevated 30.2 uIU/mL [b2456] — hyperinsulinemia-driven hypoglycemia
🚨 NAD 15.2 nmol/ml (ref 20–42) [b2822]
• NADPH 4.3 nmol/ml (ref 7.5–21) [b264]
• NADP/NADPH ratio elevated 2.7 (ref 0.5–2.0) [b1864]
• Citrate Synthase markedly elevated 42.96 nanomoles/min/mg (ref 4.4–22.0) [b2962]
Clinical Significance

The eGFR drop of 20 mL/min in 6 months with concurrent NAD/NADPH depletion signals significant metabolic-energetic compromise occurring in parallel. The low glucose + high insulin combination suggests post-bariatric hyperinsulinemia with reactive hypoglycemia.

Gastrointestinal and structural confirmation →

2025 (Oct–Nov): Coagulation, Autoimmune & Hepatic Signals + Gut Culture Confirmed

Age 55 PROGRESSING
October — Autoimmune & Structural Signals
⚠️ RF elevated 22.7 IU/mL (ref ≤14) — low positive, likely viral-driven [b824]
• D-Dimer elevated 570 ng/mL (ref 0–500) [b1779]
• aPTT short 17.2 seconds (ref 22.9–32.1) [b1688]
⚠️ Haptoglobin low 0.26 g/L (ref 0.4–2.4) [b2790]
• Ferritin low 17.7 µg/L (ref 22–322) [b2495]
✅ DHEA-S normalized to 3.9 umol/L [b2399]
• Progesterone normalized to 1.55 nmol/L [b2218]
⚠️ C5/C6 spondylosis confirmed on imaging [d1]
• MGD diagnosed bilaterally [d3]
November — Severe Gut Dysfunction
⚠️ Pancreatic Elastase severely low:
• 85 mcg/g (ref ≥200) [b705] — classifies as severe EPI [w141]
• Dientamoeba Fragilis DNA positive [b2549]
⚠️ Methane SIBO positive:
• 16.0 ppm (ref ≤10) [b2477]
• Intracellular NAD partially improved to 33.7 µM but still below range [b2084]
🚨 NK Cell Count elevated 250 cell/µL (ref 17–183) [b2222]
• Clostridium species 82.08 x10^7 CFU/g (ref 5–50) [b2871]
⚠️ Pancreatic insufficiency formally diagnosed [d2]
• Cervical spondylosis multilevel disc prolapse confirmed [d0]
• Right supraspinatus 25–50% partial tear confirmed [d4]
⚠️ Stool culture:
• Proteus Mirabilis 4+ (ref <4+) [b1001]
• Multiple beneficial species confirmed depleted [b99][b105][b2117][b2647][b2020][b2606][b2793][b1035] (Nov/Dec)
Clinical Significance

This era confirms severely disrupted gut microbiome architecture (severe EPI, pathogenic overgrowth, methane SIBO) alongside structural musculoskeletal diagnoses and emerging coagulation/autoimmune signals. The NK cell surge may reflect ongoing viral immune surveillance.

Stabilization attempts begin →

2025 (Dec): Stabilization Attempts — Partial Normalization, Ongoing Deficits

Age 55 PROGRESSING
⚠️ eGFR 70 mL/min — persisting low [b1016]
• Ferritin 19 ng/mL — persisting low [b1280]
✅ MCV normalized to 94 fL [b1595]
• WBC stable 4.4 x10^9/L [b180]
• RF slightly improving 18.0 IU/mL [b823]
⚠️ ApoB low 0.49 G/L (ref 0.63–1.33) [b879]
• Triglycerides normalized to 1.1 mmol/L [b1891]
⚠️ Persistent gut pathogen burden confirmed:
• Clostridium elevated [b2317]
• Multiple Lactobacillus and Bifidobacterium species low [b2793][b2606][b2647]
Clinical Significance

Some biomarkers are partially normalizing (likely through intervention), but fundamental deficits in kidney function, gut architecture, and energy metabolism persist. The overall trajectory remains one of high-complexity multi-system disease requiring structured intervention.

The Biological Story

Central Pathophysiology

This patient's multi-system presentation converges on two interacting biological cores: a chronic multi-pathogen immune burden driving immune senescence, and a fundamental cellular energy crisis rooted in NAD depletion, mitochondrial inefficiency, and severe gut-pancreatic disruption. The HPA-SNS neuroendocrine axis has become uncoupled — with chronic cortisol excess suppressing catecholamine synthesis — creating a stress-hormonal milieu that amplifies insulin resistance, promotes visceral adiposity, and accelerates telomere attrition. Severely disrupted gut microbiome (nearly absent Akkermansia, severe EPI, methane SIBO, Proteus/Clostridium overgrowth) disrupts nutrient absorption, generates pro-inflammatory metabolites (phenylacetylglutamine, D-lactate), and produces hyperoxaluria that likely contributes to the acutely declining kidney function. Bariatric surgery attempted to interrupt the metabolic cascade but has not resolved the underlying insulin resistance (HOMA-IR ~6.5), suggesting that deeper metabolic-infectious-energetic drivers remain active.

Condition Relationships

Root
Critical
Warning
Neutral
Drives / Worsens
Allows / Impairs

Hover over nodes to explore connections, or edges for mechanism details

Scroll to zoom in/out · Click and drag to pan

Cross-Condition Interactions 17
View details
Condition A Affects Condition B Mechanism
Multi-Pathogen Infectious Burden Drives Immune Senescence Chronic antigen stimulation exhausts naive T-cell pool, expanding terminally differentiated senescent CD8 cells [w107]
Immune Senescence Impairs Pathogen Clearance Impairment Reduced NK CD57+ and naive T-cells impair first-line pathogen surveillance and vaccine response
Multi-Pathogen Infectious Burden Drives HPA Cortisol Excess
  • Chronic infection activates HPA via IL-6 and CRH
  • Consistent with IL-6 genetic predisposition Higher [b240]
HPA Cortisol Excess Worsens Catecholamine Exhaustion
  • Pattern consistent with HPA-SNS dissociation, analogous to reduced cortisol clearance and SNS suppression described in prolonged physiological stress (NEJM 2013 [w129])
  • May reduce effective PNMT co-factor availability for epinephrine synthesis
HPA Cortisol Excess Worsens Insulin Resistance Glucocorticoids increase hepatic gluconeogenesis and peripheral glucose uptake resistance, driving compensatory hyperinsulinemia [w98]
Insulin Resistance Worsens CKD Progression
  • Hyperinsulinemia causes glomerular hypertension and hyperfiltration injury
  • Insulin resistance is an independent CKD progression risk factor (OR 1.80 [w111])
Gut Dysbiosis / EPI Dysfunction Drives Hyperoxaluria
  • Absent Oxalobacter formigenes fails to degrade intestinal oxalate
  • Urine oxalate 173 mmol/mol [b842] deposits in renal tubules
Gut Dysbiosis / EPI Dysfunction Worsens Insulin Resistance
  • Depleted Akkermansia reduces GLP-1 secretion and gut barrier integrity
  • EPI impairs nutrient signaling
  • Dysbiotic metabolites (LPS from Proteobacteria) drive hepatic insulin resistance
Gut Dysbiosis / EPI Dysfunction Creates Malnutrition Fat-soluble and micronutrient malabsorption from lipase/enzyme deficiency [w141]
Malnutrition Worsens Mitochondrial Dysfunction
  • NAD precursor (niacin/tryptophan) absorption impaired
  • Iron deficiency compromises electron transport chain complexes I–IV
NAD Depletion Worsens Accelerated Telomere Aging / Pace of Aging
  • NAD is essential for SIRT1/SIRT6 deacetylase activity that protects telomeres and DNA repair
  • NAD depletion accelerates telomere shortening [w152]
Accelerated Telomere Aging / Pace of Aging Worsens CKD Progression Short telomeres associated with 14% higher CKD mortality per 0.1-unit decrease in relative TL [w149]
Multi-Pathogen Infectious Burden Increases IgE / RF / Autoimmune Signals Chronic viral infection (CMV, EBV) drives polyclonal B-cell activation, producing non-specific RF and IgE elevation [w154]
HPA Cortisol Excess Impairs Gut Dysbiosis / EPI Dysfunction Glucocorticoids reduce intestinal mucus production and tight junction integrity, facilitating Proteobacteria expansion
Environmental Toxins (Glyphosate, PFAS) Worsens Gut Dysbiosis / EPI Dysfunction
  • Glyphosate inhibits EPSPS pathway in commensal bacteria (Bifidobacterium, Lactobacillus) while sparing Proteobacteria
  • PFAS disrupts bile acid metabolism critical for Akkermansia colonization
Insulin Resistance Worsens Liver Fibrosis Risk
  • Hepatic steatosis from insulin resistance drives MASLD cascade
  • FIB-4 1.84–2.01 in indeterminate zone [w122]
Environmental Toxins (Glyphosate, PFAS) Worsens Insulin Resistance Both are established endocrine disruptors impairing insulin signaling at receptor and post-receptor levels

Detailed Findings by System

Gastrointestinal & Pancreatic

20 CRITICAL

Diagnoses

Diagnosis Date Status Citation
Pancreatic insufficiency 2025-11-18 Chronic [d2]
Infection/inflammation 2025-06-23 Acute [d7]

Key Biomarkers

Marker Date Value Reference Status Citation
Pancreatic Elastase 2025-11-07 85.0 mcg/g ≥200.0 Low [b705]
Methane Peak Level 2025-11-17 16.0 ppm ≤10.0 Elevated [b2477]
Proteus Mirabilis Growth 2025-12-03 4+ <4+ Elevated [b1001]
Clostridium Species 2025-11-25 82.08 ×10⁷ CFU/g 5.0–50.0 Elevated [b2871]
Dientamoeba Fragilis DNA 2025-11-07 Positive Negative Positive [b2549]
Akkermansia Abundance 2025-02-24 0.001% 0.02–3.0 Low [b698]
Bifidobacterium Abundance 2025-02-24 0.108% 2.5–5.0 Low [b638]
Lactobacillus Abundance 2025-02-24 0.005% 0.01–0.5 Low [b677]
Proteobacteria Abundance 2025-02-24 7.615% 0.0–4.0 Elevated [b2559]
Bacteroides 2025-02-24 27.476% 5.0–20.0 Elevated [b933]
D-Lactate Producer Level 2025-02-24 1.69% ≤1.0 Elevated [b2653]
Oxalobacter Abundance 2025-02-24 0.0% 0.001–0.2 Low [b704]
Roseburia Abundance 2025-02-24 2.284% 5.0–11.0 Low [b795]
Dopamine Producer Level 2025-02-24 0.019% 0.03–6.5 Low [b2946]
Oxalic (Urine) 2025-07-29 173.0 mmol/mol creatinine 8.9–67.0 Elevated [b842]
5-Hydroxyindoleacetic Acid (Urine) 2025-07-29 9.1 mmol/mol creatinine ≤2.9 Elevated [b1279]
Arabinose (Urine) 2025-07-29 21.0 mmol/mol creatinine ≤20.0 Elevated [b2379]
Phenylacetylglutamine (Dysbiosis Marker) 2025-06-24 82.0 percentile 0.0–80.0 Elevated [b2550]

