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ForumsTirzepatide (Mounjaro / Zepbound)Tirzepatide and cholesterol — looking for input Page 3

Tirzepatide and cholesterol — looking for input

wei_SG Mon, Jan 20, 2025 at 4:31 PM 44 replies 2,688 viewsPage 3 of 9
JenMemphis
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Jan 21, 2025 at 1:40 PM#11
LipidDoc_ATL said:
Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

Saving this. It is the first explanation that did not require me to already understand it. Taking it to my next appointment.

6 4MikeKY_noInsulin, Dr.RaviCardio, jennifer_SEA and 3 others
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chris_chi24
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Jan 21, 2025 at 6:13 PM#12

Clinical perspective, offered as context rather than as advice.

Advanced lipoprotein testing on the lipid panel — going beyond standard lipid panel:

MarkerBaselineMonth 8Clinical Meaning
LDL-P1677977Particle count (more precise than LDL-C)
Small dense LDL57%33%Atherogenic pattern
Remnant cholesterol3716Triglyceride-rich lipoproteins
oxLDL8245Oxidative stress marker

The shift from small dense to large buoyant LDL is particularly important — it represents a fundamental change in the atherogenic profile.

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VendorMark
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Jan 21, 2025 at 10:46 PM#13
Dr.PainCLE said:
SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1.

I read this differently from Dr.PainCLE, on substance rather than tone. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

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LabKate
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Jan 22, 2025 at 3:19 AM#14
wei_SG said:
ApoB is the more informative number and it is cheap.

Tracking labs for the lipid panel — here's the panel I get every 3 months and why:

  • CMP: glucose, electrolytes, kidney function, liver enzymes
  • Lipid panel: total cholesterol, LDL, HDL, triglycerides
  • A1C: 3-month glucose average
  • hsCRP: inflammatory marker
  • CBC: blood counts, anemia screening
  • B12, folate, iron: nutritional deficiency screening
  • TSH, free T4: thyroid monitoring
  • Lipase: pancreatic safety check

Total cost with insurance: about $31 copay. Without insurance, request cash-pay pricing from Quest/Labcorp — usually $176.

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Admin
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Jan 22, 2025 at 7:52 AM#15

Moderator note: a post naming a supplier has been edited. Discuss suppliers in the review sections, not here.

Last edited: Jan 22, 2025 at 11:52 AM
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