diff --git a/docs/api/openapi.yaml b/docs/api/openapi.yaml
index 43407e243..27982c45f 100644
--- a/docs/api/openapi.yaml
+++ b/docs/api/openapi.yaml
@@ -1904,7 +1904,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": &a30
+        "501": &a44
           description: "Not implemented on this server yet: the contract is published, the effect is not. `meta.errorCode` =
             `not_implemented`, `meta.operation` names the operation. Authentication, module gates and request validation
             already answer as documented. A client reaches this only by ignoring the server feature flag that guards the
@@ -15171,7 +15171,7 @@ paths:
             schema:
               $ref: "#/components/schemas/OcrTextExtractRequest"
       responses:
-        "202": &a39
+        "202": &a37
           description: Queued for the background worker. Every refusal the route can answer quickly (capability, provider, rate
             limit, budget, validation) has already been answered; anything that goes wrong from here is reported on the
             run.
@@ -15318,7 +15318,7 @@ paths:
                 $ref: "#/components/schemas/CreateBiomarkerResponse"
         "401": *a1
         "403": *a11
-        "409": &a29
+        "409":
           description: A biomarker with this name already exists for the caller.
           content:
             application/json:
@@ -15331,7 +15331,8 @@ paths:
       tags:
         - Labs
       summary: Fetch a single biomarker
-      description: Returns the biomarker including its decrypted `context`. Cross-user rows surface as 404.
+      description: Returns the biomarker including its decrypted `context` and, since v1.43, its `aliases`. Cross-user rows
+        surface as 404. A marker merged into another answers 404 with `meta.mergedInto`.
       parameters:
         - in: path
           name: id
@@ -15361,8 +15362,10 @@ paths:
       tags:
         - Labs
       summary: Edit a biomarker
-      description: "Partial edit; omitted fields are untouched, an explicit null clears `context` / `panel` / a bound. Audits
-        as `biomarker.update`. Since v1.40.0 a `unit` different from the stored one is refused with 422
+      description: "Partial edit; omitted fields are untouched, an explicit null clears `context` / `panel` / a bound. Since
+        v1.43 `aliases` (0..50, each 1..120 characters) replaces the marker's set of other spellings: listed spellings
+        stay or are added, unlisted ones are removed; omitting the field leaves them as they are. Audits as
+        `biomarker.update`. Since v1.40.0 a `unit` different from the stored one is refused with 422
         `biomarkers.unit.locked` while any reading is linked to the marker (`meta.readingCount` carries how many):
         readers label every linked reading with the marker's unit, so a change would relabel stored numbers without
         converting them. Sending the current unit, or changing it on a marker with no readings, is accepted."
@@ -15388,7 +15391,14 @@ paths:
         "401": *a1
         "403": *a11
         "404": *a28
-        "409": *a29
+        "409":
+          description: "`labs.biomarker.duplicate`: a rename collides with another of the caller's markers.
+            `labs.biomarker.alias.taken` (v1.43): one of `aliases` is already the name or an alias of another marker;
+            `meta.alias` names the spelling and `meta.biomarkerId` the marker that answers to it."
+          content:
+            application/json:
+              schema:
+                $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
     delete:
@@ -15443,17 +15453,27 @@ paths:
               $ref: "#/components/schemas/BiomarkerMergeRequest"
       responses:
         "200":
-          description: The merge result (or the dry-run preview).
+          description: 'The merge result, or the dry-run preview. A preview reports a source that cannot be converted with
+            `conversion: "refused"` and its `refusal`; the same request without `dryRun` answers 422
+            `labs.biomarker.merge.unitMismatch`.'
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/MergeBiomarkersResponse"
         "401": *a1
+        "403": *a11
         "404": *a28
         "409": *a7
-        "422": *a4
+        "422":
+          description: "`labs.biomarker.merge.invalid`: a malformed body, or the target among the sources (Zod issues in
+            `details.issues[]`). `labs.biomarker.merge.unitMismatch`: a source holds readings in a unit the registry
+            cannot convert to the target's; `meta.sources` lists each `{ id, unit, targetUnit, reason }` with `reason`
+            one of `unknown_analyte`, `unknown_unit`, `not_finite`. Nothing was moved."
+          content:
+            application/json:
+              schema:
+                $ref: "#/components/schemas/ErrorEnvelope"
         "429": *a12
-        "501": *a30
   /api/encounters:
     get:
       tags:
@@ -15666,7 +15686,7 @@ paths:
                 $ref: "#/components/schemas/GetEncounterEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a31
+        "404": &a29
           description: Visit not found (or owned by another user).
           content:
             application/json:
@@ -15700,7 +15720,7 @@ paths:
                 $ref: "#/components/schemas/UpdateEncounterEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a31
+        "404": *a29
         "422": *a4
         "429": *a5
     delete:
@@ -15725,7 +15745,7 @@ paths:
                 $ref: "#/components/schemas/DeleteEncounterEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a31
+        "404": *a29
         "422": *a4
         "429": *a5
   /api/encounters/{id}/restore:
@@ -15751,7 +15771,7 @@ paths:
                 $ref: "#/components/schemas/RestoreEncounterEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a31
+        "404": *a29
         "422": *a4
         "429": *a5
   /api/encounters/{id}/links:
@@ -15781,7 +15801,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/LinkEncounterEnvelope"
         "401": *a1
-        "404": *a31
+        "404": *a29
         "422": *a4
         "429": *a5
     delete:
@@ -15810,7 +15830,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/UnlinkEncounterEnvelope"
         "401": *a1
-        "404": *a31
+        "404": *a29
         "422": *a4
         "429": *a5
   /api/practitioners:
@@ -15889,7 +15909,7 @@ paths:
                 $ref: "#/components/schemas/GetPractitionerEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a32
+        "404": &a30
           description: Practitioner not found (or owned by another user).
           content:
             application/json:
@@ -15923,7 +15943,7 @@ paths:
                 $ref: "#/components/schemas/UpdatePractitionerEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a32
+        "404": *a30
         "422": *a4
         "429": *a5
     delete:
@@ -15947,7 +15967,7 @@ paths:
                 $ref: "#/components/schemas/DeletePractitionerEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a32
+        "404": *a30
         "422": *a4
         "429": *a5
   /api/practitioners/{id}/restore:
@@ -15973,7 +15993,7 @@ paths:
                 $ref: "#/components/schemas/RestorePractitionerEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a32
+        "404": *a30
         "422": *a4
         "429": *a5
   /api/vaccinations/custom:
@@ -16017,7 +16037,7 @@ paths:
                 $ref: "#/components/schemas/CreateCustomVaccineEnvelope"
         "401": *a1
         "403": *a11
-        "409": &a33
+        "409": &a31
           description: A live definition on the record already carries this name, compared without case
             (`vaccination.custom.name-taken`).
           content:
@@ -16054,13 +16074,13 @@ paths:
                 $ref: "#/components/schemas/UpdateCustomVaccineEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a34
+        "404": &a32
           description: No live definition with this id on the record (`vaccination.custom.not-found`).
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "409": *a33
+        "409": *a31
         "422": *a4
         "429": *a5
     delete:
@@ -16085,7 +16105,7 @@ paths:
                 $ref: "#/components/schemas/DeleteCustomVaccineEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a34
+        "404": *a32
         "422": *a4
         "429": *a5
   /api/vaccinations:
@@ -16187,7 +16207,7 @@ paths:
                 $ref: "#/components/schemas/GetVaccinationEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a35
+        "404": &a33
           description: Vaccination not found (or owned by another user).
           content:
             application/json:
@@ -16222,7 +16242,7 @@ paths:
                 $ref: "#/components/schemas/UpdateVaccinationEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a35
+        "404": *a33
         "422": *a4
         "429": *a5
     delete:
@@ -16247,7 +16267,7 @@ paths:
                 $ref: "#/components/schemas/DeleteVaccinationEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a35
+        "404": *a33
         "422": *a4
         "429": *a5
   /api/vaccinations/{id}/restore:
@@ -16272,7 +16292,7 @@ paths:
                 $ref: "#/components/schemas/RestoreVaccinationEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a35
+        "404": *a33
         "422": *a4
         "429": *a5
   /api/vaccinations/{id}/booster:
@@ -16338,7 +16358,7 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "404": *a35
+        "404": *a33
         "422": *a4
         "429": *a5
   /api/vaccinations/suggest:
@@ -16396,7 +16416,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/LinkVaccinationEnvelope"
         "401": *a1
-        "404": *a35
+        "404": *a33
         "422": *a4
         "429": *a5
     delete:
@@ -16425,7 +16445,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/UnlinkVaccinationEnvelope"
         "401": *a1
-        "404": *a35
+        "404": *a33
         "422": *a4
         "429": *a5
   /api/illness/episodes:
@@ -16540,7 +16560,7 @@ paths:
                 $ref: "#/components/schemas/GetIllnessEpisodeEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a36
+        "404": &a34
           description: Illness episode not found (or owned by another user).
           content:
             application/json:
@@ -16575,7 +16595,7 @@ paths:
                 $ref: "#/components/schemas/UpdateIllnessEpisodeEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a36
+        "404": *a34
         "422": *a4
         "429": *a5
     delete:
@@ -16599,7 +16619,7 @@ paths:
                 $ref: "#/components/schemas/DeleteIllnessEpisodeEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a36
+        "404": *a34
         "422": *a4
         "429": *a5
   /api/illness/episodes/{id}/restore:
@@ -16627,7 +16647,7 @@ paths:
                 $ref: "#/components/schemas/RestoreIllnessEpisodeEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a36
+        "404": *a34
         "409": *a7
         "422": *a4
         "429": *a5
@@ -16660,7 +16680,7 @@ paths:
                 $ref: "#/components/schemas/ResolveIllnessEpisodeEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a36
+        "404": *a34
         "422": *a4
         "429": *a5
   /api/illness/episodes/{id}/day-logs:
@@ -16711,7 +16731,7 @@ paths:
                 $ref: "#/components/schemas/GetIllnessDayLogEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a36
+        "404": *a34
         "422": *a4
         "429": *a5
     post:
@@ -16748,7 +16768,7 @@ paths:
                 $ref: "#/components/schemas/UpsertIllnessDayLogCreatedEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a36
+        "404": *a34
         "422": *a4
         "429": *a5
   /api/illness/episodes/{id}/correlation:
@@ -16775,7 +16795,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/IllnessCorrelationEnvelope"
         "401": *a1
-        "404": *a36
+        "404": *a34
         "422": *a4
         "429": *a5
   /api/illness/insights:
@@ -16991,7 +17011,7 @@ paths:
                 $ref: "#/components/schemas/GetAllergyEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a37
+        "404": &a35
           description: Allergy not found (or owned by another user).
           content:
             application/json:
@@ -17025,7 +17045,7 @@ paths:
                 $ref: "#/components/schemas/UpdateAllergyEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a37
+        "404": *a35
         "422": *a4
         "429": *a5
     delete:
@@ -17049,7 +17069,7 @@ paths:
                 $ref: "#/components/schemas/DeleteAllergyEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a37
+        "404": *a35
         "422": *a4
         "429": *a5
   /api/family-history:
@@ -17123,7 +17143,7 @@ paths:
                 $ref: "#/components/schemas/GetFamilyHistoryEnvelope"
         "401": *a1
         "403": *a11
-        "404": &a38
+        "404": &a36
           description: Family history entry not found (or owned by another user).
           content:
             application/json:
@@ -17157,7 +17177,7 @@ paths:
                 $ref: "#/components/schemas/UpdateFamilyHistoryEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a38
+        "404": *a36
         "422": *a4
         "429": *a5
     delete:
@@ -17181,7 +17201,7 @@ paths:
                 $ref: "#/components/schemas/DeleteFamilyHistoryEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a38
+        "404": *a36
         "422": *a4
         "429": *a5
   /api/documents/inbound:
@@ -17846,7 +17866,7 @@ paths:
           required: true
           schema:
             type: string
-        - &a40
+        - &a38
           name: Prefer
           in: header
           required: false
@@ -17871,9 +17891,9 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/InboundExtractEnvelope"
-        "202": *a39
+        "202": *a37
         "401": *a1
-        "403": &a41
+        "403": &a39
           description: "AI refusal: the `documentAi` capability is unavailable for this record. The envelope carries
             `meta.errorCode`, `meta.capability` and `meta.reason` (one of `AiUnavailableReason`).
             `assistant.disabled.documentAi` — the operator turned off reading documents, or every AI feature (the master
@@ -17897,7 +17917,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "503": &a42
+        "503": &a40
           description: "`ai.unavailable` — the inputs behind the AI capability could not be read, and the answer failed closed.
             Nothing was sent. Retry later."
           content:
@@ -17927,7 +17947,7 @@ paths:
           required: true
           schema:
             type: string
-        - *a40
+        - *a38
       requestBody:
         required: false
         content:
@@ -17963,12 +17983,12 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/DocumentSuggestEnvelope"
-        "202": *a39
+        "202": *a37
         "401": *a1
-        "403": *a41
+        "403": *a39
         "422": *a4
         "429": *a5
-        "503": *a42
+        "503": *a40
   /api/documents/inbound/{id}/summary:
     post:
       tags:
@@ -18018,7 +18038,7 @@ paths:
             type: boolean
             default: false
           description: With `persist=true`, explicitly replace an existing stored summary.
-        - *a40
+        - *a38
       requestBody:
         required: false
         content:
@@ -18054,12 +18074,12 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/DocumentSummaryEnvelope"
-        "202": *a39
+        "202": *a37
         "401": *a1
-        "403": *a41
+        "403": *a39
         "422": *a4
         "429": *a5
-        "503": *a42
+        "503": *a40
   /api/documents/inbound/{id}/index:
     post:
       tags:
@@ -18085,7 +18105,7 @@ paths:
           required: true
           schema:
             type: string
-        - *a40
+        - *a38
       requestBody:
         required: false
         content:
@@ -18121,12 +18141,12 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/DocumentIndexEnvelope"
-        "202": *a39
+        "202": *a37
         "401": *a1
-        "403": *a41
+        "403": *a39
         "422": *a4
         "429": *a5
-        "503": *a42
+        "503": *a40
   /api/documents/inbound/{id}/chat:
     post:
       tags:
@@ -18166,10 +18186,10 @@ paths:
                 type: string
                 description: "SSE frames: `data: <json>\\n\\n`. See the operation description for the per-`type` frame shapes."
         "401": *a1
-        "403": *a41
+        "403": *a39
         "422": *a4
         "429": *a5
-        "503": *a42
+        "503": *a40
     get:
       tags:
         - Documents
@@ -18232,10 +18252,10 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentReindexEnvelope"
         "401": *a1
-        "403": *a41
+        "403": *a39
         "422": *a4
         "429": *a5
-        "503": *a42
+        "503": *a40
   /api/documents/inbound/{id}/facts/{factId}:
     patch:
       tags:
@@ -18342,7 +18362,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/CreateCustomMetricResponse"
         "401": *a1
-        "409": &a44
+        "409": &a42
           description: A custom metric with this name already exists for the caller.
           content:
             application/json:
@@ -18371,7 +18391,7 @@ paths:
                 $ref: "#/components/schemas/GetCustomMetricResponse"
         "401": *a1
         "403": *a11
-        "404": &a43
+        "404": &a41
           description: Custom metric not found (or owned by another user).
           content:
             application/json:
@@ -18405,8 +18425,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/UpdateCustomMetricResponse"
         "401": *a1
-        "404": *a43
-        "409": *a44
+        "404": *a41
+        "409": *a42
         "422": *a4
         "429": *a5
     delete:
@@ -18429,7 +18449,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/DeleteCustomMetricResponse"
         "401": *a1
-        "404": *a43
+        "404": *a41
         "422": *a4
         "429": *a5
   /api/custom-metrics/{id}/entries:
@@ -18473,7 +18493,7 @@ paths:
                 $ref: "#/components/schemas/ListCustomMetricEntriesEnvelope"
         "401": *a1
         "403": *a11
-        "404": *a43
+        "404": *a41
         "422": *a4
         "429": *a5
     post:
@@ -18502,7 +18522,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/CreateCustomMetricEntryResponse"
         "401": *a1
-        "404": *a43
+        "404": *a41
         "409": *a7
         "422": *a4
         "429": *a12
@@ -18538,7 +18558,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/UpdateCustomMetricEntryResponse"
         "401": *a1
-        "404": &a45
+        "404": &a43
           description: Custom metric entry not found (or owned by another user).
           content:
             application/json:
@@ -18571,7 +18591,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/DeleteCustomMetricEntryResponse"
         "401": *a1
-        "404": *a45
+        "404": *a43
         "422": *a4
         "429": *a5
   /api/custom-metrics/{id}/entries/restore:
@@ -18873,7 +18893,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/NutrientCatalogEnvelope"
         "401": *a1
-        "403": &a46
+        "403": &a45
           description: >-
             The opt-in `nutrients` module is off for this account (errorCode `module.disabled`). Stop syncing and do not
             retry; offer the enable-in-settings hint. Only run the HealthKit read-authorization flow while the module is
@@ -18895,7 +18915,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/nutrients/batch:
     post:
       tags:
@@ -19021,7 +19041,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/NutrientOverviewEnvelope"
         "401": *a1
-        "403": *a46
+        "403": *a45
         "422": *a4
         "429": *a5
   /api/nutrients/daily:
@@ -19057,7 +19077,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/NutrientDailySeriesEnvelope"
         "401": *a1
-        "403": *a46
+        "403": *a45
         "422": *a4
         "429": *a5
   /api/nutrients/water:
@@ -19086,7 +19106,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/NutrientWaterWriteEnvelope"
         "401": *a1
-        "403": *a46
+        "403": *a45
         "409": *a7
         "422": *a4
         "429": *a5
@@ -19588,26 +19608,26 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/WithingsCredentialsUpdateEnvelope"
-        "400": &a47
+        "400": &a46
           description: Body is not parseable JSON.
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "401": *a1
-        "413": &a48
+        "413": &a47
           description: Body exceeds 64 KiB.
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "415": &a49
+        "415": &a48
           description: Content-Type is not `application/json`.
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "422": &a50
+        "422": &a49
           description: "`clientId` and `clientSecret` are both required and each must be 1–200 characters. The envelope carries a
             single fixed message, not per-field issues."
           content:
@@ -19793,11 +19813,11 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/FitbitCredentialsUpdateEnvelope"
-        "400": *a47
+        "400": *a46
         "401": *a1
-        "413": *a48
-        "415": *a49
-        "422": *a50
+        "413": *a47
+        "415": *a48
+        "422": *a49
         "429": *a5
     delete:
       tags:
@@ -19940,11 +19960,11 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/GoogleHealthCredentialsUpdateEnvelope"
-        "400": *a47
+        "400": *a46
         "401": *a1
-        "413": *a48
-        "415": *a49
-        "422": *a50
+        "413": *a47
+        "415": *a48
+        "422": *a49
         "429": *a5
     delete:
       tags:
@@ -20105,11 +20125,11 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/OuraCredentialsUpdateEnvelope"
-        "400": *a47
+        "400": *a46
         "401": *a1
-        "413": *a48
-        "415": *a49
-        "422": *a50
+        "413": *a47
+        "415": *a48
+        "422": *a49
         "429": *a5
     delete:
       tags:
@@ -20185,21 +20205,21 @@ paths:
               schema:
                 $ref: "#/components/schemas/OuraTestEnvelope"
         "401": *a1
-        "422": &a51
+        "422": &a50
           description: No usable connection for this provider — nothing stored, or the stored grant could no longer be resolved
             into an access token. `meta.errorCode` = `not_configured`.
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "429": &a52
+        "429": &a51
           description: More than 5 requests in 60 s from this user. `meta.errorCode` = `rate_limited_self` — this is the local
             limiter, distinct from a `rate_limited` 502 which is the provider's.
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "502": &a53
+        "502": &a52
           description: "The probe did not complete. `meta.errorCode` names the class: `credentials_rejected` (the provider
             answered 401/403 — the stored grant is gone), `rate_limited` (the PROVIDER answered 429, which is not this
             endpoint's own limiter), `upstream_error` (5xx), `timeout` (no answer within 5 s), `connection_failed`
@@ -20244,11 +20264,11 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/PolarCredentialsUpdateEnvelope"
-        "400": *a47
+        "400": *a46
         "401": *a1
-        "413": *a48
-        "415": *a49
-        "422": *a50
+        "413": *a47
+        "415": *a48
+        "422": *a49
         "429": *a5
     delete:
       tags:
@@ -20324,9 +20344,9 @@ paths:
               schema:
                 $ref: "#/components/schemas/PolarTestEnvelope"
         "401": *a1
-        "422": *a51
-        "429": *a52
-        "502": *a53
+        "422": *a50
+        "429": *a51
+        "502": *a52
   /api/strava/credentials:
     get:
       tags:
@@ -20362,11 +20382,11 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/StravaCredentialsUpdateEnvelope"
-        "400": *a47
+        "400": *a46
         "401": *a1
-        "413": *a48
-        "415": *a49
-        "422": *a50
+        "413": *a47
+        "415": *a48
+        "422": *a49
         "429": *a5
     delete:
       tags:
@@ -20444,9 +20464,9 @@ paths:
               schema:
                 $ref: "#/components/schemas/StravaTestEnvelope"
         "401": *a1
-        "422": *a51
-        "429": *a52
-        "502": *a53
+        "422": *a50
+        "429": *a51
+        "502": *a52
   /api/integrations/status:
     get:
       tags:
@@ -20482,7 +20502,7 @@ paths:
                 $ref: "#/components/schemas/FitbitResumeEnvelope"
         "401": *a1
         "422": *a4
-        "429": *a52
+        "429": *a51
   /api/integrations/fitbit/test:
     post:
       tags:
@@ -20500,9 +20520,9 @@ paths:
               schema:
                 $ref: "#/components/schemas/FitbitIntegrationTestEnvelope"
         "401": *a1
-        "422": *a51
-        "429": *a52
-        "502": *a53
+        "422": *a50
+        "429": *a51
+        "502": *a52
   /api/integrations/google-health/resume:
     post:
       tags:
@@ -20519,7 +20539,7 @@ paths:
                 $ref: "#/components/schemas/GoogleHealthResumeEnvelope"
         "401": *a1
         "422": *a4
-        "429": *a52
+        "429": *a51
   /api/integrations/google-health/test:
     post:
       tags:
@@ -20552,9 +20572,9 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "422": *a51
-        "429": *a52
-        "502": *a53
+        "422": *a50
+        "429": *a51
+        "502": *a52
   /api/integrations/whoop/resume:
     post:
       tags:
@@ -20571,7 +20591,7 @@ paths:
                 $ref: "#/components/schemas/WhoopResumeEnvelope"
         "401": *a1
         "422": *a4
-        "429": *a52
+        "429": *a51
   /api/integrations/whoop/test:
     post:
       tags:
@@ -20588,9 +20608,9 @@ paths:
               schema:
                 $ref: "#/components/schemas/WhoopIntegrationTestEnvelope"
         "401": *a1
-        "422": *a51
-        "429": *a52
-        "502": *a53
+        "422": *a50
+        "429": *a51
+        "502": *a52
   /api/integrations/withings/resume:
     post:
       tags:
@@ -20608,7 +20628,7 @@ paths:
                 $ref: "#/components/schemas/WithingsResumeEnvelope"
         "401": *a1
         "422": *a4
-        "429": *a52
+        "429": *a51
   /api/integrations/withings/test:
     post:
       tags:
@@ -20626,8 +20646,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/WithingsIntegrationTestEnvelope"
         "401": *a1
-        "422": *a51
-        "429": *a52
+        "422": *a50
+        "429": *a51
         "502":
           description: "The probe did not complete. The shared codes apply (`credentials_rejected`, `rate_limited`,
             `upstream_error`, `timeout`, `connection_failed`) and this path adds one of its own:
@@ -21029,7 +21049,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/RecordActivityEnvelope"
         "401": *a1
-        "403": &a54
+        "403": &a53
           description: Refused. `meta.errorCode` is `sharing.not_permitted` when the request was made while acting on another
             account (grant management is never delegable), or `sharing.access.denied` when the caller may not act as the
             account they named. The latter is byte-identical for an account that does not exist and one that granted
@@ -21054,7 +21074,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/AccountGrantListEnvelope"
         "401": *a1
-        "403": *a54
+        "403": *a53
         "422": *a4
         "429": *a5