Biomarker Trends

Akkermansia Abundance [in Stool] [cb486]
→ Persistently near-zero
Persistently near-zero across both assay methods
Phenylacetylglutamine [in Blood] [cb1276]
~ Fluctuating
Fluctuating near upper threshold: 82→82→89 percentile

Clinical Interpretation

Pancreatic elastase 85 mcg/g [b705] constitutes exocrine pancreatic insufficiency (EPI) — fecal elastase <100 mcg/g represents \"good evidence of EPI\" per AGA 2023 guidelines and qualifies as severe EPI under the traditional UEG/HaPanEU classification (<100 mcg/g threshold; sensitivity 88–100% at this level). Severe EPI carries a risk of fat-soluble vitamin (A, D, E, K) and micronutrient malabsorption, as evidenced by low ferritin [b2495], low zinc [b399], low phosphorus [b1948], and absent urinary vitamin C [b794]. The formal diagnosis of pancreatic insufficiency [d2] was made November 2025; PERT (enzyme replacement therapy) is indicated. There is no documentation of PERT initiation in the current record. Concurrently, methane SIBO 16.0 ppm [b2477] exceeds the positive threshold of 10 ppm, and Proteus mirabilis 4+ overgrowth [b1001] combined with Clostridium 82.08 ×10⁷ CFU/g [b2871] (>1.6× upper limit) confirms multi-pathogen gut colonization. Dientamoeba fragilis DNA positive [b2549] adds a protozoan component.

The beneficial microbiome architecture is severely degraded: Akkermansia is virtually absent (0.001–0.0%) [b698][b699] — a gut barrier-critical commensal — and both Bifidobacterium (0.108% vs 2.5–5.0%) [b638] and Lactobacillus (0.005% vs 0.01–0.5%) [b677] are approximately 20× below reference. Oxalobacter formigenes is absent (0.0%) [b704], directly explaining markedly elevated urinary oxalate 173 mmol/mol creatinine [b842] (2.6× upper limit), which increases kidney stone risk and likely contributes to the observed eGFR decline [b1016]. The 5-HIAA elevation (9.1 mmol/mol [b1279]) in urine reflects increased serotonin turnover from gut dysbiosis. The D-lactate producer excess (1.69% [b2653]) raises a concern for D-lactic acidosis with high-carbohydrate loads. The Gut Wellness Score of 75.95 [b1498] and overall probiotic percentage (57–58% [cb1374]) offer partial reassurance that the ecosystem has not completely collapsed, but multiple specific bacterial populations remain critically depleted.

Genetic cancer risk note: Elevated genetic risk for colorectal cancer [b2667] and lung cancer [b2307] are documented from genomic profiling. While the polygenic risk for pancreatic cancer is Reduced [b900], the presence of active severe EPI [d2] and pancreatic structural stress independently raises the clinical threshold for pancreatic surveillance (CA 19-9 and cross-sectional imaging if not already performed). Colorectal risk warrants adherence to colonoscopy screening guidelines; lung cancer risk is relevant given the tobacco addiction genetic predisposition at the 82nd percentile [b2914]. Reassuringly, bladder and thyroid cancer polygenic risks are Reduced.

Treatment Plan

Acute/initiation phase (Months 0-3)

Current Medications Review

Medication Condition Decision Rationale Cross-Condition Impact
CREON
dose unknown
 Pancreatic insufficiency [d2] OPTIMIZE
  • •Dose likely insufficient (target 40,000–50,000 lipase units/main meal post-bariatric)
  • •PERT prerequisite for all fat-soluble absorption
  • •Reduces hyperoxaluria cascade
  • •Enables CoQ10/Vit D/E/K absorption
  • •Improves insulin resistance via nutrient correction
Melatonin ~10–20 mg/day
inferred supplement
 Sleep support (inferred) REDUCE URGENTLY
  • •~172× urinary ULN [b1797] — cannot be endogenous
  • •High doses paradoxically worsen HPA axis in older males [w429]
  • •Confounds all neuroendocrine testing [w559]
  • •Confounds Cushing's workup
  • •May worsen cortisol dysregulation
  • •AASM CPG supports ≤3 mg maximum [w416]
NAD+ precursors — NR/NMN
inferred
 Mitochondrial dysfunction CONTINUE & OPTIMIZE
  • •Intracellular NAD improving 20.3→33.7 µM [b2085→b2084]
  • •Still below 40 µM threshold
  • •Dose guidance per eGFR 70: NR 500 mg/day (safe to 2,000 mg/day [w1925])
  • •NMN cap 500 mg/day (uremic toxin risk ≥1.5 g at eGFR 70 [w1924])
  • •NAD+ supports SIRT1/SIRT6 telomere maintenance
  • •Reduces CD38-driven immune senescence
  • •Supports renal tubular energy

Contraindicated Medications

Medication Why Contraindicated Affected Conditions Alternative
Systemic NSAIDs
  • •Class HR 1.71 for eGFR <60 [w1731]
  • •Worsens CKD
  • •Post-bariatric marginal ulcer risk
 CKD G2, bariatric anatomy
Acetaminophen ≤3 g/day
reduced post-bariatric
Saccharomyces boulardii
  • •Fungemia OR ~14 with cortisol excess [d5] immunosuppression
  • •29–50% mortality [w754]
 Cortisol excess
Low-threshold C. difficile toxin testing strategy instead
Neomycin (oral, for SIBO)
  • •RYGB increases bioavailability 2–3× [w739]
  • •Nephrotoxic aminoglycoside
  • •eGFR 70 amplifies AKI risk
 CKD G2, bariatric anatomy
Metronidazole 500 mg TID
preferred 2nd SIBO agent
Metformin (during active infection)
  • •FDA Boxed Warning for lactic acidosis
  • •Warnings & Precautions section: withhold during illness compromising renal function (including sepsis)
  • •MALA mortality ~25–36% in modern series [w617]
 Active infection [d7]
Defer until infection resolved and eGFR reconfirmed stable
Extended-release oral metformin Poorly absorbed post-bariatric surgery Post-bariatric [p0]
  • •Immediate-release only
  • •Reduced starting dose
bioavailability ↑50% post-bariatric
Cadmium chelation (EDTA/DMSA for Cd) Mobilizes cadmium to kidneys → acute tubular necrosis [w1957] CKD G2
  • •Exposure elimination
  • •Zinc supplementation
to compete at DMT-1 transporter
BAL (British Anti-Lewisite) Redistributes methylmercury to CNS [w1985] Any mercury exposure
DMSA
deferred — pending blood mercury confirmation and toxicologist oversight
Cidofovir (for HHV-6)
  • •Directly nephrotoxic
  • •Contraindicated at eGFR 70 [w652]
 CKD G2
Foscarnet
  • •With nephrology co-management
  • •Only if HHV-6 life-threatening
Rapamycin
  • •eGFR declining (nephrotoxicity/proteinuria [w1876])
  • •Worsens insulin resistance via mTORC2 [w1874]
  • •Harmful in short-telomere models [w1843]
 CKD G2, IR, telomere age
Defer until eGFR >80, HOMA-IR <3.0
then re-evaluate
Clarithromycin
  • •CYP3A4 inhibitor: contraindicated with finerenone [w479]
  • •Macrolide QT risk
  • •Eradicates Oxalobacter formigenes [w577]
 CKD, hyperoxaluria, cardiac
Doxycycline IR
  • •For Mycoplasma
  • •No QT
  • •No renal adj. at G2
  • •Preserves Oxalobacter better
CYP3A4-metabolized statins (simvastatin, atorvastatin, lovastatin) Rhabdomyolysis risk if ketoconazole or mifepristone ever co-prescribed (Cushing's treatment) Potential future CS pharmacotherapy
Rosuvastatin or pravastatin
non-CYP3A4
Particulate methylprednisolone (cervical transforaminal) Embolic stroke risk [w1734] Musculoskeletal
Non-particulate dexamethasone only
for any cervical epidural
OGTT (post-bariatric) Contraindicated post-bariatric: rapid gastric emptying gives false results [w1595] Metabolic workup
Mixed Meal Tolerance Test (MMTT)
with GLP-1, insulin, C-peptide instead

