SarahChen_PharmD said:

need advice — in my experience this comes down to a few key factors

I respect SarahChen_PharmD perspective but I think this oversimplifies things a bit. Re: 5mg doing nothing - should I — the subgroup analyses show meaningful heterogeneity.

I am not saying SarahChen_PharmD wrong entirely — just that the picture is more nuanced than a blanket statement. The SURMOUNT data specifically shows baseline BMI-dependent responses.

Relevant to 5mg doing nothing - should I — here is my latest bloodwork comparison:

Key improvements: A1C 7.6% → 5.5%, triglycerides 225 → 95 mg/dL, hsCRP 8.0 → 1.3 mg/L. All on tirzepatide for 17 months.

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

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

Slightly tangential to 5mg doing nothing - but Dr.NephBHM_UK 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. 👍