Phase 5 marks the transition from intervention initiation to longitudinal monitoring and ongoing observation.

Following the completion of early therapeutic baselining and initial response assessment, Phase 5 is intended to track the durability, stability, and longer-term trends across liver, lipid, cardiovascular, and body composition measures, and will be updated as new data becomes available.

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Primary Intent at Phase Start:

• Continued liver recovery

• Pursue CVD stabilization/reduction

• Maintain weight within 195-200 lbs

 

Implementation Chosen at Phase Start:

• Refine diet to ensure it remains therapeutic for liver, CVD, lean mass maintenance/growth, and weight management

• Reevaluate future blood test timing and types consistent with known metabolic factors

• Continue use of Zepbound pending reassessment of liver health

• Continue existing resistance training 2-3 days/week and increase activity level

• Continue documenting biomarkers and anthropometric data

• Continue evaluation of supplement stack

• No new pharmacologic therapies were initiated at the start of this phase

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New/Pending Measurements:

• Lipoprotein (a) (Lp(a)) test completed

• Pending:

  • Repeat Lipid Panel (scheduled 1/26/2026)

  • Carotid Ultrasound (scheduled 2/5/26)

  • FibroScan Follow-Up (tentatively May 2026)

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Observed Directional Trends:

• Anthropometric Data (As of 12/19/25)

  • Body Weight:

    • 197.6 lbs (within target range)

  • Fat/Lean Mass (per Withings Body Comp scale):

    • 18.9%/77.0% to 18.3/77.6%

    • Lean Mass Change: +0.3%

  • Waist/Height Ratio: Unavailable

  • Waist/Hip Ratio: Unavailable

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Blood Test Results - 12/17/25 (Changes Since Phase 4) - for details, see Blood Test Master File

• Lipid Markers:

  • Total Cholesterol (TC) (mg/dL): 149 to 151

  • Triglycerides (TG) (mg/dL): 68 to 86

  • HDL Cholesterol (HDL-C) (mg/dL): 57 to 57

  • LDL Cholesterol (LDL-C) (mg/dL): 78 to 77

  • ApoB (measured) (mg/dL): 72 to 68

  • Cardio IQ® LP PLA2 Activity (nmol/min/mL): 103 to 93

  • Lipoprotein (a) (Lp(a)) (nmol/L): 36

• NMR LipoProfiles (LabCorp):

  • LDL Particle Count (LDL-P) (nmol/L): 1054 to 977

  • Small LDL Particles (sdLDL-P) (nmol/L): 536 to 628

  • Insulin Resistance Index (LP-IR): 30 to 52

• Fasting Glucose–Insulin Index (HOMA-IR): 1.2 to 1.1

• Fasting Insulin (µU/mL): 5.3 to 4.9 (LabCorp)

• Alanine Aminotransferase (ALT) (IU/L): 46 to 30

• Aspartate Aminotransferase (AST) (IU/L): 35 to 25

• Gamma-Glutamyl Transferase (GGT) (IU/L): 13 to 12

• FIB-4 Index (calculated from lab data): 1.72 to 1.89

 

Key Discoveries / Signals:

• Lipoprotein (a) measured at 36 nmol/L, establishing baseline inherited cardiovascular risk context

 

Constraints / Confounders Noted:

• Some metabolic indices (e.g., LP-IR vs HOMA-IR) showed divergent results in December testing, which may warrant confirmation with repeat measurements

• Monitor liver/lipid biomarker improvements to decide if reduction of Zepbound dose (currently 7.5mg) is warranted

• Work is still needed to refine new diet approach that will optimize protein intake in support of resistance training while maintaining continued CVD and liver therapy

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Open Questions as of 12/20/25:

• Monitor liver/lipid biomarker improvements to decide if reduction of Zepbound dose (currently 7.5mg) is warranted

• Work is still needed to refine new diet approach that will optimize protein intake in support of resistance training while maintaining continued CVD and liver therapy

• Addition of supplement N-Acetylcysteine (NAC) on 12/20/25 to be reviewed after 1/26/26 blood test

 

Phase 5 Updates (Append-Only)

• TBD