     post:
@@ -21156,7 +21176,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/AcceptedAccountGrantEnvelope"
         "401": *a1
-        "403": *a54
+        "403": *a53
         "404":
           description: No such invitation for this account.
           content:
@@ -21200,7 +21220,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/RevokedAccountGrantEnvelope"
         "401": *a1
-        "403": *a54
+        "403": *a53
         "404":
           description: No such grant on this account's record.
           content:
@@ -21241,7 +21261,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/RenouncedAccountGrantEnvelope"
         "401": *a1
-        "403": *a54
+        "403": *a53
         "404":
           description: No such grant held by this account.
           content:
@@ -21623,7 +21643,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "401": *a1
-        "403": *a54
+        "403": *a53
         "409":
           description: "The record this browser session is on is not the record the request asserted. `meta.errorCode` is
             `sharing.session.changed`. It is not a refusal of access — the caller may well be entitled to both records —
@@ -22003,7 +22023,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/McpConnectionListEnvelope"
         "401": *a1
-        "403": &a55
+        "403": &a54
           description: The operator has disabled the API instance-wide. Every route in this module refuses while that setting is
             off, for a cookie session as well as for a Bearer token; it is not a per-user permission and retrying will
             not help.
@@ -22036,7 +22056,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/McpConnectionRevokeEnvelope"
         "401": *a1
-        "403": *a55
+        "403": *a54
         "404":
           description: No live connection with this id for this caller — also the answer for an already-revoked one, so a repeat
             revoke is 404 rather than an idempotent 200.
@@ -22063,7 +22083,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/McpConnectorTokenListEnvelope"
         "401": *a1
-        "403": *a55
+        "403": *a54
         "422": *a4
         "429": *a5
     post:
@@ -22096,7 +22116,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "401": *a1
-        "403": *a55
+        "403": *a54
         "413":
           description: Body exceeds 16 KiB.
           content:
@@ -22139,7 +22159,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/McpConnectorTokenRevokeEnvelope"
         "401": *a1
-        "403": *a55
+        "403": *a54
         "404":
           description: No `health:read` token with this id for this caller. An already-revoked token is still found, so a repeat
             revoke answers 200.
@@ -22198,7 +22218,7 @@ paths:
       description: Returns the named family's resolved settings for the record the session is acting on. Cookie session or
         Bearer, while acting on a managed record the caller guards.
       parameters:
-        - &a56
+        - &a55
           name: family
           in: path
           required: true
@@ -22242,7 +22262,7 @@ paths:
         ride the audit row. Body capped at 64 KiB. Cookie session or Bearer, while acting on a managed record the caller
         guards.
       parameters:
-        - *a56
+        - *a55
       requestBody:
         required: true
         content:
@@ -22815,13 +22835,13 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/AdminBackupDocument"
-        "403": &a57
+        "403": &a56
           description: Caller is not an admin. `requireAdmin()` is cookie-only, so a Bearer token lands here whatever its scope.
           content:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "404": &a58
+        "404": &a57
           description: No stored copy with this id.
           content:
             application/json:
@@ -22895,8 +22915,8 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "403": *a57
-        "404": *a58
+        "403": *a56
+        "404": *a57
         "409":
           description: A restore of the same account is already queued or running (`meta.errorCode` = `backup.restore.active`,
             `meta.jobId` names it), the stored copy was replaced by a newer one while it was being checked
@@ -22940,7 +22960,7 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/AdminBackupRestoreJobListResponse"
-        "403": *a57
+        "403": *a56
   /api/admin/backups/restores/{jobId}:
     get:
       tags:
@@ -22963,7 +22983,7 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/AdminBackupRestoreJobResponse"
-        "403": *a57
+        "403": *a56
         "404":
           description: No restore job with this id.
           content:
@@ -22982,7 +23002,7 @@ paths:
         request leaves the server. Needs neither the Documents module nor the list: with the list unset, `available` is
         false and any connection still stored is listed (with `originAllowed: false`) so it can be removed. Cookie
         session only; not delegable."
-      security: &a59
+      security: &a58
         - cookieAuth: []
       responses:
         "200":
@@ -22992,7 +23012,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourcesStatusEnvelope"
         "401": *a1
-        "403": &a60
+        "403": &a59
           description: "Refused before any request to the source: `documents.sources.browserOnly` for a Bearer caller,
             `sharing.not_permitted` while acting on another person's record (a delegate or guardian never uses the
             owner's archive), or `module.disabled` when the Documents module is off."
@@ -23015,9 +23035,9 @@ paths:
         `documents.sources.tokenRequired`), so a stored token is never sent to an address it was not saved for. A Papra
         organization id is letters, digits, `_` and `-`. The token is stored encrypted (AES-256-GCM) and never returned.
         Ten saves and tests a minute per person. Cookie session only; not delegable."
-      security: *a59
+      security: *a58
       parameters:
-        - &a61
+        - &a60
           name: system
           in: path
           required: true
@@ -23056,8 +23076,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourceConnectionEnvelope"
         "401": *a1
-        "403": *a60
-        "404": &a62
+        "403": *a59
+        "404": &a61
           description: "`documents.sources.unavailable`: the operator has not listed any origin in `DOCUMENT_SOURCE_ORIGINS`, so
             the picker is off. `documents.sources.notConnected`: no connection is saved for this system.
             `documents.sources.notFound`: the source has no such document, or (Papra) no such organization, including
@@ -23076,7 +23096,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "429": *a5
-        "502": &a63
+        "502": &a62
           description: "The source could not answer usefully, with the reason in `meta.errorCode` and, when the source answered at
             all, its HTTP status in `meta.upstreamStatus` (its body is never passed on): `documents.sources.unreachable`
             (no connection, timeout, or a destination refused at dial time), `documents.sources.redirected` (the source
@@ -23095,9 +23115,9 @@ paths:
       description: Deletes the caller's connection for this system, and its token with it. Works even after the operator
         removed the origin from the list, and with the Documents module switched off. `disconnected` is false when there
         was nothing to delete. Cookie session only; not delegable.
-      security: *a59
+      security: *a58
       parameters:
-        - *a61
+        - *a60
       responses:
         "200":
           description: Removed, or there was nothing to remove.
@@ -23106,7 +23126,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourceDisconnectEnvelope"
         "401": *a1
-        "403": *a60
+        "403": *a59
         "422": *a4
         "429": *a5
   /api/documents/sources/{system}/test:
@@ -23117,9 +23137,9 @@ paths:
       description: One request to the source with the stored token. Answers `ok` with the round-trip time and stamps
         `lastVerifiedAt`, or the reason in `meta.errorCode`. Shares the save's allowance of ten a minute. Cookie session
         only; not delegable.
-      security: *a59
+      security: *a58
       parameters:
-        - *a61
+        - *a60
       responses:
         "200":
           description: The source answered.
@@ -23128,9 +23148,9 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourceTestEnvelope"
         "401": *a1
-        "403": *a60
-        "404": *a62
-        "422": &a64
+        "403": *a59
+        "404": *a61
+        "422": &a63
           description: "`documents.sources.originNotAllowed`: the base address's origin is not on the operator's list (checked on
             every request, so a connection saved earlier is cut off once its origin is removed), or another validation
             failure."
@@ -23139,7 +23159,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "429": *a5
-        "502": *a63
+        "502": *a62
   /api/documents/sources/{system}/tags:
     get:
       tags:
@@ -23147,9 +23167,9 @@ paths:
       summary: Tags of a connected archive
       description: The source's tags for the picker's filter, the first 250 by name, in the source's own ids. Shares the
         search allowance of sixty a minute. Cookie session only; not delegable.
-      security: *a59
+      security: *a58
       parameters:
-        - *a61
+        - *a60
       responses:
         "200":
           description: The tags.
@@ -23158,11 +23178,11 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourceTagsEnvelope"
         "401": *a1
-        "403": *a60
-        "404": *a62
-        "422": *a64
+        "403": *a59
+        "404": *a61
+        "422": *a63
         "429": *a5
-        "502": *a63
+        "502": *a62
   /api/documents/sources/{system}/search:
     get:
       tags:
@@ -23176,9 +23196,9 @@ paths:
         under that source key: `new`, `imported` with the vault document's `documentId`, or `deleted` (deleted in
         HealthLog; importing it again stores nothing). Nothing is stored. Sixty searches a minute, shared with the tag
         read. Cookie session only; not delegable."
-      security: *a59
+      security: *a58
       parameters:
-        - *a61
+        - *a60
         - name: q
           in: query
           required: false
@@ -23219,11 +23239,11 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourceSearchEnvelope"
         "401": *a1
-        "403": *a60
-        "404": *a62
-        "422": *a64
+        "403": *a59
+        "404": *a61
+        "422": *a63
         "429": *a5
-        "502": *a63
+        "502": *a62
   /api/documents/sources/{system}/import:
     post:
       tags:
@@ -23242,9 +23262,9 @@ paths:
         fetched), including a duplicate. `kind` sets the document type (default OTHER). Automatic AI reading follows the
         person's own setting. Counts against the person's upload allowance (60 an hour) and storage quota. 201 for a new
         document, 200 otherwise. Cookie session only; not delegable."
-      security: *a59
+      security: *a58
       parameters:
-        - *a61
+        - *a60
       requestBody:
         required: true
         content:
@@ -23302,7 +23322,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/DocumentSourceImportEnvelope"
         "401": *a1
-        "403": *a60
+        "403": *a59
         "404":
           description: "`documents.sources.unavailable`: the operator has not listed any origin in `DOCUMENT_SOURCE_ORIGINS`, so
             the picker is off. `documents.sources.notConnected`: no connection is saved for this system.
@@ -23333,7 +23353,7 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "422": *a64
+        "422": *a63
         "429":
           description: "`documents.inbound.rateLimited` (the person's hourly upload allowance, with the rate-limit headers) or
             `documents.inbound.uploadBusy` (too many uploads in progress; `Retry-After: 1`)."
@@ -23341,7 +23361,7 @@ paths:
             application/json:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
-        "502": *a63
+        "502": *a62
   /api/symptoms/definitions:
     get:
       tags:
@@ -23365,7 +23385,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ListSymptomDefinitionsEnvelope"
         "401": *a1
-        "403": &a65
+        "403": &a64
           description: >-
             `illness.disabled`: the record has the illness module switched off (or the operator turned it off
             server-wide); symptoms ride that module.
@@ -23408,7 +23428,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/CreateSymptomDefinitionEnvelope"
         "401": *a1
-        "403": *a65
+        "403": *a64
         "409": *a7
         "422": *a4
         "429": *a5
@@ -23438,8 +23458,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/UpdateSymptomDefinitionEnvelope"
         "401": *a1
-        "403": *a65
-        "404": &a66
+        "403": *a64
+        "404": &a65
           description: "`symptoms.definition.notFound`: no definition with this id on the record."
           content:
             application/json:
@@ -23473,8 +23493,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/DeleteSymptomDefinitionEnvelope"
         "401": *a1
-        "403": *a65
-        "404": *a66
+        "403": *a64
+        "404": *a65
         "422": *a4
         "429": *a5
   /api/symptoms/events:
@@ -23523,7 +23543,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ListSymptomEventsEnvelope"
         "401": *a1
-        "403": *a65
+        "403": *a64
         "422": *a4
         "429": *a5
     post:
@@ -23549,8 +23569,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/CreateSymptomEventEnvelope"
         "401": *a1
-        "403": *a65
-        "404": *a66
+        "403": *a64
+        "404": *a65
         "409": *a7
         "422": *a4
         "429": *a5
@@ -23580,8 +23600,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/UpdateSymptomEventEnvelope"
         "401": *a1
-        "403": *a65
-        "404": &a67
+        "403": *a64
+        "404": &a66
           description: "`symptoms.event.notFound`: no occurrence with this id on the record."
           content:
             application/json:
@@ -23608,8 +23628,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/DeleteSymptomEventEnvelope"
         "401": *a1
-        "403": *a65
-        "404": *a67
+        "403": *a64
+        "404": *a66
         "422": *a4
         "429": *a5
   /api/day/index:
@@ -23759,7 +23779,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/TimelineEnvelope"
         "401": *a1
-        "403": &a68
+        "403": &a67
           description: >-
             `module.disabled` with `meta.module = timeline`: the record has the timeline switched off (it is opt-in), or
             the operator turned it off server-wide.
@@ -23796,7 +23816,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/TimelineReadinessEnvelope"
         "401": *a1
-        "403": *a68
+        "403": *a67
         "422": *a4
         "429": *a5
   /api/life-events:
@@ -23814,7 +23834,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/LifeEventListEnvelope"
         "401": *a1
-        "403": &a69
+        "403": &a68
           description: >-
             Owner-only in v1.42: no share reaches life events, not a `profile` share, a whole-record share or MANAGE,
             and not a guardian acting for a managed profile.
@@ -23854,7 +23874,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/CreateLifeEventEnvelope"
         "401": *a1
-        "403": *a69
+        "403": *a68
         "409": *a7
         "422": *a4
         "429": *a12
@@ -23885,8 +23905,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/UpdateLifeEventEnvelope"
         "401": *a1
-        "403": *a69
-        "404": &a70
+        "403": *a68
+        "404": &a69
           description: No such life event on this account.
           content:
             application/json:
@@ -23913,8 +23933,8 @@ paths:
               schema:
                 $ref: "#/components/schemas/DeleteLifeEventEnvelope"
         "401": *a1
-        "403": *a69
-        "404": *a70
+        "403": *a68
+        "404": *a69
         "422": *a4
         "429": *a5
   /api/search:
@@ -23992,7 +24012,7 @@ paths:
               schema:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/medications/{id}/ingredients:
     put:
       tags:
@@ -24034,7 +24054,7 @@ paths:
         "409": *a7
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/medications/{id}/ingredients/extract:
     post:
       tags:
@@ -24064,7 +24084,7 @@ paths:
               required:
                 - file
       responses:
-        "202": *a39
+        "202": *a37
         "401": *a1
         "403": *a19
         "413":
@@ -24075,7 +24095,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
         "503":
           description: "`aiRuns.workerUnavailable`: the run could not be handed to the background worker. Nothing was read and
             nothing was charged; try again."
@@ -24100,7 +24120,7 @@ paths:
         "403": *a11
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/anamnesis/life-circumstances/ai-sections:
     patch:
       tags:
@@ -24130,7 +24150,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/anamnesis/life-circumstances/confirm:
     post:
       tags:
@@ -24154,7 +24174,7 @@ paths:
         "401": *a1
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/anamnesis/audit-c:
     post:
       tags:
@@ -24187,7 +24207,7 @@ paths:
         "409": *a7
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/anamnesis/audit-c/{id}:
     delete:
       tags:
@@ -24216,7 +24236,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/dawarich/connect:
     post:
       tags:
@@ -24242,7 +24262,7 @@ paths:
         "403": *a19
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/dawarich/status:
     get:
       tags:
@@ -24259,7 +24279,7 @@ paths:
         "403": *a19
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/dawarich/places:
     get:
       tags:
@@ -24290,7 +24310,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
         "502":
           description: "`dawarich.unreachable`."
           content:
@@ -24320,7 +24340,7 @@ paths:
         "403": *a19
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/dawarich/test:
     post:
       tags:
@@ -24339,7 +24359,7 @@ paths:
         "403": *a19
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/dawarich/sync:
     post:
       tags:
@@ -24374,7 +24394,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/dawarich/disconnect:
     post:
       tags:
@@ -24403,7 +24423,7 @@ paths:
         "403": *a19
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/environment/travel/suggestions:
     get:
       tags:
@@ -24420,7 +24440,7 @@ paths:
         "403": *a19
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/environment/travel/suggestions/{id}/dismiss:
     post:
       tags:
@@ -24450,7 +24470,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/medications/{id}/links:
     post:
       tags:
@@ -24487,7 +24507,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
     delete:
       tags:
         - Links
@@ -24523,7 +24543,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/labs/{id}/links:
     post:
       tags:
@@ -24560,7 +24580,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
     delete:
       tags:
         - Links
@@ -24596,7 +24616,7 @@ paths:
                 $ref: "#/components/schemas/ErrorEnvelope"
         "422": *a4
         "429": *a5
-        "501": *a30
+        "501": *a44
   /api/bugreport:
     post:
       security: []
@@ -31225,6 +31245,12 @@ components:
                 type: string
                 format: date-time
                 pattern: ^(?:(?:\d\d[2468][048]|\d\d[13579][26]|\d\d0[48]|[02468][048]00|[13579][26]00)-02-29|\d{4}-(?:(?:0[13578]|1[02])-(?:0[1-9]|[12]\d|3[01])|(?:0[469]|11)-(?:0[1-9]|[12]\d|30)|(?:02)-(?:0[1-9]|1\d|2[0-8])))T(?:(?:[01]\d|2[0-3]):[0-5]\d(?::[0-5]\d(?:\.\d+)?)?(?:Z))$
+              biomarkerId:
+                type: string
+                minLength: 1
+                maxLength: 64
+              rememberAlias:
+                type: boolean
             required:
               - analyte
               - takenAt
@@ -31312,6 +31338,13 @@ components:
             - type: "null"
         hidden:
           type: boolean
+        aliases:
+          maxItems: 50
+          type: array
+          items:
+            type: string
+            minLength: 1
+            maxLength: 120
       description: Partial edit of a biomarker. An omitted key leaves the column untouched; an explicit `null` on `context` /
         `panel` / a bound clears it. Set `hidden` to drop / restore the marker in the active list + lab-entry pickers. A
         rename that collides with another of the caller's markers is rejected 409.
@@ -32713,6 +32746,12 @@ components:
                 enum:
                   - approve
                   - reject
+              biomarkerId:
+                type: string
+                minLength: 1
+                maxLength: 64
+              rememberAlias:
+                type: boolean
             required:
               - factId
               - action
@@ -35553,12 +35592,13 @@ components:
                 import.apple_health.busy, import.write_failed; ingest — ingest.rate_limited; insights —
                 insights.generate.budgetExceeded, insights.generate.outboundScreened,
                 insights.generate.profileScopeChanged, insights.generate.scopeChanged; labs —
-                labs.biomarker.create.invalid, labs.biomarker.duplicate, labs.biomarker.merge.invalid,
-                labs.biomarker.notFound, labs.biomarker.update.invalid, labs.biomarker.update.referenceRangeInvalid,
-                labs.create.invalid, labs.link.invalid, labs.ocr.budgetExceeded, labs.ocr.extractFailed,
-                labs.ocr.fileTooLarge, labs.ocr.fileType, labs.ocr.localOcrDisabled, labs.ocr.pdfNeedsAnthropic,
-                labs.ocr.providerUnsupported, labs.ocr.rateLimited, labs.restore.invalid, labs.result.notFound,
-                labs.unit.mismatch, labs.update.invalid, labs.update.linkedFieldsImmutable, labs.update.numericExpected,
+                labs.biomarker.alias.taken, labs.biomarker.create.invalid, labs.biomarker.duplicate,
+                labs.biomarker.merge.invalid, labs.biomarker.merge.unitMismatch, labs.biomarker.notFound,
+                labs.biomarker.update.invalid, labs.biomarker.update.referenceRangeInvalid, labs.create.invalid,
+                labs.link.invalid, labs.ocr.budgetExceeded, labs.ocr.extractFailed, labs.ocr.fileTooLarge,
+                labs.ocr.fileType, labs.ocr.localOcrDisabled, labs.ocr.pdfNeedsAnthropic, labs.ocr.providerUnsupported,
+                labs.ocr.rateLimited, labs.restore.invalid, labs.result.notFound, labs.unit.mismatch,
+                labs.update.invalid, labs.update.linkedFieldsImmutable, labs.update.numericExpected,
                 labs.update.qualitativeExpected, labs.update.referenceRangeInvalid,
                 labs.update.sourceReferenceRangeInvalid; life_event — life_event.invalid, life_event.not_found;
                 managed_profile — managed_profile.guardian.duplicate, managed_profile.guardian.managed_invitee,
@@ -40024,6 +40064,31 @@ components:
                 anyOf:
                   - type: string
                   - type: "null"
+              aliases:
+                type: array
+                items:
+                  type: object
+                  properties:
+                    id:
+                      type: string
+                      minLength: 1
+                    name:
+                      type: string
+                      minLength: 1
+                      maxLength: 120
+                    source:
+                      type: string
+                      enum:
+                        - MERGE
+                        - IMPORT_CHOICE
+                        - MANUAL
+                    createdAt:
+                      type: string
+                      minLength: 1
+                  required:
+                    - name
+                    - source
+                  additionalProperties: {}
               createdAt:
                 type: string
                 minLength: 1
@@ -40034,6 +40099,42 @@ components:
               - name
               - unit
             additionalProperties: {}
+        biomarkerMerges:
+          default: []
+          type: array
+          items:
+            type: object
+            properties:
+              id:
+                type: string
+                minLength: 1
+              targetBiomarkerId:
+                type: string
+                minLength: 1
+              targetName:
+                type: string
+                minLength: 1
+              sourceBiomarkerId:
+                type: string
+                minLength: 1
+              sourceName:
+                type: string
+                minLength: 1
+                maxLength: 120
+              readingCount:
+                type: integer
+                minimum: 0
+                maximum: 9007199254740991
+              mergedAt:
+                type: string
+                minLength: 1
+            required:
+              - targetName
+              - sourceBiomarkerId
+              - sourceName
+              - readingCount
+              - mergedAt
+            additionalProperties: {}
         illnessEpisodes:
           default: []
           type: array
@@ -43069,6 +43170,7 @@ components:
         - customMoodTags
         - labResults
         - biomarkers
+        - biomarkerMerges
         - illnessEpisodes
         - symptomDefinitions
         - lifeEvents
@@ -69467,9 +69569,11 @@ components:
                 enum:
                   - duplicate
                   - unit_mismatch
+                  - unknown_biomarker
                 description: "`duplicate`: the row matched a live reading at commit time. `unit_mismatch`: the row states a unit other
                   than the one its marker is tracked in and the pair cannot be converted, so it was not written. A pair
-                  that can be converted is written in the marker's unit and reported with `converted: true`."
+                  that can be converted is written in the marker's unit and reported with `converted: true`.
+                  `unknown_biomarker` (v1.43): the row named a `biomarkerId` that is not one of the record's markers."
             required:
               - analyte
               - reason
diff --git a/prisma/schema.prisma b/prisma/schema.prisma
index 6328b220d..f423e3f64 100644
--- a/prisma/schema.prisma
+++ b/prisma/schema.prisma
@@ -9905,11 +9905,11 @@ model BiomarkerAlias {
   id          String   @id @default(cuid())
   userId      String   @map("user_id")
   biomarkerId String   @map("biomarker_id")
-  /// @pending-consumer(#v143-B3) The alias as written, shown on the marker.
+  /// The alias as written, shown on the marker.
   name        String   @db.VarChar(120)
-  /// @pending-consumer(#v143-B3) `foldForMatch(name)`, the match key; unique per account.
+  /// `foldForMatch(name)`, the match key; unique per account.
   nameFolded  String   @map("name_folded") @db.VarChar(120)
-  /// @pending-consumer(#v143-B3) `MERGE`, `IMPORT_CHOICE` or `MANUAL` (CHECK in migration 0403).
+  /// `MERGE`, `IMPORT_CHOICE` or `MANUAL` (CHECK in migration 0403).
   source      String
   createdAt   DateTime @default(now()) @map("created_at")
 
