700 patients109,892 observations180 daysLIVE

Patient P-02657

Synthetic patientMETA-24 · Day 160 · 55–64 · M · baseline S11Steering view · 3DOpen companion preview
Is the drug working?

Metabolic response 56 at the day-84 endpoint (observed).

Why responding?

Responding: response probability 59%, metabolic response 59 today; biology is not blocking the drug.

Is a side effect starting?

Drift detected on day 22 (inflammatory load +10); the side effect would have been reported on day 120 — 98 days of warning.

Still taking it?

46 of 61 scheduled doses in the last 60 days are biologically confirmed (75%); 13 were logged but show no dose signature. Dose signature: resting HR +6 bpm, HRV −7 ms.

last 10 doses · green confirmed · amber logged only · red missed
Plan for this patient
not yet offeredrecommendowner · Companionreview day 168Human Model →
Next action
GI-04 GI Support Protocol
59% probability of improvement
Kept if

90% of 284 similar trajectories improved after GI-04; if this one does, discontinuation risk is expected to fall from 59% to ~37%. Keeping ultra-processed low is worth 5.8 GI points a day on its own. Losing this patient costs €6k; the intervention costs €45.

Daily to-dos in the companion
  • 🍽Prepare a plain, low-fat pasta or rice meal and note how it feels afterwards
  • 🍽Choose a freshly cooked, lean protein; avoid frying, rich sauces and leftovers for now
  • Track each bowel movement today: time, stool form, urgency, overnight waking
  • A 15-minute walk after lunch
  • 💊Take the dose at the same time relative to your evening meal
  • 💊Electrolyte solution, one sachet after any loose stool
Adherence
70% worsening

Partial adherence; to-dos are being skipped on symptomatic days.

Changes the plan if

GI burden above 61 for 3 days within the onset window

LLIFE OS insight
grounded · add an LLM key for prose

P-02657 is on day 160 of META-24 (LT, baseline S11): response stable, tolerance improving, GI deteriorating. Over 14 days response moved +3 and GI +5; discontinuation risk is 59%. The state is between basins, heading towards failing, after diverging from the model on day 22.

Biology sets the gain: IL6 high-expression variant, Low microbial diversity; butyrate capacity 41/100, diversity 2.7. Pushing it down: Low butyrate capacity (-36.8), 4 keystone species absent (-27.5), Ultra-processed food (-25.7). Pulling it up: Protein (supports) (+27.7). From the daily log: ultra-processed +5.8 GI next day, protein -5.5 GI next day, fat +5.1 GI next day, simple carbs +5.1 GI next day.

Past actions: CR-01 on day 123 → improved (8%).

Next: GI-04 — 90% of 284 similar trajectories improved, 59% probability here. This would be contradicted by a further GI rise within the onset window or falling adherence.

Therapy response
Stable
Tolerance
Improving
GI state
Deteriorating
Inflammatory state
Unstable
Nutritional resilience
Unstable
Discontinuation risk
59%

Trajectory

Baseline → today → 30-day prediction · hover a day for signals and events
solid = observed · dashed = predicted · dose (daily oral dose, morning)
  1. Day 0 META-24 startedBaseline state S11
  2. Day 22 Trajectory diverged from predictionObserved response fell below the model's expected path.
  3. Day 122 CR-01 recommendedClinician Review CR-01
  4. Day 123 Patient acceptedStarted CR-01 in the companion
  5. Day 128 Deterioration detected before clinical escalationClinician Review CR-01

What changed?

Trajectory began diverging from predicted response on Day 22.

Primary contributors, last 14 days
  • Inflammatory activity+10
  • Toxicity-9
  • GI instability+5
  • Treatment adherence-4
  • Nutritional resilience-3

What helped?

  • Clinician Review CR-01Day 122
    Result: deterioration detected before clinical escalation
LIFE OS recommendation
GI Support Protocol GI-04 what is this →
59%
probability of meaningful tolerance improvement
  • 284 similar trajectories
  • 90% showed improvement
  • median effect visible after 8 days

Daily trackers

Asset settings

The trackers this program marks as important, last 14 days vs the 14 before.

Glucose, CGM daily mean
CGM
129 mg/dL
stable · -2.4 vs previous 14 d
Active minutes
Wearable
36 min
stable · +1.1 vs previous 14 d
Sleep duration
Wearable
7.8 h
stable · -0.0 vs previous 14 d
Energy level
Daily log
3.8/10
worsening · -0.4 vs previous 14 d
Steps
Wearable
4,367
stable · -18 vs previous 14 d
GI burden
Companion
52.9/100
stable · +0.6 vs previous 14 d
Adherence
Companion
69.6 %
worsening · -13.1 vs previous 14 d
This trajectory is decaying — what would help, what would not
Steering view →

Heading towards failing · 38 from the failing basin, 57 from restoration.

