Higher Insulin Resistance… After Weight Loss?

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Neurogroot

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So here’s a weird one… I did the things you’re supposed to do, got a wild amount of bloodwork done before peptide usage, and I just finished up my previous round of bloodwork into my peptide journey. Some backstory… I golf a lot, and my main workout is club speed training.

On a golf outing, on a nice 65 degree, not humid day, well hydrated, I started getting dizzy. Tried playing through it. Vision started getting pin-holed, rushing water sounds. Had to sit out for 45 minutes, water, Gatorade Zero pounding, beef jerky… Tried again, and same results.

Went through a bunch of heart tests, bloodwork for electrolytes, iron.. nothing there. Yet 2-3 days a week, I get hit with these symptoms. Brand new too, is sleep paralysis after night terrors 3-4 nights a month, the past 2 months.

So, doctor didn’t feel like ordering the blood tests I felt I needed for my peptide journey (they know 1/3 of my stack), so I ordered it. Getting results in now, and everything is looking good. 6 months in, total cholesterol is down 22 points, 186 to 164… LDL down 19 points, 114 to 95. Triglycerides from 113 to 84. A1C down from 5.9% to 5.1%. Everything was seemingly in order. Then, the weird stuff started coming in.

Fructosamine (Like A1C, but shorter time frame), 281 initially, down to 162 (range is 205-285). Fasting glucose was 105 6 months ago, now it’s 64? I didn’t have fasting insulin before, but I did now, and it’s 31.3 uIU/mL (range is 6-25), and most importantly, my HOMA2-IR score was 3.13, and high is considered 1.3.

This is a very very long way to ask my question. 6 months into my peptide journey, I lost 54 lbs. If ArboLeaf is to be believed, only 11.4 lbs was lean mass. I used to eat sugar like crazy. Easily 350g-500g a day, no exaggeration. Now, it’s more like 80-120g. How am I having more insulin resistance now? Is there a 3+ month lag for insulin production to adjust to my new me? I bought a glucose spot checker, and this morning, I was at 52. An hour after breakfast, 115. An hour after that, 79.

Any advice to get this insulin resistance thing sorted out? Already on 9 mg weekly Tirz (Friday) with a tide over of Reta/Cag (3 mg/0.6 mg) on Tuesday. Scheduled for MOTS-c protocol tomorrow (Sun/Tues/Fri), 5 mg a dose. Hoping that helps.

The doctor I see is negative supportive on non-GLP peptides. So I struggle bringing it up to them. Hoping your experiences can help me understand what’s going on. And as always, appreciate you all, and apologies for this novel of a message!
 
Neurogroot said:
So here’s a weird one… I did the things you’re supposed to do, got a wild amount of bloodwork done before peptide usage, and I just finished up my previous round of bloodwork into my peptide journey. Some backstory… I golf a lot, and my main workout is club speed training.

On a golf outing, on a nice 65 degree, not humid day, well hydrated, I started getting dizzy. Tried playing through it. Vision started getting pin-holed, rushing water sounds. Had to sit out for 45 minutes, water, Gatorade Zero pounding, beef jerky… Tried again, and same results.

Went through a bunch of heart tests, bloodwork for electrolytes, iron.. nothing there. Yet 2-3 days a week, I get hit with these symptoms. Brand new too, is sleep paralysis after night terrors 3-4 nights a month, the past 2 months.

So, doctor didn’t feel like ordering the blood tests I felt I needed for my peptide journey (they know 1/3 of my stack), so I ordered it. Getting results in now, and everything is looking good. 6 months in, total cholesterol is down 22 points, 186 to 164… LDL down 19 points, 114 to 95. Triglycerides from 113 to 84. A1C down from 5.9% to 5.1%. Everything was seemingly in order. Then, the weird stuff started coming in.

Fructosamine (Like A1C, but shorter time frame), 281 initially, down to 162 (range is 205-285). Fasting glucose was 105 6 months ago, now it’s 64? I didn’t have fasting insulin before, but I did now, and it’s 31.3 uIU/mL (range is 6-25), and most importantly, my HOMA2-IR score was 3.13, and high is considered 1.3.

