ApoB on semaglutide — drop is real, here's the chart
31 posts
I pulled ApoB every 4 weeks on a 24-week sema course. Starting dose 0.25mg, titrated to 1.0mg over 8 weeks, held 1.0mg for the rest. 41F, 5'6", baseline 189lb.
ApoB (mg/dL) timeline, all same lab (Quest), fasted AM:
- Week 0: 118
- Week 4: 112
- Week 8: 103
- Week 12: 94
- Week 16: 87
- Week 20: 83
- Week 24: 79
That's a 33% drop. Weight went 189 -> 161 over the same window.
LDL-C went 141 -> 94. Trigs 158 -> 71. HDL stayed put at 52 -> 54.
I'd been told by my PCP to 'expect some lipid improvement' but this is more than I expected. Anyone else tracking ApoB on sema/tirz and seeing similar curves?
Separately: how much of this is attributable to the drug vs the weight loss is the question I can't answer from n=1.
19 Replies
28 posts
This matches my trajectory almost exactly. 124 -> 82 ApoB on 1.0mg sema, 18 weeks, 34lb down. Trigs smashed too (182 -> 68).
The weight loss vs drug effect question is hard but there's published data — even weight-stable GLP-1 users get modest ApoB drops (~8-12%). So the 'drug alone' contribution is real but small, most of the move is likely the weight/insulin sensitivity side.
- Semaglutide · 1.7 mg · weekly · sub-Q
39 posts
Lovely chart. Quick nit: the week 0 -> 4 drop of 6 mg/dL is smaller than lab CV (ApoB CV is ~4-5%). I'd call the real signal starting at week 8. Doesn't change your story at all, just for methodological cleanliness.
44 posts
Tirz dropped my ApoB 112 -> 73 over 20 weeks, -32lb. Same story basically. The trig drop especially feels disproportionate to the weight loss — I think GLP-1s do something mechanistically to VLDL.
- Tirzepatide · 5 mg · weekly · sub-Q
31 posts
Good point, noted. The monotonic decline from week 8 is the actual signal.
10 posts
Did you pull hs-CRP too? GLP-1s drop CRP meaningfully even weight-adjusted and it would add context here.
31 posts
Yes — hs-CRP 3.4 -> 0.8. Easily the single biggest relative move of anything I tracked.
71 posts
The SELECT trial secondary endpoints showed ApoB reductions of ~12-15% on sema 2.4mg over 2+ years, weight-adjusted. So your 33% drop is partly the drug but mostly the weight. Both matter, both compound.
31 posts
32 posts
This is the best single-person ApoB chart I've seen for sema. Can I crosspost to the GLP-1 thread with credit?
36 posts
My ApoB didn't move nearly this much on tirz (139 -> 118, -15%) but I also only lost 12lb. Responder variance + weight loss amount seem to correlate. Useful thread.
26 posts
Reta here — 18 weeks, -41lb. ApoB 131 -> 71. Even steeper curve than semaglutide imo. n=1 but the triple agonist seems to hit lipids harder.
31 posts
My Lp(a) was 41 nmol/L at baseline, 43 at week 24. So yeah, no move there. Confirms cbc's point.
30 posts
31 posts
Fat went from ~33% to ~26% of calories. Protein up, carbs roughly same %. So yes, there's a dietary confound baked in.
31 posts
Did your diet composition change? Satiety on sema is wild and most people end up eating lower fat / higher protein without trying. That alone shifts lipids.
33 posts
Fantastic dataset. Pinning to the 'useful lab threads' list.
- MOTS-c · 10 mg · weekly · sub-Q
- 5-Amino-1MQ · 100 mg · daily AM · oral
6 posts