Prognosis

Expected health trajectory based on current data
Positive Findings — Clinical factors supporting a favorable outcome
  • Partial NAD+ response to supplementation
    • Intracellular NAD improved 66% (20.3 → 33.7 µM [b2085→b2084]) — suggests reversibility
  • Normalized OMICm epigenetic age
    • Normalized to 54.0 years (Aug–Sep 2025 [b2599]) — epigenetic clock responds faster than other aging metrics
  • Grip strength improvement into normal range
    • Crossed into normal range (39th → 52nd percentile [b767→b766]) — functional improvement during interventional period
  • Significant improvement in immune biological age
    • Improved 66.3 → 58.7 years [cb1790] — sustained 7.6-year improvement over 7 months suggests immune system responds to treatment
  • Partial recovery of DHEA-S levels
    • Recovered from nadir 1.9 → 3.9–3.1 µmol/L [b2397→b2398] — adrenal cortical reserve partially restored
  • Normalization of RF, triglycerides, and MCV
    • RF trending down 22.7 → 18.0 IU/mL [b824→b823]
    • Triglycerides normalized to 1.1 mmol/L [b1891]
    • MCV normalized to 94 fL [b1595]
  • Stable WBC and absence of hepatic fibrosis
    • WBC stabilized within normal range 4.4 ×10⁹/L [b180] after initial lymphopenia
    • FibroTest 0.10 (METAVIR F0 — no fibrosis)
    • LiverFAST steatosis 0.24 (rule-out threshold) — liver reassuringly not fibrotic
  • Protective polygenic risk score for CAD
    • Polygenic risk score for CAD is Reduced (protective) [b2837] — meaningful counterbalance to metabolic risk
  • Improving telomere age trend
    • Improving (72.7 → 68.2 years [b1457→b1456]) though magnitude of improvement may partly reflect measurement variability
Concerning Findings — Issues requiring attention or further investigation
  • Rapid eGFR decline meeting KDIGO rapid-progression threshold Critical
    • >90 → 70 mL/min over 5 months [b1174→b1016]
    • >20% KDIGO rapid-progression threshold met [w592]
    • uACR not formally quantified
    • Hyperoxaluria 173 mmol/mol Cr [b842] at 2.6× ULN
    • Formal CKD not yet coded
    • 54.5% ESRD rate in oxalate nephropathy series [w742] if untreated
  • Active multi-pathogen infectious burden unaddressed Critical
    • Mycoplasma triple-positive [b432][b1162][b2619]
    • Bartonella IgM+ [b442]
    • No antibiotic treatment documented
    • Each month untreated amplifies HPA cortisol excess [w581], immune senescence, and kidney stress [w585]
  • Elevated telomere biological age and accelerated pace of aging High
    • 68.2–72.7 years at chronological 55 [b1457][b1456]
    • Consistent with highest-risk mortality quartile (HR 1.26, 95% CI 1.15–1.38 [w1857])
    • VO2 max at 7th percentile [b2232] with declining trajectory
    • Pace of aging 1.2 [b401] (1.2 biological years per calendar year)
  • Persistent post-bariatric insulin resistance and prediabetes High
    • HOMA-IR ~6.5 despite bariatric surgery [p0]
    • Persistent post-bariatric insulin resistance (HOMA-IR expected 1.4–2.3 by 3–12 months [w1597])
    • HbA1c 5.9% [b2764] now in prediabetes range
    • FIB-4 1.84–2.01 in indeterminate zone
    • MASLD cannot be excluded without FibroScan
  • HPA-SNS neuroendocrine uncoupling with morning cortisol excess High
    • Morning cortisol excess [d5] (51.14 µg/g Cr [b1327]) with all-timepoint catecholamine depletion [d6] confirmed July 2025
    • Formal Cushing's workup outstanding
    • Cortisol excess independently accelerates telomere shortening 40.8% [w1908], worsens insulin resistance, impairs gut barrier, and perpetuates infectious immune permissiveness [w580]
  • Established immunosenescence and elevated IgE Moderate
    • CD8 CD28-negative senescent T-cells 58% [b2005] (ref ≤51%)
    • Memory CD8 98.5% [b1215]
    • NK CD57+ 70/µL [b488]
    • IgE 404 kU/L [b796] (4× ULN)
    • Strongyloides not yet excluded
    • Vaccine responsiveness reduced
    • CMV EliSpot 160 SI represents protective memory not disease
  • Severe gut-pancreatic disruption and dysbiosis Moderate
    • EPI [d2] may be mild functional post-bariatric form rather than severe structural (2 of 3 FE-1 normal)
    • PERT not yet confirmed initiated
    • Akkermansia virtually absent (0.001% [b698])
    • Methane SIBO 16 ppm [b2477]
    • Proteus mirabilis 4+ [b1001]
    • Ferritin 17.7–19 µg/L [b1280]
  • Worsening environmental toxin burden Moderate
    • PFAS (96th percentile [b2849], worsening)
    • Glyphosate (partially improving: 89th → 58th [b301][b2236])
    • Hair mercury 2.1 µg/g [b1661] (blood confirmation pending)
    • Post-bariatric adipose-stored PFOS mobilization ongoing [w2010]

Outcome Scenarios

— Likelihood of different health paths over the next decade

Key Determinants

— Conditions required to achieve the best possible outcome
Kidney
  • •PERT + calcium citrate + SIBO treatment halts oxalate nephropathy within 3 months
  • •uACR remains A1
  • •Nephrology initiated promptly
Infection
  • •Mycoplasma/Bartonella cleared with doxycycline 3 months
  • •VZV/EBV latent burden controlled
Metabolism
  • •HOMA-IR reaches <2.5 with semaglutide + metformin + cortisol management
Hpa
  • •Cushing's excluded or managed with osilodrostat → cortisol normalizes → downstream insulin resistance, gut permeability, and telomere attrition all improve

10-Year Outlook

— Projected trajectory if optimal conditions are met
Kidney
  • •eGFR stabilizes >75 mL/min
  • •No progression to CKD G3
Metabolism
  • •HbA1c ≤5.6%
  • •FIB-4 <1.3
Aging
  • •Telomere gap reduces to <10 years vs. chronological
  • •VO2 max >25th percentile
Overall
  • •High-quality 10-year survival
  • •Infection-free
  • •Functional musculoskeletal capacity restored

Critical Success Factor

The single most important determinant of outcome is whether the hyperoxaluria-CKD cascade is interrupted in the next 30 days — while simultaneously treating active infections without further depleting Oxalobacter.

This patient's rapid eGFR decline of ≥20 mL/min in 5 months [b1174→b1016] is already beyond the KDIGO rapid-progression threshold [w592], and the causal chain is biologically clear: absent Oxalobacter formigenes (0.0% [b704]) + post-bariatric fat malabsorption + severe EPI → urine oxalate 2.6× ULN [b842] → crystal-induced tubular necrosis [w370]. Every antibiotic course required to treat the active Mycoplasma and Bartonella infections will predictably worsen this trajectory by further depleting Oxalobacter [w550] — unless calcium citrate is prescribed with every meal and every antibiotic course simultaneously. This single co-prescription decision is more impactful than any other single intervention in this case. Concurrently, formal nephrology referral within days (not weeks) is required to obtain uACR, urine microscopy for oxalate crystals, renal Doppler ultrasound, and cystatin-C-based eGFR — four tests needed to properly characterize the lesion before it progresses. The second priority — treating Cushing's syndrome or functional HPA hyperactivation — has cascading downstream benefits for insulin resistance, gut permeability, immune senescence, and telomere attrition that cannot be achieved by any other intervention. The remaining conditions — mitochondrial dysfunction, toxin burden, musculoskeletal degeneration — are serious but manageable in a sequenced, prioritized approach once the kidney emergency and infectious burden are under control.

Treatable Cause
  • •PERT + calcium citrate + SIBO treatment halts oxalate nephropathy within 3 months
  • •uACR remains A1
  • •Mycoplasma/Bartonella cleared with doxycycline 3 months
  • •HOMA-IR reaches <2.5 with management
  • •Cushing's excluded or managed
Progressive Disease/Worst Case
  • •Untreated hyperoxaluria (≥3 additional antibiotic courses without calcium citrate protection) → oxalate nephropathy → eGFR <45 within 2 years
  • •uACR escalates to A3
  • •Undiagnosed Strongyloides → hyperinfection
  • •Confirmed Cushing's with delayed treatment

Urgent action required:

  • •Formal nephrology referral within days to obtain uACR, urine microscopy for oxalate crystals, renal Doppler ultrasound, and cystatin-C-based eGFR
  • •Prescribe calcium citrate with every meal and every antibiotic course simultaneously
  • •Formal Cushing's workup.

Long-Term Management

Maintenance phase (6+ months)

Critical Checkpoints

— Key decision milestones with branching pathways
Cushing's workup result — Checking for excessive cortisol production to determine if the cause is a specific medical condition or a general stress response. Month 2–3
If ≥2 positive first-line tests
  • •Plasma ACTH → CT adrenal vs. pituitary MRI
  • •Steroidogenesis inhibitor or surgery
if negative
  • •Reclassify to functional HPA hyperactivation
  • •Optimize ashwagandha, reduce infectious drivers
eGFR trajectory at 6 months — Monitoring kidney filtration rates and protein levels in the urine to ensure kidney health remains stable. Month 6
eGFR >70 + no uACR upgrade
  • •Continue current regimen
eGFR 60–70 + uACR A2
  • •Initiate ramipril/losartan
eGFR <60
  • •CKD G3 reclassification → all renally-cleared drug dosing revisions + nephrology-directed care
Supraspinatus tear progression — Using imaging to see if a shoulder tendon tear is getting larger and may require surgery. Month 6, 12, 18

if tear progresses beyond 50% thickness

  • •Orthopedic surgical evaluation (AAOS 2025 threshold [w1722])

Important: 10–30% full-thickness conversion rate by 36 months; 64% by 4 years for high-grade tears

mJOA reassessment (cervical DCM) — Evaluating physical function and nerve symptoms to check for worsening spinal cord compression in the neck. Every 6 months from initial assessment

Decline in mJOA from ≥15 to 12–14

  • •Urgent neurosurgical referral for C3-7 decompression
MASLD staging (FibroScan) — Measuring liver stiffness and using blood markers to check for scarring or advanced fatty liver disease. Month 2–3 (baseline)
LSM <7.0 kPa
  • •No advanced fibrosis
  • •Reassess annually
FIB-4 >2.67
  • •High-risk reclassification
LSM ≥12.0 kPa
  • •Hepatology referral
Post-SIBO gut restoration check — Testing the balance of gut bacteria after treatment for small intestinal bacterial overgrowth to ensure a healthy recovery. Month 6

if not improving

  • •Escalate probiotic protocol

Important: Stool microbiome sequencing post-treatment; Akkermansia target >0.1%

Telomere biological age — Measuring the protective caps on DNA to estimate biological aging compared to actual age. Annually

if TA-65 initiated (Month 3+ oncology screening required)

  • •Track LTL trajectory

Important: Realistic target: <65 years by Year 2 (from 68.2 [b1456])

Empagliflozin/dapagliflozin eligibility — Reviewing whether specific kidney-protective medications are appropriate based on updated lab results. Month 6

