ApoB on semaglutide — drop is real, here's the chart
34 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.
20 Replies
33 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
45 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.
50 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
34 posts
Good point, noted. The monotonic decline from week 8 is the actual signal.
16 posts
Did you pull hs-CRP too? GLP-1s drop CRP meaningfully even weight-adjusted and it would add context here.
34 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.
34 posts
40 posts
This is the best single-person ApoB chart I've seen for sema. Can I crosspost to the GLP-1 thread with credit?
46 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.
30 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.
34 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
34 posts
Fat went from ~33% to ~26% of calories. Protein up, carbs roughly same %. So yes, there's a dietary confound baked in.
38 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.
37 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
8 posts
16 posts
yeah this is sick data. the apob drop is legit impressive but yeah you're prob right that it's like 60/40 weight loss to drug effect. the satiety thing is real tho, most people just naturally eat cleaner on sema without even trying and that alone tanks your lipids hard. still worth running regardless imo