Metabolic Markers: Track Health Improvements on GLP-1
Weight loss is visible. But metabolic improvements are invisible - until you test. Here's what changes on Semaglutide and Tirzepatide.
The Most Important Metabolic Markers
What changes: Typically drops 15-30 mg/dL on GLP-1. More if diabetic at baseline. Non-diabetics stay normal but optimize.
Test frequency: Baseline, 8 weeks, 16 weeks
What changes: 3-month average blood sugar. Diabetics see 1.5-2.5% reduction. Prediabetics normalize often. Most significant health improvement metric.
Test frequency: Baseline, 12 weeks, quarterly thereafter
What changes: Drops 40-60% on GLP-1. Shows insulin sensitivity improving. Often changes before glucose normalizes.
Test frequency: Baseline, 16 weeks (optional but valuable)
What changes: Improves dramatically (can drop from 3.5 to 1.2). This is the metabolic root cause GLP-1 fixes.
Test frequency: Baseline, 12 weeks (calculated from insulin + glucose)
Lipid Panel (Cholesterol) Changes
Change: Typically drops 10-20% on GLP-1 due to weight loss + improved insulin sensitivity.
Change: Drops 15-25% on GLP-1. More improvement if dietary changes made alongside medication.
Change: Often INCREASES on GLP-1 (opposite of LDL). This is good - ratio improves cardiovascular health.
Change: Drops 20-40% on GLP-1. Particularly if high carb diet reduced (common on GLP-1 due to appetite suppression).
What Healthy Metabolic Changes Look Like
Baseline (Before GLP-1):
- Fasting glucose: 118 mg/dL (prediabetic)
- A1C: 6.2% (prediabetic)
- Fasting insulin: 16 mU/L (elevated)
- Total cholesterol: 245 mg/dL
- LDL: 165 mg/dL
- Triglycerides: 210 mg/dL
After 12 Weeks on GLP-1:
- Fasting glucose: 98 mg/dL (normal!)
- A1C: 5.6% (normal!)
- Fasting insulin: 8 mU/L (much improved)
- Total cholesterol: 195 mg/dL
- LDL: 120 mg/dL
- Triglycerides: 135 mg/dL
This is typical progression. Weight loss + metabolic repair = whole-body health transformation.
Other Markers That Improve
Blood Pressure: Often drops 10-20 mmHg systolic from weight loss + better metabolic function. If on BP meds, often need dose reduction.
C-Reactive Protein (CRP): Inflammation marker. Drops 40-60% on GLP-1, showing reduced systemic inflammation.
Kidney Function (eGFR): Often improves from better glucose control. Weight loss alone improves kidney health.
Liver Function: Fatty liver (common in obesity) reverses on GLP-1. ALT/AST improve 30-50%.
Testing Schedule
| Timeframe | Tests to Do |
|---|---|
| Before Starting | Full metabolic panel (glucose, A1C, insulin, lipids, kidney, liver) |
| 8 Weeks | Fasting glucose, basic lipids (check early improvement) |
| 12 Weeks | Full repeat panel (A1C, insulin, lipids, kidney, liver) |
| 6 Months & Beyond | Quarterly metabolic panel (monitor maintenance phase) |
Where to Test in Lagos
Arrange baseline and follow‑up testing through accredited labs. EkoPeptide can help coordinate partners and interpret your results.
Red Flag Results
If A1C increases instead of decreases: Protocol not working. May need dose escalation or medication change.
If triglycerides spike: May indicate excess carb intake despite appetite suppression. Nutrition adjustment needed.
If kidney function worsens (eGFR drops >10%): GLP-1 may need dose reduction. Monitor closely.
If liver enzymes elevate significantly: Rare, but needs evaluation. May need to pause medication.
EkoPeptide coordinates Lagos labs • Track your metabolic improvements
References
Medically Reviewed by Dr. Chukwuemeka Okonkwo
MBBS, FMCP - Endocrinology
Content reviewed by qualified healthcare professionals for accuracy.