@@ -9927,15 +9927,15 @@ model BiomarkerAlias {
 model BiomarkerMerge {
   id                String   @id @default(cuid())
   userId            String   @map("user_id")
-  /// @pending-consumer(#v143-B3) The marker the source was folded into.
+  /// The marker the source was folded into.
   targetBiomarkerId String   @map("target_biomarker_id")
-  /// @pending-consumer(#v143-B3) Id of the deleted source marker (no FK: the row is gone).
+  /// Id of the deleted source marker (no FK: the row is gone).
   sourceBiomarkerId String   @map("source_biomarker_id")
-  /// @pending-consumer(#v143-B3) The source marker's name at merge time.
+  /// The source marker's name at merge time.
   sourceName        String   @map("source_name") @db.VarChar(120)
-  /// @pending-consumer(#v143-B3) How many readings moved from the source.
+  /// How many readings moved from the source.
   readingCount      Int      @map("reading_count")
-  /// @pending-consumer(#v143-B3) When the merge ran.
+  /// When the merge ran.
   mergedAt          DateTime @default(now()) @map("merged_at")
 
   user   User      @relation(fields: [userId], references: [id], onDelete: Cascade)
diff --git a/src/__tests__/contract-stub-inventory.test.ts b/src/__tests__/contract-stub-inventory.test.ts
index 102729345..e3c69dfbc 100644
--- a/src/__tests__/contract-stub-inventory.test.ts
+++ b/src/__tests__/contract-stub-inventory.test.ts
@@ -40,7 +40,6 @@ const CONTRACT_STUBS: Readonly<Record<string, readonly string[]>> = {
   "anamnesis/life-circumstances/route.ts": ["anamnesis.life_circumstances.get"],
   "auth/claim/sso/route.ts": ["profile_claim.sso.start"],
   "auth/me/ai-usage/route.ts": ["auth.me.ai_usage.put"],
-  "biomarkers/[id]/merge/route.ts": ["labs.biomarker.merge"],
   "dawarich/connect/route.ts": ["dawarich.connect"],
   "dawarich/disconnect/route.ts": ["dawarich.disconnect"],
   "dawarich/places/route.ts": ["dawarich.places.get"],
@@ -64,7 +63,7 @@ const CONTRACT_STUBS: Readonly<Record<string, readonly string[]>> = {
 };
 
 /** The size of the register when it was written; see the header. */
-const REGISTER_SIZE = 24;
+const REGISTER_SIZE = 23;
 
 function routeFiles(): string[] {
   return walkSourceFiles(API_ROOT, { floor: 400, extensions: [".ts"] })
diff --git a/src/app/api/biomarkers/[id]/__tests__/route.test.ts b/src/app/api/biomarkers/[id]/__tests__/route.test.ts
index 9a7cb416d..9cf66d9dd 100644
--- a/src/app/api/biomarkers/[id]/__tests__/route.test.ts
+++ b/src/app/api/biomarkers/[id]/__tests__/route.test.ts
@@ -1,14 +1,28 @@
 import { describe, it, expect, vi, beforeEach } from "vitest";
 import { NextRequest } from "next/server";
 
-vi.mock("@/lib/db", () => ({
-  prisma: {
-    biomarker: { findFirst: vi.fn(), update: vi.fn(), delete: vi.fn() },
+vi.mock("@/lib/db", () => {
+  const prisma = {
+    biomarker: {
+      findFirst: vi.fn(),
+      findMany: vi.fn(async () => []),
+      update: vi.fn(),
+      delete: vi.fn(),
+    },
+    // v1.43 — the marker's other spellings, read and replaced with it.
+    biomarkerAlias: {
+      findMany: vi.fn(async () => []),
+      deleteMany: vi.fn(),
+      createMany: vi.fn(),
+    },
+    biomarkerMerge: { findFirst: vi.fn(async () => null) },
     labResult: { deleteMany: vi.fn() },
     auditLog: { create: vi.fn().mockResolvedValue({}) },
-    $transaction: vi.fn(async (ops: Promise<unknown>[]) => Promise.all(ops)),
-  },
-}));
+  };
+  // `$transaction` is set in `beforeEach`: the batch form for the delete, the
+  // callback form for the edit.
+  return { prisma: { ...prisma, $transaction: vi.fn() } };
+});
 
 vi.mock("@/lib/auth/session", () => ({ getSession: vi.fn() }));
 
@@ -82,9 +96,13 @@ beforeEach(() => {
   // v1.37.0 — the 422 breadcrumb goes through `auditLog()` and the route
   // chains `.catch()` on it; `resetAllMocks` clears the factory's resolution.
   vi.mocked(auditLog).mockResolvedValue(undefined as never);
-  vi.mocked(prisma.$transaction).mockImplementation((async (
-    ops: Promise<unknown>[],
-  ) => Promise.all(ops)) as never);
+  vi.mocked(prisma.$transaction).mockImplementation((async (arg: unknown) =>
+    typeof arg === "function"
+      ? (arg as (tx: unknown) => Promise<unknown>)(prisma)
+      : Promise.all(arg as Promise<unknown>[])) as never);
+  vi.mocked(prisma.biomarkerAlias.findMany).mockResolvedValue([] as never);
+  vi.mocked(prisma.biomarker.findMany).mockResolvedValue([] as never);
+  vi.mocked(prisma.biomarkerMerge.findFirst).mockResolvedValue(null as never);
 });
 
 describe("DELETE /api/biomarkers/[id]", () => {
diff --git a/src/app/api/biomarkers/[id]/merge/route.ts b/src/app/api/biomarkers/[id]/merge/route.ts
index d6d2b2fdd..ea266a552 100644
--- a/src/app/api/biomarkers/[id]/merge/route.ts
+++ b/src/app/api/biomarkers/[id]/merge/route.ts
@@ -7,19 +7,32 @@
  * (`MERGE`), one `biomarker_merges` row is written per source and the sources
  * are deleted. A pair of units without a known conversion refuses the whole
  * merge (422 `labs.biomarker.merge.unitMismatch`); nothing moves. `dryRun`
- * answers the same result and writes nothing. There is no undo.
+ * answers the same result and writes nothing, refusals included, so the
+ * preview can show them. There is no undo. See `src/lib/labs/biomarker-merge.ts`.
  *
- * Contract authority: `requireRecordAuth("manage", "labs")` with the shared
- * record-write ceiling. Until the merge lands the stub resolves the caller's
- * own record only.
+ * Authority: `requireRecordAuth("manage", "labs")`, the same as the edit and
+ * the delete beside it, because a merge rewrites and deletes markers. The
+ * shared record-write ceiling is charged to the ACTOR (C1). Each deleted
+ * source files what was destroyed (C3): its id and how many readings it took
+ * along, never its name; the name stays in the merge ledger.
  */
 import { NextRequest } from "next/server";
 
-import { apiHandler, requireAuth } from "@/lib/api-handler";
-import { apiError, returnAllZodIssues, safeJson } from "@/lib/api-response";
-import { notImplemented } from "@/lib/http/not-implemented";
+import { apiHandler, requireRecordAuth } from "@/lib/api-handler";
+import {
+  apiError,
+  apiSuccess,
+  getClientIp,
+  returnAllZodIssues,
+  safeJson,
+} from "@/lib/api-response";
+import { auditLog } from "@/lib/auth/audit";
+import { invalidateUserHealthScore } from "@/lib/cache/invalidate";
 import { withIdempotency } from "@/lib/idempotency";
+import { mergeBiomarkers as runMerge } from "@/lib/labs/biomarker-merge";
+import { annotate } from "@/lib/logging/context";
 import { checkRecordWriteRateLimit } from "@/lib/rate-limit";
+import { destroyedDetails } from "@/lib/sharing/audit-details";
 import { biomarkerMergeSchema } from "@/lib/validations/biomarker-merge";
 
 type RouteParams = { params: Promise<{ id: string }> };
@@ -32,10 +45,10 @@ async function mergeBiomarkers(
   request: NextRequest,
   { params }: RouteParams,
 ): Promise<Response> {
-  const { user } = await requireAuth();
+  const { user, actor } = await requireRecordAuth("manage", "labs");
   const { id } = await params;
 
-  const writeRl = await checkRecordWriteRateLimit(user.id);
+  const writeRl = await checkRecordWriteRateLimit(actor.id);
   if (!writeRl.allowed) {
     return apiError("Too many writes, try again later", 429, {
       errorCode: "record_write.rate_limited",
@@ -58,5 +71,74 @@ async function mergeBiomarkers(
     });
   }
 
