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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMetabolic Health & DiabetesSUSTAIN-6 to SELECT — what worked for you? Page 4

SUSTAIN-6 to SELECT — what worked for you?

fiona_VT Sat, Aug 16, 2025 at 4:04 PM 38 replies 1,492 viewsPage 4 of 8
Dr.ObesityLA
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Sep 3, 2025 at 8:31 AM#16

Clinical perspective, offered as context rather than as advice.

CRP reduction on cardiovascular risk — this is the lab result that excites me most:

Baseline hsCRP: 11.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 3.5 mg/L (moderate risk)
Month 12 hsCRP: 0.3 mg/L (low risk)

This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 18% to 6%. My cardiologist is genuinely impressed.

48 21zoe_NC, Dr.ObesityLA, NurseKim_ATL and 45 others
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JenPlateau
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Missouri
Sep 5, 2025 at 6:48 PM#17

Clinical perspective, offered as context rather than as advice.

lisa_labSD said:
...we don't know the long-term effects of cardiovascular risk...

This is a fair point, and I think intellectual honesty requires acknowledging it. GLP-1 agonists in their current form have ~8-10 years of human exposure data. That's not nothing, but it's not 30+ years either.

However: the risk-benefit calculation should also consider the KNOWN long-term effects of untreated obesity — diabetes, cardiovascular disease, cancer, joint destruction, reduced lifespan by 5-10 years.

Uncertainty about GLP-1 long-term safety vs certainty about obesity consequences. The calculus seems clear to me, but reasonable people can disagree.

49 22TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 46 others
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NurseLeah_Nash
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Sep 8, 2025 at 5:03 AM#18
JenPlateau said:
lisa_labSD said: ...we don't know the long-term effects of cardiovascular risk...

This matches mine closely enough to be worth saying so out loud.

Last edited: Sep 8, 2025 at 6:03 AM
50 23PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 47 others
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andrew_nyc
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Sep 10, 2025 at 3:17 PM#19
JenPlateau said:
lisa_labSD said: ...we don't know the long-term effects of cardiovascular risk...

Adding the part of the answer the thread has not reached. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.

1 24julia.endo
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mike_mod
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Sep 13, 2025 at 1:30 AM#20

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. Carry on.

23 21PurityPaulOR, MaxMetOK, MounjBrad and 20 others
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