OP here — wow, did not expect this much response! Thank you all for the thoughtful replies on Has anyone dealt with.

To answer NurseLeah_Nash: yes, I am on compounded sema from a 503B pharmacy.

Quick update: things are still going well. Thanks again for the evidence-based discussion — this is exactly why I posted in a science-based community. 🙏

Relevant to Has anyone dealt with — here is my latest bloodwork comparison:

Key improvements: A1C 8.4% → 5.5%, triglycerides 241 → 111 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.

100%. My provider said the same thing about Has anyone dealt.

Slightly tangential to Has anyone dealt with but lisa_labSD 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.

mel_PDX said:

Thank you all for the thoughtful replies on Has anyone dealt with

This is exactly right. mel_PDX articulated what I have been trying to explain to my doctor for months. The Has anyone dealt with aspect is the most important factor.