This is a very very long way to ask my question. 6 months into my peptide journey, I lost 54 lbs. If ArboLeaf is to be believed, only 11.4 lbs was lean mass. I used to eat sugar like crazy. Easily 350g-500g a day, no exaggeration. Now, it’s more like 80-120g. How am I having more insulin resistance now? Is there a 3+ month lag for insulin production to adjust to my new me? I bought a glucose spot checker, and this morning, I was at 52. An hour after breakfast, 115. An hour after that, 79.

Any advice to get this insulin resistance thing sorted out? Already on 9 mg weekly Tirz (Friday) with a tide over of Reta/Cag (3 mg/0.6 mg) on Tuesday. Scheduled for MOTS-c protocol tomorrow (Sun/Tues/Fri), 5 mg a dose. Hoping that helps.

The doctor I see is negative supportive on non-GLP peptides. So I struggle bringing it up to them. Hoping your experiences can help me understand what’s going on. And as always, appreciate you all, and apologies for this novel of a message!
Get a new dr to start with.
 
CNCCurrency said:
Get a new dr to start with.
I am working on that, for sure. I’m running into issues where I can either have a primary care physician that accepts insurance and can fill a specific prescription for me, or… Cash pay, 50/50 if they can write a certain script, and from their site at least, seem to want to push things like LIVV, where they’ll sure give me KPV, 10 mg for $249/month.

Any tips for what I should be looking for?
 
Don't try to over-optimize. Your HbA1c is good. The postprandial blood glucose peak drops rapidly enough. You mainly have episodes of hypoglycemia that could cause you to not wake up one morning...

It's time to lower your aGLP-1 doses a little, and maybe stick with just one. MOTS-C is great, but it will make hypoglycemia worse. I had three episodes last month while taking tirz+reta+mots-c.

Include more complex carbohydrates in your diet. Choose ones that don’t cause blood sugar spikes.

Buy a CGM (like the Freestyle) to monitor your blood sugar levels and get alerts before you lose consciousness.
 
Something to consider; your doctor's literal job is to help you be informed to the best of their professional expert opinion, answer your questions, help you understand the risks of any particular course of action, and support you to the best of said professional ability after you make the decisions about what to do next.

A doctor's role is NOT to tell you what to do, expect that you'll obey, and scold you if you don't. I wouldn't accept that from ANY doctor, and I don't know a ton of them that would try it if I made my expectations of what I needed clear.

My doctor wanted me on statins and off cigarettes the last two times I saw him. I wasn't ready to quit cigarettes, and I wasn't ready to accept that statins were necessary. I told him I was going to start a GLP-1, get my weight under control, and then I wanted to re-assess. He said he didn't think that would make a big enough difference, even if I did quit smoking. I said I accept that; I'm going to see how it goes. If more than six months goes by, my weight gets to normal, and the LDL is still too high, we'll talk about either smoking cessation or statins; but I won't do both at once. He told me what that does to my risk level of a cardiac event. I thanked him. We parted as a teammates.

At my next visit, if my LDL is still high, then I'm still not going on the statins. My quit date is 8/1 for cigarettes. We'll give THAT somet time, then recheck at a reasonable interval. If it's still high, then statins. I understand what that does to my risk level at present, because he told it to me, because that's the job my insurance pays him to do. He's NOT an authority over me, and even if he THOUGHT he were, he still wouldn't be.

I'm saying that because yours isn't an authority over you either. Ok, they're glp-1 negative. That's fine, they can tell you that, and they can tell you why. You made the decision to go on them. They have to accept that, and they still have to do their job by you even if you didn't obey them; and you have the right to, in a totally friendly way, insist that they do so.
 
What are your inflammation markers like? Did your test include cytokines?

My main issue after losing 60 pounds in a short time was inflammation, according to bloodwork. Glucose was also a bit high at 100. Multiple AI engines told me that the inflammation was likely due to the stress I put my body under during rapid weight loss.

Apparently, inflammation, even temporary, can cause insulin resistance. The AI engines told me to test again after my weight stabilized.

If you haven't already, consider opening up ChatGPT, telling it your race, gender, starting weight, ending weight, what meds you're on, and how long your weight-loss journey took. Then copy/paste the results of your blood work.
 
