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ForumsDosing & ProtocolsWhen to hold at a dose vs continue titrating — my results so far Page 2

When to hold at a dose vs continue titrating — my results so far

Dr.BariatricHTX Mon, Nov 11, 2024 at 8:05 PM 18 replies 1,996 viewsPage 2 of 4
MASHdoc_SA
Member
456
2,345
Aug 2024
San Antonio, TX
Nov 11, 2024 at 10:55 PM#6

lol @ treating protein like medicine. that is SO accurate. some days i look at my chicken breast and want to cry because i'm just not hungry but i know i need the protein. the things we do 😂

dan — have you tried fairlife protein shakes? 30g protein per bottle and they actually taste decent. way easier to drink than chewing food when you have zero appetite

34 23TirzTom, TrialTracker_MD, JennaRN and 31 others
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josh_phd_bmore
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389
1,678
Jul 2024
Baltimore, MD
Nov 11, 2024 at 11:12 PM#7

Follow-up: Blood work comparison

MarkerBaseline6 monthsReference
Fasting glucose108 mg/dL86 mg/dL70-100
A1C5.9%5.1%<5.7%
Fasting insulin24.3 mIU/L8.7 mIU/L2.6-24.9
HOMA-IR6.51.8<2.0
Total cholesterol224178<200
LDL-C14298<100
HDL-C3852>40
Triglycerides246118<150
hsCRP8.4 mg/L1.9 mg/L<3.0
ALT52 U/L24 U/L7-56
GGT68 U/L31 U/L9-48

I went from pre-diabetic with metabolic syndrome to completely normal metabolic health in 6 months. The HOMA-IR dropping from 6.5 to 1.8 is probably the most meaningful number here — I went from severely insulin resistant to insulin sensitive.

The liver enzymes normalizing is also notable. Likely had some NAFLD that's resolving.

Last edited: Nov 12, 2024 at 1:12 AM
3 0Dr.ObesityLA, NurseKim_ATL, paul_denver
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mia_MS2
New Member
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23
Jun 2026
Ann Arbor, MI
Nov 11, 2024 at 11:29 PM#8

this is a textbook-perfect response. The triglyceride drop of 52% is consistent with the SURPASS data and likely reflects both the direct GIP-mediated lipid effects and the visceral fat reduction (which your DEXA confirmed).

The ALT/GGT normalization strongly suggests you had non-alcoholic fatty liver disease that's resolving. SURMOUNT-3 included liver fat sub-studies and showed up to 50% reduction in hepatic steatosis with tirzepatide. Your results are consistent with that.

Honestly — and I don't say this lightly — your combination of tirz + resistance training + high protein has produced results that rival bariatric surgery outcomes, with potentially better lean mass preservation.

Please keep documenting. This kind of real-world data is invaluable.

N=1, but what an N

40 6dave_SLC, FDA_TrackerJim, ricardo_MIA and 37 others
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FDA_TrackerJim
Senior Member
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Feb 2024
Rockville, MD
Nov 11, 2024 at 11:46 PM#9

Thanks everyone. Will post my 12-month DEXA when I get it. The plan is to continue tirz at 10mg (no need to increase based on current trajectory), maintain the lifting program, and keep protein high.

For anyone reading this wondering if they should lift on tirz — YES. Do it. Start now. Even bodyweight exercises count. The drug is a gift but you have to do your part to make the weight loss high-quality.

SW: 248 | CW: 207 | GW: 195 | Lifting 4x/week | Protein is life

41 2Dr.LeslieOBGYN, MikeNYC_runner and 38 others
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