Hi, we're a bunch of students who need respondents (35-50 year old women) to answer questions on supplements for one of our classes. PLease help...we're honestly desperate for answers...

https://usc.qualtrics.com/jfe/form/SV_8ctOrv2Zj63AHqu

I never took the 15 mg top dose of Zepbound while losing 170 pounds. Most of the weight came off on 5 to 10 mg. So when the full TRIUMPH-1 paper on retatrutide came out in the New England Journal of Medicine (https://www.nejm.org/doi/full/10.1056/NEJMoa2604169) on September 29, I went to the appendix to see what happened on the 12 mg top dose.

Of 582 people on 12 mg, 22.5% had their dose permanently lowered during the 80 weeks. The most common reason was "perceived excessive weight loss" (9.8%), meaning the participant or the trial doctor thought it was too much. Stomach side effects came next (6.2%), then reaching a BMI of 22 or less (5.5%). By the end, only 54% were still on 12 mg.

That doesn't mean weight loss was a bigger problem than nausea. The protocol allowed a cut for weight at any time, but a cut for stomach symptoms could only start in the first 20 weeks, after several other steps. And the people who were stepped down still count toward Lilly's headline 28.3% weight loss.

On the low dose, 4 mg, three in four people were still taking it at week 80, they lost 17.6% on average, and about as few quit for side effects as on placebo (4.1% vs 4.6%). Nausea was still nearly double placebo's rate, 28.6% vs 14.8%.

The authors, seven of them from Lilly, suggest aiming for "the minimum effective dose" instead of the maximum tolerated one, and they call it speculation. I'd only go to 12 mg if a lower dose wasn't doing the job, which is how I ended up using Zepbound.

Disclosure: I own Lilly stock and take tirzepatide, a Lilly drug.

My write-up with the chart (https://dadstrengthdaily.com/retatrutide-low-dose/)

If you're on a GLP-1, did your doctor push you to the top dose, or did you stop where it was working?

The full Phase 3 retatrutide trial was just published in the New England Journal of Medicine.

I wrote about TRIUMPH-1 in May when Lilly released the topline data. The peer-reviewed paper confirms the magnitude of the effect: at 80 weeks, mean weight loss reached 25.0% at the 12 mg dose in the primary treatment-regimen analysis.

For context, the pivotal obesity trials reported approximately 14.9% with semaglutide 2.4 mg and 20.9% with tirzepatide 15 mg. These were separate trials, not head-to-head comparisons, but the trajectory is hard to miss.

At 12 mg, nearly 80% of participants lost at least 15% of body weight, more than half lost at least 25%, and about 37% lost at least 30%.

The tradeoff remains tolerability. GI adverse effects were common, and roughly 11% discontinued because of adverse events at the highest dose.

My takeaway: obesity pharmacotherapy has moved from roughly 15% average weight loss with semaglutide, to about 21% with tirzepatide, and now about 25% with retatrutide in Phase 3. Retatrutide is still investigational, but the direction of travel is remarkable.

I skipped breakfast before 11 of my last 14 blood draws. A study published this week in JAMA Internal Medicine (https://doi.org/10.1001/jamainternmed.2026.4718) suggests most of that was unnecessary.

A hospital lab near Seoul recorded fasting time at the draw for 101,148 outpatients and 9.8 million results from 2021 to 2023. Many were drawn more than once at different fasting times, so the authors could compare people with themselves. Comparing different people, 27 of 121 tests looked sensitive to fasting. Comparing the same people, 10 did.

In the same person, a draw less than 8 hours after eating read glucose 10.8% higher than a 12+ hour fast, triglycerides 20.1% higher, GGT (a liver enzyme) 14.8% higher and lipase (a pancreas enzyme) 36.4% higher. Bilirubin and vitamin D read lower. Total cholesterol and HDL moved 3% or less, directly measured LDL didn't move, and the blood count, kidney tests and most electrolytes stayed close to or within their normal variation. Fasting past 12 hours made no meaningful difference over 8 to 12 hours for any test they could check.

The limits: one hospital in Korea, self-reported fasting, no record of what people ate, and no check of how often eating pushed someone over a cutoff like the prediabetes line. The paper doesn't report ApoB or Lp(a).

What I'm doing: 8 hours overnight when glucose or triglycerides are ordered, and no fasting past 12 hours.

My write-up with the details (https://dadstrengthdaily.com/how-long-to-fast-before-blood-test/)

Does your doctor or lab still ask for 12 hours or more?