Neurogroot said:
So here’s a weird one… I did the things you’re supposed to do, got a wild amount of bloodwork done before peptide usage, and I just finished up my previous round of bloodwork into my peptide journey. Some backstory… I golf a lot, and my main workout is club speed training.

On a golf outing, on a nice 65 degree, not humid day, well hydrated, I started getting dizzy. Tried playing through it. Vision started getting pin-holed, rushing water sounds. Had to sit out for 45 minutes, water, Gatorade Zero pounding, beef jerky… Tried again, and same results.

Went through a bunch of heart tests, bloodwork for electrolytes, iron.. nothing there. Yet 2-3 days a week, I get hit with these symptoms. Brand new too, is sleep paralysis after night terrors 3-4 nights a month, the past 2 months.

So, doctor didn’t feel like ordering the blood tests I felt I needed for my peptide journey (they know 1/3 of my stack), so I ordered it. Getting results in now, and everything is looking good. 6 months in, total cholesterol is down 22 points, 186 to 164… LDL down 19 points, 114 to 95. Triglycerides from 113 to 84. A1C down from 5.9% to 5.1%. Everything was seemingly in order. Then, the weird stuff started coming in.

Fructosamine (Like A1C, but shorter time frame), 281 initially, down to 162 (range is 205-285). Fasting glucose was 105 6 months ago, now it’s 64? I didn’t have fasting insulin before, but I did now, and it’s 31.3 uIU/mL (range is 6-25), and most importantly, my HOMA2-IR score was 3.13, and high is considered 1.3.

This is a very very long way to ask my question. 6 months into my peptide journey, I lost 54 lbs. If ArboLeaf is to be believed, only 11.4 lbs was lean mass. I used to eat sugar like crazy. Easily 350g-500g a day, no exaggeration. Now, it’s more like 80-120g. How am I having more insulin resistance now? Is there a 3+ month lag for insulin production to adjust to my new me? I bought a glucose spot checker, and this morning, I was at 52. An hour after breakfast, 115. An hour after that, 79.

Any advice to get this insulin resistance thing sorted out? Already on 9 mg weekly Tirz (Friday) with a tide over of Reta/Cag (3 mg/0.6 mg) on Tuesday. Scheduled for MOTS-c protocol tomorrow (Sun/Tues/Fri), 5 mg a dose. Hoping that helps.

The doctor I see is negative supportive on non-GLP peptides. So I struggle bringing it up to them. Hoping your experiences can help me understand what’s going on. And as always, appreciate you all, and apologies for this novel of a message!
Sorry to post a big AI reply , but it is from chatgpt in research/scholar mode with extra prompts so should be pretty reliable. And usefully it gives confidence levels on its assessments. I was just confused and could not see the evidence for your statement about the increased insulin resistance so copied your post and asked it. It does offer some possible explanations for the results and the symptoms. i will do it in 2 parts as it is long.

AI answer

I agree with your skepticism. Based on what is written, I do not think the post provides convincing evidence that insulin resistance worsened.

In fact, several findings point in the opposite direction.

The biggest issue is:

HOMA2-IR is being interpreted without context and possibly outside the conditions where it is reliable.

1. What is HOMA2-IR?

The original HOMA model estimates insulin resistance from:

fasting glucose

fasting insulin

The HOMA2 version is a more sophisticated nonlinear model (calculator-based) that adjusts for physiology better than the original formula.

Conceptually:

higher fasting insulin for a given glucose → more insulin resistance.

But it is not a direct measurement of insulin sensitivity.

It is a surrogate, and a noisy one.

Evidence confidence: high.

2. Why the post looks internally inconsistent

The person reports:

Before

HbA1c 5.9%

fasting glucose 105 mg/dL

fructosamine 281

After 54 lb loss on tirzepatide/retatrutide/cagrilintide

HbA1c 5.1%

fasting glucose 64 mg/dL

fructosamine 162 (below reference range)

fasting insulin 31 μIU/mL

HOMA2-IR 3.13

Those metabolic markers are discordant.

