DAMNIT-V COMBINED EVIDENCE SNAPSHOT v18
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PATIENT
-------
Name: Eddy
Owner: Bright
Species: Canine
Breed: Border Collie
Sex: Male
Desexed Status: 
Life Stage: 
Activity Level: 
Current Weight kg: 23.00
Ideal Weight kg: 
BCS: 7.00

CASE
----
Case Title: Vomiting
Primary Complaint: Vomiting for 2 days 
Status: Open
Date Opened: 30/05/2026

CLINICAL NARRATIVE
------------------
Vomiting for 2 days , blood - was eating a bone

INITIAL DIFFERENTIAL NOTES
--------------------------
Suspect FB vs Garbage vs Bacterial infection 

CLINICAL INTAKE DOCUMENTS
-------------------------

DOCUMENT: History
Type: Clinical History
Source: Manual
Uploaded: 30/05/2026 05:44

O called early today - dog is Vomiting

NUTRITION ASSESSMENTS
---------------------
Total nutrition assessments for this case: 71

LATEST NUTRITION ASSESSMENT
---------------------------
Assessment ID: 70
Title: Nutrition Assessment
Date: 05/06/2026
Feeding Goal: Maintenance
Current Diet Type: Commercial complete
Body Weight kg: 23.00
Ideal Weight kg: 
BCS: 7.00
Muscle Condition: Normal
Appetite: Normal
Owner Goals: 
Diet Concerns: 
Skin / Coat Notes: 
Digestive Notes: 
Stool Quality: 
Owner-Reactive Foods: O: Chicken, beef, lamb, roo, pork, cheese, eggs, yoghurt, kibble, wheat, peanut butter,
Owner-Tolerated Foods: : Goat, venison, wild boar, [meat must have no fillers added - that's why Canine Country is best as raw food without fillers] blueberries, strawberries, raspberries, apples, bananas, mango, cucumber/gukes, broccoli/broccolini, cauliflower, pumpkin, peas, zucchini, beans, watermelon (all vegetables are cooked), he doesn’t like carrot or celery

NUTRITION EVIDENCE SNAPSHOT
---------------------------
Latest Assessment ID: 70
Assessment Date: 05/06/2026
Energy Intake: 420.7 kcal/day
Estimated Requirement: 997.74 kcal/day
Energy Percent: 42.2%
Energy Status: Low / below estimated requirement
Protein: 45.71 g/day
Fat: 18.24 g/day
Carbohydrate: 30.6 g/day
Matched Diet Items: 7 / 19
Unmatched Diet Items: 12
Micronutrient Confidence: Partial / incomplete
Nutrition Confidence: Moderate / partial evidence

Owner-Reactive / Avoid Foods:
O: Chicken, beef, lamb, roo, pork, cheese, eggs, yoghurt, kibble, wheat, peanut butter,

Owner-Tolerated Foods:
: Goat, venison, wild boar, [meat must have no fillers added - that's why Canine Country is best as raw food without fillers] blueberries, strawberries, raspberries, apples, bananas, mango, cucumber/gukes, broccoli/broccolini, cauliflower, pumpkin, peas, zucchini, beans, watermelon (all vegetables are cooked), he doesn’t like carrot or celery

Ingredient-Derived Reactive Groups:
cruciferous, fibre, fodmap, iodine_source, lectin, oxalate_possible, purine, salicylate_possible, sulphur

RAC-Reactive Foods:
Not yet connected. Future build will compare RAC-reactive foods against current diet, owner-reactive foods and tolerated foods.

EVIDENCE INCLUDED
-----------------
Clinical intake documents: 1
Nutrition assessments: 71
RAC / Audiomixer documents: 0
Pathology / laboratory reports: 0
Imaging reports: 0
HTMA reports: 0
Microbiome reports: 0
Supplement reviews: 0

EVIDENCE PENDING / NOT YET ADDED
--------------------------------
- Food entries, treat entries, supplement entries
- RAC / Audiomixer DOCX reports
- Pathology / laboratory reports
- Imaging reports
- HTMA report if requested
- Microbiome report if requested
- Supplement review

EVIDENCE PRIORITISATION
-----------------------

High Priority Evidence:
- Vomiting reported in clinical intake.
- Blood reported with vomiting or gastrointestinal signs.
- History of bone ingestion or bone exposure.

