Body composition — --

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85% fat loss is a favorable composition ratio for GLP-1/GIP agonist therapy. Published tirzepatide trials (SURMOUNT-1) showed ~70% fat / ~30% lean mass ratio. This ratio is better than the clinical trial average, suggesting good protein intake (daily salmon) and preserved muscle mass despite significant total loss.

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Visceral fat drives insulin resistance, systemic inflammation (CRP), and autoimmune dysregulation. Reducing from 16 to 8 directly correlates with HbA1c normalizing (5.9%→5.3%), CRP falling (3.12→0.4 mg/L), and improved autoimmune load tolerance.

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~150–180 kcal reduction from mass alone. Actual drop of 233 kcal suggests ~50–80 kcal of adaptive thermogenesis — typical for significant weight loss.

-- Target: rebuild lean mass to bring metabolic age down toward chronological age.

171–198 lbs with significant cycling. Muscle mass was higher in this period (up to 122 lbs in Aug 2022). The rebound from 171 to 196 lbs (Jan–Mar 2023, +25 lbs) likely marks onset of thyroid deterioration.

Ranged 9–12, generally well-controlled in 2021–2022, worsening through 2023.

Old scale malfunctioned Oct 2023 – May 2024, showing false losses. Real weight was increasing during this period. New scale data from May 2024 confirms true trajectory.

205.9 lbs, 45.8% body fat, visceral fat 16, metabolic age 63. Coincides exactly with TSH 8.77 on Oct 31, 2024 — uncontrolled hypothyroidism driving fat accumulation.

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Fastest Mar–Jun 2025 (~5 lbs/month at ~5 mg dose). Plateau at 151–154 lbs since Nov 2025 on 7.5 mg — 4+ months stable.

85% fat / 15% lean — better than SURMOUNT-1 trial average (~70/30). Daily salmon protein intake likely protective of lean mass.

Absolute muscle mass at -- lbs is low for age --F at -- lbs. Sarcopenia risk warrants resistance training and creatine consideration (3–5 g/day) — discuss with prescriber.

With BMR at 1,361 kcal and muscle mass declining, target 110–130g protein/day minimum. Daily salmon supports this.

3–5 g/day — evidence-based intervention for preserving lean mass during caloric restriction. Also reduces SAM-e demand, benefiting COMT methylation. Discuss with prescriber.

Visceral fat 16→8 directly explains CRP dropping 3.12→0.4 mg/L. Visceral adipose tissue is a major source of IL-6 and TNF-α. Continued visceral fat reduction will continue to modulate autoimmune load.

DHEA 35 mg/day may modestly support lean mass via androgen conversion. 5b-dominant metabolism pattern (DUTCH) means less direct androgenic effect, but general anabolic environment is supportive.