Ongoing Monitoring Schedule

— Regular tests to track treatment response and detect problems early
Kidney — Monitor kidney filtration efficiency and mineral balance to prevent chronic disease progression.
4 tests
Test Frequency Target
eGFR (creatinine-cystatin C combined) Every 3 months
  • •Slope <5 mL/min/year
  • •No single-visit decline >20%
Urine ACR (certified lab) Every 3 months
  • •Maintain A1
  • •Escalate RAAS blockade if A2
24-hour urine metabolic profile (oxalate, citrate, calcium, uric acid, volume)
  • •Every 6 months once stable
  • •Quarterly while trajectory active
 Urine oxalate <67 mmol/mol creatinine
Serum phosphate, calcium, PTH Every 6 months CKD-MBD surveillance
Metabolic — Track blood sugar control and liver health to manage metabolic risk factors.
5 tests
Test Frequency Target
HOMA-IR (fasting insulin + glucose) Every 3 months <2.5
HbA1c Every 3 months
  • •≤5.6% (prediabetes threshold: 5.7%
  • •Two consecutive ≥5.7% = confirmed prediabetes)
FIB-4; ALT; AST; GGT Every 6 months
  • •FIB-4 <1.3
  • •Normal transaminases
FibroScan (VCTE + CAP) Annually from baseline
  • •LSM <7.0 kPa
  • •CAP <248 dB/m
Triglycerides; ApoB; ApoA1; HDL Every 6 months
  • •TG ≤1.7 mmol/L
  • •ApoB within range
Hormonal — Evaluate adrenal and thyroid hormone levels to ensure proper endocrine function.
3 tests
Test Frequency Target
Morning cortisol; DHEA-S; testosterone; SHBG; progesterone Every 3 months
  • •Cortisol 145–400 nmol/L AM
  • •DHEA-S 2.7–6.5 µmol/L
24-hour UFC (maintenance)
  • •Every 6 months if diagnosis pending
  • •Annually if confirmed functional
 ≤3× ULN
TSH + FT4 + FT3 Every 6 months
  • •All within normal range
  • •PFAS thyroid monitoring
Immune/Infectious — Monitor for active infections and track markers of immune system aging and inflammation.
6 tests
Test Frequency Target
CMV PCR
  • •Every 3 months while on antivirals
  • •Every 6 months surveillance
 Undetectable
Mycoplasma EliSpot
  • •Month 2 post-treatment
  • •Then every 6 months
 Approach 0–1 SI (ref range)
CD8 CD28-negative % Every 6 months Track decline from 58% [b2005] toward ≤51%
NK CD57+ absolute count Every 6 months Track toward 100/µL (currently 70/µL [b488])
RF Every 6 months
  • •Trend to <14 IU/mL
  • •Obtain anti-CCP if persistently elevated
IgE Every 6 months
  • •Trend toward <100 kU/L (currently 404 kU/L [b796])
  • •Strongyloides IgG if still elevated
Mitochondrial/Energy — Assess cellular energy production and biological aging markers to guide longevity interventions.
4 tests
Test Frequency Target
Intracellular NAD + blood NAD + NADPH Every 3 months
  • •Intracellular NAD >40 µM
  • •Blood NAD >20 nmol/mL
  • •NADPH >7.5 nmol/mL
Pace of aging (DunedinPACE) Every 6 months <1.0 (currently 1.2 [b401])
Telomere biological age Annually
  • •Track gap reduction
  • •Target <65 years by Year 2
OMICm Fit Age Every 6 months Target <58 years (currently 60.9–62.2 [b2828])
Physical Fitness — Track cardiovascular endurance and physical strength as key indicators of overall health and mobility.
2 tests
Test Frequency Target
VO2 max percentile Every 6 months ≥15th–20th percentile (currently 7th [b2232])
Gait speed + grip strength Every 3 months
  • •Gait speed from 10th %ile toward 25th
  • •Grip strength maintain ≥52nd percentile [b766]
Toxicology — Monitor levels of environmental toxins and heavy metals to guide detoxification efforts.
4 tests
Test Frequency Target
PFAS (serum 7-compound panel, ng/mL) Annually minimum (long half-life [w1986]) Track decline from 96th percentile [b2849]
Glyphosate (blood or urine) Every 3 months Continued decline from 89th → 58th [b301][b2236]
Blood mercury (after baseline) Every 6 months
  • •<5 µg/L
  • •If chelation: before each cycle
Blood lead; urine cadmium + β₂-microglobulin Every 6 months
  • •Below action thresholds
  • •Β₂-microglobulin <300 µg/g creatinine
Nutritional — Ensure adequate levels of essential vitamins and minerals during specialized treatments.
1 test
Test Frequency Target
Full nutritional panel (Vit A, D, E, K, B12, folate, Mg, Zn, Fe/ferritin, copper)
  • •Every 3 months while on cholestyramine
  • •Every 6 months otherwise
 All within normal range
Gut — Monitor digestive health and the balance of beneficial bacteria in the intestinal tract.
3 tests
Test Frequency Target
Stool microbiome sequencing Every 6 months
  • •Akkermansia >0.1%
  • •Bifidobacterium >1%
  • •Oxalobacter restoration
SIBO breath test 6–12 months post-eradication Methane <10 ppm
Pancreatic elastase (solid stool only)
  • •Every 6 months
  • •Repeat on solid stool only
  • •>200 µg/g (normal)
  • •Or therapeutic PERT trial response
Cardiovascular — Check heart health and blood vessel integrity to manage risks of high blood pressure and aneurysms.
2 tests
Test Frequency Target
Blood pressure Every visit <130/80 mmHg
Abdominal aortic ultrasound (baseline) Once (elevated AAA genetic risk [b1311]) No aneurysmal dilation
Musculoskeletal — Monitor joint and spine health to track the status of known injuries or structural changes.
2 tests
Test Frequency Target
Right shoulder MRI or dynamic ultrasound Every 6 months No progression beyond 50% tear width [d4]
Cervical MRI
  • •At 12 months from initial diagnosis
  • •Or with any new neurological symptom
  • •No new T2 cord signal change
  • •No stenosis progression
Bone — Assess bone density to monitor for signs of weakening or osteoporosis.
1 test
Test Frequency Target
DEXA scan Annually (baseline first)
  • •T-score >-1.0
  • •Triple osteoporosis risk (EPI + bariatric + cortisol)
Ophthalmology — Regular eye exams to detect early signs of glaucoma or corneal disease.
2 tests
Test Frequency Target
IOP + gonioscopy + OCT nerve fiber layer Annually Rule out glaucomatous progression (exfoliation glaucoma Very Elevated genetic risk [b2557])
Specular microscopy (corneal endothelial density) Every 2 years Fuchs' corneal dystrophy surveillance [b2752]

Vaccinations

— Recommended immunizations based on age, conditions, and immune status
Vaccine Status Timing & Notes
Recombinant Zoster Vaccine (RZV/Shingrix) 2-dose Recommended

HIGH PRIORITY; initiate now
  • •Dose 1 immediately
  • •Dose 2 at 2–6 months
High-dose or adjuvanted influenza (FLUAD / Fluzone HD) Recommended annually
  • •Annual
  • •CD28-null host requires enhanced formulation [w651]
Pneumococcal PCV20 Recommended

immunocompromised protocol

Single dose now (if not previously received)
Updated COVID-19 booster Recommended annually

Per current guidelines
Hepatitis B (verify immune status) Check anti-HBs titer

boost if <10 IU/L
  • •Before nephrology interventions
  • •Hepatitis risk in CKD
Tetanus/diphtheria/pertussis (Tdap/Td) Verify up to date

Per standard adult schedule (every 10 years)

Preventive Screenings

— Scheduled checks to catch new issues early

Every 6 Months

Urine oxalate (24-hr) and kidney function panel

  • •Active — quarterly during acute phase
  • •6-monthly once stabilized

Glyphosate + gut microbiome

Active monitoring during dietary intervention

CMV PCR, Mycoplasma EliSpot

Active — taper to 6-monthly after confirmed pathogen clearance

Annually

DEXA bone density scan

Baseline overdue — triple osteoporosis risk

Ophthalmology (IOP, gonioscopy, OCT)

  • •Exfoliation glaucoma Very Elevated genetic risk [b2557]
  • •Initiate structured annual surveillance

Abdominal aortic ultrasound

Elevated AAA genetic risk [b1311] — baseline scan outstanding

Right shoulder MRI progression assessment

  • •Active — 25–50% tear [d4]
  • •6-monthly first 2 years, then annually

Stool microbiome (full sequencing)

  • •Semi-annual initially
  • •Annual once microbiome restored

Full toxicology panel update (PFAS, mercury, lead trend)

Annual minimum per ATSDR [w1986]

FibroScan (VCTE) liver stiffness

Annually from baseline (FIB-4 indeterminate 1.84–2.01 [b117][b116])

Every 2+ Years / One-Time

Colonoscopy

Overdue — initiate

Per elevated colorectal cancer genetic risk [b2667]; standard interval every 10 years; consider starting age 50 or earlier given genetic risk

Lung cancer screening (low-dose CT)

Initiate

Annually — eligible given tobacco addiction genetic risk 82nd percentile [b2914] + lung cancer genetic risk elevated [b2307]; USPSTF criteria: discuss with pulmonologist

Corneal specular microscopy

Schedule baseline [b2752]

Every 2 years

Prostate cancer (PSA + digital rectal exam)

  • •Standard schedule
  • •Polygenic prostate cancer risk [cb1390] requires assessment
Every 1–2 years from age 55 per ACS guidelines

CA 19-9 + cross-sectional pancreatic imaging

Schedule with gastroenterology

Once (baseline) — severe EPI + pancreatic structural stress; polygenic pancreatic cancer risk is Reduced [b900] but clinical EPI warrants low-threshold baseline

Lifestyle Maintenance Monitoring

— Day-to-day habits that support treatment outcomes
Gait speed Every 3 months
Target: Improvement from 10th percentile [b2024]

If off-target:

  • •Add physiotherapy-supervised gait training
  • •Aquatic therapy if pain limits land-based
VO2 max Every 6 months
Target: ≥15th–20th percentile (from 7th [b2232])

If off-target:

  • •Escalate to supervised HIIT if still <15th at 6 months and ECG/cardiologist clearance obtained
Body weight + waist circumference Monthly self-monitoring; every 3 months clinical
Target: Maintain bariatric benefit (trunk fat mass 2.7 kg [b458])

If weight regain >5% from bariatric nadir::

  • •Endocrinology review (cortisol excess predicts OR 1.216 weight regain [w645])
Grip strength Every 3 months
Target: ≥52nd percentile [b766] (maintain)

If off-target:

  • •Escalate upper extremity resistance program when shoulder rehab allows
Sleep quality (subjective; Epworth/PSQI) Monthly diary; clinical assessment every 6 months
Target: Sleep efficiency ≥85%

If off-target:

  • •OSA workup if ESS >10
  • •CBT-I escalation
Melatonin dose Track during taper
Target: ≤3 mg by month 2

If off-target:

  • •CBT-I referral if rebound insomnia limits taper
Dietary oxalate adherence Urine oxalate every 3 months
Target: Urinary oxalate declining toward <100 mmol/mol Cr

If off-target:

