Cholesterol peaked at 7.05 mmol/L (Dec 2025) and has since improved to 5.69 (Jun 2026) — still above the 5.0 target but trending in the right direction. LDL dropped sharply from 4.13 (May 2026) to 2.87 mmol/L (Jun 2026) — now within range. Triglycerides normalized from 3.30 (Oct 2025) to 1.44 (May 2026) without medication, suggesting lifestyle changes are working. Non-HDL is still elevated at 4.30 (target <3.80).

Context: Given your Gilbert syndrome + SLCO1B1 genetic variant, statins require extra caution. Fenofibrate (Lipanthyl) is effective for TG control but not for LDL/total cholesterol. Current trajectory without medication is positive — sustain with continued low alcohol intake and reduced refined carbohydrates.

B12 has been 2–3× above the upper limit across all tests: 882, 882, 842, 891 pmol/L (range: 145–569). This is consistent and significant. Possible causes include B12 supplementation, liver-related storage issues, or rarely a myeloproliferative condition. Your liver enzymes are mostly normal (AST briefly elevated Oct 2024).

Intersection with genetics: Your MTRR A66G +/- variant reduces B12 recycling efficiency — the body may compensate by accumulating more. However at these levels, it's worth discussing with your doctor whether you are supplementing B12 and if so, whether to reduce the dose.

Bilirubin was elevated in Mar 2024 (27.2 H) and Oct 2025 (27.1 H), with normal values in between. This pattern — intermittent isolated bilirubin elevation with otherwise normal liver enzymes — is classic for Gilbert's syndrome, a benign genetic variant in bilirubin processing that affects ~5–10% of people.

Recommendation: If not already confirmed, mention this pattern to your doctor. Gilbert's is benign and typically triggered by fasting, stress, or illness. No treatment needed, but worth confirming the diagnosis.

Creatinine was elevated at 111–112 µmol/L in 2024 (above range of 62–106) but returned to normal in 2025 (88–91). GFR is consistently normal. Uric acid spiked to 422 in Feb 2025 (slightly above 417 limit) but returned to normal.

Kidney function is currently good. The earlier creatinine elevation may have reflected higher muscle mass, dehydration, or temporary factors.

In Mar and Oct 2024, neutrophils were low (42.4%) and lymphocytes elevated (48.1%). Normalized through 2025. Latest Jun 2026: neutrophils 55.3%, lymphocytes 35.7% — both well within normal range. WBC elevated at 8.1 × 10⁹/L (Jun 2026), up from 5.2 (May 2026) and 7.5 (Dec 2025), likely related to the active Borrelia IgM finding. Doctor has reviewed the Borrelia results and assessed the immune response as not requiring treatment.

Glucose stable (4.3–4.7 mmol/L, well within range). HbA1c normal at 30–31 mmol/mol — no pre-diabetes risk. Testosterone healthy at 20.7–24.3 nmol/L. TSH stable: 2.13 (Dec 2025), 1.85 (Jun 2026) — well within range. Vitamin D recovered to 97.4 nmol/L (May 2026), up from 75.5 (Dec 2025) — Revihair D3 supplementation is working. Cortisol normal. PSA normal and stable.