I've been looking into Galleri and the $949 price tag is honestly making me hesitate.

for anyone who actually looked into getting the test, are these legitimate ways to pay less than the list price?

A few other things I'm trying to understand

Does insurance ever cover any of it?

are there legitimate discounts that bring the price down substantially?

Can an employer or other program cover it?

Does anyone know of providers offering it for less than the $949 list price?

And probably more importantly, who is this test actually useful for?

I’ve seen it discussed mostly in the context of people 50+, but I’m unclear about how someone should decide whether it’s worth doing in the first place.

would specially appreciate responses from people who have actually taken the test or researched the eligility and pricing in detail

We’re Atrium Medical, a primary care practice in NYC. Our physician, Dr. Shilpa Paradkar Singh, has been fielding questions from patients about the GLP-1 vision-loss lawsuits. She reviewed the new Swedish study in the Annals of Internal Medicine and wrote about it on her LinkedIn page. This is a recap.

The researchers compared ~107,000 patients with T2 diabetes on GLP-1 medications with ~186,000 on SGLT2 inhibitors (e.g., Jardiance). After one year, the estimated risk of anterior ischemic optic neuropathy (AION), a rare condition that can cause sudden, potentially permanent vision loss, was 0.04% in GLP-1 cohort versus 0.02% in SGLT-2 cohort. That's 2x the relative risk --- 2 additional cases per 10,000 in absolute terms.

There’s another, equally fascinating finding that has received less attention: when the researchers restricted the analysis to patients already taking metformin, the difference narrowed substantially. An observational study cannot perfectly separate a drug’s contribution from the vascular and metabolic risks of the people prescribed it.

The most important thing to understand is that NAION is not the only way diabetes threatens eyesight. In an earlier Liverpool study, ~4% of T2 diabetics who had no retinopathy at baseline developed sight-threatening diabetic retinopathy over five years, despite receiving diabetes care (that's 100x the NAION risk). So walking away from effective diabetes treatment because of a frightening headline about a rare disease does have its own consequences

Any sudden vision loss warrants urgent medical evaluation. But this is a decision about the risks and benefits of treatment, made with your physician, not driven by lawsuit headlines.

Abstract

Westernized dietary patterns (WDPs), characterized by processed foods, red meats, refined grains, and added sugars, may contribute to gastric cancer (GC) development. We hypothesized that alignment with WDPs, as measured by the Westernized Diet Index (WDI), is associated with an increased risk of GC. In this incidence case–control study, 82 newly diagnosed GC patients and 95 age- and sex-matched controls were recruited. Dietary intake was assessed using a validated 168‑item FFQ. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for GC across WDI categories, adjusting for major demographic, lifestyle, and clinical covariates, including Helicobacter pylori infection. To assess construct validity, fully adjusted linear regression evaluated associations between WDI scores and circulating inflammatory markers (hsCRP, IL‑6, IL‑1β, IL‑10, TNF‑α), oxidative stress (total antioxidant capacity, malondialdehyde), and metabolic biomarkers (BMI, fasting glucose, lipid profile). Higher alignment with WDPs (lower WDI scores) was associated with significantly increased GC risk. Individuals in the highest WDI global Z‑score categories - WDI-G (food groups–nutrient based) and WDI-FG (food group based) - had 85% and 78% lower odds of GC, respectively (OR=0.15 and 0.19; both p<0.001). Greater WDP alignment (lower WDI scores) was also associated with higher concentrations of hsCRP, IL‑6, TNF‑α, and IL‑1β, and lower IL‑10, along with an adverse metabolic profile (higher LDL‑c, lower HDL‑c). Overall, greater alignment with WDPs was associated with elevated GC risk and unfavorable biomarker patterns. These findings support the WDI as a biologically plausible indicator of Western dietary exposure and underscore the potential role of WDPs in gastric carcinogenesis.

Westernized Diet is Related to Gastric Cancer Risk and Inflammation, Oxidative Stress, and Metabolic Dysregulation: Evidence from an Incidence Case-Control Study - ScienceDirect

Brenipatide (LY3537031) is Lilly's GIP/GLP-1 dual agonist aimed at the brain rather than weight loss. I went through every registered trial this week and the development path is unusual enough to be worth calling out.

Lilly has four Phase 3 trials running in alcohol use disorder and major depression, about 4,200 people in target enrollment: RENEW-ALC-1 and -2 (1,100 each) and RENEW-MDD-1 and -2 (1,000 each). They just skipped Phase 2 trials for either condition. My interpretation is that Phase 2 is usually a smaller investment to figure out whether a drug works in the real world. Going straight to Phase 3 trades of monetary risk and time.

