OK, just to give you guys an update, I have done a couple of things to see if I can narrow down the issue. I put some fuel injector cleaner into the gas, put some lifter cleaner into the oil and swapped out the ICV with the one in my 330ci. I though swapping out the ICV fixed the issue but it came back the next morning. It does seem to be somewhat better though but that is probably because the ICV was cleaned before I put it in.

Should I try swapping injectors? My fuel pump is original and tested at 50psi when running but could it be slow to build pressure on start up? A simple test for this would be to turn on the key and let the pump run for a few seconds before starting right?

After restarting the X5 it appears to run great which is what is driving me crazy. It is like a splinter in my mind! I am shooting for 300k on this beast.....

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2001 3.0 X5 5M - 227k - "Station Wagon according to the great communist state of IL"
1995 M3 5M - 230k and waiting for a new head gasket
1988 325i Auto Convertible - sold
1992 318i 5M Convertible - sold
1992 325i 5M Convertible - sold
2001 330i 5M Convertible - The more money I put in, the better it gets...
1998 K1200RS - Done all 48 Contiguous States, looking forward to Alaska at some point in my life