Moderate Priority Evidence:
- Nutrition assessment evidence is present.
- Owner-reported food reactivity / avoid foods are present.

Low Priority / Missing Evidence:
- Owner-tolerated food list is present and may assist future diet planning.
- RAC / Audiomixer evidence is not yet included in this snapshot.
- HTMA evidence is not yet included in this snapshot.
- Microbiome evidence is not yet included in this snapshot.

EVIDENCE STATUS
---------------

Evidence Used In This Snapshot:
- Clinical Intake: Used
- Nutrition: Used

Additional Evidence Available If Clinically Indicated:
- RAC / Audiomixer screening: may help prioritise which physical tests or evidence domains should be pursued next.
- Pathology / laboratory testing: available if clinical signs, risk assessment, or response to treatment justify testing.
- Imaging: available if obstruction, foreign body, mass, trauma or structural disease remains a concern.
- HTMA: available if mineral/toxic element patterning is clinically relevant.
- Microbiome: available if chronic gastrointestinal, immune, dermatological or inflammatory patterns require deeper investigation.

Clinical Context:
A veterinary assessment is commonly made using the evidence that is clinically justified and practically available. This section records what was used and what could be added later, without implying that every possible test is required for every patient.

EVIDENCE WEIGHTING ENGINE v1
----------------------------
Domain weights used in this snapshot:
- Imaging: 5
- Pathology / Laboratory: 5
- Clinical Examination: 4
- Clinical History / Intake: 4
- Nutrition: 3
- HTMA: 2
- Microbiome: 2
- RAC / Audiomixer: 1
- Supplement Review: 1

Current snapshot contains Clinical Intake and Nutrition evidence only. Imaging, pathology, HTMA, microbiome and RAC are pending.

DIFFERENTIAL PRIORITIES v2 - WEIGHTED
-------------------------------------

1. Gastrointestinal foreign body / obstructive bone fragment
Weighted Evidence Score: 12
Weighted Confidence: High
Evidence:
- [Clinical History +4] Vomiting reported.
- [Clinical History +4] Bone ingestion/exposure reported.
- [Clinical History +4] Blood reported with vomiting or gastrointestinal signs.

2. Acute gastritis / gastroenteritis
Weighted Evidence Score: 8
Weighted Confidence: Moderate
Evidence:
- [Clinical History +4] Vomiting reported.
- [Clinical History +4] Blood may indicate mucosal irritation, ulceration or injury.

3. Dietary indiscretion / garbage gut
Weighted Evidence Score: 8
Weighted Confidence: Moderate
Evidence:
- [Clinical History +4] Vomiting reported.
- [Clinical History +4] Dietary exposure history should be reviewed.

4. Food reactivity / intolerance contribution
Weighted Evidence Score: 6
Weighted Confidence: Low-Moderate
Evidence:
- [Nutrition +3] Owner-reported reactive foods present.
- [Nutrition +3] Nutrition snapshot shows ingredient-derived reactive burden evidence.

AI DAMNIT-V POSSIBILITY EXPANSION v3

CATEGORY: D - Degenerative / Structural  
Relative Priority: Moderate  
Why this category may be relevant:  
- Vomiting with blood after eating a bone suggests possible mechanical injury or obstruction (bone fragment causing mucosal damage, partial obstruction).  
- Potential for gastric or intestinal ulceration, perforation, or partial obstruction from traumatic bone ingestion.  
- Structural damage to GI tract (mucosal injury, erosions) or local inflammation secondary to trauma.  

Why this category may be less likely or currently weak:  
- No chronic degenerative history or age-related structural disease noted.  
- Vomiting is acute in onset.  
- Physical exam/imaging data not yet available to confirm obstruction or ulceration.  

Possible Diseases / Processes:  
- Gastric or intestinal mucosal erosion/ulceration  
- Partial gastrointestinal foreign body or obstruction  
- Traumatic gastritis or enteritis (bone-induced)  
- Esophageal trauma (less likely without regurgitation noted)  

Possible Organs / Systems:  
- Stomach, small intestine, esophagus  

Suggested RAC Screening Targets:  
- Gastrointestinal mucosal integrity  
- GI tract epithelial inflammatory markers  
- Localised GI tract inflammation or structural marker panels  

