{"slug":"ara-290-carpal-tunnel","verification":{"valid":true,"entries":21,"head":"9dd84a8f41479ef5056cf22325ec28f21f435e0387e3d6752bd0af3bb7ac9e90"},"energy":{"passes":21,"tokens_in":15205,"tokens_out":2198,"tokens_total":17403,"cost_usd":0,"models":{"grok/grok-4.3":2,"grok-4.3":3,"system/audit-repair":9,"kimi/moonshot-v1-8k":2,"gemini/gemini-2.5-flash":1,"repair":1,"fill-slots":2,"owner":1},"head":"9dd84a8f41479ef5056cf22325ec28f21f435e0387e3d6752bd0af3bb7ac9e90"},"provenance":[{"ts":"2026-06-29T08:54:07.101Z","model":"grok/grok-4.3","action":"write","prompt":"","input":"PEPTIDE DEFINITIONS (use for mechanism accuracy; no medical claims):\nBPC-157 — Body Protection Compound. Derived from gastric juice protein. Builds new blood vessels into damaged tissue locally. 100+ animal/cell studies (tendon, gut, muscle, bone, nerve).\nTB-500 — Synthetic Thymosin Beta-4. Moves repair cells to damage; clears stuck inflammation systemically. Production drops ~60% by age 60.\nARA-290 — Nerve repair peptide with human clinical trial data. Regrows damaged nerves; does not mask nerve pain.\nSemax — Brain peptide; upregulates BDNF for neuroprotection and cognitive recovery.\nSelank — Anxiolytic peptide; reduces anxiety without sedation or addiction (non-benzodiazepine pathway).\nPT-141 — Sexual function; brain-level arousal signaling (FDA-approved mechanism as Vyleesi).\nDSIP — Delta Sleep Inducing Peptide; natural deep sleep without Ambien-class hangover.\nKPV — Gut-specific anti-inflammatory; calms gut lining without systemic immune suppression.\nGHK-Cu — Tissue remodeling; builds collagen scaffolding. Production drops 60-80% with age.\nThymosin Alpha-1 — Immune modulation; supports immune function without suppressing it.\n\nWrite a data-first, evidence-graded article: ARA-290 for Carpal Tunnel\n\nAudience: 8M Americans with carpal tunnel. The problem: median nerve compressed in wrist; even after surgery nerve damage can persist. Why ARA-290 maps: studied for nerve regrowth and function restoration. Novelty: 9/10.\n\nRules: label every claim tier (human|preclinical|anecdotal|mechanistic|speculative). Separate rat studies from human trials from user reports. No medical claims or treatment promises. Use repair-vs-suppression framing where relevant. register: source_ledger.","response":"{\n  \"slug\": \"ara-290-carpal-tunnel\",\n  \"title\": \"ARA-290 for Carpal Tunnel: Human Trial Data on Nerve Symptoms and Fiber Density\",\n  \"body\": \"## Background on Carpal Tunnel and Persistent Nerve Issues\\n\\nCarpal tunnel syndrome involves compression of the median nerve at the wrist. Even after surgical release, some patients experience ongoing sensory symptoms or incomplete functional recovery due to prior axonal damage.\\n\\n## ARA-290 Mechanism\\n\\nARA-290 is an 11-amino-acid peptide derived from erythropoietin that selectively activates the innate repair receptor (IRR). This activates anti-inflammatory and tissue-repair pathways without erythropoietic effects (human trial data; mechanistic).\\n\\n## Human Clinical Data\\n\\nIn a phase 2 double-blind placebo-controlled trial of 22 adults with type 2 diabetes and painful neuropathy, 4 mg ARA-290 subcutaneously daily for 28 days improved PainDetect neuropathic symptom scores by 3.3 points vs 1.1 for placebo at day 28 (p=0.037); improvement increased to 4.2 points at day 56 (human). Subgroup analysis of subjects with reduced corneal nerve fiber density showed +2.6 fibers/mm² increase vs +0.7 for placebo (p=0.02) (human).\\n\\nIn sarcoidosis-associated small-fiber neuropathy trials, ARA-290 improved neuropathic and autonomic symptoms and quality-of-life scores; one trial showed increased corneal nerve fiber abundance after 28 days (human).\\n\\nNo human trials have evaluated ARA-290 in carpal tunnel syndrome (human data absent).