Dr.EM_Chicago said:Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep). Called my pharmacist — they said it's not dangerous but may absorb faster, potentially causing more GI effects.
Sure enough, had worse nausea that day. Lesson learned: pinch the skin properly and use the right needle length for your body composition.
Dr.EndoEP said:Agreed on the ranges, with the condition that a single DEXA is not a measurement, it is one draw from a distribution.
Thank you — that is the clearest version of this I have read, and I have read a lot of them. Printing the relevant bit and taking it with me.
Dr.EM_Chicago said:Bone density monitoring on lean mass: DEXA bone density at baseline and month 12.
Sharing my comprehensive lab data relevant to lean mass:
| Biomarker | Baseline | Month 3 | Month 6 | Month 9 |
|---|---|---|---|---|
| Weight (lbs) | 275 | 235 | 215 | 195 |
| A1C (%) | 7.0 | 6.5 | 5.6 | 5.2 |
| hsCRP (mg/L) | 5.0 | 5.0 | 2.5 | 1.1 |
| Triglycerides | 185 | 165 | 135 | 95 |
Protocol: Tirzepatide 15mg/wk, resistance training 4x/week, protein 1.6g/kg/day.
The improvements in lean mass are clearly reflected in these numbers. The inflammatory marker reduction (hsCRP) is particularly striking.
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Shop Reference Standardssarah_TO said:Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.
Physical therapist weighing in on lean mass. I work with bariatric and metabolic patients daily.
The resistance training evidence is critical here:
The Lundgren 2024 JAMA paper[1] showed that structured resistance training preserved 73% more lean mass in GLP-1 patients vs medication alone. When discussing lean mass, we MUST include the exercise component.
My minimum prescription: 3x/week compound movements (squat, deadlift, press, row), progressive overload, 7-10K steps/day, and 1.2-1.6g protein/kg/day.
[1] Lundgren JR, et al. JAMA. 2024;331(1):38-48.
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