If RAC is positive, physical confirmation options:  
- Abdominal radiographs or ultrasound to identify foreign bodies/obstruction  
- Endoscopy to directly visualise mucosal injury or bone fragments  
- Clinical exam for abdominal pain or distension  
- CBC/chemistry for secondary inflammation or anemia  

If RAC is negative, interpretation:  
- Structural injury less likely; consider alternative causes for vomiting and blood  
- May require watchful waiting or further testing if symptoms persist  

Cost-aware staged approach:  
- Low-cost / immediate: Abdominal palpation, plain abdominal radiographs  
- Moderate-cost: Abdominal ultrasound, CBC and biochemistry panel  
- Higher-cost / referral: Endoscopy or advanced imaging (CT/MRI if obstruction unclear)  

Notes for longitudinal validation:  
- RAC prediction to record: Presence of mucosal injury or mechanical obstruction markers  
- Physical confirmation or outcome that would validate/refute: Imaging/endoscopy findings, resolution with vs without obstruction removal  

---

CATEGORY: A - Allergic / Autoimmune / Reactive  
Relative Priority: Low-Moderate  
Why this category may be relevant:  
- Owner reports multiple reactive/avoid foods; history of food reactivity raises possibility of food allergy/intolerance contributing to vomiting or GI irritation.  
- Chronic dietary sensitivity could predispose to mucosal inflammation or exacerbate injury.  

Why this category may be less likely or currently weak:  
- Vomiting is acute in onset rather than chronic or intermittent typical of allergic enteropathies.  
- No documented dermatological or systemic allergic signs currently.  
- No RAC/reactive food evidence yet integrated.  

Possible Diseases / Processes:  
- Food allergy or intolerance causing acute gastroenteritis  
- Immune-mediated gastritis or enteritis (less likely without chronicity)  

Possible Organs / Systems:  
- Gastrointestinal mucosa (stomach, small intestine)  

Suggested RAC Screening Targets:  
- Food antigen-specific immune reactivity markers  
- GI mucosal immune activation markers  

If RAC is positive, physical confirmation options:  
- Food elimination trials followed by challenge  
- Biopsy of GI mucosa if indicated  
- Trial of immunomodulatory or hypoallergenic diet  

If RAC is negative, interpretation:  
- Food allergy/immune reaction less likely as cause of acute vomiting; consider mechanical or infectious causes.  

Cost-aware staged approach:  
- Low-cost / immediate: Dietary history refinement, food trial elimination  
- Moderate-cost: Gastrointestinal immune panels if available  
- Higher-cost / referral: Gastrointestinal biopsy via endoscopy or surgery if chronic/refractory  

Notes for longitudinal validation:  
- RAC prediction to record: Immune-mediated food reactivity markers  
- Physical confirmation or outcome that would validate/refute: Response to elimination diet or immunomodulation  

---

CATEGORY: M - Metabolic / Nutritional / Endocrine  
Relative Priority: Low-Moderate  
Why this category may be relevant:  
- Nutrition history shows suboptimal energy intake (42% of requirement) which can predispose to GI dysfunction.  
- Metabolic disturbances (eg. hypoadrenocorticism, electrolyte abnormalities) may cause vomiting.  
- Owner has a complex reactive diet which may cause nutritional imbalances.  

Why this category may be less likely or currently weak:  
- No clinical signs of chronic systemic illness or endocrine signs in history.  
- Vomiting is acute rather than chronic or episodic as in some metabolic/endocrine disorders.  

Possible Diseases / Processes:  
- Electrolyte imbalance (secondary to vomiting or primary disorder)  
- Hypoadrenocorticism (Addison’s disease)  
- Hepatic or renal dysfunction causing secondary vomiting  
- Nutritional deficiency-induced gastritis (weak evidence)  

Possible Organs / Systems:  
- Adrenal glands, liver, kidney, GI tract  

Suggested RAC Screening Targets:  
- Electrolyte and metabolic panel markers  
- Endocrine hormone markers (cortisol, thyroid function)  

If RAC is positive, physical confirmation options:  
- Blood biochemistry and hematology  
- ACTH stimulation test or baseline cortisol  
- Imaging for organ structure if abnormalities suspected  

If RAC is negative, interpretation:  
- Metabolic or endocrine causes unlikely the primary driver  
- Focus on other DAMNIT-V categories  

Cost-aware staged approach:  
- Low-cost / immediate: Basic bloodwork including electrolytes, renal and liver parameters  
- Moderate-cost: Endocrine function testing (ACTH stim, thyroid panel)  
- Higher-cost / referral: Advanced imaging or specialised metabolic testing  

Notes for longitudinal validation:  
- RAC prediction to record: Metabolic derangements or endocrine abnormalities  
- Physical confirmation or outcome that would validate/refute: Lab test results, clinical response to treatment  

---

CATEGORY: N - Neoplastic  
Relative Priority: Low  
Why this category may be relevant:  
- Vomiting and blood may rarely be caused by GI neoplasia (ulceration, bleeding mass).  
- Could be incidental underlying neoplastic disease contributing to inflammation.  

