i know a lot of people are skeptical about rythm health, but for some like me its literally my only option. do you test at the same time each month? or does it really matter that much? and thanks for vouching for biopharma im on my 2nd order and was skeptical at first from so of the comments, but so far they have been the best ive delt with.

Brother, going to give you a different kind of reply than most guys are getting on these blood threads because honestly your panel is in good shape and I don't want you to overcorrect. A couple of guys in the thread are pointing at things to "fix" that don't really need fixing. Let me sort signal from noise.
What you actually have here:
Total cholesterol 150, LDL 104, ApoB 96 these are better than most non-cycling guys. Population median ApoB is around 100. You're on 250 test + 250 deca + just-started var and your atherogenic markers are basically normal. That's an unusually responsive lipid profile, lucky genetics, or both.
HDL tanked yes, but this is expected and not the emergency some guys make it out to be when the rest of the panel is this clean. HDL is a marker, ApoB is the driver. Your ApoB is fine.
Liver clean ✓
Inflammation decent ✓
E2 mildly elevated but you have zero symptoms ✓
Prolactin in range on deca ✓ this is actually the dangerous one with nandrolone, glad to see it controlled
Progesterone undetectable ✓ normal on deca, exactly as expected
The genuinely interesting thing in your update the lump under your left nipple from prior cycles that "seems to have dissipated." That's actually worth a word. Gyno tissue once formed is usually permanent without surgery or a SERM. If it's genuinely getting smaller on this protocol, possibilities are:
It wasn't true glandular gyno, it was fibrous tissue or fat that's leaning out
You're getting some recompositioning that's making it less prominent
Deca + test at this ratio (1:1) actually has interesting effects on local breast tissue there's some evidence that managed E2 + low prolactin + androgen dominance can shrink fibrotic gyno in some guys, though "make it disappear" is rare
If it genuinely keeps shrinking, that's a nice unexpected win. If you start it growing or feel tenderness, that's the moment to act raloxifene 60mg/day for 8 weeks is the standard answer and works well on early/responsive gyno tissue. Don't run nolva for this, raloxifene is better for breast tissue specifically and doesn't tank IGF-1.
What press1 flagged on the creatinine is a real loose end. No eGFR reported is sloppy from the lab, not just an inconvenience. Your guess is probably right creatine supplementation, heavy training, sauna, slight dehydration. But you actually want to know. Two things to do:
Next test, make sure eGFR is reported (and ideally calculated with the CKD-EPI 2021 equation, not the older MDRD)
If eGFR comes back flagged, get cystatin C as a follow-up it's not muscle-mass-dependent like creatinine, so it gives you the real kidney picture for someone who lifts. A lot of bodybuilders look like they have CKD on creatinine-based eGFR and have perfect cystatin C eGFR. That's the test that settles it.
On the supplement stack you ordered:
Keep:
Citrus bergamot ✓ real lipid data, especially on cycle
Omega-3 fish oil ✓ but dose matters. 1g/day does basically nothing. You want 2-3g EPA+DHA combined daily to actually move trigs and have anti-inflammatory effect. Read the back of the bottle, not the front most "1000mg fish oil" capsules only have 300mg actual EPA+DHA.
D3+K2 ✓ fine, especially if your D is low (which most guys' is). 5000 IU D3 + 100mcg K2-MK7 is the standard stack.
Zinc glycinate ✓ supports testosterone production and helps with aromatase. 25-30mg/day is plenty, more isn't better and long-term high-dose zinc tanks copper.
Reconsider:
Berberine honestly, you don't need this. Berberine is for insulin resistance / elevated glucose / metabolic syndrome. Your glucose and metabolic markers are fine. Berberine also has GI side effects, hits the liver mildly, and inhibits some CYP enzymes which can affect how you process other things. Save the money and the liver bandwidth. If you ever pick up retatrutide or a GLP-1 and want metabolic support, then revisit it.
Worth adding:
CoQ10 bgonz mentioned it, he's right. 100-200mg/day. Especially useful if you ever end up on a statin (probably not needed for you given your lipids).
TUDCA you didn't mention it but you just started anavar. 250mg/day while running orals is the single most evidence-backed liver protectant. Cheap insurance. Drop it when you drop the var.
On the var specifically:
Heads up you started var about a week before testing, so your retest in 4 weeks will be your 5-week-on-var snapshot. Expect HDL to drop further (maybe to 25-30), LDL to bump 15-25% (so probably 120-130s), and ApoB to follow (probably 110-120s). That's the var doing var things. Don't panic when you see it — that's the expected oral curve, not a sign your cycle is hurting you uniquely. The question for retest is whether HDL is catastrophically down (like sub-20) or whether it's settling in the 25-30 range, which is normal for var users.
On the E2 at 80s:
Bgonz's "wait until you have symptoms" framing is correct for your situation specifically because you actually have zero symptoms. The test:E2 ratio thing he mentioned (10:1 to 30:1) is a useful heuristic but it gets weird when your test is reported as ">1500" — you can't calculate a real ratio off a censored number. For next test, push for a quantitative total T number, not censored. Most labs can dilute the sample and re-run if the doctor requests it; otherwise switch to a panel that doesn't cap at 1500. Superpower (which bgonz mentioned) and some others do this.
Things to actually do for retest in 4 weeks:
Get a more comprehensive panel this time bgonz's Superpower suggestion isn't bad, or any panel that includes:
Quantitative total T (no >1500 cap)
Free T (measured, not just calculated)
eGFR + ideally cystatin C for kidney
hs-CRP specifically (not just CRP)
Hematocrit + hemoglobin trend (deca + test can polycythemia you, watch this)
GGT alongside ALT/AST for full liver picture
Fasting insulin to pair with glucose for HOMA-IR
Get BP at home before retest daily for 2 weeks, average it. Cheap cuff, $30. Nobody on your thread asked about BP and it's the most underrated marker for guys on cycle. Deca + test can creep BP up without symptoms.
Don't fast 12+ hours and don't do test after no sleep. Standard 8-10 hour fast, well-rested, morning draw, no training the day before. Gives you a real number, not a stress-skewed one.
Track the nipple lump. If it grows or gets tender, that's a different conversation (raloxifene). If it keeps shrinking, just note it for your own records.
The honest bottom line:
You're running a relatively moderate cycle (250/250 is conservative for a blast), your body is responding well, your lipids are unusually good for someone on cycle, your prolactin is controlled on deca (which is the actually-dangerous risk with nandrolone), and you have no symptoms. The supplements you ordered are mostly fine, just drop the berberine, add TUDCA while on var, dose the fish oil correctly.
Real risks to watch on your specific protocol:
Hematocrit creep (deca + test will push it up if you go above 52-53%, donate blood)
BP creep (silent, common, easy to fix if caught)
Prolactin can swing on deca recheck every panel, don't get complacent because this one was good
HDL recovery post-cycle (will take 2-4 months after stopping var/deca)
You're doing this about as right as a guy in your spot can. Don't let the HDL number psych you out it's the expected response, not a sign something's broken.

Can't say I like that Health App very much - not easy to determine where your actual levels are in relation to the parameters they should be in. Any reason for the high Creatinine level mate - did they not state your eGFR anywhere?

Ive had my e2 up in the 80s before too. I honestly had no symptoms and no noticeable problems. No bitch tits or water retention.

Was gonna ask if you are running any orals with those hdl numbers? Or is that the deca only causing that? Just reupped a bunch of the same sups you mentioned for an upcoming tbol run.

Also thanks for the testing man. This source was catching some heat recently for under-dosed tren, so glad to see some positives.