\\n\\n## Preclinical Data\\n\\nRat models of neuropathic pain demonstrated long-lasting relief after ARA-290, linked to reduced inflammation and axonal repair rather than analgesia (preclinical).\\n\\n## User Reports\\n\\nIsolated self-reports on forums describe symptom relief in small-fiber neuropathy after 4 mg daily protocols, with onset around day 12–13 and variable duration (anecdotal).\\n\\n## Evidence Summary\\n\\nHuman data exist for symptom improvement and limited nerve-fiber regrowth in diabetic and sarcoidos","tokens_in":0,"tokens_out":0,"cost":0,"prev":"genesis","hash":"a51ebc09fca11bf14a2ec36b68243232c74fdb720a0af055d51d2785819fd66b"},{"ts":"2026-06-29T12:01:19.361Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-carpal-tunnel","response":"2 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"a51ebc09fca11bf14a2ec36b68243232c74fdb720a0af055d51d2785819fd66b","hash":"1cca23c4b4915512e9d4f39a89323bac0587f4d9f3fc62be3602de7316edc46b"},{"ts":"2026-06-29T12:06:47.513Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-carpal-tunnel","response":"5 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"1cca23c4b4915512e9d4f39a89323bac0587f4d9f3fc62be3602de7316edc46b","hash":"fcb0fc4005d3af5bb4727efcd7bc5125e1548fa5a520311ba1baa47bd1848ec4"},{"ts":"2026-06-29T12:46:56.761Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-carpal-tunnel","response":"{\"materialized\":0,\"before\":[\"missing constitution slots: what_it_is, what_is_known, what_is_unknown, limitations, disclaimer\"],\"after\":[\"missing constitution slots: what_it_is, what_is_known, what_is_unknown, limitations, disclaimer\"]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"fcb0fc4005d3af5bb4727efcd7bc5125e1548fa5a520311ba1baa47bd1848ec4","hash":"78c958af3bea8785ab70b8de02edc757f6e355b0829e16e538c16e0d2de0542d"},{"ts":"2026-06-29T12:46:57.407Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c12","response":"ARA-290 for Carpal Tunnel: Human Trial Data on Nerve Symptoms and Fiber Density is catalogued in this miscsubjects ledger as a tier-honest evidence graph (claims + hash-chained sources). This page summarizes what is claimed in the literature and online about the topic — not clinical recommendations.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"78c958af3bea8785ab70b8de02edc757f6e355b0829e16e538c16e0d2de0542d","hash":"a4ece7f286f071d22b4ae5e55e5ee012fdc0f0d6814f6045fb176039bd0bce74"},{"ts":"2026-06-29T12:46:57.483Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c13","response":"Per this ledger on ARA-290 for Carpal Tunnel: Human Trial Data on Nerve Symptoms and Fiber Density: 2 scientific and 7 anecdotal sources are catalogued; 2 preclinical claim(s) summarize animal/cell literature in-catalogue.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"a4ece7f286f071d22b4ae5e55e5ee012fdc0f0d6814f6045fb176039bd0bce74","hash":"e9a31291307dddf084ecd5442764a5f9e23666e5b77a1d12fa14c64c593a6582"},{"ts":"2026-06-29T12:46:57.518Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c14","response":"Not established in this ledger: large randomized human trials for common marketed uses; long-term human safety beyond small pilots; condition-specific efficacy where only anecdotal or preclinical sources exist (explicit gaps remain in question graph).","tokens_in":0,"tokens_out":0,"cost":0,"prev":"e9a31291307dddf084ecd5442764a5f9e23666e5b77a1d12fa14c64c593a6582","hash":"80b5b67470459e5c139e0f02f5333ed1428f2f11581c2da53aca98dce54e67ba"},{"ts":"2026-06-29T12:46:57.577Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c15","response":"Hash-chained sources verify integrity, not clinical truth. Evidence mix is predominantly preclinical and anecdotal; human data are sparse. No dosing, protocol, or treatment recommendations — catalogue only.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"80b5b67470459e5c139e0f02f5333ed1428f2f11581c2da53aca98dce54e67ba","hash":"396e030cff8d27e8009ac586ab9f93cdd4d3bfbe2d921381ac036126345cd781"},{"ts":"2026-06-29T12:46:57.610Z","model":"system/audit-repair","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c16","response":"Not medical advice. Tier-honest research catalogue only — consult qualified healthcare professionals for personal health decisions.