Why this category may be less likely or currently weak:  
- Acute onset vomiting with clear history of bone ingestion suggests trauma over neoplasia.  
- No evidence of weight loss, chronic illness, or mass effects documented.  
- Age and history not provided, but sudden symptom onset less typical for neoplasia.  

Possible Diseases / Processes:  
- Gastric or intestinal neoplasia causing ulceration or bleeding  
- Lymphoma, adenocarcinoma, gastrointestinal stromal tumor (GIST)  

Possible Organs / Systems:  
- Stomach, intestines  

Suggested RAC Screening Targets:  
- Tumor-associated markers or GI tract neoplastic biomarker panels  
- Circulating tumor DNA or other novel cancer biomarkers (if available)  

If RAC is positive, physical confirmation options:  
- Imaging (radiographs, ultrasound, CT) to detect masses or thickening  
- Endoscopic biopsy for histopathology  
- Cytology of abdominal fluid if effusion present  

If RAC is negative, interpretation:  
- Neoplasia unlikely at this stage, especially acute vomiting presentation.  

Cost-aware staged approach:  
- Low-cost / immediate: Physical examination, abdominal palpation  
- Moderate-cost: Abdominal ultrasound  
- Higher-cost / referral: Endoscopic or surgical biopsy  

Notes for longitudinal validation:  
- RAC prediction to record: Neoplastic marker positivity  
- Physical confirmation or outcome that would validate/refute: Histopathology, imaging evidence  

---

CATEGORY: I - Infectious / Inflammatory  
Relative Priority: Moderate-High  
Why this category may be relevant:  
- Vomiting and blood could be caused by infectious gastroenteritis (bacterial, viral, parasitic).  
- Bacterial infection or toxin exposure possible given dietary indiscretion history ("garbage gut").  
- Inflammatory GI disease (eg. acute hemorrhagic gastritis) could cause these signs.  

Why this category may be less likely or currently weak:  
- No current information on fever, systemic illness, or known infectious contacts.  
- No lab data yet to support infection or inflammation.  

Possible Diseases / Processes:  
- Acute bacterial gastroenteritis (e.g., Clostridium, Campylobacter)  
- Viral gastroenteritis (parvovirus less likely if vaccinated)  
- Parasitic infection (hookworms, whipworms causing bleeding)  
- Hemorrhagic gastritis or gastroenteritis of inflammatory origin  

Possible Organs / Systems:  
- GI tract (especially stomach and small intestine)  

Suggested RAC Screening Targets:  
- GI infectious pathogen markers (bacterial, viral, parasitic)  
- Host inflammatory response mediators  

If RAC is positive, physical confirmation options:  
- Fecal parasite exam, culture or PCR for pathogens  
- CBC (look for leukocytosis, neutrophilia)  
- Abdominal ultrasound for wall thickening or complications  
- Response to antimicrobial or antiparasitic therapy  

If RAC is negative, interpretation:  
- Infectious or inflammatory cause less likely as primary cause—reconsider other categories.  

Cost-aware staged approach:  
- Low-cost / immediate: Fecal flotation/smear, basic clinical bloodwork  
- Moderate-cost: PCR panels for enteropathogens, abdominal ultrasound  
- Higher-cost / referral: Endoscopic biopsy if chronic or refractory  

Notes for longitudinal validation:  
- RAC prediction to record: Infectious or inflammatory biomarker presence  
- Physical confirmation or outcome that would validate/refute: Fecal/pathogen test results, clinical treatment response  

---

CATEGORY: T - Toxic / Traumatic  
Relative Priority: High  
Why this category may be relevant:  
- History of bone ingestion strongly supports traumatic injury to the GI tract causing vomiting and bleeding.  
- Possible mucosal laceration, perforation, or local trauma from sharp bone fragments.  
- Potential for secondary toxin exposure via bone or garbage ingestion.  

