One sheet per day, 7/5 → 7/9. This build folds in the Claude⟷Perplexity cross-check: the held cascade is being brought back in a sequenced wave (violet = returning to protocol), not all at once — so any GI, BP, or CGM signal stays attributable. Two hard gates still govern: sucralfate ends 7/7, and the 7/8 surgical visit unlocks the bleed-sensitive items. The glucose stack and probiotics pick up after this week (roadmap at the bottom).
✎ What changed in 7.6 — from the cross-validation
L-Citrulline moved UP (→ 7/6, was near the back). The "benefit decayed at 2.5 wk" logic only held for the NO-perfusion channel; collagen + immune channels run through wk 6–8, and albumin 2.8 makes the arginine pillar more relevant now.
NAC staged, not simply "released" — post-7/8 it restarts at 1,200–1,800 mg (not the full 4,800); the bedtime bolus + selenium are restored last. Its hemostatic mechanism is more complete than fish oil's, so the taper is cheap insurance.
Added: a Leucine/EAA anabolic trigger (the mTOR switch HMB doesn't cover) + Vitamin C bumped to ~1,000 mg for collagen across the three seams.
EGCG timing corrected — moved off the fasted 10 AM slot to with food, ≤400 mg (fixes a fasted-bolus hepatic-load risk, independent of bleeding).
Quercetin prioritized first — on histamine grounds, not despite them: at your phytosome dose the real effect is mast-cell stabilization, and it was double-costing you alongside held HistaminX.
Glucose stack formalized with CGM windows; SerinAid PS cleared — soy-lecithin PS is protein-free, so it's Creon-safe; no swap needed (see Verify).
📋 The 6/30 scope — the read this all rests on
Enteroscopy reached the mid-jejunum. Clean-based ulcers — Forrest III — at three healing seams (duodenal sweep ~5 cm past the pylorus, proximal jejunum, and circumferentially around the side-side anastomosis). Mildly friable but clean; no hemostatic maneuvers needed.
Why it governs the wave: clean-based is the low re-bleed category (~5%). That fact lifts the "reintroducing into a freshly-bled field" caution off the polyphenol bloc — the in-vitro antiplatelet flags don't translate to human oral-dose bleeding. What survives it: NAC (coagulation-factor effect, staged) and Vitamin E (weak vit-K signal, dose-gated). Fish oil already cleared on the same logic.
Three rules that still govern
🛡️
Sucralfate wins the clock (through 7/7).Empty stomach, 2 h clear of everything. If a cluster lands too close, move the cluster. Priority: sucralfate › omeprazole › Adderall › all else. Keep reintroduced polyphenols + berberine ≥2 h from it.
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Only advance if yesterday was clean.No new nausea, cramping, or stool change → take the next item in the wave. Anything off → hold today's addition and repeat.
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Hard stop.Dark/tarry stool · visible blood · new dizziness · resting HR climbing → call the team, pause all additions. Not a supplement question.
Every meal, in two passes
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A · fat-anchored — first bites.Creon in, then foundation aminos + everything fat-soluble: D3/K2, ubiquinol, PS, benfotiamine, urolithin A, PEA, HMB, omega-3 — and the returning fat-soluble polyphenols (curcumin, resveratrol, boswellia, astaxanthin, EGCG, quercetin).
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B · water-soluble — once you've eaten.Taurine, TMG, PQQ, ergothioneine, Bacopa, Avmacol, myo-inositol, MSM, leucine/EAA.
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Food-first overrides both.Albumin 2.8 → protein and calories win. If capsules crowd out the plate, the order failed.
💊 Spasm / pain, PRN: methocarbamol 750 mg q8h as needed (sedating — keep clear of the Adderall window). Oxycodone is stopped. Off the table both directions: acetaminophen (documented adverse) and NSAIDs (ulcer + bleed history) — so oral analgesia is genuinely narrow. Which is why the anti-inflammatories returning this week matter double: curcumin, boswellia, omega-3/SPM, and active PEA aren't just "safe to resume" — they're a real slice of your available analgesic-adjacent toolkit.
⚡ This week's headline move — L-Citrulline up
The arginine pillar of immunonutrition, reprioritized to 7/6. The old gate ("after fish oil, not urgent — perfusion decayed") conflated two channels: the acute NO-perfusion effect has decayed (iNOS peaks 24–72 h, gone by wk 2–3), but the collagen-synthesis pathway (arginine → proline) and immune support run through weeks 6–8 — and at albumin 2.8, that's the dominant concern. Citrulline also delivers arginine better than arginine itself (bypasses first-pass arginase). It joins glutamine 15 g + omega-3 already in. Fasted AM, 3 g DL-malate; watch your 2×/day BP log (mild vasodilator, you're off telmisartan).
⚖ On NAC — right to hold, staged on return
Held through 7/8, then staged back at 1,200–1,800 mg — not the full 4,800, with the bedtime bolus restored last. Honest calibration: the load-bearing evidence (IV cardiac-surgery bleeding, in-vitro plasma spiking) doesn't map cleanly to your oral dose, so the absolute risk against a Forrest III lesion is likely modest. But NAC's effect spans both platelet inhibition and coagulation-factor depression — a more complete mechanism than fish oil's — and the downside of tapering is near-zero (glycine, the other GlyNAC half, is already running at 7 g). Cautious because it's cheap, not because it's proven.
🔎 Verify / housekeeping
SerinAid PS — soy-derived, but Creon-safe (resolved).The soy that blunts Creon is its trypsin inhibitors (Kunitz / Bowman-Birk) — proteins, concentrated in the soy protein fraction. PS is extracted from soy lecithin (the lipid fraction) and refined protein-free (<2.5 ppm soy protein, often non-detectable), so it doesn't carry them. No sunflower swap needed. Keep 300 mg/day (200 noon + 100 dinner). Your soy-food avoidance still stands — those carry the inhibitors + histamine; PS is the exception.
Rx NaCl tablet strength.Confirm mg NaCl/tablet with pharmacy. 1 g tab = 393 mg Na ×4 ≈ 1,572 mg/day (on target); some Rx tabs are 2.25 g = 886 mg Na (would overshoot).
Potassium.Given active hyponatremia + prescribed sodium, don't over-supplement K — potassium promotes natriuresis and can work against the sodium goal. Lean on dietary K (high-veg already); confirm a target range at 7/8.