-  return notImplemented("labs.biomarker.merge");
+  const outcome = await runMerge({
+    userId: user.id,
+    targetId: id,
+    sourceIds: parsed.data.sourceIds,
+    dryRun: parsed.data.dryRun,
+  });
+
+  if (outcome.kind === "notFound") {
+    return apiError("Biomarker not found", 404, {
+      errorCode: "labs.biomarker.notFound",
+      ids: outcome.ids,
+    });
+  }
+  if (outcome.kind === "unitMismatch") {
+    annotate({
+      action: { name: "labs.biomarker.merge.unit-mismatch" },
+      meta: { biomarkerId: id, refused: outcome.sources.length },
+    });
+    return apiError(
+      "Some readings are in a unit that cannot be converted to the target's unit",
+      422,
+      {
+        errorCode: "labs.biomarker.merge.unitMismatch",
+        sources: outcome.sources,
+      },
+    );
+  }
+
+  const { result } = outcome;
+  annotate({
+    action: {
+      name: result.dryRun
+        ? "labs.biomarker.merge.preview"
+        : "labs.biomarker.merge",
+    },
+    meta: {
+      biomarkerId: id,
+      sources: result.sources.length,
+      movedReadings: result.movedReadings,
+      convertedReadings: result.convertedReadings,
+    },
+  });
+  if (result.dryRun) return apiSuccess(result);
+
+  invalidateUserHealthScore(user.id);
+  const ipAddress = getClientIp(request);
+  for (const source of result.sources) {
+    await auditLog("labs.biomarker.merge", {
+      userId: user.id,
+      ipAddress,
+      // IDs and numbers only. The source's name is not filed here; the merge
+      // ledger keeps it with the row this audit points at.
+      details: {
+        biomarkerId: id,
+        mergeId: result.mergeId,
+        ...destroyedDetails({
+          model: "Biomarker",
+          id: source.id,
+          label: null,
+          effectiveAt: new Date(),
+          extra: {
+            readingCount: source.readingCount,
+            converted: source.conversion === "converted",
+          },
+        }),
+      },
+    });
+  }
+
+  return apiSuccess(result);
 }
diff --git a/src/app/api/biomarkers/[id]/route.ts b/src/app/api/biomarkers/[id]/route.ts
index bdfdbae1b..0cc1601b9 100644
--- a/src/app/api/biomarkers/[id]/route.ts
+++ b/src/app/api/biomarkers/[id]/route.ts
@@ -17,9 +17,13 @@ import {
 import { prisma } from "@/lib/db";
 import { invalidateUserHealthScore } from "@/lib/cache/invalidate";
 import {
-  decryptContextFromBytes,
-  encryptContextToBytes,
-} from "@/lib/labs/biomarker-store";
+  aliasNamesByMarker,
+  findAliasConflict,
+  replaceAliases,
+} from "@/lib/labs/biomarker-aliases";
+import { serialiseBiomarker } from "@/lib/labs/biomarker-dto";
+import { mergedInto } from "@/lib/labs/biomarker-merge";
+import { encryptContextToBytes } from "@/lib/labs/biomarker-store";
 import { matchAnalyteKey } from "@/lib/labs/analyte-match";
 import { annotate } from "@/lib/logging/context";
 import { updateBiomarkerSchema } from "@/lib/validations/biomarkers";
@@ -38,37 +42,6 @@ import { effectiveBound, isInvertedRange } from "@/lib/validations/labs";
 
 type RouteParams = { params: Promise<{ id: string }> };
 
-function serialiseBiomarker(row: {
-  id: string;
-  name: string;
-  unit: string;
-  lowerBound: number | null;
-  upperBound: number | null;
-  panel: string | null;
-  analyteKey: string | null;
-  hidden: boolean;
-  contextEncrypted: Uint8Array | null;
-  createdAt: Date;
-  updatedAt: Date;
-}) {
-  return {
-    id: row.id,
-    name: row.name,
-    unit: row.unit,
-    lowerBound: row.lowerBound,
-    upperBound: row.upperBound,
-    panel: row.panel,
-    analyteKey: row.analyteKey,
-    hasContext: row.contextEncrypted !== null,
-    context: row.contextEncrypted
-      ? decryptContextFromBytes(row.contextEncrypted)
-      : null,
-    hidden: row.hidden,
-    createdAt: row.createdAt.toISOString(),
-    updatedAt: row.updatedAt.toISOString(),
-  };
-}
-
 export const GET = apiHandler(
   async (_request: NextRequest, { params }: RouteParams) => {
     const { user } = await requireRecordAuth("read", "labs");
@@ -76,15 +49,23 @@ export const GET = apiHandler(
 
     const row = await prisma.biomarker.findFirst({ where: { id } });
     if (!row || row.userId !== user.id) {
-      return apiError("Biomarker not found", 404);
+      // v1.43 — a marker merged into another names where it went, so a
+      // client holding the old id (a cached screen, a bookmark) can follow.
+      const into = await mergedInto(user.id, id);
+      return apiError("Biomarker not found", 404, {
+        errorCode: "labs.biomarker.notFound",
+        ...(into ? { mergedInto: into } : {}),
+      });
     }
 
+    const aliases = await aliasNamesByMarker(prisma, user.id, [row]);
+
     annotate({
       action: { name: "labs.biomarker.get" },
       meta: { biomarkerId: id },
     });
 
-    return apiSuccess(serialiseBiomarker(row));
+    return apiSuccess(serialiseBiomarker(row, aliases.get(row.id) ?? []));
   },
 );
 
@@ -171,6 +152,20 @@ export const PUT = apiHandler(
       }
     }
 
+    // v1.43 — the aliases, when sent, become the marker's whole set. A
+    // spelling another marker already answers to (its name or one of its
+    // aliases) is refused rather than silently moved.
+    if (d.aliases !== undefined) {
+      const conflict = await findAliasConflict(prisma, user.id, id, d.aliases);
+      if (conflict) {
+        return apiError("Another biomarker already answers to this name", 409, {
+          errorCode: "labs.biomarker.alias.taken",
+          alias: conflict.alias,
+          biomarkerId: conflict.biomarkerId,
+        });
+      }
+    }
+
     // Build `data` field-by-field. `undefined` → leave the column untouched;
     // an explicit `null` on `context` / `panel` / a bound clears it.
     const data: Record<string, unknown> = {};
@@ -212,7 +207,17 @@ export const PUT = apiHandler(
         : null;
     }
 
-    const updated = await prisma.biomarker.update({ where: { id }, data });
+    const aliasesBefore =
+      (await aliasNamesByMarker(prisma, user.id, [existing])).get(id) ?? [];
+    const updated = await prisma.$transaction(async (tx) => {
+      const row = await tx.biomarker.update({ where: { id }, data });
+      if (d.aliases !== undefined) {
+        await replaceAliases(tx, user.id, row, d.aliases);
+      }
+      return row;
+    });
+    const aliasesAfter =
+      (await aliasNamesByMarker(prisma, user.id, [updated])).get(id) ?? [];
     invalidateUserHealthScore(user.id);
 
     await auditLog("biomarker.update", {
@@ -241,7 +246,13 @@ export const PUT = apiHandler(
             panel: updated.panel,
             hidden: updated.hidden,
           },
-          redacted: d.context !== undefined ? ["context"] : [],
+          redacted: [
+            ...(d.context !== undefined ? ["context"] : []),
+            // Named, not quoted: the spellings are the person's own text.
+            ...(aliasesBefore.join("\n") !== aliasesAfter.join("\n")
+              ? ["aliases"]
+              : []),
+          ],
         }),
       },
     });
@@ -251,7 +262,7 @@ export const PUT = apiHandler(
       meta: { biomarkerId: id },
     });
 
-    return apiSuccess(serialiseBiomarker(updated));
+    return apiSuccess(serialiseBiomarker(updated, aliasesAfter));
   },
 );
 
diff --git a/src/app/api/biomarkers/route.ts b/src/app/api/biomarkers/route.ts
index 8736ab76d..2ff94ce4f 100644
--- a/src/app/api/biomarkers/route.ts
+++ b/src/app/api/biomarkers/route.ts
@@ -13,10 +13,9 @@ import { checkRecordWriteRateLimit } from "@/lib/rate-limit";
 import { auditLog } from "@/lib/auth/audit";
 import { prisma } from "@/lib/db";
 import { withIdempotency } from "@/lib/idempotency";
-import {
-  decryptContextSoft,
-  encryptContextToBytes,
-} from "@/lib/labs/biomarker-store";
+import { aliasNamesByMarker } from "@/lib/labs/biomarker-aliases";
+import { serialiseBiomarker } from "@/lib/labs/biomarker-dto";
+import { encryptContextToBytes } from "@/lib/labs/biomarker-store";
 import { matchAnalyteKey } from "@/lib/labs/analyte-match";
 import { annotate } from "@/lib/logging/context";
 import { createBiomarkerSchema } from "@/lib/validations/biomarkers";
@@ -45,35 +44,6 @@ import { createBiomarkerSchema } from "@/lib/validations/biomarkers";
 // a bad-key / malformed row) so one un-decryptable row never 500s the whole
 // catalog — the single-resource GET is the authoritative read for the
 // plaintext context. This bounds the fail-closed blast radius to one marker.
-function serialiseBiomarker(row: {
-  id: string;
-  name: string;
-  unit: string;
-  lowerBound: number | null;
-  upperBound: number | null;
-  panel: string | null;
-  analyteKey: string | null;
-  hidden: boolean;
-  contextEncrypted: Uint8Array | null;
-  createdAt: Date;
-  updatedAt: Date;
-}) {
-  return {
-    id: row.id,
-    name: row.name,
-    unit: row.unit,
-    lowerBound: row.lowerBound,
-    upperBound: row.upperBound,
-    panel: row.panel,
-    analyteKey: row.analyteKey,
-    hasContext: row.contextEncrypted !== null,
-    context: decryptContextSoft(row.contextEncrypted),
-    hidden: row.hidden,
-    createdAt: row.createdAt.toISOString(),
-    updatedAt: row.updatedAt.toISOString(),
-  };
-}
-
 export const GET = apiHandler(async () => {
   const { user } = await requireRecordAuth("read", "labs");
 
@@ -84,12 +54,19 @@ export const GET = apiHandler(async () => {
     orderBy: [{ hidden: "asc" }, { name: "asc" }],
   });
 
+  // v1.43 — every marker's other spellings, one read for the whole list.
+  const aliases = await aliasNamesByMarker(prisma, user.id, rows);
+
   annotate({
     action: { name: "labs.biomarker.list" },
     meta: { total: rows.length },
   });
 
-  return apiSuccess({ biomarkers: rows.map(serialiseBiomarker) });
+  return apiSuccess({
+    biomarkers: rows.map((row) =>
+      serialiseBiomarker(row, aliases.get(row.id) ?? [], { soft: true }),
+    ),
+  });
 });
 
 export const POST = apiHandler(withIdempotency<[NextRequest]>(postBiomarker));
@@ -179,5 +156,5 @@ async function postBiomarker(request: NextRequest) {
     meta: { biomarkerId: created.id },
   });
 
-  return apiSuccess(serialiseBiomarker(created), 201);
+  return apiSuccess(serialiseBiomarker(created, [], { soft: true }), 201);
 }
diff --git a/src/app/api/documents/inbound/[id]/confirm/route.ts b/src/app/api/documents/inbound/[id]/confirm/route.ts
index a4fbba519..0fc910a1f 100644
--- a/src/app/api/documents/inbound/[id]/confirm/route.ts
+++ b/src/app/api/documents/inbound/[id]/confirm/route.ts
@@ -100,7 +100,12 @@ async function confirmDocument(
     }
 
     try {
-      const ref = await commitApprovedFact(user.id, fact);
+      // v1.43 (D1223) — an OBSERVATION may name the marker the person chose
+      // on the review screen; the label is then remembered as its alias.
+      const ref = await commitApprovedFact(user.id, fact, {
+        biomarkerId: decision.biomarkerId,
+        rememberAlias: decision.rememberAlias,
+      });
       await prisma.extractedFact.update({
         where: { id: fact.id },
         data: {
diff --git a/src/app/api/documents/inbound/[id]/extract/__tests__/route.test.ts b/src/app/api/documents/inbound/[id]/extract/__tests__/route.test.ts
index a03e75fe6..74a90428d 100644
--- a/src/app/api/documents/inbound/[id]/extract/__tests__/route.test.ts
+++ b/src/app/api/documents/inbound/[id]/extract/__tests__/route.test.ts
@@ -51,6 +51,7 @@ vi.mock("@/lib/documents/store", () => ({
   encryptFactData: vi.fn(() => new Uint8Array([1])),
   encryptFactProvenance: vi.fn(() => new Uint8Array([2])),
   serialiseDocumentDetail: vi.fn(() => ({ id: "doc-1", facts: [] })),
+  markerIndexForFacts: vi.fn(async () => null),
 }));
 vi.mock("@/lib/documents/content-index", () => ({
   loadDocumentChatText: vi.fn(),
diff --git a/src/app/api/documents/inbound/[id]/extract/route.ts b/src/app/api/documents/inbound/[id]/extract/route.ts
index e011909a8..e3f9eebbf 100644
--- a/src/app/api/documents/inbound/[id]/extract/route.ts
+++ b/src/app/api/documents/inbound/[id]/extract/route.ts
@@ -55,7 +55,10 @@ import {
 } from "@/lib/ai/coach/budget";
 import type { ProviderChainType } from "@/lib/ai/provider-chain";
 import { prisma } from "@/lib/db";
-import { serialiseDocumentDetail } from "@/lib/documents/store";
+import {
+  markerIndexForFacts,
+  serialiseDocumentDetail,
+} from "@/lib/documents/store";
 import {
   requireDocumentTextProvider,
   requireDocumentVisionProvider,
@@ -241,7 +244,19 @@ async function runNow(
     origin: { ipAddress: getClientIp(request), worker: false },
   });
   if (!outcome.ok) return outcomeResponse(outcome);
-  return apiSuccess(serialiseDocumentDetail(outcome.data, outcome.data.facts));
+  return apiSuccess(
+    serialiseDocumentDetail(
+      outcome.data,
+      outcome.data.facts,
+      undefined,
+      undefined,
+      undefined,
+      undefined,
+      undefined,
+      undefined,
+      await markerIndexForFacts(userId, outcome.data.facts),
+    ),
+  );
 }
 
 /** TEXT mode — structure in-browser-OCR'd text against the stored row. */
diff --git a/src/app/api/documents/inbound/[id]/facts/[factId]/route.ts b/src/app/api/documents/inbound/[id]/facts/[factId]/route.ts
index 498a7ce25..808f6c789 100644
--- a/src/app/api/documents/inbound/[id]/facts/[factId]/route.ts
+++ b/src/app/api/documents/inbound/[id]/facts/[factId]/route.ts
@@ -18,7 +18,11 @@ import {
   safeJson,
 } from "@/lib/api-response";
 import { prisma } from "@/lib/db";
-import { encryptFactData, serialiseFact } from "@/lib/documents/store";
+import {
+  encryptFactData,
+  markerIndexForFacts,
+  serialiseFact,
+} from "@/lib/documents/store";
 import { annotate } from "@/lib/logging/context";
 import { requireModuleEnabled } from "@/lib/modules/gate";
 import {
@@ -125,6 +129,8 @@ export const PATCH = apiHandler(
       meta: { documentId: id, factId: fact.id, factType: fact.factType },
     });
 
-    return apiSuccess(serialiseFact(updated));
+    return apiSuccess(
+      serialiseFact(updated, await markerIndexForFacts(user.id, [updated])),
+    );
   },
 );
diff --git a/src/app/api/documents/inbound/[id]/route.ts b/src/app/api/documents/inbound/[id]/route.ts
index b6f512a27..0d3468b07 100644
--- a/src/app/api/documents/inbound/[id]/route.ts
+++ b/src/app/api/documents/inbound/[id]/route.ts
@@ -32,7 +32,10 @@ import {
   replaceVaccinationLinks,
 } from "@/lib/documents/links";
 import { actingDomainVisibility } from "@/lib/sharing/acting-domains";
-import { serialiseDocumentDetail } from "@/lib/documents/store";
+import {
+  markerIndexForFacts,
+  serialiseDocumentDetail,
+} from "@/lib/documents/store";
 import { annotate } from "@/lib/logging/context";
 import { requireModuleEnabled } from "@/lib/modules/gate";
 import { checkRateLimit, rateLimitHeaders } from "@/lib/rate-limit";
@@ -138,6 +141,8 @@ export const GET = apiHandler(
         thumbnail !== null,
         visitLinks.get(document.id) ?? [],
         doseLinks === null ? null : (doseLinks.get(document.id) ?? []),
+        // v1.43 — the marker each pending lab value resolves to, or choices.
+        await markerIndexForFacts(user.id, document.facts),
       ),
     );
   },
diff --git a/src/app/api/labs/ocr/commit/__tests__/route.test.ts b/src/app/api/labs/ocr/commit/__tests__/route.test.ts
index 3ab2468ad..b855c1fd6 100644
--- a/src/app/api/labs/ocr/commit/__tests__/route.test.ts
+++ b/src/app/api/labs/ocr/commit/__tests__/route.test.ts
@@ -16,6 +16,9 @@ vi.mock("@/lib/db", () => ({
       findMany: vi.fn(),
       create: vi.fn(),
     },
+    // v1.43 — the account's markers and aliases, loaded once per commit.
+    biomarker: { findMany: vi.fn() },
+    biomarkerAlias: { findMany: vi.fn(), upsert: vi.fn() },
     auditLog: { create: vi.fn() },
   },
 }));
@@ -107,6 +110,8 @@ beforeEach(() => {
   // No live reading collides at commit time — the in-batch path is what's
   // under test, so the DB-visibility check returns empty for every row.
   vi.mocked(prisma.labResult.findMany).mockResolvedValue([] as never);
+  vi.mocked(prisma.biomarker.findMany).mockResolvedValue([] as never);
+  vi.mocked(prisma.biomarkerAlias.findMany).mockResolvedValue([] as never);
   let nextId = 0;
   vi.mocked(prisma.labResult.create).mockImplementation((() =>
     Promise.resolve({ id: `lr-${++nextId}` })) as never);
diff --git a/src/app/api/labs/ocr/commit/route.ts b/src/app/api/labs/ocr/commit/route.ts
index 7e0a00d17..9dbc01d45 100644
--- a/src/app/api/labs/ocr/commit/route.ts
+++ b/src/app/api/labs/ocr/commit/route.ts
@@ -34,6 +34,13 @@ import { withIdempotency } from "@/lib/idempotency";
 import { checkRecordWriteRateLimit } from "@/lib/rate-limit";
 import { enqueueReminderSatisfy } from "@/lib/jobs/reminder-satisfy";
 import { emitDataArrival } from "@/lib/arrivals/emit-shared";
+import { rememberImportAlias } from "@/lib/labs/biomarker-aliases";
+import {
+  addAliasToIndex,
+  loadMarkerIndex,
+  resolveInIndex,
+  type IndexedMarker,
+} from "@/lib/labs/biomarker-resolve";
 import { resolveOrMintBiomarker } from "@/lib/labs/biomarker-store";
 import { readingInMarkerUnit } from "@/lib/labs/reading-conversion";
 import { sameLabUnit } from "@/lib/labs/unit-normalise";
@@ -69,13 +76,20 @@ async function isDuplicate(
   userId: string,
   row: OcrCommitRow,
   tz: string,
+  /** The marker the row resolves to, when it resolves to one already. */
+  biomarkerId: string | null,
 ): Promise<boolean> {
   const day = labReadingDay(new Date(row.takenAt), tz);
   const rows = await prisma.labResult.findMany({
     where: {
       userId,
       deletedAt: null,
-      analyte: { equals: row.analyte.trim(), mode: "insensitive" },
+      // The printed name, or a reading already filed under the marker this
+      // name resolves to: an earlier report may have spelled it another way.
+      OR: [
+        { analyte: { equals: row.analyte.trim(), mode: "insensitive" } },
+        ...(biomarkerId ? [{ biomarkerId }] : []),
+      ],
       takenAt: labReadingDaySearchRange(day),
     },
     select: {
@@ -123,8 +137,15 @@ async function isDuplicate(
  * Mirrors the `isDuplicate` match semantics so in-batch dedup no longer depends
  * on a prior row autocommitting before the next row's live query runs.
  */
-function inBatchKey(row: OcrCommitRow, tz: string): string {
-  const analyte = row.analyte.trim().toLowerCase();
+function inBatchKey(
+  row: OcrCommitRow,
+  tz: string,
+  biomarkerId: string | null,
+): string {
+  // Two spellings of one marker in one document are one marker (D1223).
+  const analyte = biomarkerId
+    ? `bm:${biomarkerId}`
+    : row.analyte.trim().toLowerCase();
   const dayKey = labReadingDay(new Date(row.takenAt), tz);
   const valuePart =
     row.value !== undefined
@@ -188,14 +209,59 @@ async function commitOcrRows(request: NextRequest) {
   const writtenInBatch = new Set<string>();
 
   const tz = await resolveUserTimezone(user.id);
+  // v1.43 (D1223) — the account's markers and aliases, loaded once: every row
+  // resolves its name against them (name, alias, catalog abbreviation) the
+  // way the review did, and a marker minted for one row is found by the next.
+  const markerIndex = await loadMarkerIndex(prisma, user.id);
+  let aliasesRemembered = 0;
   for (const row of parsed.data.rows) {
-    const key = inBatchKey(row, tz);
-    if (writtenInBatch.has(key) || (await isDuplicate(user.id, row, tz))) {
+    const isQualitative = row.valueText !== undefined;
+
+    // The marker the person picked on the review screen, if they picked one.
+    let chosen: IndexedMarker | null = null;
+    if (row.biomarkerId) {
+      chosen =
+        markerIndex.markers.find((m) => m.id === row.biomarkerId) ?? null;
+      if (!chosen) {
+        skipped.push({
+          analyte: row.analyte.trim(),
+          reason: "unknown_biomarker",
+        });
+        continue;
+      }
+      // The choice is remembered, so the next report spelled this way
+      // matches on its own.
+      if (row.rememberAlias !== false) {
+        const wrote = await rememberImportAlias(
+          prisma,
+          user.id,
+          chosen,
+          row.analyte,
+        );
+        if (wrote) {
+          addAliasToIndex(markerIndex, chosen.id, row.analyte);
+          aliasesRemembered += 1;
+        }
+      }
+    }
+    const resolvedId =
+      chosen?.id ??
+      resolveInIndex(
+        markerIndex,
+        row.analyte,
+        isQualitative ? null : (row.unit ?? null),
+      )?.marker.id ??
+      null;
+
+    const key = inBatchKey(row, tz, resolvedId);
+    if (
+      writtenInBatch.has(key) ||
+      (await isDuplicate(user.id, row, tz, resolvedId))
+    ) {
       skipped.push({ analyte: row.analyte.trim(), reason: "duplicate" });
       continue;
     }
 