Why this category may be less likely or currently weak:  
- No direct evidence of toxin exposure yet.  
- Physical trauma focused on GI tract but systemic trauma signs not noted.  

Possible Diseases / Processes:  
- Traumatic gastroenteritis/hemorrhage from bone ingestion  
- Mucosal laceration or perforation from sharp foreign body  
- Secondary toxicity from ingestion of spoiled/contaminated garbage (less evidence)  

Possible Organs / Systems:  
- Stomach, intestines  

Suggested RAC Screening Targets:  
- Trauma-related inflammation markers  
- Gastrointestinal mucosal injury indicators  
- Common enteric toxin biomarkers (if available)  

If RAC is positive, physical confirmation options:  
- Abdominal imaging for foreign bodies, gas, or perforation  
- Clinical exam for abdominal pain, peritonitis signs  
- Endoscopy to directly assess trauma  

If RAC is negative, interpretation:  
- Traumatic cause less likely to be severe or ongoing; consider other causes for persistent vomiting.  

Cost-aware staged approach:  
- Low-cost / immediate: Abdominal palpation, radiographs  
- Moderate-cost: Abdominal ultrasound, CBC  
- Higher-cost / referral: Endoscopy or exploratory surgery if unstable or refractory  

Notes for longitudinal validation:  
- RAC prediction to record: Trauma or toxin related GI injury markers  
- Physical confirmation or outcome that would validate/refute: Imaging/endoscopy findings and clinical course  

---

CATEGORY: V - Vascular / Neurological  
Relative Priority: Low  
Why this category may be relevant:  
- Vascular causes (eg. gastric ulcers due to ischemia) or neurological causes (vestibular dysfunction causing nausea/vomiting) could contribute episodically.  
- Neurological vomiting from central causes possible but less likely with blood in vomitus.  

Why this category may be less likely or currently weak:  
- No neurological signs reported (ataxia, seizures, circling).  
- No evidence of ischemic events or vascular compromise reported.  
- Blood with vomiting suggests mucosal injury rather than central cause.  

Possible Diseases / Processes:  
- Vestibular disease causing vomiting  
- Gastric ischemia/ulceration secondary to vascular event (rare)  
- Increased intracranial pressure vomiting (unlikely in this case)  

Possible Organs / Systems:  
- Brain (vestibular nuclei), gastrointestinal vasculature  

Suggested RAC Screening Targets:  
- Neurological biomarkers (if applicable)  
- Vascular injury or ischemia markers  

If RAC is positive, physical confirmation options:  
- Neurological exam  
- Brain imaging (MRI/CT) if indicated  
- Abdominal Doppler ultrasound for vascular flow if suspicious  

If RAC is negative, interpretation:  
- Vascular or neurological origin unlikely for this vomiting episode.  

Cost-aware staged approach:  
- Low-cost / immediate: Neurological examination  
- Moderate-cost: MRI brain if neurological signs present  
- Higher-cost / referral: Vascular imaging if clinical suspicion arises  

Notes for longitudinal validation:  
- RAC prediction to record: Neurological or vascular injury markers  
- Physical confirmation or outcome that would validate/refute: Neuro exam findings, imaging studies  

---

RAC SCREENING PRIORITY LIST  
---------------------------  
1. Urgent / safety-critical:  
- GI mucosal injury / obstruction markers (Degenerative/Traumatic category)  
- Trauma-related GI injury markers (Toxic/Traumatic category)  
- Infectious/inflammatory GI pathogen detection markers  

2. High-yield:  
- Food antigen-specific immune reactivity (Allergic/Reactive category)  
- Metabolic/endocrine panel markers (including electrolytes, cortisol)  

3. Secondary / if time permits:  
- Neoplastic biomarker screening  
- Neurological and vascular injury markers  

PHYSICAL TESTING PRIORITY IF RAC SUPPORTS  
-----------------------------------------  
- Abdominal radiographs and ultrasound (foreign body, obstruction, masses)  
- Endoscopy with biopsy (mucosal injury, neoplasia, immune-mediated disease)  
- Fecal testing (parasites, bacterial culture, PCR)  
- Bloodwork: CBC, chemistry, electrolyte panels, endocrine tests (ACTH stim)  
- Neurological examination and imaging if indicated  

This approach balances initial safety critical screening for obstruction and trauma with efficient screening for infection and inflammation; it then extends to immune, metabolic, neoplastic, and neurological possibilities as indicated by RAC and clinical progression.