Would help
  • ME-01 Monitoring Escalation
    100% improved among 45 similar · onset 3 d · confidence 61%
  • GI-04 GI Support Protocol
    67% improved among 67 similar · onset 8 d · confidence 52%
  • NP-02 Dietary Support Protocol
    62% improved among 37 similar · onset 10 d · confidence 61%
  • More protein
    GI -5.5 next day on high-intake days · n 19
Would not help
  • Keep ultra-processed low
    GI +5.8 next day on high-intake days · n 16
  • Keep fat low
    GI +5.1 next day on high-intake days · n 21
  • Keep simple carbs low
    GI +5.1 next day on high-intake days · n 19
State influencers · digestive

Next-day GI change on high-intake vs low-intake days, last 60 days. Attribution from this patient's own log; sensitivity set by their biology.

  • Ultra-processed food
    +5.8detractor · 95%
  • Protein
    -5.5supporter · 95%
  • Dietary fat load
    +5.1detractor · 95%
  • Simple carbohydrates
    +5.1detractor · 95%
  • Alcohol
    +4detractor · 95%
  • Insoluble fibre
    +0.5no signal · 15%

DeepGene damage signature

The metagenomic + host-DNA read-out that initializes this patient's biology and, on retest, measures whether the steering worked.

Damage score · retest day 90
68/100
vs baseline (day 0)
+1
5 improved · 5 worsened
synthetic signature · consistent with this patient's biology
  • 2 opportunists above range: Streptococcus gallolyticus, Clostridioides difficile
  • 4 keystone species absent
  • Shannon 2.38 (expected ≥ 3)
  • 8 resistance genes
  • Host DNA fragmentation atypical
  • Tissue recycling index 46
Pathogens / opportunists2/5
from 3
Keystone species4/8
Diversity2/2
from 1
Metabolic modules0/4
from 1
Vitamin synthesis3/7
Oral translocation1/1
Host DNA1/1
from 0
Tissue recycling1/1
Central mechanisms0/2
from 2
Virulence factors4/4
Antibiotic resistance genes8/8
from 6
Genetic predisposition2/2
Opportunists above range
Streptococcus gallolyticus 1.953% AR
Clostridioides difficile 1.953% AR
Keystone species absent
Akkermansia muciniphila, Bifidobacterium longum, Butyricicoccus pullicaecorum, Eubacterium rectale
Capacity
Shannon 2.38 · butyrate 570 CPM · SCFA 997
3 vitamins below
Host & mechanisms
host DNA fragmentation atypical
tissue recycling 46/100
oral translocation 4.45% AR
8 resistance genes · 4 virulence factors

Biological layers

Which pathways look influenced, and by which layer of this person's biology.

Pathways under pressure
  • Inflammatory signalling 65
    • DNAIL6 -174 variant raises baseline inflammatory tone
    • BloodInflammatory load index 63
    • WearableHRV 23 ms, trending down
  • Butyrate / short-chain fatty acid production 55
    • MicrobiomeButyrate capacity 41/100
    • Daily logFibre intake low in recent food logs
  • Mucosal barrier integrity 20
    • Daily logGI symptom score 53 and rising
  • Drug metabolism and exposure 20
    • BloodToxicity index 52
DNA
Fictional pharmacogenomic panel
  • IL6 -174 G/C
    Higher inflammatory tone
  • CYP2D6 Rapid metabolizer
    Expected exposure
Microbiome
Shannon diversity 2.7 · butyrate capacity 41/100
  • Akkermansia muciniphilaNormal
  • Faecalibacterium prausnitziiNormal
  • Bacteroides fragilisNormal
  • Bifidobacterium longumLow
  • EnterobacteriaceaeHigh
Wearable, last 14 days
daily evolution fed into the runtime
HRV
24 ms
Sleep
7.3 h
Steps
3,733
Resting HR
66 bpm
Daily log: GI score 53, nutritional resilience 39, adherence 70.

What this patient sees in NostraAI

The content that steers the trajectory: what to eat, what to do, what to take.

Open companion preview
What to eat
  • Prepare a plain, low-fat pasta or rice meal and note how it feels afterwards
  • Choose a freshly cooked, lean protein; avoid frying, rich sauces and leftovers for now
  • Add one soluble-fibre source (oats, cooked carrots, banana) to breakfast
  • Eat slowly and stop at comfortable fullness — smaller volume, more often
What to do
  • Track each bowel movement today: time, stool form, urgency, overnight waking
  • A 15-minute walk after lunch
  • Keep the sleep window steady
  • Keep hydration steady: small amounts through the day rather than large volumes at once
What to take
  • Take the dose at the same time relative to your evening meal
  • Electrolyte solution, one sachet after any loose stool
  • Fictional demo item: oral nutrition supplement with lunch

284 biologically similar trajectories

Black: this patient. Green: similar patients whose intervention worked. Orange: similar patients where it did not.

PatientSimilarityBaselineInterventionOutcomeResponse today
P-0227456%S10CR-01improved58
P-0221155%S11CR-01improved56
P-0202754%S11CR-01improved62
P-0240554%S11GI-04no change60
P-0211350%S0259
P-0264548%S11GI-04improved60
P-0203547%S1162
P-0213945%S02CR-01improved61
P-0226345%S01CR-01improved62
P-0231745%S04CR-01improved58
P-0247344%S01CR-01improved56
P-0251044%S13GI-04improved61