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Reintroduction cascade · v7.8.2026
Gate Board
Every held or staged compound, judged against its own mechanism versus the actual clinical facts — not a blanket rule.
What changed · 7/8
The bleed-sensitive gate cleared. NAC and Vitamin E released; the probiotic gate opened on stent removal; SPM cleared. Nothing remains held on bleeding or septic grounds. Source: Wancata 7/8 · Labs 7/7
🟢 Cleared — active now
NAC (staged)600 × 2 = 1,200/dayMeal 1 + Dinner
Gate: surgeon heal-clearance + no active bleed → opened. Ramp +500 per clean 7-day step toward 4,800. The overnight 1,800 + Selenium bolus lands last.
Vitamin E≤400 IUDinner
Gate: vitamin-K antagonism at high dose. Released with a hard dose cap — no high-dose or tocotrienol megadose forms.
CurcuminNanocur 1 g + Longvida 200Meals 1 · 2 · Dinner
In-vitro-only antiplatelet. Already live and staying — and it doubles as analgesia, which matters because NSAIDs and acetaminophen are both off the table.
Boswellia (Casperome)350 × 2Meal 1 + Dinner
Mild; AKBA is mucosa-favorable. Needs fat — anchored in the fat-first batch.
Quercetin Phytosome—Meal 1
Mild antiplatelet, but its role here is histamine / mast-cell stabilizing. Platelets 411 and no re-bleed make the bleeding concern moot.
PQQ20 mgMeal 1
Minimal intrinsic risk — it was held only by the blanket bleed gate, which is now open.
L-Citrulline DL-Malate3 g (2 g citrulline)7:00 AM fasted
Already running. The anesthetic-hypotension window is closed. Its live risk is additive vasodilation — and telmisartan is still held, so the 2×/day BP log is the governing data.
🔵 Cleared — dated stages
ProBiota HistaminX1 cap~7/10 · Meal 1
Gate reassessed. Held for bacterial translocation while stents were indwelling — all 3 stents are out, WBC normal, ulcers healing. Cleared. Single-variable start. Minor omeprazole-pH caveat; not a blocker.
SPM Pro-Resolve1 softgel~7/11 · Dinner
No safety gate — it was only waiting on ~1 week of stable fish oil. Serves resolution and healing directly.
MegaSporeBiotic1 cap~7/13 · Dinner
🟡 Partial. Same unlock as ProBiota, but spore-formers get one extra notch of caution — starts only after ProBiota tolerance is confirmed.
Berberine Phytosome275 × 2live · 6:15 + 7:45 PM
Not a bleed gate — a CGM attribution gate. ~5× bioavailable, stacks with gymnema + myo-inositol. Opens a 7-day window before R-ALA.
R-ALA (OptimALA)—~7/16
Attribution-sequenced behind the Berberine CGM window.
Bilberry · Panax GS15-4100 mg · —~7/21 · ~7/26
Each takes its own CGM window so any post-meal nadir is attributable to one agent.
🍄 Sequenced — parallel track
Mushroom lineLion's Mane · Erinamax · Turkey Tail · Cordyceps~7/19 → ~8/5
Held pre-op on a blanket bleeding rule and
never re-gated — they are not in the current sheet. They don't share a risk profile, so they don't share a date:
Lion's Mane ~7/19 (in-vitro-only signal; gastroprotective — a healing duodenum argues
for it),
Turkey Tail ~7/28 (no antiplatelet mechanism, but prebiotic — waits for probiotic attribution),
Cordyceps ~8/5 (only one that is both antiplatelet-adjacent and CGM-active; goes last, alone, half-dose). Zero slippage to the glucose spine.
Full protocol →
🔴 Not a supplement call
Telmisartan 80 mgheldBP holding without it
Your 2×/day BP log is the dataset that answers restart timing — and it is also the safety net under L-Citrulline.
Facts to obtain — each moves a real decision
1 · Ferritin + iron saturation. Not drawn 7/7. It decides iron repletion vs. let-it-rebuild. Interim: food-first, and if iron is added, low-dose bisglycinate away from the AM window — iron is mucosally irritating and pro-oxidant into a healing duodenum.
2 · PPI plan past 7/14. Sets the ulcer runway, the acid environment the probiotics land in, and rebound-acid risk.
3 · Telmisartan restart criteria. What BP range and what date — this also releases the citrulline watch.
Nothing here is a supplement question. Each is a clinical fact only the team can supply — bring the numbers, get the answer, finish the call yourself.
No change this cycle
NaCl even-spread — sodium reached 134 (in range, first time). The protocol is working; hold it steady rather than easing off on one good draw.
Canonical cuts stand — Hist Reset, P5P, standalone Selenium, saffron.
SerinAid PS stays — soy lecithin's lipid fraction carries no trypsin inhibitors, so it doesn't touch Creon.
These are a phone call, not a supplement question
Dark or tarry stool · visible blood · new dizziness · resting HR climbing · fever or rigors. Pause every addition. Clinical suspicion outweighs a normal WBC — your inflammatory markers run supplement-suppressed.
Gate Board · v7.8.2026 · precision risk-matching, not blanket rules
Wancata 7/8 · Labs 7/7 · never acetaminophen · never NSAIDs · no soy