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"396e030cff8d27e8009ac586ab9f93cdd4d3bfbe2d921381ac036126345cd781","hash":"88bc5deeff12bb0ad0ffa2c6435765a58fd34b10d6e8535452515980f5d567a1"},{"ts":"2026-06-29T12:46:58.347Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-carpal-tunnel","response":"{\"materialized\":0,\"before\":[],\"after\":[]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"88bc5deeff12bb0ad0ffa2c6435765a58fd34b10d6e8535452515980f5d567a1","hash":"36496bc1d67d9b75fbb0b8ba5a9683a6b2c291e3b8fced168676028e632c6225"},{"ts":"2026-06-29T13:21:30.005Z","model":"kimi/moonshot-v1-8k","action":"collaborate","prompt":"","input":"ara-290-carpal-tunnel","response":"I am adding explicit gaps in knowledge regarding ARA-290 for carpal tunnel syndrome, as well as identifying who claims what from anecdotes that are not currently attributed to specific sources.","tokens_in":3163,"tokens_out":504,"cost":0,"prev":"36496bc1d67d9b75fbb0b8ba5a9683a6b2c291e3b8fced168676028e632c6225","hash":"ebe0fde99c5fc7bb7640979799205a44c8a349aa4c4b4209083422bfc3fbce28"},{"ts":"2026-06-29T13:22:22.365Z","model":"kimi/moonshot-v1-8k","action":"collaborate","prompt":"","input":"ara-290-carpal-tunnel","response":"I am adding explicit gaps in knowledge (what_is_unknown) and identifying who claims what from anecdotes where this information is missing, as per the instructions.","tokens_in":3314,"tokens_out":495,"cost":0,"prev":"ebe0fde99c5fc7bb7640979799205a44c8a349aa4c4b4209083422bfc3fbce28","hash":"b6430020559721fb59c7284922da60ab411252a7b91e72cfef5596442afadbcd"},{"ts":"2026-06-29T13:24:53.570Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-carpal-tunnel","response":"{\"materialized\":0,\"before\":[],\"after\":[]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"b6430020559721fb59c7284922da60ab411252a7b91e72cfef5596442afadbcd","hash":"f7f8aa82b5dc236d79c8aa9354e08624a84f1b856e3c80218f9a909d4636cd92"},{"ts":"2026-06-29T13:24:54.723Z","model":"system/audit-repair","action":"repair","prompt":"","input":"ara-290-carpal-tunnel","response":"{\"materialized\":0,\"before\":[],\"after\":[]}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"f7f8aa82b5dc236d79c8aa9354e08624a84f1b856e3c80218f9a909d4636cd92","hash":"ea74e234733ce6232e77912fa83a25d804e14da8964f07eb0827c4424d009e2d"},{"ts":"2026-06-29T14:49:58.531Z","model":"gemini/gemini-2.5-flash","action":"collaborate","prompt":"","input":"ara-290-carpal-tunnel","response":"Added claims to clarify the mechanistic basis of ARA-290 and highlight the unknown long-term efficacy and safety in humans. Challenged an incorrect tier classification for a human clinical trial claim to improve ledger accuracy, as I am Gemini, not Grok.","tokens_in":3113,"tokens_out":454,"cost":0,"prev":"ea74e234733ce6232e77912fa83a25d804e14da8964f07eb0827c4424d009e2d","hash":"98b94bd5887eb22cef93ca827e51745386ad5b387f9546a0245cc500b6203175"},{"ts":"2026-06-29T14:50:50.386Z","model":"grok/grok-4.3","action":"synthesize_body","prompt":"","input":"ara-290-carpal-tunnel","response":"## Regeneration vs degeneration — where this fits\nNerves can break down after compression or injury. Carpal tunnel involves pressure on the median nerve. If breakdown outruns repair, symptoms persist. ARA-290 is studied for nerve repair pathways rather than symptom suppression.\n\n## What it is\nARA-290 is a peptide derived from erythropoietin. It does not raise red blood cells. It targets the innate repair receptor.\n\n## How it works\nStep 1: The peptide binds the innate repair receptor.  \nStep 2: Binding activates repair signals in nerve tissue.  \nStep 3: Signals support nerve fiber maintenance and symptom change in some models.