-    const isQualitative = row.valueText !== undefined;
     // The window the scan read off the report. The confirmed numeric bounds
     // win over a re-parse of the string (the human may have corrected them on
     // the review screen); the string rides along either way.
@@ -203,14 +269,20 @@ async function commitOcrRows(request: NextRequest) {
     const sourceLow = row.referenceLow ?? printed?.low ?? null;
     const sourceHigh = row.referenceHigh ?? printed?.high ?? null;
     const sourceText = printed?.text ?? null;
-    const biomarker = await resolveOrMintBiomarker(user.id, {
-      analyte: row.analyte,
-      // A qualitative reading has no numeric unit / range.
-      unit: isQualitative ? (row.unit ?? "") : (row.unit as string),
-      referenceLow: isQualitative ? null : sourceLow,
-      referenceHigh: isQualitative ? null : sourceHigh,
-      panel: row.panel ?? null,
-    });
+    const biomarker = chosen
+      ? chosen
+      : await resolveOrMintBiomarker(
+          user.id,
+          {
+            analyte: row.analyte,
+            // A qualitative reading has no numeric unit / range.
+            unit: isQualitative ? (row.unit ?? "") : (row.unit as string),
+            referenceLow: isQualitative ? null : sourceLow,
+            referenceHigh: isQualitative ? null : sourceHigh,
+            panel: row.panel ?? null,
+          },
+          { index: markerIndex },
+        );
 
     // The marker's unit is the one the reading is stored under. A row that
     // states another unit is converted when the marker's analyte is known and
@@ -273,6 +345,8 @@ async function commitOcrRows(request: NextRequest) {
     });
 
     writtenInBatch.add(key);
+    // A freshly minted marker is now the row's; key the batch on it too.
+    writtenInBatch.add(inBatchKey(row, tz, biomarker.id));
     inserted.push(serialiseLabResult(created, biomarker));
     linkable.push({
       labResultId: created.id,
@@ -319,7 +393,11 @@ async function commitOcrRows(request: NextRequest) {
   await auditLog("labs.ocr.commit", {
     userId: user.id,
     ipAddress: getClientIp(request),
-    details: { count: inserted.length, skipped: skipped.length },
+    details: {
+      count: inserted.length,
+      skipped: skipped.length,
+      aliasesRemembered,
+    },
   });
 
   annotate({
diff --git a/src/components/labs/__tests__/ocr-review-validation.test.ts b/src/components/labs/__tests__/ocr-review-validation.test.ts
index 234d18a59..aca6c0535 100644
--- a/src/components/labs/__tests__/ocr-review-validation.test.ts
+++ b/src/components/labs/__tests__/ocr-review-validation.test.ts
@@ -205,6 +205,9 @@ describe("a reading in another unit than its marker's", () => {
       markerUnit,
       markerAnalyteKey: null,
       duplicateOf: null,
+      biomarkerId: "bm-glucose",
+      matchKind: "name" as const,
+      suggestions: [],
     });
     const [same, other, fresh] = seedReviewRows(
       [dto("mmol/L", "mmol/L"), dto("mmol/L", "mg/dL"), dto("mmol/L", null)],
@@ -271,6 +274,9 @@ describe("a reading in another unit that can be converted", () => {
       markerUnit: "mg/dL",
       markerAnalyteKey: "fasting-glucose",
       duplicateOf: null,
+      biomarkerId: "bm-glucose",
+      matchKind: "name" as const,
+      suggestions: [],
     };
     const [converts, blocked] = seedReviewRows(
       [dto, { ...dto, markerAnalyteKey: null }],
diff --git a/src/lib/doctor-report/clinical-records.ts b/src/lib/doctor-report/clinical-records.ts
index 423d42f19..e6eddc582 100644
--- a/src/lib/doctor-report/clinical-records.ts
+++ b/src/lib/doctor-report/clinical-records.ts
@@ -34,8 +34,9 @@ import type {
 
 /**
  * Structured lab results over the window, reduced to the latest reading per
- * analyte with a count, so the report is a concise panel rather than a raw
- * dump. Analyte keys fold case-insensitively.
+ * marker with a count, so the report is a concise panel rather than a raw
+ * dump. Readings group by their biomarker and carry its name; a legacy
+ * unlinked reading groups by its own name, case-insensitively.
  */
 export async function loadLabResults(
   userId: string,
@@ -58,6 +59,8 @@ export async function loadLabResults(
       sourceReferenceText: true,
       sourceUnit: true,
       takenAt: true,
+      biomarkerId: true,
+      biomarker: { select: { name: true, panel: true } },
     },
   });
   const byAnalyte = new Map<
@@ -65,7 +68,13 @@ export async function loadLabResults(
     NonNullable<DoctorReportData["labResults"]>[number]
   >();
   for (const r of rows) {
-    const key = r.analyte.toLowerCase();
+    // One line per marker: readings filed under one biomarker are one series
+    // whatever each report printed (a merge keeps the printed `analyte` on
+    // every reading), and the marker's own name heads it. A legacy unlinked
+    // reading still groups by its name.
+    const key = r.biomarkerId
+      ? `bm:${r.biomarkerId}`
+      : `analyte:${r.analyte.toLowerCase()}`;
     const prev = byAnalyte.get(key);
     // The row already stamps the catalog band it was written under; the
     // reading's own report window, when present, is what the physician read
@@ -77,8 +86,8 @@ export async function loadLabResults(
       r,
     );
     byAnalyte.set(key, {
-      panel: r.panel,
-      analyte: r.analyte,
+      panel: r.biomarker?.panel ?? r.panel,
+      analyte: r.biomarker?.name ?? r.analyte,
       value: r.value,
       valueText: r.valueText,
       unit: r.unit,
diff --git a/src/lib/documents/commit.ts b/src/lib/documents/commit.ts
index a29b4ddc6..8c92183d8 100644
--- a/src/lib/documents/commit.ts
+++ b/src/lib/documents/commit.ts
@@ -27,7 +27,11 @@ import { prisma } from "@/lib/db";
 import { invalidateUserHealthScore } from "@/lib/cache/invalidate";
 import { emitDataArrival } from "@/lib/arrivals/emit-shared";
 import { decryptFactData } from "@/lib/documents/store";
-import { resolveOrMintBiomarker } from "@/lib/labs/biomarker-store";
+import { rememberImportAlias } from "@/lib/labs/biomarker-aliases";
+import {
+  resolveOrMintBiomarker,
+  type MintedBiomarker,
+} from "@/lib/labs/biomarker-store";
 import { readingInMarkerUnit } from "@/lib/labs/reading-conversion";
 import {
   isUnreadableRange,
@@ -67,9 +71,19 @@ function statedDateOrNow(date: string | null): Date {
   return new Date();
 }
 
+/**
+ * v1.43 (D1223) — the marker the person picked for an OBSERVATION on the
+ * review screen, and whether to remember the label as its alias.
+ */
+export interface ObservationChoice {
+  biomarkerId?: string;
+  rememberAlias?: boolean;
+}
+
 async function commitObservation(
   userId: string,
   data: ObservationFactData,
+  choice: ObservationChoice = {},
 ): Promise<CommittedRecordRef> {
   const isQualitative = typeof data.value !== "number";
   // A numeric reading needs a unit so the catalog has something to mint with —
@@ -121,13 +135,41 @@ async function commitObservation(
     });
   }
 
-  const biomarker = await resolveOrMintBiomarker(userId, {
-    analyte: data.label,
-    unit: isQualitative ? (data.unit ?? "") : (data.unit as string),
-    referenceLow: isQualitative ? null : sourceLow,
-    referenceHigh: isQualitative ? null : sourceHigh,
-    panel: null,
-  });
+  // The marker the person chose wins; otherwise the label resolves through
+  // the account's names, aliases and the catalog, or a marker is minted.
+  let biomarker: MintedBiomarker;
+  if (choice.biomarkerId) {
+    const chosen = await prisma.biomarker.findFirst({
+      where: { id: choice.biomarkerId, userId },
+      select: {
+        id: true,
+        name: true,
+        unit: true,
+        lowerBound: true,
+        upperBound: true,
+        panel: true,
+        analyteKey: true,
+      },
+    });
+    if (!chosen) {
+      throw new FactCommitError(
+        "observation.unknownBiomarker",
+        "The chosen marker does not exist",
+      );
+    }
+    if (choice.rememberAlias !== false) {
+      await rememberImportAlias(prisma, userId, chosen, data.label);
+    }
+    biomarker = chosen;
+  } else {
+    biomarker = await resolveOrMintBiomarker(userId, {
+      analyte: data.label,
+      unit: isQualitative ? (data.unit ?? "") : (data.unit as string),
+      referenceLow: isQualitative ? null : sourceLow,
+      referenceHigh: isQualitative ? null : sourceHigh,
+      panel: null,
+    });
+  }
   // A unit that differs from an EXISTING marker's is converted when the
   // marker's analyte is known and the registry has the pair (a document states
   // "6.1 mmol/L" against a marker stored in mg/dL), keeping what the document
@@ -274,12 +316,13 @@ async function commitMedication(
 export async function commitApprovedFact(
   userId: string,
   fact: ExtractedFact,
+  choice: ObservationChoice = {},
 ): Promise<CommittedRecordRef> {
   // Decrypt the staged payload at confirm time to write it into the normal
   // structured store. Fail-closed: a bad key id throws and aborts the commit.
   const data = decryptFactData(fact.dataEncrypted);
   if (fact.factType === "OBSERVATION") {
-    return commitObservation(userId, data as ObservationFactData);
+    return commitObservation(userId, data as ObservationFactData, choice);
   }
   if (fact.factType === "CONDITION") {
     return commitCondition(userId, data as ConditionFactData);
diff --git a/src/lib/documents/store.ts b/src/lib/documents/store.ts
index 41849833b..a6ef65d24 100644
--- a/src/lib/documents/store.ts
+++ b/src/lib/documents/store.ts
@@ -16,7 +16,13 @@ import type {
   InboundDocument,
   InboundDocumentStatus,
 } from "@/generated/prisma/client";
+import { prisma } from "@/lib/db";
 import { servingClassFor } from "@/lib/documents/upload-policy";
+import {
+  loadMarkerIndex,
+  matchForReview,
+  type MarkerIndex,
+} from "@/lib/labs/biomarker-resolve";
 import {
   toDocumentSourceSystem,
   toIndexOutcome,
@@ -32,6 +38,7 @@ import type {
   FactProvenance,
   InboundDocumentDetailDto,
   InboundDocumentDto,
+  ObservationFactData,
   InboundDocumentKindValue,
   InboundFactType,
 } from "@/lib/validations/inbound-documents";
@@ -254,19 +261,54 @@ export function serialiseDocument(
   };
 }
 
-/** Map a persisted staged-fact row to the review DTO. */
-export function serialiseFact(fact: ExtractedFact): ExtractedFactDto {
-  return {
+/**
+ * Map a persisted staged-fact row to the review DTO.
+ *
+ * v1.43 (D1223) — with the account's `markerIndex`, a pending OBSERVATION
+ * also says which marker its label resolves to (`biomarkerId`, `matchKind`)
+ * or offers up to three (`suggestions`), the same resolution the confirm
+ * applies. Without an index, or for any other fact, the fields are absent.
+ */
+export function serialiseFact(
+  fact: ExtractedFact,
+  markerIndex?: MarkerIndex | null,
+): ExtractedFactDto {
+  const data = decryptFactData(fact.dataEncrypted);
+  const dto: ExtractedFactDto = {
     id: fact.id,
     factType: fact.factType as InboundFactType,
     status: fact.status as ExtractedFactStatus,
     confidence: fact.confidence,
     needsReview: fact.needsReview,
-    data: decryptFactData(fact.dataEncrypted),
+    data,
     provenance: decryptFactProvenance(fact.provenanceEncrypted),
     committedRecordId: fact.committedRecordId,
     committedRecordType: fact.committedRecordType,
   };
+  if (markerIndex && fact.factType === "OBSERVATION") {
+    const observation = data as ObservationFactData;
+    const isNumeric = typeof observation.value === "number";
+    const { match, suggestions } = matchForReview(
+      markerIndex,
+      observation.label ?? "",
+      isNumeric ? (observation.unit ?? null) : null,
+    );
+    dto.biomarkerId = match?.marker.id ?? null;
+    dto.matchKind = match?.matchKind ?? null;
+    dto.suggestions = suggestions;
+  }
+  return dto;
+}
+
+/** The marker index a review needs, or null when no fact would use it. */
+export async function markerIndexForFacts(
+  userId: string,
+  facts: readonly Pick<ExtractedFact, "factType" | "status">[],
+): Promise<MarkerIndex | null> {
+  const needed = facts.some(
+    (f) => f.factType === "OBSERVATION" && f.status === "PENDING",
+  );
+  return needed ? loadMarkerIndex(prisma, userId) : null;
 }
 
 /** Assemble the detail DTO (document + its staged facts + links). */
@@ -279,6 +321,7 @@ export function serialiseDocumentDetail(
   hasThumbnail = false,
   encounterLinks: DocumentEncounterLinkDto[] = [],
   vaccinationLinks: DocumentVaccinationLinkDto[] | null = [],
+  markerIndex: MarkerIndex | null = null,
 ): InboundDocumentDetailDto {
   const pendingCount = facts.filter((f) => f.status === "PENDING").length;
   // `factCount` excludes REJECTED facts (a rejected fact is discarded, not part
@@ -327,7 +370,7 @@ export function serialiseDocumentDetail(
       hasThumbnail,
       encounterLinks,
     ),
-    facts: facts.map(serialiseFact),
+    facts: facts.map((fact) => serialiseFact(fact, markerIndex)),
     vaccinationLinks,
     summary,
     summaryGeneratedAt: doc.summaryGeneratedAt
diff --git a/src/lib/export/__tests__/records-backup.test.ts b/src/lib/export/__tests__/records-backup.test.ts
index 8a1eb2838..c0d68ee1b 100644
--- a/src/lib/export/__tests__/records-backup.test.ts
+++ b/src/lib/export/__tests__/records-backup.test.ts
@@ -73,6 +73,8 @@ function buildMockPrisma() {
         },
       ]),
     },
+    biomarkerAlias: { findMany: vi.fn().mockResolvedValue([]) },
+    biomarkerMerge: { findMany: vi.fn().mockResolvedValue([]) },
     illnessEpisode: {
       findMany: vi.fn().mockResolvedValue([
         {
diff --git a/src/lib/export/__tests__/restore-backup-round-trip.test.ts b/src/lib/export/__tests__/restore-backup-round-trip.test.ts
index 3bad664fe..a4dbcd92b 100644
--- a/src/lib/export/__tests__/restore-backup-round-trip.test.ts
+++ b/src/lib/export/__tests__/restore-backup-round-trip.test.ts
@@ -160,6 +160,8 @@ function sourceClient() {
     // Records section: empty, exercised by its own suite.
     labResult: empty,
     biomarker: empty,
+    biomarkerAlias: empty,
+    biomarkerMerge: empty,
     illnessEpisode: empty,
     allergy: empty,
     familyHistoryEntry: empty,
diff --git a/src/lib/export/backup-plan.ts b/src/lib/export/backup-plan.ts
index 7409fc369..aeba3f647 100644
--- a/src/lib/export/backup-plan.ts
+++ b/src/lib/export/backup-plan.ts
@@ -576,6 +576,14 @@ export const TWO_ENDED_MODELS = [
   // questionnaire over every module decision taken in Settings since. It is
   // carried and asserted, not defaulted.
   "OnboardingRecord",
+  // v1.43 (D1223) — a marker's other spellings ride on the marker as
+  // `aliases[]`, and the merge ledger travels as its own list whose target is
+  // resolved by id or by name like a lab result's marker. Without the aliases a
+  // restored account is asked again at the next scan which marker each
+  // spelling belongs to; without the ledger a link to a merged marker reads as
+  // a plain 404 instead of leading to the marker it went into.
+  "BiomarkerAlias",
+  "BiomarkerMerge",
 ] as const;
 