DIFFERENTIAL POSSIBILITY MAP v1
--------------------------------
Purpose: broaden the clinical thinking before final prioritisation. This is not a diagnosis list; it is a structured map of plausible branches that may be explored using RAC screening and, where justified, physical confirmation testing.

Gastrointestinal / Obstructive / Traumatic
------------------------------------------
Possible branches to consider:
- Foreign body
- Bone fragment irritation or obstruction
- Gastritis
- Enteritis
- Gastrointestinal mucosal trauma
- Intestinal pain / spasm
- Pancreatic irritation
- Peritonitis risk if deterioration occurs
Suggested RAC screening targets:
- GIT obstruction signal
- Stomach trauma / irritation
- Small intestinal trauma / irritation
- Abdominal pain
- Pancreas stress
- Inflammation
- Peritoneal irritation
Possible physical confirmation if RAC/clinical evidence supports:
- Abdominal radiographs
- Abdominal ultrasound
- CBC / biochemistry
- Electrolytes / hydration assessment
- Serial abdominal palpation and pain scoring
- Surgical referral if obstruction/perforation concern increases

Dietary / Food Reactivity / Toxicity
------------------------------------
Possible branches to consider:
- Dietary indiscretion
- Food intolerance flare
- Reactive food exposure
- High fat exposure / pancreatitis risk
- Toxin or irritant ingestion
- Microbiome disruption
Suggested RAC screening targets:
- Reactive foods currently in diet
- Owner-reported reactive foods
- Histamine / sulphur / lectin / oxalate / purine burden
- Pancreas stress
- Liver detoxification burden
- Gut dysbiosis pattern
Possible physical confirmation if RAC/clinical evidence supports:
- Diet history review
- Elimination / bland diet trial if stable
- CBC / biochemistry if persistent or systemic signs
- cPL / pancreatitis testing if indicated
- Microbiome testing if chronic or recurrent

Systemic / Metabolic / Infectious
---------------------------------
Possible branches to consider:
- Systemic infection / inflammatory disease
- Renal or hepatic contribution
- Endocrine/metabolic stress
- Electrolyte disturbance
- Pain-driven nausea
Suggested RAC screening targets:
- Kidney stress
- Liver stress
- Systemic inflammation
- Electrolyte disturbance
- Pain focus
- Fever / infection pattern
Possible physical confirmation if RAC/clinical evidence supports:
- Temperature and physical exam
- CBC / biochemistry
- Urinalysis
- Electrolytes
- Further infectious disease testing if clinically indicated

DAMNIT-V Integrative Screening Branches
---------------------------------------
Possible branches to consider:
- Degenerative / structural
- Allergic / autoimmune / reactive
- Metabolic / nutritional
- Neoplastic
- Infectious / inflammatory
- Toxic / traumatic
- Vascular / neurological
Suggested RAC screening targets:
- Run RAC screening across DAMNIT-V categories
- Identify strongest organ/system signals
- Identify strongest pathology-type signals
- Compare RAC positives with clinical history and nutrition evidence
Possible physical confirmation if RAC/clinical evidence supports:
- Select physical confirmation based on strongest RAC-supported branch
- Use pathology, imaging, HTMA, microbiome, or referral testing only where clinically justified

RAC-GUIDED NEXT EVIDENCE v1
---------------------------
RAC is treated here as a screening and prioritisation layer. A positive RAC signal does not replace physical diagnosis, but it can increase the justification for targeted physical testing when cost, risk, or uncertainty make broad testing difficult.

Suggested workflow:
1. Generate broad differential possibility map.
2. Run RAC screening against the most plausible branches.
3. Compare RAC positives with clinical history, nutrition, examination and owner observations.
4. Increase priority for physical confirmation where RAC and clinical evidence converge.
5. Record later confirmation and outcome so RAC predictions can be validated longitudinally.

INTERPRETIVE CAUTION
--------------------
This evidence snapshot is not a final diagnosis. It represents the evidence currently available at the time of generation. Later laboratory, imaging, HTMA, microbiome, RAC, nutrition, or supplement evidence may change the interpretation.