I've never had my hsCRP checked. Is this something I should ask my doctor about before starting or while on GLP-1 therapy? I have a BMI of 36 and am about to start tirzepatide.

Absolutely. I recommend baseline hsCRP for all patients starting GLP-1 RA therapy, for two reasons:

1. Risk stratification: An elevated hsCRP (>3 mg/L) identifies residual inflammatory risk that goes beyond traditional lipid-based risk assessment. This can inform how aggressively we pursue cardiometabolic risk factor modification.
2. Treatment response tracking: Serial hsCRP measurements (I typically check at baseline, 6 months, and 12 months) help quantify the anti-inflammatory benefit and can be motivating for patients.

Important caveats: hsCRP should be drawn when you're not acutely ill (no infections, recent injuries, or flares of autoimmune conditions). An isolated value >10 mg/L likely reflects acute inflammation rather than chronic cardiovascular risk and should be repeated in 2-4 weeks.

Also request that the lab runs the high-sensitivity CRP assay, not the standard CRP. The standard assay is calibrated for detecting acute inflammation (infections, etc.) and lacks the precision to assess cardiovascular risk in the 0-3 mg/L range.

One more clinical pearl: the anti-inflammatory effect of GLP-1 RAs appears to be additive with statins. Statins have their own anti-inflammatory properties (JUPITER trial showed rosuvastatin reduced hsCRP by ~37%), and the combination of statin + GLP-1 RA can produce profound CRP reductions.

In the patient described in the OP, she was already on atorvastatin 40 mg, which means her baseline hsCRP of 8.4 was despite statin therapy. The semaglutide added a second anti-inflammatory mechanism on top of the statin, resulting in the 93% total reduction. This is the kind of residual inflammatory risk reduction that we've been searching for since CANTOS.

Pinning this thread. The inflammation data is one of the most underappreciated aspects of GLP-1 RA therapy, and this discussion covers both the mechanistic basis and the clinical evidence beautifully. The complete inflammatory panel (not just hsCRP) in the original post is particularly valuable as a clinical example.