OP here — wow, did not expect this much response! Thank you all for the thoughtful replies on Couple's transformation .

To answer nick_SD_fit: 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 Couple's transformation — here is my latest bloodwork comparison:

Key improvements: A1C 8.4% → 5.5%, triglycerides 229 → 99 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 Couple's transformat.

Slightly tangential to Couple's transformation but pam_stl 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.

AmyNC_wife said:

Thank you all for the thoughtful replies on Couple's transformation

This is exactly right. AmyNC_wife articulated what I have been trying to explain to my doctor for months. The Couple's transformation aspect is the most important factor.