Creatine kinase elevations on GLP-1 — looking for input

sean_dublin said:

Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep).

Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.

Lumbar spine T-score: -0.8 → -0.6 (stable to slightly improved)
Femoral neck T-score: -0.13 → -0.7 (stable)

No significant bone loss despite 60 lbs of weight loss. Key factors: adequate calcium (1200mg/day), vitamin D (5000 IU/day), resistance training 3x/week, and adequate protein. Weight-bearing exercise is critical for maintaining bone density during rapid weight loss.

roxy_nash said:

Right, and protein targets should be set on a reference weight rather than current weight.

Genuinely useful, thank you. I had the facts and not the framework.

sean_dublin said:

Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep).

sean_dublin said:

...the muscle loss concern with lean mass...

This is a legitimate and well-studied concern. Let me put some numbers on it:

In STEP 1, approximately 39% of weight lost was lean mass. However, the Lundgren 2024 study showed that structured resistance training reduced this to ~25% lean mass loss.

Context matters: at BMI 35+, you're carrying excess lean mass to support the extra weight. Losing some lean mass is expected and not inherently harmful if you maintain adequate muscle function through exercise.

The solution isn't avoiding the medication — it's combining it with proper exercise and protein intake.

BethLabQueen said:

Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.

OMG yes. lean mass + resistance training is the combo. Can confirm.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Tagging this one for the weekly digest.