Dr.ObesityMed said:

Short answer: yes, it is worth it

I respect Dr.ObesityMed perspective but I think this oversimplifies things a bit. Re: Oral sema empty stomach — the subgroup analyses show meaningful heterogeneity.

I am not saying Dr.ObesityMed wrong entirely — just that the picture is more nuanced than a blanket statement. The SUSTAIN data specifically shows different outcomes in different metabolic phenotypes.

Relevant to Oral sema empty stomach — here is my latest bloodwork comparison:

Key improvements: A1C 8.4% → 5.5%, triglycerides 193 → 93 mg/dL, hsCRP 8.0 → 1.1 mg/L. All on tirzepatide for 9 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.

Thank you ingrid_STO! This is incredibly helpful. Taking this to my next appointment. 🙏

Slightly tangential to Oral sema empty stomach but fiona_VT reminded me — does anyone have experience combining this with metformin?

I know it is not exactly on-topic but it seems related enough to ask here rather than starting a new thread. Apologies if this has been covered — I did search first.

Moderator note: Great discussion, everyone. Just a reminder to keep things civil and evidence-based.

Thread quality is excellent — keep it up. 👍