steve_okc said:Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.
Can confirm. Same sequence, different timescale.
steve_okc said:Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 285 | 255 | 235 | 195 |
| A1C (%) | 7.5 | 6.5 | 5.8 | 5.2 |
| hsCRP (mg/L) | 5.0 | 4.0 | 2.5 | 1.1 |
| Triglycerides | 205 | 165 | 145 | 115 |
Protocol: Tirzepatide 10mg/wk, resistance training 5x/week, protein 1.5g/kg/day.
The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.
steve_okc said:Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.
Physical therapist weighing in on lean mass. I work with bariatric and metabolic patients daily.
The resistance training evidence is critical here:
The Lundgren 2024 JAMA paper[1] showed that structured resistance training preserved 73% more lean mass in GLP-1 patients vs medication alone. When discussing lean mass, we MUST include the exercise component.
My minimum prescription: 3x/week compound movements (squat, deadlift, press, row), progressive overload, 7-10K steps/day, and 1.2-1.6g protein/kg/day.
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Shop Reference StandardsOne thing that is still open after steve_okc’s answer:
What did you change at the same time, and can you separate the two now?
anders_CPH said:Physical therapist weighing in on lean mass.
DEXA scan update relevant to lean mass:
Scanned at months 0, 6, and 12. Here are the body comp numbers:
| Baseline | Month 6 | Month 12 | |
|---|---|---|---|
| Total mass | 284 lbs | 229 lbs | 221 lbs |
| Fat mass | 124 lbs | 84 lbs | 56 lbs |
| Lean mass | 162 lbs | 155 lbs | 158 lbs |
| Body fat % | 45% | 35% | 25% |
Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.6g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.