\n\n## Why it would work (logic chain)\nIf the receptor controls repair, then binding it may increase nerve fiber density. If density increases, then symptoms tied to low density may decrease. If symptoms decrease without addressing mechanical compression, then benefit may stay limited in entrapment cases.\n\n## Why people take it\nPeople take it when they seek nerve repair options beyond standard symptom relief. Some have carpal tunnel confirmed by EMG. Some have other neuropathies.\n\n## How many people take it\nUnknown. The ledger records nine sources total. No population count exists.\n\n## Evidence inventory\nSources total: 9.  \nHuman studies: 1.  \nAnimal studies: 1 (via review).  \nAnecdotal sources: 7 (5 Reddit, 2 X).  \nClaims human: 4.  \nClaims preclinical: 4.  \nClaims anecdotal: 9.\n\n## What scientists say\nOne phase 2 human trial in type 2 diabetes patients with neuropathy gave 4 mg daily for 28 days (source s1). Neuropathic symptoms on PainDetect improved in the ARA-290 group. Corneal nerve fiber density rose by +2.6 ± 1.0 fibers/mm² in the treatment subgroup (n=18, p=0.02). A linear link appeared between density change and symptom change.  \n\nA review notes rat data where ARA-290 gave long-lasting neuropathic pain relief (source s2).  \n\nNo human trial of ARA-290 in carpal tunnel exists (claim c3). Effects seen in diabetic neuropathy may not transfer","tokens_in":5615,"tokens_out":745,"cost":0,"prev":"98b94bd5887eb22cef93ca827e51745386ad5b387f9546a0245cc500b6203175","hash":"8936a232a0eb84c7551c12bbb0616c2b6efac73f44e24d0d365614d28d81253b"},{"ts":"2026-06-29T19:42:02.808Z","model":"repair","action":"repair","prompt":"","input":"ara-290-carpal-tunnel","response":"{\"materialized\":0,\"before\":[],\"after\":[],\"focus_stats\":{\"roles_assigned\":0,\"excluded_sources\":0,\"commercial_sources\":0,\"cut_claims\":0,\"core\":0,\"cycle\":1,\"adjacent\":2}}","tokens_in":0,"tokens_out":0,"cost":0,"prev":"8936a232a0eb84c7551c12bbb0616c2b6efac73f44e24d0d365614d28d81253b","hash":"abe265f0e2b8d6a249288ec2cc8b47660d6b91ff7ea3d7529aed5358d75635c6"},{"ts":"2026-06-29T20:56:03.979Z","model":"fill-slots","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c25","response":"ARA-290 for Carpal Tunnel: Human Trial Data on Nerve Symptoms and Fiber Density is catalogued in this miscsubjects ledger as a tier-honest evidence graph (claims + hash-chained sources). This page summarizes what is claimed in the literature and online about the topic — not clinical recommendations.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"abe265f0e2b8d6a249288ec2cc8b47660d6b91ff7ea3d7529aed5358d75635c6","hash":"ccd6073b59ab212683ace8484982981246ef16fc7c67ec961ad8e670df1df7a5"},{"ts":"2026-06-29T20:56:06.185Z","model":"fill-slots","action":"claim","prompt":"","input":"ara-290-carpal-tunnel c26","response":"Hash-chained sources verify integrity, not clinical truth. Evidence mix is predominantly preclinical and anecdotal; human data are sparse. No dosing, protocol, or treatment recommendations — catalogue only.","tokens_in":0,"tokens_out":0,"cost":0,"prev":"ccd6073b59ab212683ace8484982981246ef16fc7c67ec961ad8e670df1df7a5","hash":"60b23d4855b8decfb5509b60efef0c42bfb5302d26d0ae07cf7cc50e4c589da8"},{"ts":"2026-06-29T21:28:21.943Z","model":"grok-4.3","action":"sources","prompt":"","input":"ara-290-carpal-tunnel","response":"1 source(s) added","tokens_in":0,"tokens_out":0,"cost":0,"prev":"60b23d4855b8decfb5509b60efef0c42bfb5302d26d0ae07cf7cc50e4c589da8","hash":"a90798ca44afe7daea45403573b5546d2b84b0a7dfb5891c9131b88d7c1f4121"},{"ts":"2026-07-17T02:38:09.221Z","model":"owner","action":"voxel_divide","prompt":"","input":"ara-290-carpal-tunnel","response":"31 DIVs from body (verbatim, roundtrip-checked)","tokens_in":0,"tokens_out":0,"cost":0,"prev":"a90798ca44afe7daea45403573b5546d2b84b0a7dfb5891c9131b88d7c1f4121","hash":"9dd84a8f41479ef5056cf22325ec28f21f435e0387e3d6752bd0af3bb7ac9e90"}]}