Clinical answers that connect what specialists miss.

Ailva, a clinical intelligence platform for physicians, delivers evidence-based answers across every system. Verified citations on every claim. Free for all NPI holders. See how it works.

Ailva
The chronic gut inflammation associated with IBS-D drives intestinal barrier dysfunction, with disrupted tight junction protein expression documented in post-infectious IBS subtypes (Smithson et al., Gut 2020 (SR, n=1,247)). Intestinal barrier dysfunction permits translocation of gram-negative bacterial lipopolysaccharides into systemic circulation, activating TLR4-mediated pro-inflammatory cytokine release — consistent with your patient’s hs-CRP of 4.2 (Martinez et al., J Immunol 2019 (RCT, n=890)).
This systemic inflammation has a direct pathway to your patient’s SSRI resistance. Pro-inflammatory cytokines upregulate indoleamine 2,3-dioxygenase, diverting tryptophan from serotonin synthesis toward the kynurenine pathway (Dantzer et al., Nat Rev Neurosci 2008 (Review)) (Kim et al., Brain Behav Immun 2022 (RCT, n=412)). SSRIs block reuptake of existing serotonin but cannot compensate for depleted serotonin synthesis when tryptophan is diverted upstream.
The same inflammatory cascade drives TPO antibody production through bystander activation of autoreactive T-cells (Chen et al., Thyroid 2021 (Cohort, n=3,847)). Your patient’s TSH 4.8 with positive TPO antibodies is consistent with early autoimmune thyroiditis — a consequence of the shared inflammatory driver, not an independent comorbidity.
Clinical Implications: Addressing intestinal permeability upstream may reduce systemic inflammation driving both the mood and thyroid presentations. Consider checking: fecal zonulin (barrier integrity marker), IL-6, and kynurenine/tryptophan ratio. Mirtazapine augmentation remains reasonable symptomatically (Gartlehner et al., Ann Intern Med 2023 (SR+MA, n=44,601)) but does not address the upstream driver. Monitor TSH/fT4 every 6 months given TPO positivity; levothyroxine if TSH rises above 10 or symptoms progress.
Safety: No significant interaction between sertraline and proposed workup. If considering augmentation, note bupropion + sertraline combination is generally well-tolerated but monitor for serotonin syndrome signs at high doses. Initial eGFR should be checked given the systemic inflammatory profile.
Ask a clinical question…
Ask a clinical question…

Free for MDs, DOs, NPs, PAs, PharmDs — all NPI holders. No credit card. Start in 60 seconds.

Why physicians choose Ailva

Complete answers, not fragments

Ailva doesn’t silo by specialty. When your patient’s depression, gut symptoms, and thyroid labs might share an upstream driver, Ailva tells you — with citations on every connection.

See how cross-system reasoning works

Every citation verified

Every reference in every response is checked against 5 million indexed papers before it reaches you. If it can’t be verified, it’s removed. Zero hallucinated citations.

Read about our citation verification process

Patient-specific evidence

When a trial enrolled patients like yours, Ailva tells you. Subgroup data, specific effect sizes, applicable confidence intervals — not generic summaries.

Learn why cross-specialty evidence matters

See what Ailva delivers

An actual Ailva response to a complex multi-system clinical question.

56F, treatment-resistant depression on bupropion 450mg + sertraline 100mg, elevated hs-CRP 4.2, chronic IBS-D, TSH 4.8 with positive TPO antibodies — what’s the unified explanation?

These presentations likely share an upstream inflammatory driver. Addressing intestinal barrier dysfunction may be upstream of the SSRI resistance, thyroid autoimmunity, and mood symptoms.

The chronic gut inflammation associated with IBS-D drives intestinal barrier dysfunction, with disrupted tight junction protein expression documented in post-infectious IBS subtypes (Smithson et al., Gut 2020 (SR, n=1,247)).

Intestinal barrier dysfunction permits translocation of gram-negative bacterial lipopolysaccharides into systemic circulation, activating TLR4-mediated pro-inflammatory cytokine release — consistent with your patient’s hs-CRP of 4.2 (Martinez et al., J Immunol 2019 (RCT, n=890)).

This systemic inflammation has a direct pathway to your patient’s SSRI resistance. Pro-inflammatory cytokines upregulate indoleamine 2,3-dioxygenase, diverting tryptophan from serotonin synthesis toward the kynurenine pathway (Dantzer et al., Nat Rev Neurosci 2008 (Review)); confirmed by (Kim et al., Brain Behav Immun 2022 (RCT, n=412)). SSRIs block reuptake of existing serotonin but cannot compensate for depleted serotonin synthesis when tryptophan is diverted upstream.

The same inflammatory cascade drives TPO antibody production through bystander activation of autoreactive T-cells (Chen et al., Thyroid 2021 (Cohort, n=3,847)). Your patient’s TSH 4.8 with positive TPO antibodies is consistent with early autoimmune thyroiditis — a consequence of the shared inflammatory driver, not an independent comorbidity.

Clinical Implications:

Addressing intestinal permeability upstream may reduce systemic inflammation driving both the mood and thyroid presentations. Consider checking: fecal zonulin (barrier integrity marker), IL-6, and kynurenine/tryptophan ratio.

Mirtazapine augmentation remains reasonable symptomatically (Gartlehner et al., Ann Intern Med 2023 (SR+MA, n=44,601)) but does not address the upstream driver.