  • •Dietitian consultation
  • •Calcium citrate adherence check
Organic produce + PFAS exposure Every 3–6 months lab
Target:
  • •Glyphosate below 80th percentile
  • •PFAS declining

If off-target:

  • •Occupational exposure history review
  • •PFOS source audit

References

Citation Key

[wN] Web research
[dN] Diagnosis
[pN] Procedure
[bN] Biomarker test
[cbN] Canonical biomarker

A. Patient Evidence

A1. Canonical Biomarkers

Ref Name Unit Sample Supported By
[cb1041] Telomere Biological Age [in Blood] Years Blood [b1456], [b1457]
[cb1140] Mean Corpuscular Volume [in Blood] fL Blood [b1593], [b1594], [b1595]
[cb121] White Blood Cell Count [in Blood] x10^9/L Blood [b177], [b178], [b179], [b180], [b181]
[cb1276] Phenylacetylglutamine [in Blood] percentile Blood [b1780], [b1781], [b1782]
[cb1293] Hematocrit [in Blood] % Blood [b1799], [b1800]
[cb1350] Mitochondrial Function [in Blood] percentile Blood [b1875], [b1876]
[cb1362] Triglycerides [in Blood] mmol/L Blood [b1888], [b1889], [b1890], [b1891], [b1892]
[cb1374] Probiotics (Overall) [in Stool] % Stool [b1907], [b1908]
[cb1390] Polygenic Risk Score for Prostate Cancer (if male) [in Undetermined] N/A Undetermined [b1931]
[cb1469] Gait Speed Percentile [in Undetermined] Percentile Undetermined [b2024], [b2025]
[cb1490] Biological Age (Hormone) [in Blood] Years Blood [b2046], [b2047], [b2048], [b2049]
[cb1520] Intracellular Nicotinamide Adenine Dinucleotide [in Blood] µM Blood [b2084], [b2085]
[cb1594] Biological Age (Kidney) [in Blood] Years Blood [b2194], [b2195], [b2196], [b2197]
[cb1609] Progesterone [in Blood] nmol/L Blood [b2217], [b2218]
[cb1620] VO2 Max Percentile [in Undetermined] Percentile Undetermined [b2232], [b2233]
[cb1685] Biological Age (Blood) [in Blood] Years Blood [b2328], [b2329], [b2330], [b2331]
[cb1737] Dehydroepiandrosterone Sulfate [in Serum] umol/L Serum [b2397], [b2398], [b2399]
[cb1782] Insulin [in Serum] uIU/mL Serum [b2454], [b2455], [b2456], [b2457]
[cb1790] Biological Age (Immune) [in Blood] Years Blood [b2467], [b2468], [b2469], [b2470]
[cb1796] Systolic Blood Pressure [in Undetermined] percentile Undetermined [b2478], [b2479]
[cb1805] Norepinephrine [in Urine] µg/g Cr Urine [b2489], [b2490], [b2491], [b2492]
[cb1879] Biological Age (Heart) [in Blood] Years Blood [b2585], [b2586], [b2587], [b2588]
[cb1886] OMICm Age [in Blood] Years Blood [b2595], [b2596], [b2597], [b2598], [b2599], [b2600], [b2601], [b2602], [b2603], [b2604]
[cb2047] OMICm Fit Age [in Undetermined] Years Undetermined [b2828], [b2829]
[cb2065] Perfluorooctanesulfonate [in Undetermined] percentile Undetermined [b2849], [b2850]
[cb2136] SYMPHONY Age [in Blood] Years Blood [b2940], [b2941], [b2942], [b2943], [b2944]
[cb272] Pace of Aging [in Blood] Ratio Blood [b400], [b401], [b402], [b403], [b404]
[cb312] Heart System Age [in Undetermined] Years Undetermined [b459], [b460]
[cb425] Glucose [in Blood] mmol/L Blood [b605], [b606], [b607], [b608]
[cb486] Akkermansia Abundance [in Stool] % Stool [b698], [b699]
[cb488] Toxins [in Blood] percentile Blood [b701], [b702]
[cb537] Grip Strength Percentile [in Undetermined] Percentile Undetermined [b766], [b767]
[cb587] Rheumatoid Factor [in Blood] IU/ML Blood [b823], [b824]
[cb599] Leptin [in Blood] percentile Blood [b838], [b839]
[cb634] Apolipoprotein B [in Blood] G/L Blood [b879], [b880]
[cb667] Apolipoprotein A1 [in Blood] G/L Blood [b918], [b919]
[cb728] CD4 to CD8 Ratio (T Cells) [in Blood] Ratio Blood [b1002], [b1003], [b1004], [b1005]
[cb744] Red Blood Cell Count [in Blood] x10^12/L Blood [b1025], [b1026], [b1027], [b1028], [b1029]
[cb75] Fibrosis Score FIB4 [in Undetermined] N/A Undetermined [b116], [b117]
[cb813] Progesterone [in Serum] nmol/L Serum [b1127], [b1128]
[cb843] Estimated Glomerular Filtration Rate (CKD-EPI) [in Blood] ml/min/1.73m^2 Blood [b1174], [b1175], [b1176]
[cb84] Dehydroepiandrosterone Sulfate [in Blood] umol/L Blood [b126], [b127]
[cb872] Memory CD8 T Cell Percentage [in Blood] % Blood [b1215], [b1216]
[cb904] Lymphocytes Absolute Count [in Blood] x10^9/L Blood [b1262], [b1263], [b1264], [b1265], [b1266]
[cb984] Immune Markers [in Blood] percentile Blood [b1380], [b1381]