 /** One model claimed to travel both ways. */
@@ -614,10 +622,6 @@ export const STRUCTURALLY_UNATTRIBUTABLE: Readonly<Record<string, string>> = {
 export const COVERAGE_PENDING: Readonly<Record<string, string>> = {
   // v1.43 — the new tables are declared here with the schema and move to
   // TWO_ENDED_MODELS when their section writer and restore branch land.
-  BiomarkerAlias:
-    "Every other spelling a marker answers to: the names folded in by a merge, the choices made at a scan or a document import, the ones typed on the marker. Without them a restored account asks again at the next scan which marker each spelling belongs to.",
-  BiomarkerMerge:
-    "The ledger of which markers were merged into which. Without it a link or a cached screen that still names a merged marker reads as a plain 404 instead of being sent to the marker it went into.",
   MedicationIngredient:
     "What one tablet or capsule of a supplement contains. Without it a restored account's supplements stop counting toward the day's micronutrients, and the composition has to be typed in again from the label.",
   DawarichDay:
diff --git a/src/lib/export/records-backup.ts b/src/lib/export/records-backup.ts
index b0ef9e7a2..f2ca65bd2 100644
--- a/src/lib/export/records-backup.ts
+++ b/src/lib/export/records-backup.ts
@@ -126,10 +126,38 @@ export interface BiomarkerBackupEntry {
   context: string | null;
   /** The catalogue key the marker's name and unit resolve to. */
   analyteKey?: string | null;
+  /**
+   * v1.43 (D1223) — the other spellings the marker answers to, with where
+   * each came from. Absent on files written before them.
+   */
+  aliases?: BiomarkerAliasBackupEntry[];
   createdAt?: string;
   updatedAt?: string;
 }
 
+export interface BiomarkerAliasBackupEntry {
+  /** Present in canonical DR payloads. */
+  id?: string;
+  name: string;
+  source: "MERGE" | "IMPORT_CHOICE" | "MANUAL";
+  createdAt?: string;
+}
+
+/**
+ * v1.43 (D1223) — one marker folded into another. The target travels by id
+ * in a disaster-recovery file and by name in both, the way a lab result's
+ * marker does; the source is gone, so its id and name are the record.
+ */
+export interface BiomarkerMergeBackupEntry {
+  id?: string;
+  targetBiomarkerId?: string;
+  targetName: string;
+  sourceBiomarkerId: string;
+  sourceName: string;
+  readingCount: number;
+  mergedAt: string;
+}
+
 export interface WorkoutBackupEntry {
   /** Present in canonical DR payloads for manual workouts without externalId. */
   id?: string;
@@ -237,6 +265,7 @@ type CanonicalAllergy = AllergyDTO & {
 export interface RecordsBackupSection {
   labResults: LabResultBackupEntry[];
   biomarkers: BiomarkerBackupEntry[];
+  biomarkerMerges: BiomarkerMergeBackupEntry[];
   illnessEpisodes: CanonicalIllnessEpisode[];
   allergies: CanonicalAllergy[];
   familyHistory: FamilyHistoryEntryDTO[];
@@ -286,6 +315,8 @@ export async function buildRecordsBackupSection(
     PrismaClient,
     | "labResult"
     | "biomarker"
+    | "biomarkerAlias"
+    | "biomarkerMerge"
     | "illnessEpisode"
     | "allergy"
     | "familyHistoryEntry"
@@ -351,6 +382,8 @@ export async function buildRecordsBackupSection(
   const [
     labResultRows,
     biomarkerRows,
+    biomarkerAliasRows,
+    biomarkerMergeRows,
     episodeRows,
     allergyRows,
     familyRows,
@@ -366,6 +399,22 @@ export async function buildRecordsBackupSection(
       where: { userId },
       orderBy: { name: "asc" },
     }),
+    prisma.biomarkerAlias.findMany({
+      where: { userId },
+      orderBy: [{ biomarkerId: "asc" }, { nameFolded: "asc" }],
+      select: {
+        id: true,
+        biomarkerId: true,
+        name: true,
+        source: true,
+        createdAt: true,
+      },
+    }),
+    prisma.biomarkerMerge.findMany({
+      where: { userId },
+      orderBy: { mergedAt: "asc" },
+      include: { target: { select: { name: true } } },
+    }),
     prisma.illnessEpisode.findMany({
       where: disasterRecovery ? { userId } : { userId, deletedAt: null },
       orderBy: { onsetAt: "desc" },
@@ -429,6 +478,32 @@ export async function buildRecordsBackupSection(
     biomarkerName: r.biomarker?.name ?? null,
   }));
 
+  const aliasesByMarker = new Map<string, BiomarkerAliasBackupEntry[]>();
+  for (const alias of biomarkerAliasRows) {
+    const list = aliasesByMarker.get(alias.biomarkerId) ?? [];
+    list.push({
+      name: alias.name,
+      source: alias.source as BiomarkerAliasBackupEntry["source"],
+      ...(disasterRecovery
+        ? { id: alias.id, createdAt: alias.createdAt.toISOString() }
+        : {}),
+    });
+    aliasesByMarker.set(alias.biomarkerId, list);
+  }
+
+  const biomarkerMerges: BiomarkerMergeBackupEntry[] = biomarkerMergeRows.map(
+    (m) => ({
+      ...(disasterRecovery
+        ? { id: m.id, targetBiomarkerId: m.targetBiomarkerId }
+        : {}),
+      targetName: m.target.name,
+      sourceBiomarkerId: m.sourceBiomarkerId,
+      sourceName: m.sourceName,
+      readingCount: m.readingCount,
+      mergedAt: m.mergedAt.toISOString(),
+    }),
+  );
+
   const biomarkers: BiomarkerBackupEntry[] = biomarkerRows.map((b) => ({
     ...(disasterRecovery
       ? {
@@ -449,6 +524,7 @@ export async function buildRecordsBackupSection(
       decryptContextFromBytes,
     ),
     analyteKey: b.analyteKey,
+    aliases: aliasesByMarker.get(b.id) ?? [],
   }));
 
   const illnessEpisodes: CanonicalIllnessEpisode[] = disasterRecovery
@@ -598,6 +674,7 @@ export async function buildRecordsBackupSection(
   return {
     labResults,
     biomarkers,
+    biomarkerMerges,
     illnessEpisodes,
     allergies,
     familyHistory,
diff --git a/src/lib/export/restore-backup.ts b/src/lib/export/restore-backup.ts
index b2659d8ea..2ee7c4416 100644
--- a/src/lib/export/restore-backup.ts
+++ b/src/lib/export/restore-backup.ts
@@ -72,6 +72,7 @@ import { encryptToBytes } from "@/lib/ai/coach/bytes-codec";
 import { encryptContextToBytes } from "@/lib/labs/biomarker-store";
 import { encryptNoteToBytes } from "@/lib/labs/store";
 import { annotate } from "@/lib/logging/context";
+import { foldForMatch } from "@/lib/i18n/fold-for-match";
 import type { BackupMeasurement } from "@/lib/validations/backup";
 import {
   isCompatibleSchemaVersion,
@@ -2076,6 +2077,76 @@ export async function restoreBackup(
           });
           biomarkerByName.set(biomarker.name, created.id);
           restoredBiomarkerIds.add(created.id);
+          // v1.43 (D1223) — the other spellings, folded the way the resolver
+          // reads them, so the next scan matches them again.
+          const aliasRows = (biomarker.aliases ?? [])
+            .map((alias) => ({
+              id: alias.id,
+              name: alias.name.trim().slice(0, 120),
+              nameFolded: foldForMatch(alias.name).slice(0, 120),
+              source: alias.source,
+              createdAt: alias.createdAt,
+            }))
+            .filter(
+              (alias) =>
+                alias.nameFolded !== "" &&
+                alias.nameFolded !== foldForMatch(biomarker.name),
+            );
+          if (aliasRows.length > 0) {
+            await tx.biomarkerAlias.createMany({
+              data: aliasRows.map((alias) => ({
+                ...(alias.id ? { id: alias.id } : {}),
+                userId: ownerId,
+                biomarkerId: created.id,
+                name: alias.name,
+                nameFolded: alias.nameFolded,
+                source: alias.source,
+                ...(alias.createdAt
+                  ? { createdAt: new Date(alias.createdAt) }
+                  : {}),
+              })),
+              // One spelling answers to one marker per account; a file that
+              // names it twice keeps the first.
+              skipDuplicates: true,
+            });
+          }
+        }
+
+        // v1.43 (D1223) — the merge ledger, against the markers just written:
+        // by id where the file carries one this restore kept, by name
+        // otherwise. A row whose target the file does not carry has nothing
+        // to point at and is left out (counted on the event).
+        let unresolvedMerges = 0;
+        const mergeRows = (payload.biomarkerMerges ?? []).flatMap((merge) => {
+          const targetId =
+            merge.targetBiomarkerId &&
+            restoredBiomarkerIds.has(merge.targetBiomarkerId)
+              ? merge.targetBiomarkerId
+              : biomarkerByName.get(merge.targetName);
+          if (!targetId) {
+            unresolvedMerges += 1;
+            return [];
+          }
+          return [
+            {
+              ...(merge.id ? { id: merge.id } : {}),
+              userId: ownerId,
+              targetBiomarkerId: targetId,
+              sourceBiomarkerId: merge.sourceBiomarkerId,
+              sourceName: merge.sourceName,
+              readingCount: merge.readingCount,
+              mergedAt: new Date(merge.mergedAt),
+            },
+          ];
+        });
+        if (mergeRows.length > 0) {
+          await tx.biomarkerMerge.createMany({ data: mergeRows });
+        }
+        if (unresolvedMerges > 0) {
+          annotate({
+            action: { name: "backup.restore.biomarkerMerge.unresolved" },
+            meta: { count: unresolvedMerges },
+          });
         }
 
         // Collected for the staged facts further down: an approved fact's
diff --git a/src/lib/fhir/resources/labs.ts b/src/lib/fhir/resources/labs.ts
index 60b70d019..3b9bf0dab 100644
--- a/src/lib/fhir/resources/labs.ts
+++ b/src/lib/fhir/resources/labs.ts
@@ -35,9 +35,9 @@ export function labObservations(
   const observations: FhirObservation[] = [];
 
   for (const lab of data.labResults ?? []) {
-    // Forward-compat: when the DTO carries a resolved canonical analyte name,
-    // thread it as the third arg so the catalog name wins over the free-text
-    // `analyte`. Absent today.
+    // `analyte` is the marker's own name (v1.43): readings of one biomarker
+    // are one Observation whatever each report printed, so two spellings
+    // merged into one marker never reach a receiver as two analytes.
     const coding = resolveLabCoding(lab.analyte, lab.unit);
     const text = lab.panel ? `${lab.analyte} (${lab.panel})` : lab.analyte;
     const code = coding
diff --git a/src/lib/labs/biomarker-dto.ts b/src/lib/labs/biomarker-dto.ts
new file mode 100644
index 000000000..2c0294d83
--- /dev/null
+++ b/src/lib/labs/biomarker-dto.ts
@@ -0,0 +1,56 @@
+/**
+ * The `Biomarker` DTO, one shape for the list, the detail, the edit and the
+ * merge result. The encrypted context bytes are never echoed: `hasContext`
+ * flags them and `context` carries the plaintext. `aliases` are the other
+ * spellings the marker answers to (v1.43), sorted, without its own name.
+ */
+import {
+  decryptContextFromBytes,
+  decryptContextSoft,
+} from "@/lib/labs/biomarker-store";
+
+export interface BiomarkerDtoRow {
+  id: string;
+  name: string;
+  unit: string;
+  lowerBound: number | null;
+  upperBound: number | null;
+  panel: string | null;
+  analyteKey: string | null;
+  hidden: boolean;
+  contextEncrypted: Uint8Array | null;
+  createdAt: Date;
+  updatedAt: Date;
+}
+
+/**
+ * `soft` decrypts fail-soft (the list: one bad row must not 500 the catalog);
+ * otherwise a decrypt failure throws so a key gap surfaces on the detail.
+ */
+export function serialiseBiomarker(
+  row: BiomarkerDtoRow,
+  aliases: readonly string[],
+  options: { soft?: boolean } = {},
+) {
+  return {
+    id: row.id,
+    name: row.name,
+    unit: row.unit,
+    lowerBound: row.lowerBound,
+    upperBound: row.upperBound,
+    panel: row.panel,
+    analyteKey: row.analyteKey,
+    hasContext: row.contextEncrypted !== null,
+    context: options.soft
+      ? decryptContextSoft(row.contextEncrypted)
+      : row.contextEncrypted
+        ? decryptContextFromBytes(row.contextEncrypted)
+        : null,
+    hidden: row.hidden,
+    aliases: [...aliases],
+    createdAt: row.createdAt.toISOString(),
+    updatedAt: row.updatedAt.toISOString(),
+  };
+}
+
+export type BiomarkerDto = ReturnType<typeof serialiseBiomarker>;
diff --git a/src/lib/labs/biomarker-merge.ts b/src/lib/labs/biomarker-merge.ts
new file mode 100644
index 000000000..ac8c545f8
--- /dev/null
+++ b/src/lib/labs/biomarker-merge.ts
@@ -0,0 +1,388 @@
+/**
+ * Merge markers into one (D1223): "Alk.P" and "Alkaline Phosphatase" become
+ * one marker with one history.
+ *
+ * The plan and the write are one function, so a dry run answers exactly what
+ * the merge would do: it reads the same rows, converts the same values and
+ * returns the same numbers, and only the write step is skipped.
+ *
+ * What a merge does, in one transaction:
+ *   - every reading of every source moves to the target. A reading in a unit
+ *     other than the target's is converted with the target's analyte
+ *     (`convertLabValue`), together with the windows stamped on it; the value
+ *     and unit the report printed stay in `sourceValue` / `sourceUnit` (a
+ *     reading that was already converted keeps its original pair). The
+ *     reading's own `analyte` stays the name that was printed.
+ *   - a pair of units the registry cannot convert refuses the WHOLE merge;
+ *     nothing moves, not even the sources that would convert;
+ *   - medication efficacy targets follow their marker;
+ *   - each source's name and its aliases become aliases of the target
+ *     (`MERGE`), unless the target's name or another marker already answers
+ *     to that spelling;
+ *   - one `biomarker_merges` row per source, and the rows that already pointed
+ *     at a source now point at the target, so an id merged twice still finds
+ *     where it went;
+ *   - the sources are deleted.
+ *
+ * There is no undo. The ledger keeps what a later split would need to know
+ * (which marker, which name, how many readings).
+ */
+import type { Prisma } from "@/generated/prisma/client";
+import { prisma } from "@/lib/db";
+import { foldForMatch } from "@/lib/i18n/fold-for-match";
+
+import { matchAnalyteKey } from "./analyte-match";
+import {
+  BIOMARKER_ALIAS_MAX_LENGTH,
+  aliasNamesByMarker,
+} from "./biomarker-aliases";
+import { serialiseBiomarker, type BiomarkerDto } from "./biomarker-dto";
+import {
+  convertLabRange,
+  convertLabValue,
+  type ConversionRefusal,
+} from "./unit-conversion/convert";
+import { sameLabUnit } from "./unit-normalise";
+
+export type MergeConversion = "none" | "converted" | "refused";
+
+export interface MergeSourceSummary {
+  id: string;
+  name: string;
+  unit: string;
+  readingCount: number;
+  conversion: MergeConversion;
+  refusal: ConversionRefusal | null;
+}
+
+export interface BiomarkerMergeResult {
+  dryRun: boolean;
+  target: BiomarkerDto;
+  sources: MergeSourceSummary[];
+  movedReadings: number;
+  convertedReadings: number;
+  aliasesAdded: string[];
+  mergeId: string | null;
+}
+
+export type BiomarkerMergeOutcome =
+  | { kind: "ok"; result: BiomarkerMergeResult }
+  | { kind: "notFound"; ids: string[] }
+  | {
+      kind: "unitMismatch";
+      sources: Array<{
+        id: string;
+        unit: string;
+        targetUnit: string;
+        reason: ConversionRefusal;
+      }>;
+    };
+
+interface ReadingUpdate {
+  id: string;
+  value: number;
+  unit: string;
+  referenceLow: number | null;
+  referenceHigh: number | null;
+  sourceReferenceLow: number | null;
+  sourceReferenceHigh: number | null;
+  sourceValue: number;
+  sourceUnit: string;
+}
+
+/** Thrown inside the transaction to roll it back with the refusal. */
+class MergeRefused extends Error {
+  constructor(readonly outcome: BiomarkerMergeOutcome) {
+    super("merge refused");
+  }
+}
+
+export async function mergeBiomarkers(input: {
+  userId: string;
+  targetId: string;
+  sourceIds: readonly string[];
+  dryRun: boolean;
+}): Promise<BiomarkerMergeOutcome> {
+  try {
+    return await prisma.$transaction(
+      (tx) => runMerge(tx, input),
+      // A source with a long history updates row by row where it converts.
+      { timeout: 60_000, maxWait: 10_000 },
+    );
+  } catch (err) {
+    if (err instanceof MergeRefused) return err.outcome;
+    throw err;
+  }
+}
+
+async function runMerge(
+  tx: Prisma.TransactionClient,
+  input: {
+    userId: string;
+    targetId: string;
+    sourceIds: readonly string[];
+    dryRun: boolean;
+  },
+): Promise<BiomarkerMergeOutcome> {
+  const { userId, targetId, sourceIds, dryRun } = input;
+
+  const markers = await tx.biomarker.findMany({
+    where: { userId, id: { in: [targetId, ...sourceIds] } },
+  });
+  const byId = new Map(markers.map((m) => [m.id, m]));
+  const missing = [targetId, ...sourceIds].filter((id) => !byId.has(id));
+  if (missing.length > 0) return { kind: "notFound", ids: missing };
+  const target = byId.get(targetId)!;
+  const sources = sourceIds.map((id) => byId.get(id)!);
+
+  // The target's analyte, derived the way every write path derives it, so a
+  // stale stored key cannot pick the wrong factor.
+  const analyteKey = matchAnalyteKey({ name: target.name, unit: target.unit });
+
+  const readings = await tx.labResult.findMany({
+    where: { userId, biomarkerId: { in: [...sourceIds] } },
+    select: {
+      id: true,
+      biomarkerId: true,
+      value: true,
+      unit: true,
+      referenceLow: true,
+      referenceHigh: true,
+      sourceReferenceLow: true,
+      sourceReferenceHigh: true,
+      sourceValue: true,
+      sourceUnit: true,
+      deletedAt: true,
+    },
+  });
+
+  const summaries: MergeSourceSummary[] = [];
+  const updates: ReadingUpdate[] = [];
+  let movedReadings = 0;
+  // Counted like `readingCount`: the live readings a person sees. A tombstoned
+  // reading moves and converts with them, so an undo brings it back right.
+  let convertedLive = 0;
+  for (const source of sources) {
+    const own = readings.filter((r) => r.biomarkerId === source.id);
+    let converted = 0;
+    let refusal: ConversionRefusal | null = null;
+    for (const reading of own) {
+      // A qualitative reading, or one already in the target's unit, moves as
+      // it is.
+      if (reading.value === null || sameLabUnit(reading.unit, target.unit)) {
+        continue;
+      }
+      const value = convertLabValue({
+        analyteKey,
+        value: reading.value,
+        from: reading.unit,
+        to: target.unit,
+      });
+      const stamped = convertLabRange({
+        analyteKey,
+        low: reading.referenceLow,
+        high: reading.referenceHigh,
+        from: reading.unit,
+        to: target.unit,
+      });
+      const printed = convertLabRange({
+        analyteKey,
+        low: reading.sourceReferenceLow,
+        high: reading.sourceReferenceHigh,
+        from: reading.unit,
+        to: target.unit,
+      });
+      if (!value.ok || !stamped.ok || !printed.ok) {
+        refusal ??= !value.ok
+          ? value.reason
+          : !stamped.ok
+            ? stamped.reason
+            : !printed.ok
+              ? printed.reason
+              : "unknown_unit";
+        continue;
+      }
+      converted += 1;
+      if (reading.deletedAt === null) convertedLive += 1;
+      updates.push({
+        id: reading.id,
+        value: value.value,
+        unit: target.unit,
+        referenceLow: stamped.low,
+        referenceHigh: stamped.high,
+        sourceReferenceLow: printed.low,
+        sourceReferenceHigh: printed.high,
+        // A reading converted on its way in keeps what the report printed.
+        sourceValue: reading.sourceValue ?? reading.value,
+        sourceUnit: reading.sourceUnit ?? reading.unit.trim(),
+      });
+    }
+    const live = own.filter((r) => r.deletedAt === null).length;
+    movedReadings += live;
+    summaries.push({
+      id: source.id,
+      name: source.name,
+      unit: source.unit,
+      readingCount: live,
+      conversion: refusal ? "refused" : converted > 0 ? "converted" : "none",
+      refusal,
+    });
+  }
+  const convertedReadings = convertedLive;
+
+  // The spellings the target gains: each source's name and its aliases, once
+  // each, except what the target's name already is or another marker (not a
+  // source) already answers to.
+  const sourceAliases = await tx.biomarkerAlias.findMany({
+    where: { userId, biomarkerId: { in: [...sourceIds] } },
+    select: { id: true, name: true, nameFolded: true },
+  });
+  const otherAliases = await tx.biomarkerAlias.findMany({
+    where: { userId, biomarkerId: { notIn: [...sourceIds] } },
+    select: { biomarkerId: true, nameFolded: true },
+  });
+  const blocked = new Set(
+    otherAliases
+      .filter((a) => a.biomarkerId !== targetId)
+      .map((a) => a.nameFolded),
+  );
+  const targetAliasFolds = new Set(
+    otherAliases
+      .filter((a) => a.biomarkerId === targetId)
+      .map((a) => a.nameFolded),
+  );
+  const otherMarkerFolds = new Set(
+    (
+      await tx.biomarker.findMany({
+        where: { userId, id: { notIn: [targetId, ...sourceIds] } },
+        select: { name: true },
+      })
+    ).map((m) => foldForMatch(m.name)),
+  );
+  const targetFold = foldForMatch(target.name);
+  const added = new Map<string, string>();
+  const consider = (name: string) => {
+    const folded = foldForMatch(name).slice(0, BIOMARKER_ALIAS_MAX_LENGTH);
+    if (!folded || folded === targetFold) return;
+    if (targetAliasFolds.has(folded) || added.has(folded)) return;
+    if (blocked.has(folded) || otherMarkerFolds.has(folded)) return;
+    added.set(folded, name.trim().slice(0, BIOMARKER_ALIAS_MAX_LENGTH));
+  };
+  for (const source of sources) consider(source.name);
+  for (const alias of sourceAliases) consider(alias.name);
+  const aliasesAdded = [...added.values()];
+
+  const refused = summaries.filter((s) => s.conversion === "refused");
+  if (!dryRun && refused.length > 0) {
+    throw new MergeRefused({
+      kind: "unitMismatch",
+      sources: refused.map((s) => ({
+        id: s.id,
+        unit: s.unit,
+        targetUnit: target.unit,
+        reason: s.refusal ?? "unknown_unit",
+      })),
+    });
+  }
+
+  let mergeId: string | null = null;
+  if (!dryRun) {
+    for (const update of updates) {
+      await tx.labResult.update({
+        where: { id: update.id },
+        data: {
+          biomarkerId: targetId,
+          value: update.value,
+          unit: update.unit,
+          referenceLow: update.referenceLow,
+          referenceHigh: update.referenceHigh,
+          sourceReferenceLow: update.sourceReferenceLow,
+          sourceReferenceHigh: update.sourceReferenceHigh,
+          sourceValue: update.sourceValue,
+          sourceUnit: update.sourceUnit,
+        },
+      });
+    }
+    await tx.labResult.updateMany({
+      where: { userId, biomarkerId: { in: [...sourceIds] } },
+      data: { biomarkerId: targetId },
+    });
+    await tx.medicationEfficacyTarget.updateMany({
+      where: { biomarkerId: { in: [...sourceIds] } },
+      data: { biomarkerId: targetId },
+    });
+    // The sources' own alias rows go with the sources; the spellings that
+    // survive are written again on the target below.
+    await tx.biomarkerAlias.deleteMany({
+      where: { userId, id: { in: sourceAliases.map((a) => a.id) } },
+    });
+    if (added.size > 0) {
+      await tx.biomarkerAlias.createMany({
+        data: [...added].map(([nameFolded, name]) => ({
+          userId,
+          biomarkerId: targetId,
+          name,
+          nameFolded,
+          source: "MERGE",
+        })),
+      });
+    }
+    await tx.biomarkerMerge.updateMany({
+      where: { userId, targetBiomarkerId: { in: [...sourceIds] } },
+      data: { targetBiomarkerId: targetId },
+    });
+    const now = new Date();
+    for (const summary of summaries) {
+      const row = await tx.biomarkerMerge.create({
+        data: {
+          userId,
+          targetBiomarkerId: targetId,
+          sourceBiomarkerId: summary.id,
+          sourceName: summary.name.slice(0, BIOMARKER_ALIAS_MAX_LENGTH),
+          readingCount: summary.readingCount,
+          mergedAt: now,
+        },
+        select: { id: true },
+      });
+      mergeId ??= row.id;
+    }
+    await tx.biomarker.deleteMany({
+      where: { userId, id: { in: [...sourceIds] } },
+    });
+  }
+
+  const after = dryRun
+    ? target
+    : await tx.biomarker.findUniqueOrThrow({ where: { id: targetId } });
+  const aliases = await aliasNamesByMarker(tx, userId, [after]);
+
+  return {
+    kind: "ok",
+    result: {
+      dryRun,
+      target: serialiseBiomarker(after, aliases.get(after.id) ?? []),
+      sources: summaries,
+      movedReadings,
+      convertedReadings,
+      aliasesAdded,
+      mergeId,
+    },
+  };
+}
+
+/**
+ * Where a merged marker went: the target of the newest merge that removed
+ * `id`, or null. Chains resolve because a merge re-points the rows that named
+ * its sources.
+ */
+export async function mergedInto(
+  userId: string,
+  id: string,
+): Promise<string | null> {
+  const row = await prisma.biomarkerMerge.findFirst({
+    where: { userId, sourceBiomarkerId: id },
+    orderBy: { mergedAt: "desc" },
+    select: { targetBiomarkerId: true },
+  });
+  return row?.targetBiomarkerId ?? null;
+}
diff --git a/src/lib/labs/ocr-extract.ts b/src/lib/labs/ocr-extract.ts
index 59740c81a..adebcc033 100644
--- a/src/lib/labs/ocr-extract.ts
+++ b/src/lib/labs/ocr-extract.ts
@@ -29,6 +29,11 @@ import {
   parseReferenceRange,
 } from "@/lib/labs/parse-reference-range";
 import { matchAnalyteKey } from "@/lib/labs/analyte-match";
+import {
+  loadMarkerIndex,
+  matchForReview,
+  type MarkerIndex,
+} from "@/lib/labs/biomarker-resolve";
 import { sameLabUnit } from "@/lib/labs/unit-normalise";
 import { annotate } from "@/lib/logging/context";
 import {
@@ -138,16 +143,18 @@ export async function annotateRow(
   row: ExtractedRow,
   reportDate: string | null,
   tz: string,
+  /** The account's markers and aliases, loaded once per extraction. */
+  markerIndex?: MarkerIndex,
 ): Promise<OcrExtractedRowDto> {
   const analyte = row.analyte.trim();
   const takenAt = normaliseDate(row.takenAt) ?? reportDate;
   const printed = parseReferenceRange(row.referenceText, row.unit);
 
