Audit: QRS - Liothyronine for Health & Longevity

Audit conducted on 09/08/2026 21:07 using AI4L / Grok 4

Iterations

Summary

Items	Count
Total	91
Passed	81
Failed	0
N/A	10
Pass Rate	100.00%

• Total = Passed + Failed + N/A
• Pass Rate = Passed / (Passed + Failed) × 100
• N/A items are excluded from the pass rate calculation

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1. General Rules

#	Description	Result	Comments
1.1	Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER.	🟢
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢
1.4	The QRS does not relabel an ER fact under a different decision category. A “Benefit-Modifying Factor” from ER section is not surfaced as a “Caution”; a “Risk-Modifying Factor” is not surfaced as a “Side Effect”; etc.	🟢
1.5	PubMed IDs, study citations, expert names, clinical trial identifiers (NCT*), and brand names appear in the QRS only if they appear in the source ER for the same fact.	🟢
1.6	The QRS does not introduce new attributions.	🟢

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2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢
2.4	The QRS avoids language that implies medical or clinical advice	🟢
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢
2.8	Information is presented in a concise and very compact manner	🟢
2.9	It DOES NOT address the reader directly	🟢
2.10	The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review.	🟢
2.11	The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort.	🟢
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢
2.13	Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience.	🟢
2.14	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢
2.15	The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt.	🟢

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3. Template Integrity

#	Description	Result	Comments
3.1	The following labels and headings on the QRS are fixed and not modified: * Card and section headings: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment” * Gate headings: “Contraindications”, “Key Interactions” * Tier labels: “High”, “Medium”, “Low”, “Speculative” * Table column headers in Monitoring: “Marker”, “Target”, “Why”	🟢
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢

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4. Formatting

#	Description	Result	Comments
4.1	When the source ER section is empty, the QRS uses the ER’s own empty-state phrasing verbatim. Typical phrasings are “None documented in human trials to date” and “Not formally studied”	N/A	No empty source-ER sections requiring empty-state phrasing.
4.2	Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label.	🟢
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢
4.5	The QRS is designed to render on one A4 page. Any section that has more content in the ER than fits the per-section budget is condensed by the LLM, not extended onto a second page.	🟢

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5. Metadata

#	Description	Result	Comments
5.1	The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content.	🟢
5.2	Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML.	🟢
5.3	The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet.	🟢
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢

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6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢

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7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢
7.2	[at_a_glance] is no longer than 60 words	🟢
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢

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8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢
8.2	[stop_items] represent the Contraindications from the ER	🟢
8.3	Individual [stop_items] are formatted as <li></li>	🟢
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢
8.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	ER does not use “>” ranking notation in stop-item parentheticals.
8.7	If no [stop_items] are present the section is left empty	N/A	Stop items are present.

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9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢
9.3	Individual [caution_items] are formatted as <li></li>	🟢
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢
9.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	ER does not use “>” ranking notation in caution-item parentheticals.
9.7	If no [caution_items] are present the section is left empty	N/A	Caution items are present.

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10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	Three actionable protocol aspects are present.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢

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11. Time to Effect

#	Description	Result	Comments
11.1	The three sets of [time] items cover the three most important time-to-effect aspects from the ER	🟢
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢
11.3	If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	Three time-to-effect aspects are present.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢
11.5	If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel	N/A	ER provides time-to-effect information.

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12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	All four benefit tiers contain items.

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13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢
13.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢
13.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	All four risk tiers contain items.

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14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢
14.3	[monitoring_cadence] is populated with the monitoring cadence/frequency derived from the ER Monitoring section. It is not left with placeholder text or empty.	🟢

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15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢

Issues 09/08/2026 21:07

Pass rate 100.00%. No issues found.

Issues 09/08/2026 20:57

1. 1.1 — Unsupported mood time-to-effect: time_2_value/time_2_sub present “Weeks to months” and “Studied trial durations” as time-to-effect; the ER supports those phrases as depression-augmentation course length, not onset of mood effect.

2. 11.1 — Non-TTE mood cell: The second time set is not a true time-to-effect aspect from the ER; it mirrors protocol duration rather than Practical Considerations onset timing.

3. 11.4 — Mood TTE content wrong: Used cells should reflect ER mood/symptom onset (about 1–3 weeks per dose step) and related steady-state assessment, not trial-duration wording.