A2. Biomarker Tests

Ref Test Name Result Ref Range Date Status Source Page
[b25] EBV EA p54 IgG Positive Negative 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 6
[b83] Tin 0.35 <= 0.3 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b99] Akkermansia muciniphila Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 14
[b105] Oxalobacter formigenes Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 14
[b116] Fibrosis Score, FIB4 2.01 N/A <1.30 (Low risk) 2025-07-08 Abnormal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 2
[b117] Fibrosis Score, FIB4 1.84 N/A 1.30-2.67 2025-06-23 Normal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 2
[b126] DHEA - Sulphate 2.5 umol/L 2.2 - 15.2 2025-06-23 Normal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 4
[b127] DHEA - Sulphate 2.7 umol/L 3.7 - 12.2 2025-09-04 Abnormal 20250904 PWPP - non-fasting.PDF 4
[b140] Urine Protein Negative N/A 2025-10-17 - 20251017 blood test - non-fasting.PDF 12
[b171] Glycan Youth (G2) 0.187 N/A 2025-05-23 Abnormal 20250523 Glycanage.pdf 8
[b172] Iodine 3.2 0.25 - 1.8 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b177] White Blood Cell 3.7 x10^9/L 4.0 - 11.0 2025-06-23 Abnormal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 1
[b178] White Blood Cell 4.6 x10^9/L 4.0 - 11.0 2025-07-08 Normal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 1
[b179] White Blood Cell 4.2 x10^9/L 4.0 - 11.0 2025-09-04 Normal 20250904 PWPP - non-fasting.PDF 1
[b180] WBC 4.4 x10^9/L 4.0 - 11.2 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 1
[b181] White Blood Cell 4.6 x10^9/L 4.0 - 11.0 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 1
[b240] Interleukin 6 (IL-6) Level Higher N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 8
[b264] NADPH 4.3 7.5 - 21.0 2025-09-22 Abnormal 20250922 Nutripath NAD profile.pdf 1
[b276] Weight - Body Mass Index Higher N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 6
[b300] Free Cortisol (2nd Morning) 94.69 23.4 - 68.9 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 1
[b301] Glyphosate 89.0 0.0 - 80.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 25
[b307] 1-Methylnicotinamide 69.0 <= 60.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 27
[b363] Palmitoylcarnitine 96.0 5.0 - 95.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 19
[b399] Zinc 106.3 125.0-155.0 2025-11-05 Abnormal 20251105 Oligoscan_JEAN-VYES SIREAU (Spectrophotometry).pdf 1
[b400] Pace of Aging 1.0 Ratio N/A 2025-01-02 - 20250513 - Advanced TruAge Report.pdf 2
[b401] Pace of Aging 1.2 Ratio <= 1.0 2025-08-19 Abnormal 20250819 Advanced Truage report.pdf 1
[b402] Pace of Aging 0.7 Ratio N/A 2025-01-06 Normal 20250513 - Advanced TruAge Report.pdf 2
[b403] Pace of Aging 1.0 Ratio N/A 2025-01-03 - 20250513 - Advanced TruAge Report.pdf 2
[b404] Pace of Aging 0.9 Ratio N/A 2024-01-03 - 20250513 - Advanced TruAge Report.pdf 2
[b432] Mycoplasma pneumoniae IgG Antibody 0.993 <= 0.8 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 5
[b436] Energy Transport Protein 91.0 N/A 2025-09-10 Abnormal 20250819 Truhealth report.pdf 8
[b442] Bartonella Species IgM Antibody Positive N/A 2025-05-26 Abnormal 20250526 Igx test - Lyme Bartonella.pdf 8
[b449] Potassium 6.0 9.0 - 80.0 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b451] Glycan Median (G1) 86.0 N/A 2025-05-23 Abnormal 20250523 Glycanage.pdf 3
[b458] Trunk Fat Mass 2.7 N/A 2025-11-05 Abnormal 20251105 Laureate - Inbody.pdf 1
[b459] Heart System Age 55.5 Years 54.7 - 54.7 2025-01-08 Abnormal 20250819 Advanced Truage report.pdf 4
[b460] Heart Organ System Age 56.1 Years 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b478] Lyme Screen Immunoglobulin G IND Negative 2025-05-26 Abnormal 20250526 Igx test - Lyme Bartonella.pdf 4
[b487] Liver Organ System Age 57.1 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b488] CD57+ NK-cells (absolute) 70.0 100.0 - 360.0 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 2
[b563] Varicella-zoster EliSpot 3.0 0.0 - 1.0 2025-08-26 Abnormal 20250821 Arminlabs Elispot.pdf 4
[b605] Glucose 4.2 mmol/L 3.9 - 6.0 2025-06-23 Normal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 3
[b606] Glucose 3.0 mmol/L 3.9 - 6.0 2025-09-04 Abnormal 20250904 PWPP - non-fasting.PDF 3
[b607] GLUCOSE 4.4 mmol/L 3.9 - 6.0 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 2
[b608] Glucose 4.9 mmol/L 3.9 - 6.0 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 5
[b633] Iron 5.9 7.0 - 16.0 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b638] Bifidobacterium 0.108 2.5 - 5.0 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 3
[b677] Lactobacillus 0.005 0.01 - 0.5 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 6
[b682] Sulphur 46.4 48.1-52.0 2025-11-05 Abnormal 20251105 Oligoscan_JEAN-VYES SIREAU (Spectrophotometry).pdf 1
[b698] Akkermansia 0.001 % 0.02 - 3.0 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 1
[b699] Akkermansia 0.0 % >= 0.002 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 2
[b701] Toxins 42.0 percentile 41.0 - 100.0 2025-08-19 Normal 20250819 Truhealth report.pdf 2
[b702] Toxins 30.0 percentile N/A 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 4
[b704] Oxalobacter 0.0 0.001 - 0.2 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 13
[b705] Pancreatic Elastase 85.0 >= 200.0 2025-11-07 Abnormal 20251124 Pancreatic Elastase.PDF 2
[b747] Nickel 0.29 <= 0.2 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b766] Grip Strength Percentile 52.3 Percentile N/A 2025-08-19 - 20250819 Advanced Truage report.pdf 9
[b767] Grip Strength Percentile 39.0 Percentile >= 50.0 2025-05-13 Abnormal 20250513 - Advanced TruAge Report.pdf 15
[b794] Ascorbic 0.0 10.0 - 200.0 2025-07-29 Abnormal 20250729 MosaicDX organic acids.pdf 4
[b795] Roseburia 2.284 5.0 - 11.0 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 7
[b796] Immunoglobulin E (IgE) 404.0 <= 100.0 2025-07-08 Abnormal 20250708 immunology.pdf 1
[b805] Mitochondrial Efficiency 26 low: 0-45 optimal: 46-65 optimal +: 66-100 2025-05-23 Abnormal 20250523 mescreen.com results.pdf 3
[b823] RHEUMATOID FACTOR 18.0 IU/ML <= 14.0 2025-11-30 Abnormal 20251130 Pathlab Puchong.pdf 7
[b824] Rheumatoid Factor 22.7 IU/ML <= 14.0 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 10
[b838] Leptin 94.0 percentile 0-100 percentile 2025-08-19 Abnormal 20250819 Truhealth report.pdf 7
[b839] Leptin 88.0 percentile 0.0 - 80.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 19
[b842] Oxalic 173.0 8.9 - 67.0 2025-07-29 Abnormal 20250729 MosaicDX organic acids.pdf 3
[b879] APOLIPOPROTEIN B 0.49 G/L 0.63 - 1.33 2025-11-30 Abnormal 20251130 Pathlab Puchong.pdf 4
[b880] Apolipoprotein B 0.63 G/L 0.46 - 1.74 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 8
[b884] Age-Related Macular Degeneration Very Reduced N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 23
[b900] Pancreatic Cancer Risk Reduced N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 21
[b918] APOLIPOPROTEIN A1 1.29 G/L 0.94 - 1.78 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 4
[b919] Apolipoprotein A1 1.77 G/L 0.79 - 1.69 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 5
[b933] Bacteroides (Bacteroidetes) 27.476 5.0 - 20.0 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 10
[b949] Herpes Simplex Virus 1/2 Immunoglobulin G Antibody 31.92 <= 20.0 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 6
[b966] Glomerular Filtration Rate LOWER N/A N/A Abnormal screencapture-my-lifedna-reports-e9c2d724-ddbb-4d74-9dab-7995ddca7be4-2024-09-02-15_20_30.pdf 1
[b976] Dientamoeba fragilis <DL <1.00 2025-12-03 Normal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 2
[b1001] Proteus mirabilis Growth 4+ <4+ 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 8
[b1002] CD4/CD8 ratio (T Cells) 0.86 Ratio 0.9 - 2.5 2025-07-08 Abnormal 20250708 CD4 CD8.PDF 2
[b1003] CD4T/CD8T Ratio 7.1 Ratio N/A 2025-08-19 Abnormal 20250819 Advanced Truage report.pdf 7
[b1004] CD4T/CD8T Ratio 8.2 Ratio N/A 2025-01-06 Normal 20250513 - Advanced TruAge Report.pdf 12
[b1005] CD4/CD8 ratio (T Cells) 1.0 Ratio 0.9 - 2.5 2025-11-19 Normal 20251119 NK cells activity test.pdf 1
[b1016] EGFR 70.0 >= 90.0 2025-11-30 Abnormal 20251130 Pathlab Puchong.pdf 3
[b1025] Red Blood Cell 4.7 x10^12/L 4.5 - 6.5 2025-06-23 Normal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 1
[b1026] Red Blood Cell 4.73 x10^12/L 4.5 - 6.5 2025-07-08 Normal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 1
[b1027] Red Blood Cell 4.77 x10^12/L 4.5 - 6.5 2025-09-04 Normal 20250904 PWPP - non-fasting.PDF 1
[b1028] RBC 4.4 x10^12/L 4.5 - 6.0 2025-11-30 Abnormal 20251130 Pathlab Puchong.pdf 1
[b1029] Red Blood Cell 4.72 x10^12/L 4.5 - 6.5 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 1
[b1035] Lactobacillus Delbrueckii Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 13
[b1081] CMV Latent 160.0 0.0 - 1.0 2025-08-26 Abnormal 20250821 Arminlabs Elispot.pdf 4
[b1127] Progesterone 0.72 nmol/L 0.89 - 3.88 2025-07-08 Abnormal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 5
[b1128] Progesterone 0.8 nmol/L 0.89 - 3.88 2025-09-04 Abnormal 20250904 PWPP - non-fasting.PDF 5
[b1162] Mycoplasma pneumoniae IgA Antibody 1.504 <= 0.8 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 5
[b1173] Musculoskeletal Organ System Age 51.6 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b1174] Estimated - GFR (CKD-EPI) >90 ml/min/1.73m^2 >90 2025-06-23 Normal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 3
[b1175] Estimated - GFR (CKD-EPI) 87.0 ml/min/1.73m^2 >= 90.0 2025-09-04 Abnormal 20250904 PWPP - non-fasting.PDF 3
[b1176] Estimated Glomerular Filtration Rate (CKD-EPI) >90 ml/min/1.73m^2 >90 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 6
[b1215] Memory CD8T 98.5 % N/A 2025-08-19 Abnormal 20250819 Advanced Truage report.pdf 7
[b1216] Memory CD8T 96.8 % N/A 2025-01-06 Abnormal 20250513 - Advanced TruAge Report.pdf 12
[b1245] Cadmium 0.12 <= 0.065 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b1248] SYMPHONY Age (Inflammation) 58.0 N/A 2024-03-18 Abnormal 20250513 - TruAgeReport.pdf 4
[b1262] Lymphocytes (#) 1.3 x10^9/L 1.5 - 4.5 2025-06-23 Abnormal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 1
[b1263] Lymphocytes (#) 1.9 x10^9/L 1.5 - 4.5 2025-07-08 Normal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 1
[b1264] Lymphocytes (#) 1.6 x10^9/L 1.5 - 4.5 2025-09-04 Normal 20250904 PWPP - non-fasting.PDF 1
[b1265] LYMPHOCYTE 1.9 x10^9/L 1.5 - 4.5 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 1
[b1266] Lymphocytes (#) 1.5 x10^9/L 1.5 - 4.5 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 1
[b1279] 5-Hydroxyindoleacetic Acid 9.1 <= 2.9 2025-07-29 Abnormal 20250729 MosaicDX organic acids.pdf 3
[b1280] FERRITIN 19.0 22.0 - 322.0 2025-11-30 Abnormal 20251130 Pathlab Puchong.pdf 1
[b1311] Abdominal Aortic Aneurysm Risk Elevated N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 22
[b1327] Free Cortisol (1st Morning) 51.14 7.8 - 29.5 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 1
[b1372] HHV-6-AB IgG 1:320 < 1:10 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 1
[b1375] Immune Organ System Age 59.0 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b1380] Immune Markers 20.0 percentile 41.0 - 100.0 2025-08-19 Abnormal 20250819 Truhealth report.pdf 2
[b1381] Immune Markers 30.0 percentile N/A 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 4
[b1397] Sleep Impairment Low Medium 2024-12-07 Abnormal Health Action Plan - Health Enrichment - Jean-Yves Sireau.pdf 4
[b1399] Vanadium 0.069 0.018 - 0.065 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b1456] Telomere Biological Age 68.2 Years N/A 2025-08-01 - 20250819 Advanced Truage report.pdf 8
[b1457] Telomere Biological Age 72.7 Years <= 54.4 2025-05-13 Abnormal 20250513 - Advanced TruAge Report.pdf 13
[b1472] Toxicity Index Moderate Optimal (0) 2025-11-05 Abnormal 20251105 THERMOGRAPHY JEAN-YVES SIREAU.pdf 3
[b1498] Gut Wellness Score 75.95 N/A 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 1
[b1522] VZV IgA Antibodies 1.529 <= 0.8 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 7
[b1530] TNF - ALPHA 3.63 4.6 - 12.4 2025-07-08 Abnormal 20250708 TNF-α.PDF 2
[b1567] Norepinephrine (2nd Morning) 2.32 12.6 - 38.2 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 1
[b1568] Thyroid Function LOWER N/A N/A Abnormal screencapture-my-lifedna-reports-e9c2d724-ddbb-4d74-9dab-7995ddca7be4-2024-09-02-15_20_30.pdf 1
[b1593] Mean Cell Volume 94.0 fL 76.0 - 96.0 2025-07-08 Normal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 1
[b1594] MCV 112.7 fL 80.0 - 96.0 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 1
[b1595] MCV 94.0 fL 80.0 - 96.0 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 1
[b1597] Thyroid (Autoimmune, Anomalous) Minimal Optimal (0) 2025-11-05 Abnormal 20251105 THERMOGRAPHY JEAN-YVES SIREAU.pdf 3
[b1661] Mercury 2.1 <= 0.8 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b1678] Von Willebrand Factor (VWF) Level Much Lower N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 8
[b1688] Activated Partial Thromboplastin Time 17.2 22.9 - 32.1 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 2
[b1709] Hormone Organ System Age 62.3 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b1728] Lung Organ System Age 57.9 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b1735] Coxsackie-IgG Type A7 (IFT) 1:100 < 1:100 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 8
[b1756] CMV lytic 61.0 0.0 - 1.0 2025-08-26 Abnormal 20250821 Arminlabs Elispot.pdf 4
[b1769] Coxsackie-IgA Type A7 (IFT) 1:100 < 1:10 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 8
[b1779] D-Dimer 570.0 0.0 - 500.0 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 2
[b1780] Phenylacetylglutaminem 89.0 percentile 0.0 - 100.0 2025-08-19 Normal 20250819 Truhealth report.pdf 6
[b1781] Phenylacetylglutamine 82.1 percentile >80 percentile 2025-01-06 Abnormal 20250513 - Advanced TruAge Report.pdf 5
[b1782] Phenylacetylglutamine 82.0 percentile 0.0 - 80.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 18