-  // Biomarker match — case-insensitive on the catalog identity, presence-only.
-  const existingBiomarker = await prisma.biomarker.findFirst({
-    where: { userId, name: { equals: analyte, mode: "insensitive" } },
-    select: { id: true, name: true, unit: true },
-  });
+  // v1.43 (D1223) — the marker this name resolves to (name, alias, catalog),
+  // exactly as the commit resolves it, or up to three to choose from.
+  const index = markerIndex ?? (await loadMarkerIndex(prisma, userId));
+  const { match, suggestions } = matchForReview(index, analyte, row.unit);
+  const existingBiomarker = match?.marker ?? null;
   // The analyte the marker is, so the review can say whether a row in another
   // unit converts. Derived from the name and unit exactly as the commit derives
   // it (a stored key is only that derivation, written down), so the review and
@@ -171,7 +178,12 @@ export async function annotateRow(
       where: {
         userId,
         deletedAt: null,
-        analyte: { equals: analyte, mode: "insensitive" },
+        // The printed name, or any reading already filed under the marker it
+        // resolves to: an earlier report may have spelled it another way.
+        OR: [
+          { analyte: { equals: analyte, mode: "insensitive" } },
+          ...(existingBiomarker ? [{ biomarkerId: existingBiomarker.id }] : []),
+        ],
         takenAt: labReadingDaySearchRange(takenAt),
       },
       select: {
@@ -235,6 +247,9 @@ export async function annotateRow(
     markerUnit: existingBiomarker?.unit ?? null,
     markerAnalyteKey,
     duplicateOf,
+    biomarkerId: existingBiomarker?.id ?? null,
+    matchKind: match?.matchKind ?? null,
+    suggestions,
   };
 }
 
@@ -322,11 +337,12 @@ export async function runOcrExtraction(
   // hearing about it. A count only: the string is the user's document.
   let unreadableRanges = 0;
   const tz = await resolveUserTimezone(args.userId);
+  const markerIndex = await loadMarkerIndex(prisma, args.userId);
   for (const row of envelope.rows.slice(0, OCR_MAX_ROWS)) {
     if (isUnreadableRange(parseReferenceRange(row.referenceText, row.unit))) {
       unreadableRanges += 1;
     }
-    rows.push(await annotateRow(args.userId, row, reportDate, tz));
+    rows.push(await annotateRow(args.userId, row, reportDate, tz, markerIndex));
   }
 
   annotate({
@@ -337,6 +353,8 @@ export async function runOcrExtraction(
       rows: rows.length,
       duplicates: rows.filter((r) => r.duplicateOf !== null).length,
       newBiomarkers: rows.filter((r) => r.biomarkerMatch === "new").length,
+      aliasMatches: rows.filter((r) => r.matchKind === "alias").length,
+      catalogMatches: rows.filter((r) => r.matchKind === "catalog").length,
       unreadableRanges,
     },
   });
diff --git a/src/lib/mcp/__tests__/module-gate-sweep.test.ts b/src/lib/mcp/__tests__/module-gate-sweep.test.ts
index 64847aa79..20d0bfdf6 100644
--- a/src/lib/mcp/__tests__/module-gate-sweep.test.ts
+++ b/src/lib/mcp/__tests__/module-gate-sweep.test.ts
@@ -51,6 +51,7 @@ vi.mock("@/lib/db", () => ({
       })),
     },
     labResult: { findMany: vi.fn(async () => [{ analyte: "LDL" }]) },
+    biomarker: { findMany: vi.fn(async () => []) },
     encounter: {
       findMany: vi.fn(async () => [
         {
diff --git a/src/lib/mcp/__tests__/resource-templates.test.ts b/src/lib/mcp/__tests__/resource-templates.test.ts
index c170449b7..4b467f61f 100644
--- a/src/lib/mcp/__tests__/resource-templates.test.ts
+++ b/src/lib/mcp/__tests__/resource-templates.test.ts
@@ -4,6 +4,7 @@ vi.mock("@/lib/db", () => ({
   prisma: {
     medication: { findMany: vi.fn(), findFirst: vi.fn() },
     labResult: { findMany: vi.fn() },
+    biomarker: { findMany: vi.fn(async () => []) },
     // v1.30 (G1) — the nutrients pipeline.
     nutrientIntakeDay: {
       findMany: vi.fn(async () => []),
@@ -13,6 +14,9 @@ vi.mock("@/lib/db", () => ({
   },
 }));
 vi.mock("@/lib/logging/context", () => ({ annotate: vi.fn() }));
+vi.mock("@/lib/labs/biomarker-resolve", () => ({
+  resolveMarkerForRead: vi.fn(async () => null),
+}));
 vi.mock("@/lib/ai/coach/tools/executor", () => ({
   executeCoachTool: vi.fn(),
 }));
@@ -284,15 +288,25 @@ describe("argument completion (user-scoped, doubles as discovery)", () => {
   });
 
   it("completes analytes from ONLY the user's own lab set", async () => {
+    // One name per marker: the markers with readings, then the names of
+    // readings filed under no marker (v1.43).
+    vi.mocked(prisma.biomarker.findMany).mockResolvedValue([
+      { name: "LDL" },
+    ] as never);
     vi.mocked(prisma.labResult.findMany).mockResolvedValue([
-      { analyte: "LDL" },
       { analyte: "HDL" },
+      { analyte: "ldl" },
     ] as never);
     const complete = template("lab").complete!.analyte;
     const result = await complete(CTX, "ld");
+    expect(prisma.biomarker.findMany).toHaveBeenCalledWith(
+      expect.objectContaining({
+        where: { userId: "user-1", results: { some: { deletedAt: null } } },
+      }),
+    );
     expect(prisma.labResult.findMany).toHaveBeenCalledWith(
       expect.objectContaining({
-        where: { userId: "user-1", deletedAt: null },
+        where: { userId: "user-1", deletedAt: null, biomarkerId: null },
         distinct: ["analyte"],
       }),
     );
diff --git a/src/lib/mcp/__tests__/rich-reads.test.ts b/src/lib/mcp/__tests__/rich-reads.test.ts
index 08bedaa6d..6fe0c667d 100644
--- a/src/lib/mcp/__tests__/rich-reads.test.ts
+++ b/src/lib/mcp/__tests__/rich-reads.test.ts
@@ -27,6 +27,11 @@ const { labResult, measurement, user } = vi.hoisted(() => ({
   // narrated sentence, which reads the stored preference.
   user: { findUnique: vi.fn(async () => ({ locale: "de" })) },
 }));
+// v1.43 — a lab name resolves to a marker through the account's names and
+// aliases; no marker resolves here, so the reads keep their text match.
+vi.mock("@/lib/labs/biomarker-resolve", () => ({
+  resolveMarkerForRead: vi.fn(async () => null),
+}));
 vi.mock("@/lib/db", () => ({ prisma: { labResult, measurement, user } }));
 
 import {
diff --git a/src/lib/mcp/__tests__/tools.test.ts b/src/lib/mcp/__tests__/tools.test.ts
index 08c06007d..fa2a07e2b 100644
--- a/src/lib/mcp/__tests__/tools.test.ts
+++ b/src/lib/mcp/__tests__/tools.test.ts
@@ -23,6 +23,11 @@ vi.mock("@/lib/mcp/record-search", async (importOriginal) => ({
   ...(await importOriginal<typeof import("@/lib/mcp/record-search")>()),
   loadRecordCandidates: vi.fn(async () => []),
 }));
+// v1.43 — a lab name resolves to a marker through the account's names and
+// aliases; no marker resolves here, so the reads keep their text match.
+vi.mock("@/lib/labs/biomarker-resolve", () => ({
+  resolveMarkerForRead: vi.fn(async () => null),
+}));
 // v1.22.0 — `search` reads the record directly via Prisma; stub it so the
 // registry-wide loops never reach a DB.
 vi.mock("@/lib/db", () => ({
diff --git a/src/lib/mcp/resources.ts b/src/lib/mcp/resources.ts
index d3374d90c..8f3a8e3e9 100644
--- a/src/lib/mcp/resources.ts
+++ b/src/lib/mcp/resources.ts
@@ -26,6 +26,7 @@
  * external-assistant boundary.
  */
 import { prisma } from "@/lib/db";
+import { resolveMarkerForRead } from "@/lib/labs/biomarker-resolve";
 import { fenceUserText } from "@/lib/ai/coach/data-fence";
 import { resolveMedicationCategories } from "@/lib/medication-category";
 import { dayKeyOfDate } from "@/lib/medications/course-window";
@@ -397,13 +398,35 @@ async function completeMetric(
 async function userAnalytes(ctx: McpAuthContext): Promise<string[]> {
   // A switched-off labs module lists and completes nothing (v1.39.3).
   if (!(await isModuleEnabled(ctx.userId, "labs"))) return [];
-  const rows = await prisma.labResult.findMany({
-    where: { userId: ctx.userId, deletedAt: null },
-    select: { analyte: true },
-    distinct: ["analyte"],
-    take: 200,
-  });
-  return rows.map((r) => r.analyte);
+  // One name per marker (v1.43): readings filed under a biomarker list as the
+  // marker's name, whatever each report printed, so two spellings merged into
+  // one marker are one resource. A legacy unlinked reading keeps its own name.
+  const [markers, unlinked] = await Promise.all([
+    prisma.biomarker.findMany({
+      where: {
+        userId: ctx.userId,
+        results: { some: { deletedAt: null } },
+      },
+      select: { name: true },
+      orderBy: { name: "asc" },
+      take: 200,
+    }),
+    prisma.labResult.findMany({
+      where: { userId: ctx.userId, deletedAt: null, biomarkerId: null },
+      select: { analyte: true },
+      distinct: ["analyte"],
+      take: 200,
+    }),
+  ]);
+  const names = new Map<string, string>();
+  for (const name of [
+    ...markers.map((m) => m.name),
+    ...unlinked.map((r) => r.analyte),
+  ]) {
+    const key = name.trim().toLowerCase();
+    if (!names.has(key)) names.set(key, name);
+  }
+  return [...names.values()].slice(0, 200);
 }
 
 async function completeAnalyte(
@@ -514,7 +537,12 @@ export const MCP_RESOURCE_TEMPLATES: McpResourceTemplateDefinition[] = [
       if (!(await isModuleEnabled(ctx.userId, "labs"))) {
         return MODULE_DISABLED;
       }
-      const analyte = decodeURIComponent(firstVar(variables.analyte));
+      const asked = decodeURIComponent(firstVar(variables.analyte));
+      // An alias or a catalog abbreviation reads as the marker's own name.
+      const marker = asked.trim()
+        ? await resolveMarkerForRead(ctx.userId, asked)
+        : null;
+      const analyte = marker?.name ?? asked;
       const result = await executeCoachTool({
         userId: ctx.userId,
         name: "get_labs",
diff --git a/src/lib/mcp/rich-reads.ts b/src/lib/mcp/rich-reads.ts
index 398d20559..4c7318286 100644
--- a/src/lib/mcp/rich-reads.ts
+++ b/src/lib/mcp/rich-reads.ts
@@ -31,6 +31,7 @@
 import type { MeasurementType } from "@/generated/prisma/client";
 
 import { prisma } from "@/lib/db";
+import { resolveMarkerForRead } from "@/lib/labs/biomarker-resolve";
 import { windowWeighting } from "@/lib/measurements/day-statistic";
 import { annotate } from "@/lib/logging/context";
 import { isModuleEnabled } from "@/lib/modules/gate";
@@ -1400,18 +1401,33 @@ export async function getLabHistory(
       : LAB_HISTORY_MAX_LIMIT;
   const limit = Math.min(LAB_HISTORY_MAX_LIMIT, rawLimit);
 