Strong signals of improved glycemia

HbA1c improved substantially (5.9 → 5.1%)

fasting glucose normalized and arguably became low

fructosamine dramatically lower

triglycerides improved

large weight loss.

Collectively, those findings usually imply:

improved insulin sensitivity and improved metabolic health

not worsening resistance.

Confidence: moderate–high.

3. The fasting insulin value is the weird part

The striking abnormality is:

fasting insulin 31 μIU/mL with glucose 64 mg/dL.

That combination is odd.

If true, it raises possibilities.

A. Non-fasting sample / protocol issue (common)

Most likely base-rate explanation.

Was it truly fasting?

GLP drugs + delayed gastric emptying complicate this.

Someone may think they are fasting, but still have:

prolonged nutrient absorption

delayed insulin secretion

residual postprandial physiology.

With tirzepatide/retatrutide especially, gastric emptying and meal timing matter.

If he ate late or had delayed absorption:

fasting insulin may not really be “fasting.”

This is probably my leading explanation.

Confidence: moderate.
 
continued

B. Hyperinsulinemia lagging behind weight loss

Possible but overstated online.

The idea:

pancreatic β-cells still oversecrete insulin despite improved sensitivity.

There is some biologic plausibility.

Insulin secretion dynamics can lag metabolic improvement.

But:

a HOMA of 3 from one timepoint does not prove this.

And the very low glucose complicates interpretation.

Confidence: low–moderate.

C. Reactive hyperinsulinemia / exaggerated incretin effect

Interesting possibility.

GLP/GIP drugs can markedly augment insulin secretion in response to nutrients.

If there was residual nutrient absorption (because of delayed gastric emptying):

you could theoretically see:

relatively high insulin + low glucose.

Especially if measured at the wrong time.

The reported home glucose values:

fasting 52

1 hr after breakfast 115

1 hr later 79

do not scream insulin resistance.

If anything they suggest:

strong glucose control and possibly overcorrection / hypoglycemia tendency.

Confidence: low–moderate.

D. Lab artifact or interpretation issue

Not impossible.

Fructosamine 162 is interesting because it is below reference range.

That could reflect:

unusually low glycemia

altered protein/albumin turnover

assay issues.

Fructosamine is less familiar clinically because HbA1c displaced it for most use.

It reflects roughly:

prior 2–3 weeks glycemia

because it measures glycated serum proteins (mostly albumin).

4. Why HOMA2 may be misleading here

HOMA assumes something like:

fasting steady-state physiology.

But this person has:

large recent weight loss

multiple incretin drugs

cagrilintide

delayed gastric emptying

low glucose

possible reactive physiology.

That is not the clean physiology HOMA was designed around.

A single elevated HOMA2-IR here could simply be:

model misuse.

Or at least:

overinterpretation.

Confidence: moderate.

5. HbA1c reduction does not necessarily prove improved insulin sensitivity — but strongly suggests it here

You asked whether HbA1c reduction implies reduced insulin resistance.

Strictly speaking:

No.

Lower HbA1c could occur from:

higher insulin secretion

drugs

reduced carbohydrate intake

weight loss

improved insulin sensitivity.

But in context:

54 lb loss

lower triglycerides

lower fasting glucose

much lower sugar intake

GLP therapy

the prior probability shifts toward:

insulin resistance improved substantially.

I would regard:

“my insulin resistance got much worse”

as not demonstrated by the data presented.

6. The biggest red flag in the post is actually recurrent dizziness + vision narrowing

The symptom cluster:

dizziness + tunnel/pinhole vision + rushing-water sound

during exertion

plus measured glucose:

52 mg/dL

makes me think more about:

hypoglycemia-like physiology, hypotension, dehydration, or autonomic effects

than insulin resistance.

Especially on:

tirzepatide

retatrutide

cagrilintide

large weight loss

reduced intake.

GLP forum users sometimes underestimate:

lower blood pressure

lower intake

dehydration/electrolyte changes

exertional underfueling.

“Gatorade Zero + beef jerky” also provides:

salt/protein but little glucose.

Golf + calorie restriction + incretins + long fasting windows could plausibly create symptoms.