[b1797] Melatonin (1st Morning) 4466.06 10.1 - 26.0 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 1
[b1799] Haematocrit 52.5 % 40.0 - 51.0 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 1
[b1800] Hematocrit 33.2 % 20.0 - 100.0 2025-05-13 Normal 20250513 - Advanced TruAge Report.pdf 18
[b1811] VZV IgG Antibodies 3702.0 <= 80.0 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 7
[b1855] Silicon 13.3 15.0-31.0 2025-11-05 Abnormal 20251105 Oligoscan_JEAN-VYES SIREAU (Spectrophotometry).pdf 1
[b1864] NADP/NADPH Ratio 2.7 0.5 - 2.0 2025-09-22 Abnormal 20250922 Nutripath NAD profile.pdf 1
[b1875] Mitochondrial Function 25.0 percentile 41.0 - 100.0 2025-08-19 Abnormal 20250819 Truhealth report.pdf 2
[b1876] Mitochondrial Function 15.0 percentile N/A 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 4
[b1888] Triglycerides 1.7 mmol/L <= 1.7 2025-06-23 Normal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 4
[b1889] Triglycerides 2.1 mmol/L <= 2.0 2025-07-08 Abnormal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 4
[b1890] Triglycerides 1.6 mmol/L <= 1.7 2025-09-04 Normal 20250904 PWPP - non-fasting.PDF 4
[b1891] TRIGLYCERIDES 1.1 mmol/L <= 1.7 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 4
[b1892] Triglycerides 2.0 mmol/L <= 1.7 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 5
[b1907] Probiotics Score 58 % N/A 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 1
[b1908] Probiotics (Overall) 57.87 % N/A 2025-02-24 - Biomesight_Microbiome_Summary_18237.pdf 1
[b1909] Bartonella ImmunoBlot IgM Positive Negative: No Bartonella specific antibody detected 2025-05-26 Abnormal 20250526 Igx test - Lyme Bartonella.pdf 7
[b1930] Selenium, serum (ICPMS) 153.0 70.0 - 150.0 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 13
[b1931] Your Susceptibility to Prostate Cancer (if male) Reduced N/A Typical 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 27
[b1948] Phosphorus 120.3 144.0-199.0 2025-11-05 Abnormal 20251105 Oligoscan_JEAN-VYES SIREAU (Spectrophotometry).pdf 1
[b1985] Schistosoma-spp.-AB IgG (EIA) 2.2 <= 0.8 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 2
[b2005] CD8+/CD28- in CD8 (CD8+CD28-) 58.0 4.0 - 51.0 2025-07-21 Abnormal 20250721 Senescent T CD8.pdf 2
[b2020] Lactobacillus rhamnosus Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 14
[b2024] Gait Speed Percentile 10.2 Percentile N/A 2025-08-19 - 20250819 Advanced Truage report.pdf 9
[b2025] Gait Speed Percentile 35.4 Percentile N/A 2025-05-13 Abnormal 20250513 - Advanced TruAge Report.pdf 16
[b2031] Epinephrine 9.26 2.3 - 8.1 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 2
[b2046] Hormone 55.9 Years N/A 2025-02-06 - 20250819 Truage report.pdf 3
[b2047] Hormone 58.1 Years N/A 2025-03-14 - 20250819 Truage report.pdf 3
[b2048] Hormone 61.8 Years N/A 2025-09-10 Abnormal 20250819 Truage report.pdf 3
[b2049] Hormone 62.3 Years N/A 2025-06-13 - 20250819 Truage report.pdf 3
[b2082] Sodium 3.0 20.0 - 180.0 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b2084] Intracellular NAD 33.7 µM 40.0 - 100.0 2025-11-17 Abnormal 20251117 Jinfiniti NAD.pdf 1
[b2085] Intracellular NAD 20.3 µM 40.0 - 100.0 2024-11-12 Abnormal 20251117 Jinfiniti NAD.pdf 1
[b2117] Bifidobacterium Adolescentis Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 13
[b2136] Thyroid (Hypo) Moderate Optimal (0) 2025-11-05 Abnormal 20251105 THERMOGRAPHY JEAN-YVES SIREAU.pdf 3
[b2141] Basoph. Granulocytes 3.5 <= 2.0 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 1
[b2144] Kidney Organ System Age 60.2 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b2147] Detoxification Capacity Lack Moderate Optimal (0) 2025-11-05 Abnormal 20251105 THERMOGRAPHY JEAN-YVES SIREAU.pdf 3
[b2161] Lyme ImmunoBlot IgG (IGX Criteria) Positive N/A 2025-05-26 Abnormal 20250526 Igx test - Lyme Bartonella.pdf 3
[b2164] Lung 55.2 N/A 2025-09-10 Abnormal 20250819 Truage report.pdf 3
[b2191] N1-methyl-2-pyridone-5-carboxamide (2PY) 96.0 <= 80.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 27
[b2194] Kidney 60.3 Years N/A 2025-03-14 - 20250819 Truage report.pdf 3
[b2195] Kidney 60.2 Years N/A 2025-06-13 - 20250819 Truage report.pdf 3
[b2196] Kidney 58.2 Years N/A 2025-02-06 - 20250819 Truage report.pdf 3
[b2197] Kidney 57.8 Years N/A 2025-09-10 Abnormal 20250819 Truage report.pdf 3
[b2201] Norepinephrine (1st Morning) 4.11 9.4 - 22.0 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 1
[b2210] Calcium High Medium 2024-12-07 Abnormal Health Action Plan - Health Enrichment - Jean-Yves Sireau.pdf 4
[b2217] Progesterone 0.71 nmol/L 0.89 - 3.88 2025-06-23 Abnormal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 5
[b2218] Progesterone 1.55 nmol/L 0.89 - 3.88 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 10
[b2222] NK Cells (count) 250.0 17.0 - 183.0 2025-11-19 Abnormal 20251119 NK cells activity test.pdf 1
[b2232] VO2 Max Percentile 7.4 Percentile N/A 2025-08-19 - 20250819 Advanced Truage report.pdf 9
[b2233] VO2 Max Percentile 17.0 Percentile N/A 2025-05-13 Abnormal 20250513 - Advanced TruAge Report.pdf 16
[b2236] Pesticides 58.0 N/A 2025-09-10 Normal 20250819 Truhealth report.pdf 8
[b2240] Aluminum 18.0 <= 7.0 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b2298] Iron Low N/A 2024-07-12 Abnormal Health Action Plan - Health Enrichment - Jean-Yves Sireau.pdf 5
[b2306] Baseline Respiration 70.0 0.0 - 65.0 2025-05-23 Abnormal 20250523 mescreen.com results.pdf 3
[b2307] Lung Cancer Risk Elevated N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 21
[b2317] Clostridium species Elevated N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 14
[b2328] Blood 64.4 Years N/A 2025-03-14 - 20250819 Truage report.pdf 3
[b2329] Blood 58.6 Years N/A 2025-06-13 - 20250819 Truage report.pdf 3
[b2330] Blood 58.3 Years N/A 2025-02-06 - 20250819 Truage report.pdf 3
[b2331] Blood 55.9 Years N/A 2025-09-10 Abnormal 20250819 Truage report.pdf 3
[b2341] Exercise & Fat Loss Low Medium 2024-12-07 Abnormal Health Action Plan - Health Enrichment - Jean-Yves Sireau.pdf 4
[b2372] Selenium 0.63 0.7 - 1.2 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b2379] Arabinose 21.0 <= 20.0 2025-07-29 Abnormal 20250729 MosaicDX organic acids.pdf 1
[b2394] Metabolic Organ System Age 58.2 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b2397] DHEA - Sulphate 1.9 umol/L 3.7 - 12.2 2025-07-08 Abnormal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 4
[b2398] DHEA-SO4 3.1 umol/L 2.2 - 15.2 2025-11-30 Normal 20251130 Pathlab Puchong.pdf 6
[b2399] DHEA - Sulphate 3.9 umol/L 3.7 - 12.2 2025-10-17 Normal 20251017 blood test - non-fasting.PDF 9
[b2415] Chlam.pneum. IgG-AB 1.233 0.8 - 1.1 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 4
[b2454] Insulin, Serum 28.0 uIU/mL 3.0 - 25.0 2025-06-23 Abnormal 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 4
[b2455] Insulin, Serum 11.4 uIU/mL 3.0 - 25.0 2025-07-08 Normal 20250708 Dr Afiff tests - Premier Integrated Labs - non-fasting.pdf 5
[b2456] Insulin, Serum 30.2 uIU/mL 3.0 - 25.0 2025-09-04 Abnormal 20250904 PWPP - non-fasting.PDF 4
[b2457] Insulin, Serum 28.3 uIU/mL 3.0 - 25.0 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 9
[b2465] Blood Organ System Age 58.6 54.4 - 54.4 2025-01-03 Abnormal 20250513 - Advanced TruAge Report.pdf 7
[b2467] Immune 64.6 Years N/A 2025-03-14 - 20250819 Truage report.pdf 3
[b2468] Immune 59.0 Years N/A 2025-06-13 - 20250819 Truage report.pdf 3
[b2469] Immune 66.3 Years N/A 2025-02-06 - 20250819 Truage report.pdf 3
[b2470] Immune 58.7 Years N/A 2025-09-10 Abnormal 20250819 Truage report.pdf 3
[b2477] CH4 Peak 16.0 <= 10.0 2025-11-17 Abnormal 20251117 SIBO test.pdf 1
[b2478] Systolic Blood Pressurem 91.0 percentile 0.0 - 100.0 2025-08-19 Normal 20250819 Truhealth report.pdf 6
[b2479] Systolic Blood Pressure 93.0 percentile 0.0 - 80.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 18
[b2489] Urinary Norepinephrine 22.0 µg/g Cr 15.0 - 35.0 2025-07-25 Normal 20250721 ZRT urinary and adrenal hormones.pdf 3
[b2490] Urinary Norepinephrine 5.0 µg/g Cr 5.0 - 15.0 2025-07-25 Normal 20250721 ZRT urinary and adrenal hormones.pdf 3
[b2491] Urinary Norepinephrine 12.0 µg/g Cr 10.0 - 25.0 2025-07-25 Normal 20250721 ZRT urinary and adrenal hormones.pdf 3
[b2492] Urinary Norepinephrine 3.0 µg/g Cr 5.0 - 15.0 2025-07-25 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 3
[b2495] Ferritin 17.7 22.0 - 322.0 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 8
[b2535] Chlamydia Pneumoniae EliSpot 2.0 0.0 - 1.0 2025-08-26 Abnormal 20250821 Arminlabs Elispot.pdf 2
[b2545] Norepinephrine 10.2 16.9 - 38.8 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 2
[b2548] Chromium 0.74 0.82-1.25 2025-11-05 Abnormal 20251105 Oligoscan_JEAN-VYES SIREAU (Spectrophotometry).pdf 1
[b2549] Dientamoeba fragilis DNA Positive Negative 2025-11-07 Abnormal 20250710 Arminlabs - parasites.pdf 1
[b2550] Phenylalanine Dysbiosis Marker (Phenylacetylglutamine) 82.0 0.0 - 80.0 2025-06-24 Abnormal 20250513 - TruHealth Report .pdf 20
[b2557] Exfoliation Glaucoma Very Elevated N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 23
[b2559] Proteobacteria 7.615 0.0 - 4.0 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 17
[b2585] Heart 56.1 Years N/A 2025-06-13 - 20250819 Truage report.pdf 3
[b2586] Heart 54.9 Years N/A 2025-02-06 - 20250819 Truage report.pdf 3
[b2587] Heart 55.9 Years N/A 2025-03-14 - 20250819 Truage report.pdf 3
[b2588] Heart 55.5 Years N/A 2025-09-10 Abnormal 20250819 Truage report.pdf 3
[b2595] OMICm Age 60.3 Years N/A 2025-02-06 - 20250513 - TruAgeReport.pdf 3
[b2596] OMICm Age 57.9 Years N/A 2025-06-13 - 20250513 - TruAgeReport.pdf 3
[b2597] OMICm Age 56.7 Years N/A 2025-03-14 - 20250513 - TruAgeReport.pdf 3
[b2598] OMICm Age 59.0 Years N/A 2024-03-18 - 20250513 - TruAgeReport.pdf 3
[b2599] OMICm Age 54.0 Years N/A 2025-08-19 - 20250819 Truage report.pdf 1
[b2600] OMICm Age 54.0 Years N/A 2025-09-10 - 20250819 Truage report.pdf 2
[b2601] OMICm Age 60.3 Years 54.4 Years 2025-01-02 - 20250513 - Advanced TruAge Report.pdf 2
[b2602] OMICm Age 57.9 Years 54.4 Years 2025-01-06 Abnormal 20250513 - Advanced TruAge Report.pdf 2
[b2603] OMICm Age 56.7 Years 54.4 Years 2025-01-03 - 20250513 - Advanced TruAge Report.pdf 2
[b2604] OMICm Age 59.0 Years 54.4 Years 2024-01-03 - 20250513 - Advanced TruAge Report.pdf 2
[b2606] Lactobacillus plantarum Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 14
[b2619] Mycoplasma Pneumoniae EliSpot 5.0 0.0 - 1.0 2025-08-26 Abnormal 20250821 Arminlabs Elispot.pdf 2
[b2621] Toxoplasma gondii IgG Antibody 2.129 <= 0.8 2025-07-22 Abnormal 20250710 Armin Labs - pathogens.pdf 5
[b2647] Bifidobacterium Breve Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 13
[b2653] D-Lactate Producer Level 1.69 <= 1.0 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 36
[b2666] Your Susceptibility to Type 2 Diabetes Reduced Typical 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 27
[b2667] Colorectal Cancer Risk Elevated N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 21
[b2709] Epinephrine <dl 0.5-1.5 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 2
[b2710] Free Cortisol (Night) 2.07 2.6 - 8.4 2025-07-21 Abnormal 20250721 ZRT urinary and adrenal hormones.pdf 1
[b2752] Fuchs' Corneal Dystrophy Elevated N/A 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 23
[b2764] Hemoglobin A1c 5.9 N/A 2025-11-29 - 20251129 - Diabetic Retinopathy Screening Report.pdf 2
[b2790] Haptoglobin 0.26 0.4 - 2.4 2025-10-17 Abnormal 20251017 blood test - non-fasting.PDF 5
[b2793] Lactobacillus salivarius Low N/A 2025-12-03 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 14
[b2817] Strontium 8.8 0.3 - 3.5 2025-06-18 Abnormal 20250618 Doctors Data.pdf 1
[b2822] NAD (NAD+) 15.2 20.0 - 42.0 2025-09-22 Abnormal 20250922 Nutripath NAD profile.pdf 1
[b2828] OMICm Fit Age 60.9 Years 54.7 - 54.7 2025-08-19 Abnormal 20250819 Advanced Truage report.pdf 9
[b2829] OMICm Fit Age 62.2 Years <= 54.4 2025-05-13 Abnormal 20250513 - Advanced TruAge Report.pdf 15
[b2837] Your Susceptibility to Coronary Artery Disease Reduced Typical 2024-07-24 Abnormal APznzaa12ylJxi3eK-a-_eKMst5t6i4pfK_6rhopYLQsYIS8qHK_NiiFqu1zXMTbVr7ro-fgj--drUfom-sOORuKEFSGfCc9Sy8q5EfMFGS0HVRMKGhbb627ruvEItwM7fQlxzJoiixdSaQ4xYp-tAyH_ti1kslt-Kg_w2pxrrar0Sv9vu-SgsDtQhzHLYVOq-9GwyAcaP0aqO99r-NyRWGI8jg-_4TQ6Twv1pTU8Avb0Zgc.pdf 27
[b2849] PFAS (Forever Chemicals) 96.0 percentile N/A 2025-09-10 Abnormal 20250819 Truhealth report.pdf 8
[b2850] Perfluorooctanesulfonate 92.0 percentile 0.0 - 95.0 2025-06-24 Normal 20250513 - TruHealth Report .pdf 24
[b2871] Clostridium species 82.08 5.0 - 50.0 2025-11-25 Abnormal 20251117 Complete Microbiome - JY Sireau - Welllab.pdf 6
[b2877] SYMPHONY Age (Blood) 58.6 N/A 2024-03-18 Abnormal 20250513 - TruAgeReport.pdf 4
[b2878] Pyridoxic Acid (B6) Below Mean N/A 2025-07-29 Abnormal 20250729 MosaicDX organic acids.pdf 10
[b2884] Vitamin D3 High Medium 2024-12-07 Abnormal Health Action Plan - Health Enrichment - Jean-Yves Sireau.pdf 4
[b2908] Hepatobiliary Stress Minimal Optimal (0) 2025-11-05 Abnormal 20251105 THERMOGRAPHY JEAN-YVES SIREAU.pdf 3
[b2914] Tobacco Addiction Risk 82.0 <= 50.0 2024-07-11 Abnormal Brain-Health---Mental-Health-and-Mood-22035395-Jean-YvesSireau-24Jul11.pdf 31
[b2940] SYMPHONY Age 56.7 Years >= 54.7 2025-08-19 Normal 20250819 Advanced Truage report.pdf 1
[b2941] Symphony Age 54.7 Years N/A 2024-01-03 - 20250513 - Advanced TruAge Report.pdf 2
[b2942] Symphony Age 56.0 Years N/A 2025-01-03 - 20250513 - Advanced TruAge Report.pdf 2
[b2943] Symphony Age 57.8 Years Less than or equal to 54.4 Years 2025-01-06 Abnormal 20250513 - Advanced TruAge Report.pdf 2
[b2944] Symphony Age 54.7 Years N/A 2025-01-02 - 20250513 - Advanced TruAge Report.pdf 2
[b2946] Dopamine producer level 0.019 0.03 - 6.5 2025-02-24 Abnormal Biomesight_Microbiome_Summary_18237.pdf 32
[b2959] Proteinuria HIGHER N/A N/A Abnormal screencapture-my-lifedna-reports-e9c2d724-ddbb-4d74-9dab-7995ddca7be4-2024-09-02-15_20_30.pdf 1
[b2962] Citrate Synthase 42.96 4.4 - 22.0 2025-09-10 Abnormal 20250910 Mitoswab.pdf 1