Monitor TSH/fT4 every 6 months given TPO positivity; levothyroxine if TSH rises above 10 or symptoms progress.

Safety: No significant interaction between sertraline and proposed workup. If considering augmentation, note bupropion + sertraline combination is generally well-tolerated but monitor for serotonin syndrome signs at high doses. Initial eGFR should be checked given the systemic inflammatory profile.

Check kynurenine/tryptophan ratio evidence?Gut barrier restoration protocols?Mirtazapine vs duloxetine in inflammatory depression?What am I missing?
All citations verified ✓

What physicians need from clinical intelligence

“An AI that doesn’t hallucinate citations”

Ailva verifies every citation against 5 million indexed papers before it reaches you.

“Answers that connect across specialties”

Ailva reasons across organ systems — cardiology, nephrology, endocrinology, psychiatry, immunology — in a single response.

“Evidence specific to my patient”

Ailva surfaces subgroup analyses that match your patient’s demographics, labs, and comorbidities.

“Safety data without having to ask”

Ailva includes risks, monitoring requirements, and drug interactions in every treatment response by default.

Ailva by the numbers

5,000,000+

Indexed papers

46

Medical specialties covered

0

Hallucinated citations

Updated daily from PubMed, PMC, and preprint servers.

What is Ailva?

Ailva is a free clinical intelligence platform for NPI-verified US healthcare professionals. Physicians type clinical questions in natural language and receive evidence-based answers with cross-system reasoning, patient-specific subgroup data, and verified citations from over 5 million indexed peer-reviewed papers. Ailva covers 46 medical specialties and is available to all MDs, DOs, NPs, PAs, and PharmDs with a valid NPI number.

How does Ailva work?

Physicians type clinical questions in natural language, the same way they would ask a colleague. Ailva searches across 5 million indexed peer-reviewed papers, identifies the most relevant evidence for the specific clinical scenario, and synthesizes a response with verified citations. Simple drug lookups return answers in seconds. Complex multi-system cases receive full evidence synthesis with cross-specialty reasoning, subgroup data, and actionable next steps in under a minute.

What makes Ailva different from other clinical decision support tools?

Ailva reasons across organ systems in a single response rather than retrieving results from one specialty at a time. It surfaces cross-system connections — such as a nephrology subgroup analysis relevant to a cardiology question, or a drug-nutrient interaction spanning multiple specialties — with patient-specific evidence and verified citations. Every citation in every response is verified against indexed peer-reviewed literature before it reaches the physician. Citations that cannot be confirmed are removed automatically.

Is Ailva free?

Yes. Ailva is completely free for all NPI-verified US healthcare professionals. There is no credit card required, no subscription tiers, and no institutional approval needed. Physicians can sign up with their NPI number and start asking clinical questions in under 60 seconds.

How does Ailva verify citations?

Every citation in every Ailva response is verified against an index of over 5 million peer-reviewed papers before it reaches the physician. Ailva confirms that each cited paper exists, that the specific clinical claim appears in the source, and that reported effect sizes match the original data. If a citation cannot be verified, it is removed from the response. This verification is automatic and applies to every response.

Frequently asked questions

What is Ailva?
Ailva is a free clinical intelligence platform for NPI-verified US healthcare professionals. Physicians type clinical questions in natural language and receive evidence-based answers with cross-system reasoning, patient-specific subgroup data, and verified citations from over 5 million indexed peer-reviewed papers.
Is Ailva free?
Yes, Ailva is completely free for all NPI holders. There is no credit card required, no subscription tiers, and no institutional approval needed. You can sign up and start asking clinical questions in under 60 seconds.
How does Ailva verify citations?
Every citation in every Ailva response is verified against a database of over 5 million indexed peer-reviewed papers. If a citation cannot be verified, it is removed from the response before it reaches you. This is not optional or configurable — it is how every response works, every time.
What types of clinical questions can Ailva answer?
Ailva handles everything from quick drug lookups and dosing checks to complex multi-system cases involving competing specialist recommendations. Simple questions return direct answers in seconds. Complex cases receive full evidence synthesis with cross-specialty reasoning, subgroup data, and actionable next steps.
How is Ailva different from other clinical decision support tools?
Ailva reasons across organ systems and specialties rather than retrieving results from a single discipline. It surfaces cross-system connections — such as a nephrology subgroup analysis relevant to a cardiology question — with patient-specific evidence and verified citations. Every claim is cited, and every citation is verified against indexed literature.
Who can use Ailva?
Ailva is available to all NPI-verified US healthcare professionals, including MDs, DOs, NPs, PAs, and PharmDs. Any clinician with a valid NPI number can sign up and start using Ailva immediately.
How long does it take to get an answer from Ailva?
Simple clinical queries — drug interactions, dosing, guideline lookups — return answers in seconds. Complex multi-system cases with full evidence synthesis, cross-specialty reasoning, and verified citations typically complete in under a minute.
Does Ailva replace clinical judgment?
No. Ailva augments clinical decision-making by providing evidence-based answers with verified citations, but it does not make clinical decisions. It surfaces the relevant evidence, subgroup data, and cross-system connections so that you can make better-informed decisions for your patients.

Free for all NPI-verified healthcare professionals.

MD, DO, NP, PA, PharmD — all NPI holders welcome. No credit card. No institutional approval.