1-year semaglutide anniversary — May 2025

What's HOMA-IR? Sorry, I'm new to all this lab stuff.

No need to apologize — HOMA-IR stands for Homeostatic Model Assessment of Insulin Resistance. It's a calculated value that estimates how resistant your cells are to insulin.

Basically: your body makes insulin to move sugar out of your blood and into cells. If your cells are resistant, you need MORE insulin to do the same job. So high fasting insulin + high fasting glucose = high HOMA-IR = your metabolism is struggling.

Under 1.0 is very insulin sensitive. Under 2.5 is generally normal. Above 2.5 indicates insulin resistance. Mine was 7.0 — which is quite bad. Now at 2.1 I'm back in normal range.

Great breakdown. One additional marker I'd suggest for anyone doing comprehensive panels: Lp(a) — lipoprotein(a). It's genetically determined and doesn't change with lifestyle or most medications, but it's important for cardiovascular risk stratification. About 20% of people have elevated Lp(a) and don't know it. You only need to test it once since it doesn't change.

Also: ApoB is increasingly regarded as superior to LDL-C for assessing atherogenic risk. It counts all the particles that can contribute to plaque, not just cholesterol content. Worth adding to the panel.

Good call — I actually did get ApoB tested but forgot to include it. Baseline was 142 mg/dL, now 98 mg/dL. Optimal is generally considered under 90, so still a bit elevated but trending the right direction. Lp(a) was 18 nmol/L which is low risk, thankfully.