A3. Diagnoses

Ref Name Status First Documented Source Page
[d0] Cervical spondylosis with multilevel disc prolapse Chronic 2025-11-27 20251128 MRI Cervical Spine.pdf 2
[d10] Mild acromioclavicular arthropathy (right shoulder) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1
[d11] Subacromial subdeltoid bursitis (left shoulder) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1
[d12] Cervical disc bulge (C5/6 and C6/7) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1
[d13] Mild supraspinatus tendinosis (left shoulder) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1
[d14] Infraspinatus partial tear (right shoulder) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1
[d1] ${C}_{5}/{C}_{6}$ spondylosis Chronic 2025-10-21 20251021 - Orthopaedic Hospital - Letter frm doctor.pdf 1
[d2] Pancreatic insufficiency Chronic 2025-11-18 20251124 Pancreatic Elastase.PDF 2
[d3] Meibomian Gland Dysfunction Chronic 2025-10-24 20251027 Cyberjaya optician report.pdf 1
[d4] Partial tear of the right supraspinatus tendon with tendinopathy Acute 2025-11-27 20251128 MRI right shoulder.pdf 1
[d5] Chronic excess cortisol Chronic 2025-07-25 20250721 ZRT urinary and adrenal hormones.pdf 8
[d6] severe exhaustion of the adrenal glands (medulla) and their inability to synthesize catecholamines Chronic 2025-07-25 20250721 ZRT urinary and adrenal hormones.pdf 9
[d7] Infection/inflammation Acute 2025-06-23 20250623 Dr Afiff Premier labs - during Bartonella treatment (not fasting).pdf 2
[d8] Supraspinatus tendinosis/partial thickness tear (right shoulder) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1
[d9] Subacromial subdeltoid bursitis (right shoulder) Acute 2025-05-11 20250513 Chiropractor assessment.pdf 1

A4. Procedures

Ref Name Date Source Page
[p0] Bariatric surgery 2025-05-23 20250523 Glycanage.pdf 17

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