Not a diagnosis — just what jumps out.

My overall interpretation:

The post does not convincingly show worsening insulin resistance.

The evidence more strongly supports:

markedly improved glycemic control with one puzzling fasting insulin result that may reflect measurement context, residual postprandial physiology, or HOMA misinterpretation.

I would be cautious about taking a single HOMA2-IR value at face value in someone on a stack of incretin/amylin drugs after major recent weight loss.

My interpretation of all that is do not be too concerned about a couple of test results that do not fit perfectly, there are reasons why they might not be as expected, given overall the evidence suggests improved insulin resistance, further repeat tests later might clear the issue up.

The symptoms sound more like blood pressure/hydration/electrolyte issues to me as well as the AI.
 
Ok, in our diabetes clinic I hav seen this. This seems the opposite of insulin resistance. It seems like hypersensitivty to insulin, but there seems to be glucose dysregulation. Your low glucose levels indicate this. Frm what I remember, your symptoms sound close to hypoglycemia than the opposite. The huge weight loss could be the driver of this. It sounds like a sudden shock to your system. There's also the glucagon action which really does a number on our hormonal profile.

Some time might be necessary for the endocrine signaling to reach normal levels. I would keep some glucose powder in hand for future emergency episodes. HbA1c is the real number. It is super for you.

Dont think Mots-C would be a great choice at this moment. Maybe you could try some weight training? Getting the glucose turned to glycogen might minimize insulin production.
 
FartfulCodger said:
What are your inflammation markers like? Did your test include cytokines?

My main issue after losing 60 pounds in a short time was inflammation, according to bloodwork. Glucose was also a bit high at 100. Multiple AI engines told me that the inflammation was likely due to the stress I put my body under during rapid weight loss.

Apparently, inflammation, even temporary, can cause insulin resistance. The AI engines told me to test again after my weight stabilized.

If you haven't already, consider opening up ChatGPT, telling it your race, gender, starting weight, ending weight, what meds you're on, and how long your weight-loss journey took. Then copy/paste the results of your blood work.
Excellent question! Pre tirzepatide, I was 3 years into a psoriatic arthritis diagnosis, treated (barely) by Otezla. Tirzepatide (and from what I can tell, KPV) has backed off the need for Otezla. My PsA was mild on skin but more severe in my joints. Thumb, index and middle fingers on both hands, both wrists, neck and ankles. Weirdly symmetrical. Patterns from 15 years of average of 55 organized games of baseball and all the practice that went with it, and now golf for fun.

Inflammation related stuff?

-RF was 11 iU/mL

-hs-CRP was 2.8, I will take this as a huge win since it was 7+ at its worst.

-Fibrinogen was 423 mg/dL, slightly out of range.

No cytokine results yet. Went through Goodlabs and basically got a ton of panels and then a la carted things like testosterone, igf-1, etc as well.

The method of the demographics and upload to AI was my approach too, albeit with Gemini. I wonder if Id get different advice from the big 3 with ChatGPT and Claude...

I'm also starting to wonder, after doing more research if Hyperinsulinemia is what Gemini meant, and not insulin resistance. I feel like the insulin my body produces works well, but it turns the faucet on full blast if I eat a single carb.

Congrats on the big accomplishment of 60 lbs, that is a huge deal!!
 
Meritocrat said:
Dont think Mots-C would be a great choice at this moment. Maybe you could try some weight training? Getting the glucose turned to glycogen might minimize insulin production.
Looking at this more, I think you're 100% right... I think my insulin is effective, I dont think I should be ramping it up. After thinking for myself instead of submitting to AI panic, I realize it might be Hyperinsulinemia more than insulin resistance. That seems to make more sense. I have tons of insulin blasting, and it does a great job knocking down those sugars, but producing far more than needed. Is that a more reasonable deduction?
 
Neurogroot said:
Looking at this more, I think you're 100% right... I think my insulin is effective, I dont think I should be ramping it up. After thinking for myself instead of submitting to AI panic, I realize it might be Hyperinsulinemia more than insulin resistance. That seems to make more sense. I have tons of insulin blasting, and it does a great job knocking down those sugars, but producing far more than needed. Is that a more reasonable deduction?
I'm not sure, tbh. hyperinsulinemia feels like an acute, if not chronic condition. You lost some 25kilos, or so you said? I guess you were overweight or obese before. That almost always leads to some form of glucose malfunction.