-  // Match the analyte either on the LabResult's own `analyte` column or on the
-  // linked Biomarker's canonical name. `take: limit + 1` peeks one row past the
-  // page to decide whether a `nextCursor` is warranted. Field-by-field `where`.
+  // A name that resolves to one marker (its name, an alias of the account, a
+  // catalog abbreviation) reads that marker's whole series, merged spellings
+  // included (v1.43). Anything else matches the analyte either on the
+  // LabResult's own `analyte` column, on the linked Biomarker's canonical name
+  // or on one of its aliases. `take: limit + 1` peeks one row past the page to
+  // decide whether a `nextCursor` is warranted. Field-by-field `where`.
+  const marker = await resolveMarkerForRead(userId, needle);
   const rows = await prisma.labResult.findMany({
-    where: {
-      userId,
-      deletedAt: null,
-      OR: [
-        { analyte: { contains: needle, mode: "insensitive" } },
-        { biomarker: { name: { contains: needle, mode: "insensitive" } } },
-      ],
-    },
+    where: marker
+      ? { userId, deletedAt: null, biomarkerId: marker.id }
+      : {
+          userId,
+          deletedAt: null,
+          OR: [
+            { analyte: { contains: needle, mode: "insensitive" } },
+            {
+              biomarker: { name: { contains: needle, mode: "insensitive" } },
+            },
+            {
+              biomarker: {
+                aliases: {
+                  some: { name: { contains: needle, mode: "insensitive" } },
+                },
+              },
+            },
+          ],
+        },
     orderBy: { takenAt: "desc" },
     skip: offset,
     take: limit + 1,
diff --git a/src/lib/mcp/tools.ts b/src/lib/mcp/tools.ts
index d00699618..e4c53cb80 100644
--- a/src/lib/mcp/tools.ts
+++ b/src/lib/mcp/tools.ts
@@ -20,6 +20,7 @@
 import { z } from "zod/v4";
 
 import { prisma } from "@/lib/db";
+import { resolveMarkerForRead } from "@/lib/labs/biomarker-resolve";
 import { annotate } from "@/lib/logging/context";
 import { getDayArgsSchema } from "@/lib/ai/coach/tools/definitions";
 import { readDayForTool } from "@/lib/ai/coach/tools/day-read";
@@ -1510,10 +1511,18 @@ function readLabs(
       limit: LAB_HISTORY_MAX_LIMIT,
     });
   }
-  // Default: latest reading per biomarker via the Coach labs read.
-  return runCoachTool(ctx, "get_labs", {
-    ...(typeof args.analyte === "string" ? { analyte: args.analyte } : {}),
-  });
+  // Default: latest reading per biomarker via the Coach labs read. A name that
+  // resolves to one of the user's markers (an alias or a catalog abbreviation
+  // such as "GPT" for "ALT") is read as that marker's own name (v1.43).
+  return (async () => {
+    const asked = typeof args.analyte === "string" ? args.analyte : null;
+    const marker = asked?.trim()
+      ? await resolveMarkerForRead(ctx.userId, asked)
+      : null;
+    return runCoachTool(ctx, "get_labs", {
+      ...(asked !== null ? { analyte: marker?.name ?? asked } : {}),
+    });
+  })();
 }
 
 export const MCP_TOOLS: McpToolDefinition[] = [
diff --git a/src/lib/openapi/error-codes.ts b/src/lib/openapi/error-codes.ts
index b2acc7860..5bfc38b1f 100644
--- a/src/lib/openapi/error-codes.ts
+++ b/src/lib/openapi/error-codes.ts
@@ -216,9 +216,11 @@ export const ERROR_CODE_CATALOGUE: Readonly<Record<string, readonly string[]>> =
       "insights.generate.scopeChanged",
     ],
     labs: [
+      "labs.biomarker.alias.taken",
       "labs.biomarker.create.invalid",
       "labs.biomarker.duplicate",
       "labs.biomarker.merge.invalid",
+      "labs.biomarker.merge.unitMismatch",
       "labs.biomarker.notFound",
       "labs.biomarker.update.invalid",
       "labs.biomarker.update.referenceRangeInvalid",
diff --git a/src/lib/openapi/routes/biomarkers.ts b/src/lib/openapi/routes/biomarkers.ts
index 123627175..b467b9ba3 100644
--- a/src/lib/openapi/routes/biomarkers.ts
+++ b/src/lib/openapi/routes/biomarkers.ts
@@ -29,7 +29,6 @@ import {
   errorEnvelope,
   idempotencyKeyParameter,
   idempotentWrite,
-  notImplementedResponse,
   recordRefusal,
   recordWriteRateLimitResponse,
   stdResponses,
@@ -89,6 +88,14 @@ const conflict = {
   },
 };
 
+const updateConflict = {
+  "409": {
+    description:
+      "`labs.biomarker.duplicate`: a rename collides with another of the caller's markers. `labs.biomarker.alias.taken` (v1.43): one of `aliases` is already the name or an alias of another marker; `meta.alias` names the spelling and `meta.biomarkerId` the marker that answers to it.",
+    content: { "application/json": { schema: errorEnvelope } },
+  },
+};
+
 const notFound = {
   "404": {
     description:
@@ -184,7 +191,7 @@ export const biomarkerPaths: NonNullable<ZodOpenApiObject["paths"]> = {
       tags: ["Labs"],
       summary: "Fetch a single biomarker",
       description:
-        "Returns the biomarker including its decrypted `context`. Cross-user rows surface as 404.",
+        "Returns the biomarker including its decrypted `context` and, since v1.43, its `aliases`. Cross-user rows surface as 404. A marker merged into another answers 404 with `meta.mergedInto`.",
       requestParams: { path: z.object({ id: z.string() }) },
       responses: {
         ...recordRefusal(),
@@ -204,7 +211,7 @@ export const biomarkerPaths: NonNullable<ZodOpenApiObject["paths"]> = {
       tags: ["Labs"],
       summary: "Edit a biomarker",
       description:
-        "Partial edit; omitted fields are untouched, an explicit null clears `context` / `panel` / a bound. Audits as `biomarker.update`. Since v1.40.0 a `unit` different from the stored one is refused with 422 `biomarkers.unit.locked` while any reading is linked to the marker (`meta.readingCount` carries how many): readers label every linked reading with the marker's unit, so a change would relabel stored numbers without converting them. Sending the current unit, or changing it on a marker with no readings, is accepted.",
+        "Partial edit; omitted fields are untouched, an explicit null clears `context` / `panel` / a bound. Since v1.43 `aliases` (0..50, each 1..120 characters) replaces the marker's set of other spellings: listed spellings stay or are added, unlisted ones are removed; omitting the field leaves them as they are. Audits as `biomarker.update`. Since v1.40.0 a `unit` different from the stored one is refused with 422 `biomarkers.unit.locked` while any reading is linked to the marker (`meta.readingCount` carries how many): readers label every linked reading with the marker's unit, so a change would relabel stored numbers without converting them. Sending the current unit, or changing it on a marker with no readings, is accepted.",
       requestParams: { path: z.object({ id: z.string() }) },
       requestBody: {
         required: true,
@@ -220,7 +227,7 @@ export const biomarkerPaths: NonNullable<ZodOpenApiObject["paths"]> = {
             },
           },
         },
-        ...conflict,
+        ...updateConflict,
         ...notFound,
         ...stdResponses,
       },
@@ -263,8 +270,10 @@ export const biomarkerPaths: NonNullable<ZodOpenApiObject["paths"]> = {
       },
       responses: {
         ...idempotentWrite(),
+        ...recordRefusal(),
         "200": {
-          description: "The merge result (or the dry-run preview).",
+          description:
+            'The merge result, or the dry-run preview. A preview reports a source that cannot be converted with `conversion: "refused"` and its `refusal`; the same request without `dryRun` answers 422 `labs.biomarker.merge.unitMismatch`.',
           content: {
             "application/json": {
               schema: dataEnvelope(
@@ -276,8 +285,12 @@ export const biomarkerPaths: NonNullable<ZodOpenApiObject["paths"]> = {
         },
         ...notFound,
         ...stdResponses,
+        "422": {
+          description:
+            "`labs.biomarker.merge.invalid`: a malformed body, or the target among the sources (Zod issues in `details.issues[]`). `labs.biomarker.merge.unitMismatch`: a source holds readings in a unit the registry cannot convert to the target's; `meta.sources` lists each `{ id, unit, targetUnit, reason }` with `reason` one of `unknown_analyte`, `unknown_unit`, `not_finite`. Nothing was moved.",
+          content: { "application/json": { schema: errorEnvelope } },
+        },
         ...recordWriteRateLimitResponse,
-        ...notImplementedResponse,
       },
     },
   },
diff --git a/src/lib/openapi/routes/ocr.ts b/src/lib/openapi/routes/ocr.ts
index 8b9834d26..7bc03b47a 100644
--- a/src/lib/openapi/routes/ocr.ts
+++ b/src/lib/openapi/routes/ocr.ts
@@ -177,10 +177,12 @@ const commitResponse = z
     skipped: z.array(
       z.object({
         analyte: z.string(),
-        reason: z.enum(["duplicate", "unit_mismatch"]).meta({
-          description:
-            "`duplicate`: the row matched a live reading at commit time. `unit_mismatch`: the row states a unit other than the one its marker is tracked in and the pair cannot be converted, so it was not written. A pair that can be converted is written in the marker's unit and reported with `converted: true`.",
-        }),
+        reason: z
+          .enum(["duplicate", "unit_mismatch", "unknown_biomarker"])
+          .meta({
+            description:
+              "`duplicate`: the row matched a live reading at commit time. `unit_mismatch`: the row states a unit other than the one its marker is tracked in and the pair cannot be converted, so it was not written. A pair that can be converted is written in the marker's unit and reported with `converted: true`. `unknown_biomarker` (v1.43): the row named a `biomarkerId` that is not one of the record's markers.",
+          }),
       }),
     ),
     outcome: z.enum(["empty", "failed", "partial", "success"]).meta({
diff --git a/src/lib/validations/backup.ts b/src/lib/validations/backup.ts
index 70ca04c42..3cdb869bb 100644
--- a/src/lib/validations/backup.ts
+++ b/src/lib/validations/backup.ts
@@ -1134,11 +1134,38 @@ const biomarkerBackupSchema = z
     // v1.42 (#1095) — the catalogue analyte the marker resolves to.
     analyteKey: z.string().nullable().optional(),
     context: z.string().nullable().optional(),
+    // v1.43 (D1223) — the other spellings the marker answers to. Absent on
+    // files written before them.
+    aliases: z
+      .array(
+        z
+          .object({
+            id: z.string().min(1).optional(),
+            name: z.string().min(1).max(120),
+            source: z.enum(["MERGE", "IMPORT_CHOICE", "MANUAL"]),
+            createdAt: isoDateTime.optional(),
+          })
+          .passthrough(),
+      )
+      .optional(),
     createdAt: isoDateTime.optional(),
     updatedAt: isoDateTime.optional(),
   })
   .passthrough();
 
+// v1.43 (D1223) — the ledger of markers merged into others.
+const biomarkerMergeBackupSchema = z
+  .object({
+    id: z.string().min(1).optional(),
+    targetBiomarkerId: z.string().min(1).optional(),
+    targetName: z.string().min(1),
+    sourceBiomarkerId: z.string().min(1),
+    sourceName: z.string().min(1).max(120),
+    readingCount: z.number().int().min(0),
+    mergedAt: isoDateTime,
+  })
+  .passthrough();
+
 const illnessSymptomBackupSchema = z
   .object({
     key: z.string().min(1),
@@ -2101,6 +2128,8 @@ export const backupPayloadSchema = z
     // fields; portable exports retain the metadata-only subset.
     labResults: z.array(labResultBackupSchema).default([]),
     biomarkers: z.array(biomarkerBackupSchema).default([]),
+    // Defaulted: a file written before v1.43 carries no key.
+    biomarkerMerges: z.array(biomarkerMergeBackupSchema).default([]),
     illnessEpisodes: z.array(illnessEpisodeBackupSchema).default([]),
     // Defaulted: a file written before v1.40 carries no key.
     symptomDefinitions: z.array(symptomDefinitionBackupSchema).default([]),
diff --git a/src/lib/validations/biomarkers.ts b/src/lib/validations/biomarkers.ts
index 7718fa087..c0b2973a5 100644
--- a/src/lib/validations/biomarkers.ts
+++ b/src/lib/validations/biomarkers.ts
@@ -75,6 +75,10 @@ export const updateBiomarkerSchema = z
     // v1.22 — hide / unhide a marker. An omitted key leaves visibility
     // untouched; `true` drops the marker from the active list + pickers.
     hidden: z.boolean().optional(),
+    // v1.43 (D1223) — the other spellings this marker answers to, as a whole
+    // set: what is listed stays or is added, what is not is removed. Omitted
+    // leaves them untouched, so an older client's PUT keeps them.
+    aliases: z.array(z.string().trim().min(1).max(120)).max(50).optional(),
   })
   .refine(
     (d) =>
diff --git a/src/lib/validations/inbound-documents.ts b/src/lib/validations/inbound-documents.ts
index 1768dfe99..b33ae103c 100644
--- a/src/lib/validations/inbound-documents.ts
+++ b/src/lib/validations/inbound-documents.ts
@@ -340,6 +340,18 @@ export interface ExtractedFactDto {
   provenance: FactProvenance;
   committedRecordId: string | null;
   committedRecordType: string | null;
+  /**
+   * v1.43 (D1223), pending OBSERVATION facts only — the marker the label
+   * resolves to and how, or up to three markers to choose from.
+   */
+  biomarkerId?: string | null;
+  matchKind?: "name" | "alias" | "catalog" | null;
+  suggestions?: Array<{
+    biomarkerId: string;
+    name: string;
+    unit: string;
+    matchKind: "catalog" | "similar";
+  }>;
 }
 
 /** One condition link on a document DTO (chip → `/illness/[id]`). */
@@ -602,6 +614,15 @@ export const inboundConfirmSchema = z.object({
       z.object({
         factId: z.string().trim().min(1).max(40),
         action: z.enum(["approve", "reject"]),
+        /**
+         * v1.43 (D1223), OBSERVATION only — the marker the person chose for
+         * the fact; the reading is filed under it whatever the label says.
+         * An id that is not one of the record's markers fails the fact with
+         * `observation.unknownBiomarker`.
+         */
+        biomarkerId: z.string().trim().min(1).max(64).optional(),
+        /** With `biomarkerId`: remember the label as an alias. Default true. */
+        rememberAlias: z.boolean().optional(),
       }),
     )
     .min(1)
diff --git a/src/lib/validations/labs-ocr.ts b/src/lib/validations/labs-ocr.ts
index 8e11aa7d9..38c7937dd 100644
--- a/src/lib/validations/labs-ocr.ts
+++ b/src/lib/validations/labs-ocr.ts
@@ -138,6 +138,19 @@ export interface OcrExtractedRowDto {
    */
   markerAnalyteKey: string | null;
   duplicateOf: string | null;
+  /**
+   * v1.43 (D1223) — the marker the row was matched to automatically: by its
+   * name, an alias of the account, or a catalog abbreviation. Null when none.
+   */
+  biomarkerId: string | null;
+  matchKind: "name" | "alias" | "catalog" | null;
+  /** Up to three markers to choose from when nothing matched; else empty. */
+  suggestions: Array<{
+    biomarkerId: string;
+    name: string;
+    unit: string;
+    matchKind: "catalog" | "similar";
+  }>;
 }
 
 export interface OcrExtractResponseDto {
@@ -190,6 +203,18 @@ export const ocrCommitRowSchema = z
       .optional()
       .or(z.literal("").transform(() => undefined)),
     takenAt: takenAtField,
+    /**
+     * v1.43 (D1223) — the marker the person chose for this row on the review
+     * screen. The row is written under it whatever `analyte` says; an id that
+     * is not one of the record's markers skips the row (`unknown_biomarker`).
+     */
+    biomarkerId: z.string().trim().min(1).max(64).optional(),
+    /**
+     * With `biomarkerId`: remember `analyte` as another spelling of that
+     * marker, so the next report with the same name matches on its own.
+     * Default true. Ignored when the name is the marker's own.
+     */
+    rememberAlias: z.boolean().optional(),
   })
   // Numeric XOR qualitative: exactly one of value / valueText.
   .refine((d) => (d.value !== undefined) !== (d.valueText !== undefined), {
@@ -246,11 +271,12 @@ export type OcrCommitInput = z.infer<typeof ocrCommitSchema>;
 /**
  * A row the commit route did not write. `duplicate`: it matched a live reading
  * at commit time. `unit_mismatch`: it states a unit other than the one its
- * marker is tracked in.
+ * marker is tracked in. `unknown_biomarker`: the chosen `biomarkerId` is not
+ * one of the record's markers.
  */
 export interface OcrSkippedRowDto {
   analyte: string;
-  reason: "duplicate" | "unit_mismatch";
+  reason: "duplicate" | "unit_mismatch" | "unknown_biomarker";
 }
 
 export interface OcrCommitResponseDto {
diff --git a/tests/integration/backup-round-trip.test.ts b/tests/integration/backup-round-trip.test.ts
index 88971c88a..1f2497960 100644
--- a/tests/integration/backup-round-trip.test.ts
+++ b/tests/integration/backup-round-trip.test.ts
@@ -244,6 +244,8 @@ const COUNT_BACK: Record<
   MoodTag: (p, userId) => p.moodTag.count({ where: { userId } }),
   LabResult: (p, userId) => p.labResult.count({ where: { userId } }),
   Biomarker: (p, userId) => p.biomarker.count({ where: { userId } }),
+  BiomarkerAlias: (p, userId) => p.biomarkerAlias.count({ where: { userId } }),
+  BiomarkerMerge: (p, userId) => p.biomarkerMerge.count({ where: { userId } }),
   Allergy: (p, userId) => p.allergy.count({ where: { userId } }),
   FamilyHistoryEntry: (p, userId) =>
     p.familyHistoryEntry.count({ where: { userId } }),
@@ -738,6 +740,26 @@ async function seedEveryTwoEndedModel(prisma: PrismaClient): Promise<void> {
   const biomarker = await prisma.biomarker.create({
     data: { userId: OWNER_ID, name: "Ferritin", unit: "ng/mL" },
   });
+  // Another spelling of the marker, and the ledger row of a marker that was
+  // merged into it: both ride the marker (D1223).
+  await prisma.biomarkerAlias.create({
+    data: {
+      userId: OWNER_ID,
+      biomarkerId: biomarker.id,
+      name: "Ferr.",
+      nameFolded: "ferr.",
+      source: "IMPORT_CHOICE",
+    },
+  });
+  await prisma.biomarkerMerge.create({
+    data: {
+      userId: OWNER_ID,
+      targetBiomarkerId: biomarker.id,
+      sourceBiomarkerId: "merged-away-marker",
+      sourceName: "Ferritin (Serum)",
+      readingCount: 3,
+    },
+  });
   const labResult = await prisma.labResult.create({
     data: {
       userId: OWNER_ID,