Fixes 09/08/2026 20:57

1. 1.1 / 11.1 / 11.4 — Mood time-to-effect: Replaced time_2_value “Weeks to months” and time_2_sub “Studied trial durations; antidepressant continued” with onset timing from the ER Practical Considerations: “1–3 weeks per dose step” and “Antidepressant continued; full assessment after several weeks on a stable regimen”.

Issues 09/08/2026 20:50

1. 1.3 — Strengthened dosing preference: action_2_sub says “morning/midday preferred”; ER conditions morning/midday split on insomnia or afternoon crash, not a general preference.

2. 4.2 / 4.3 — Protocol labels paraphrased: Action labels “Combination dose”, “Split dosing”, and “Depression add-on” do not match ER Protocol bold labels (“Combination LT4/LT3 (integrative and some academic clinics)”, “Half-life and split dosing”, “Depression augmentation”).

Fixes 09/08/2026 20:52

1. 1.3 — Strengthened dosing preference: Replaced “morning/midday preferred” in action_2_sub with ER-aligned conditional wording: “split morning/midday if insomnia or afternoon crash”.

2. 4.2 / 4.3 — Protocol labels paraphrased: Set action labels to ER Protocol bold labels: “Combination LT4/LT3 (integrative and some academic clinics)”, “Half-life and split dosing”, and “Depression augmentation”.

Issues 09/08/2026 20:43

1. 1.2 — At-a-glance cautious phrasing: At-a-glance says “Monitored use is more reassuring than early fears implied” and drops the ER Conclusion’s scoped phrasing “Safety evidence for regulated, monitored use is more reassuring than early fears implied”.
2. 1.3 — Safety claim strengthened: The same at-a-glance sentence converts an evidence-scoped safety statement into a stronger claim about “monitored use” itself.
3. 9.4 — Supplements interaction wording: Key Interactions item “undeclared T3/T4 “thyroid support,”” is unclear/mangled versus ER wording on undeclared T3/T4 in “thyroid support” or “adrenal” supplements.

Fixes 09/08/2026 20:45

1. 1.2 / 1.3 — At-a-glance safety phrasing: Restored ER-aligned wording “Safety evidence for regulated, monitored use is more reassuring than early fears” and tightened combination phrasing within the 60-word limit.
2. 9.4 — Supplements interaction wording: Rewrote the supplements caution item to “undeclared T3/T4 in “thyroid support” or “adrenal” products” matching the ER.

Issues 09/08/2026 20:34

1. 1.3 — Strengthened ER safety phrasing: At-a-glance uses “safer than early fears suggested” and absolute “do not show combination outperforming” versus ER Conclusion “more reassuring than early fears implied” and “does not reliably outperform.”
2. 8.4 — Attribution in stop item: Contraindication “Weight-loss use in euthyroid individuals (labeling / FDA boxed warning)” retains attribution/citation parenthetical instead of the key fact alone.

Fixes 09/08/2026 20:34

1. 1.3 — Strengthened ER safety phrasing: Revised at-a-glance to “do not reliably show combination outperforming” and “more reassuring than early fears implied,” matching ER Conclusion wording.
2. 8.4 — Attribution in stop item: Removed “(labeling / FDA boxed warning)” from the weight-loss contraindication; left “Weight-loss use in euthyroid individuals.”

Issues 09/08/2026 20:29

1. 2.15 — Colloquial “beats” wording: at_a_glance says combination “beats” optimized standard replacement; ER Conclusion uses formal “outperform”/”does not reliably outperform”.

2. 9.4 — Caution item elaborations: Key Interactions keep operational elaborations (specialist micro-titration; monitor INR; monitor glucose; heart-rate/ECG vigilance) instead of key interaction facts only.

3. 10.4 — Split-dose count off-section: action_2_value “2–3 doses/day” takes the explicit 2–3 count from Risk Mitigation Strategies, not Therapeutic Protocol (Protocol only requires splitting immediate-release doses).

Fixes 09/08/2026 20:30

1. 2.15 — Colloquial beats wording: Replaced “beats” with “outperforming” in at_a_glance so combination-trial language matches formal ER Conclusion wording.

2. 9.4 — Caution item elaborations: Stripped operational elaborations from Key Interactions (specialist micro-titration; monitor INR; monitor glucose; heart-rate/ECG vigilance), leaving key interaction facts and allowed parenthetical qualifiers.

3. 10.4 — Split-dose Protocol source: Replaced action_2_value “2–3 doses/day (immediate-release)” with Protocol-derived “Split immediate-release doses” and moved Protocol conditions (low single-digit mcg / post-dose jitter) into action_2_sub.