With my diabetes, they say that when we lost weight, the glucose control or sensitivity improves first at our peripheral tissues before the effects reach the viscera. In your case, one cant be certain, but, it does look like a temporary situation with elevated insulin and extremely reduced glucose.

I look at it like this. You are not taking external insulin. Your glucose is too low. It is the opposite of diabetes so you have enhanced insulin sensitivity. But your body is making more insulin than is needed. That is a glucose dysregulation example, I think. As such, if it were me, I would think about how to reduce insulin production.

There are many ways to do this. Keto diet, fasting, protein-rich meals, are all valid measures. But I dont know if I could continue that pragmatically. But I know that with more muscle-making, the glucose would not have to be converted to fat. This is what insulin does, right?

Then, if the body needs glucose turned into glycogen, why would there be need for insulin? That is my thinking anyway. You taking cagri too, yes? That may also worsen the scenario, me thinks. I guess, reduced food intake, lower glucose, higher insulin, yea I think it is a compounding issue. I think you may have to hit the weights sooner than after.
 
Meritocrat said:
I'm not sure, tbh. hyperinsulinemia feels like an acute, if not chronic condition. You lost some 25kilos, or so you said? I guess you were overweight or obese before. That almost always leads to some form of glucose malfunction.

With my diabetes, they say that when we lost weight, the glucose control or sensitivity improves first at our peripheral tissues before the effects reach the viscera. In your case, one cant be certain, but, it does look like a temporary situation with elevated insulin and extremely reduced glucose.

I look at it like this. You are not taking external insulin. Your glucose is too low. It is the opposite of diabetes so you have enhanced insulin sensitivity. But your body is making more insulin than is needed. That is a glucose dysregulation example, I think. As such, if it were me, I would think about how to reduce insulin production.

There are many ways to do this. Keto diet, fasting, protein-rich meals, are all valid measures. But I dont know if I could continue that pragmatically. But I know that with more muscle-making, the glucose would not have to be converted to fat. This is what insulin does, right?

Then, if the body needs glucose turned into glycogen, why would there be need for insulin? That is my thinking anyway. You taking cagri too, yes? That may also worsen the scenario, me thinks. I guess, reduced food intake, lower glucose, higher insulin, yea I think it is a compounding issue. I think you may have to hit the weights sooner than after.
Yeah, I definitely agree. Timing is lining up well with this, I’m actually heading out of the country for a little over 2 weeks. Only taking Tirz with me. I think until I reach initial goal weight, maybe I’ll just split Tirz into a main Friday dose and a helper Tuesday dose. Once I get that goal, I’ll titrate over to just Reta, and lose a final 10-12 lbs super slow, while putting an extra emphasis on muscle gain.

As far as lifting, I know it’s not the same, remotely, but you should check out golf club swing speed training. It’s a crazy strength blast with a good deal of cardio attached to it. Went from a sad 132 mph ball speed off the tee on average, to a mediocre 141. Extra 15ish yards of carry, since my ball flight isn’t ideal, but +22 yards to my average drive compared to the end of last year. It’s been helpful, well, at least until my next shots, haha.
 
Neurogroot said:
you should check out golf club swing speed training. It’s a crazy strength blast with a good deal of cardio attached to it. Went from a sad 132 mph ball speed off the tee on average, to a mediocre 141
I may be wrong, but rather than strength, isnt that power training? Instead of total force generated, it sounds like maximum force generated per unit time. I do a bit of mma, tug of war, grip strength, and this sounds similar to the power training my tug of war and striking training regimen consists of.
 
Meritocrat said:
I may be wrong, but rather than strength, isnt that power training? Instead of total force generated, it sounds like maximum force generated per unit time. I do a bit of mma, tug of war, grip strength, and this sounds similar to the power training my tug of war and striking training regimen consists of.
There’s a lot of different methods. A lot of it involves increasing fast twitch muscles, which apparently I have zero of. Talking lighter weights with squats where you hop off the ground a bit. Or, using a similar machine for triceps pulldowns, but attaching a set of ropes to it, getting into the back swing position, full stretch, and alternating sets of lighter resistance fast swings down, to heavier, slow/controlled smooth swings.

