Three clean time points: Nov 2024, March 2026, May 2026. Direction is judged against your own historically-healthy frame, not the pharma-era targets.4
| Marker | Mar 2026 | May 2026 | Move | Read |
|---|---|---|---|---|
| LDL-P (nmol/L) | 1,740 | 1,253 | down, Moderate band | The win. Beat the under-1,400 checkpoint.1 |
| Small LDL (nmol/L) | 327 | 246 | down | Still High on the report's own range (High over 219).1 |
| ApoB (mg/dL) | 96 | 99 | up, stalled | Still off the under-90 checkpoint.1 |
| LDL-C (mg/dL) | 122 | 126 | up slightly | Still in historically-healthy zone (under 130).4 |
| HDL (mg/dL) | 42 | 40 | down | Just above the floor of 40.1 |
| Triglycerides (mg/dL) | 71 | 129 | up sharply | Still under 150, but the biggest adverse move.1 |
| Trig / HDL ratio | 1.69 | 3.23 | over target | Crossed the under-2 metabolic line.1 |
| HbA1c (%) | 5.5 | 5.4 | improved | Berberine plus diet holding.1 |
| Fasting insulin (uIU/mL) | 9.2 | 8.1 | improved | Underlying metabolic health improving.1 |
| Fasting glucose (mg/dL) | 95 | 101 | flagged H | Single value, likely noise given A1c and insulin.1 |
| Uric acid (mg/dL) | 7.3 | 6.7 | down | Improved but still over the 6.0 gout target.1 |
| hs-CRP (mg/L) | <0.2 | <0.2 | flat | Excellent. No inflammation.1 |
| Hemoglobin (g/dL) | 15.0 | 13.6 | down, in range | Part of a red-cell drop in step. See item 3.1 |
| MCH (pg) | 25.9 | 26.3 | still Low | Below the 27.0 floor. Iron vs trait question.1 |
You run four LDL levers plus omega-3. Against the new labs, the verdict is: it is working on particle count, so do not bolt on more. The adverse signals are diet-driven.
LDL-P fell 1,740 to 1,253 and small LDL 327 to 246 over roughly 60 days.1 That is the strongest single interval of the project and it happened on this exact stack plus diet. The particle count is the metric that matters for you, and it is bending the right way.
Levers, for the record: CholestOff blocks dietary cholesterol absorption, Thorne RYR supplies monacolin K (a statin compound), berberine adds lipid and glucose support, omega-3 is EPA-dominant.2
This is the one place the labs moved against you, and the temptation is to add a supplement. Resist it. A1c and fasting insulin both improved over the same window,1 which is the signature of short-window diet or a less-clean run-up to the draw, not a structural metabolic slide.
Action: recheck on a clean draw in 8 to 12 weeks (target ~Aug 2026), diet tightened in the run-up, before changing anything.1 If triglycerides are genuinely still elevated on that clean draw, the evidence-based lever is omega-3 dose (push EPA+DHA toward 2 to 4 g/day), not more sterols or a new product.
Your own value audit already flagged this as the most redundant LDL lever: statin-sized claims on low-quality trials, and you have three stronger levers already moving the number.3 The new labs do not give it a new reason to stay. If you want to thin the pill count, this is the first to go. No lab will get worse for dropping it.
This is the only item where the new labs and the stack genuinely interact, and it is a trap if you act on instinct.
The CBC dropped in step: hemoglobin 15.0 to 13.6, hematocrit 46.6 to 42.4, RBC 5.79 to 5.17, all still in range, with MCH still under the 27.0 floor.1 Read alone, that is an early iron deficiency signature, and the obvious move would be to start iron or swap to an iron-containing multi.
Do not. Two reasons collide here:
1. Your Methyl Multi is deliberately iron-free because of your beta-thalassemia trait3, and that trait itself produces small, low-MCH red cells that mimic iron deficiency. The low MCH may be the trait, not a deficiency.
2. Supplementing iron into a beta-thal trait without a confirmed low ferritin risks iron overload.
Action: order a ferritin + iron panel at the next draw (already your open item).1 If ferritin is genuinely low, iron is then warranted and worth a short course. If ferritin is normal or high, the microcytosis is the trait, and you keep the multi iron-free exactly as it is. The panel is the only thing that tells these two apart.
Thorne RYR is a real statin (monacolin K = lovastatin), and you stack it with berberine, which adds to the liver and muscle load.2,3 CK was deferred off the May order and your own closeout flagged it as the safety read on the RYR-plus-berberine combination.3 This panel does not appear to carry CK or an AST/ALT liver-enzyme read.
Action: add CK + AST/ALT to the next draw, bundled with the ferritin/iron panel. One stick covers both open items. This is monitoring you should be doing regardless of any prescription decision.
| Item | Verdict | What the May labs say about it |
|---|---|---|
| D3 + K2 (Sports Research) | Keep, hold dose | Vitamin D already 69 ng/mL (high-optimal).3 This is maintenance, do not increase. K2 earns its place for arterial calcium handling given the lipid focus. Recheck D to confirm it is not drifting over 80. |
| Berberine (WLV) | Keep | A1c 5.5 to 5.4 and insulin 9.2 to 8.1 both improved.1 Glucose lever is working. The single glucose 101 is noise against those two. |
| Quercetin (Thorne Phytosome) | Keep | Uric acid 7.3 to 6.7, improving but still over the 6.0 target.1 Quercetin has real urate data; your bedtime Toniiq tart cherry doubles as urate support. Working, not yet at goal. |
| Omega-3 (Sports Research) | Keep | Arachidonic acid 8.3 L and linoleic acid 17.4 L are low, a benign sign of a clean, omega-3-weighted diet.1 Balance is favorable. Hold this as the lever in reserve if the triglyceride recheck stays high. |
| NAC, Glutathione, ALA, Glycine, Mag Glycinate | Keep | hs-CRP under 0.2 and flat.1 The antioxidant and sleep load plus diet is keeping inflammation crushed. No additions needed, nothing to cut. |
| Creatine (Orgain, 5 g/day) | Keep | Strongly evidenced.3 Note for the PCP: it raises creatinine and lowers the eGFR reading, so flag it before any kidney-function interpretation.3 |
Diet note from your trajectory file: tighten the run-up so the triglyceride and ApoB recheck is a true reading, not a post-indulgence one.1