Semaglutide microdose for metabolic health (not weight loss) — dose range and outcomes
29 posts
For anyone who's not obese but wants GLP-1 benefits for HbA1c, ApoB, insulin sensitivity. Microdosing is the framework I've been running for 9 months.
Current protocol: sema 0.25mg weekly, held at that dose (no titration up). I run 12-week blocks with 4 week washouts between. Two blocks done, third in progress.
Outcomes after 2 blocks:
- HbA1c 5.4 → 5.1
- Fasting insulin 8.8 → 5.4
- ApoB 89 → 78
- Triglycerides 112 → 72
- Weight: stable (-1.2kg unintentional)
- No nausea at this dose
Cost is ~$45/month which is wild for the marker moves.
Downsides: still have appetite weirdness first 24hr post-pin, occasional reflux if I eat too close to bed, slightly decreased enjoyment of high-fat meals (welcome or unwelcome depending on goal).
Is anyone else running microdose for metabolic rather than weight? What doses are you landing at?
11 Replies
33 posts
0.25 is the sweet spot for metabolic-only. Tried 0.5 briefly to see if markers moved more, they didn't meaningfully, but nausea showed up. Rolled back to 0.25.
28 posts
I run 0.25 weekly continuous for the same reasons. Markers similar to yours. The metabolic health use case for sema is under-appreciated because the marketing is all weight loss.
- Semaglutide · 1.7 mg · weekly · sub-Q
32 posts
This matches the emerging clinical literature on GLP-1 for metabolic health in non-obese patients with prediabetes. 0.25 is lower than trial doses but seems to capture most of the metabolic benefit at a fraction of the side effect profile.
31 posts
The ApoB drop from 89 to 78 at that dose is the headline for me. 12 points on a compound that's not a statin, with metabolic co-benefits, is notable. Don't sleep on this use case.
44 posts
Tirz microdose (1mg weekly) is a parallel protocol worth trying if sema doesn't click. Slightly less nausea at dose-matched efficacy.
- Tirzepatide · 5 mg · weekly · sub-Q
29 posts
@showmethestudy exactly. The emerging CV outcome data on GLP-1s is the most interesting piece. If CV benefit holds at microdose (which is plausible via ApoB and BP effects alone), it's basically a metabolic health drug.
115 posts
The 'non-obese GLP-1 for metabolic health' space is genuinely interesting and under-studied. Most trials enrolled obese patients because that's where FDA approval lives. The microdose-for-metabolic-health cohort is running ahead of the literature.
50 posts
Consider adding fasting insulin + C-peptide to your next panel. HOMA-IR movement tells you about hepatic IS. Matsuda from an OGTT would give you whole-body but few do OGTT routinely.
119 posts
The reason I'm bullish on this use case: lifestyle interventions are highly effective at the metabolic markers you're targeting, but adherence is the problem. A weekly pin at $45 has extraordinary adherence. The behavioral half of the intervention is essentially free.