Then, there’s just… Swinging the weighted clubs, or drills where you have a dozen balls tee’d up a foot apart, and step up, max swing without caring about direction so much, just ball speed. Immediately after swinging, step forward, full launch again. 12 full max drives in a minute.

Shockingly, the parts that end up with the most soreness would be my hamstrings, quads, and obliques. Never really the arms, which you’d think would get hammered.
 
Neurogroot said:
There’s a lot of different methods. A lot of it involves increasing fast twitch muscles, which apparently I have zero of. Talking lighter weights with squats where you hop off the ground a bit. Or, using a similar machine for triceps pulldowns, but attaching a set of ropes to it, getting into the back swing position, full stretch, and alternating sets of lighter resistance fast swings down, to heavier, slow/controlled smooth swings.

Then, there’s just… Swinging the weighted clubs, or drills where you have a dozen balls tee’d up a foot apart, and step up, max swing without caring about direction so much, just ball speed. Immediately after swinging, step forward, full launch again. 12 full max drives in a minute.

Shockingly, the parts that end up with the most soreness would be my hamstrings, quads, and obliques. Never really the arms, which you’d think would get hammered.
yup, thats power training aka plyometrics.
 
eidos said:
Don't try to over-optimize. Your HbA1c is good. The postprandial blood glucose peak drops rapidly enough. You mainly have episodes of hypoglycemia that could cause you to not wake up one morning...

It's time to lower your aGLP-1 doses a little, and maybe stick with just one. MOTS-C is great, but it will make hypoglycemia worse. I had three episodes last month while taking tirz+reta+mots-c.

Include more complex carbohydrates in your diet. Choose ones that don’t cause blood sugar spikes.

Buy a CGM (like the Freestyle) to monitor your blood sugar levels and get alerts before you lose consciousness.
CGM is on the way! Been doing finger tests lately until it gets here, since Amazon lost my order over the weekend. It sucks. I’ve had 2 mornings where it just gives me “Lo”, which means below 50. 68 and 71 the other times. Hoping the CGM gives me a little more idea on how quickly it handles glucose. There’s a test, I think, that you can have done over 2 hours that tracks it. Not sure what it’s called though.

MOTS-c is out of consideration now, thank you for the advice. Reta, I’m holding off on for awhile. At least until I hit my goal weight, and want to go full throttle on more of a muscle building (as much as an out of shape nerd like me can, anyways), and I reduce tirz more. Backing down another mg of that on my next dose as well.
 
Meritocrat said:
yup, thats power training aka plyometrics.
Shows what I know then… Honestly, I’ve never hit the fitness side as much as I should have. I’ve been functionally strong enough, and just… ignored it. Regretting it too, the older I get and the more that functional strength that was just there begins to disappear.
 
RS struggles with hypoglycemia - low blood sugar, more small consistent meals is important versus eating at 6 PM and the not eating until 10 or 11am the next morning for example. Also , backing down on the glp1 dose. 50 is too low.
 
randompersonrandom said:
Something to consider; your doctor's literal job is to help you be informed to the best of their professional expert opinion, answer your questions, help you understand the risks of any particular course of action, and support you to the best of said professional ability after you make the decisions about what to do next.

A doctor's role is NOT to tell you what to do, expect that you'll obey, and scold you if you don't. I wouldn't accept that from ANY doctor, and I don't know a ton of them that would try it if I made my expectations of what I needed clear.
This does boil down to a me issue. I am crazy passive, and still, at my age, associate certain professions and personalities with authority. Like, there isn’t another doctor out there or something wild.

Part of it, if I’m being honest, is this the fact I take certain medications. Medications that were a pain in the ass to get prescribed, and a lot of docs are trending towards not writing them so much anymore, or making me jump through the many many hoops all over again.

But, you are right. I really need to just man up, and get a new doctor. God knows I pay enough in medical costs.
 
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