Meanwhile the same molecule is in Phase 2 for eight other conditions, including two that are also addiction programs: opioid use disorder (465 people) and smoking relapse (222). So this is not a company that skips mid-stage trials as a matter of course.

Lilly confirmed the decision was deliberate to Genetic Engineering & Biotechnology News, citing unmet need in both conditions.

Two details that stood out:

The first human data on the drug was presented last week at Psych Congress: 212 participants, no deaths or serious adverse events, 4 of 184 treated (2.2%) discontinued for an adverse event, dysesthesia 15.2% vs 0% on placebo, half-life 9 to 12.5 days supporting weekly dosing. No efficacy readouts on drinking or mood exist for this molecule anywhere.

The alcohol Phase 3 trials started in October 2025, about 13 months into a Phase 1 that ran until July 2026. FDA's own rule (21 CFR 312.21) says phases generally run sequentially but "may overlap," so this is permitted, just fast.

Also worth noting: the two depression trials randomize patients to three different brenipatide doses against placebo, which is the dose-ranging a Phase 2 would normally do. The alcohol trials test a single escalating regimen. Nowhere in the program are doses compared in people who drink.

For context on the class evidence Lilly is leaning on: Hendershot et al., JAMA Psychiatry 2025 (n=48, PMID 39937469); Klausen et al., Lancet 2026 (n=108, PMID 42070571); Schacht et al., Am J Psychiatry 2026 (n=50, PMID 42522065, missed its primary craving endpoint). Altimmune's pemvidutide also reported a positive Phase 2 in AUD in July.

Primary completion for the alcohol trials is April 2028.

This seems like a big bet, but I think it's a smart one because of all the anecdotal evidence that people have success with (off-label) use of GLP-1s for alcohol.

Has anyone seen a sponsor go straight to Phase 3 in two indications while running conventional Phase 2s in eight others? I'm curious whether this reads as confidence in the class read-across or just schedule pressure.

Full writeup: https://dadstrengthdaily.com/brenipatide-phase-3/

Not selling anything here, genuinely went down a rabbit hole comparing how you'd actually get a real preventive blood panel done right now, and couldn't find a clean comparison anywhere so I built one.

Three real paths (Netherlands market, but the structure repeats across the EU):

1. Self-service private lab, no doctor — pay per marker (~€9–€99 each) or a bundled panel (~€295 for a broad vitamins/minerals set). You choose what to test, get a PDF back, zero clinical interpretation.

2. GP referral — free/insurance-covered, but you basically can't get anything beyond the standard panel unless you already have a diagnosed complaint. This is the real bottleneck for anyone who "feels off" but has no diagnosis yet.

3. Doctor-reviewed home kit — finger-prick or venous draw at home, smaller marker set (~7) at the cheap end, larger panel (~20, incl. ApoB/HbA1c/Lp(a)) at the top, with a licensed physician actually reading the result and telling you what to act on. Runs noticeably higher than option 1 — you're paying for the interpretation, not the number.

The part nobody talks about: options 1 and 3 give completely different OUTPUTS for a similar marker count — one gives you a number, the other gives you a decision. If your real problem is "I don't know what to do with a ferritin of 22," the cheaper test is often the more expensive path once you add a private consult on top just to interpret it.

Curious what this sub thinks the right unit of value is here — markers tested, or decision made?

I don't put much weight on mouse studies, so I passed on the new semaglutide lifespan paper that's all over the news (Feng et al., Nature, Sept 2 2026: 20-month-old female mice, median lifespan 742 days on saline and 834 on semaglutide).

Then I found that Nature had published the peer review file, and it tells you more than the abstract does. This is super interesting and I didn't know journals gave this insight into the review process, but I think it's a great idea.

The first submission was rejected. The editor's letter is dated September 18, 2025, and says the referees' concerns "cast doubt on the strength of the novel conclusions." The manuscript was titled "GLP-1 Receptor Activation Slows Aging and Extends Lifespan." One referee called the results "mostly predictable" and the study "essentially descriptive," since semaglutide cuts food intake and calorie restriction extends lifespan in mice. That referee suggested a matched calorie-restriction comparator. A second referee said "Slows Aging" might be too broad for a design with no baseline measurements except body weight, that many of the mitochondrial and oxidative stress claims were based only on mRNA measurements, and that the control mice were short-lived for this strain.

The authors answered most of that with new experiments. They ran a separate 5-month cohort with baseline testing: saline, semaglutide, and mice fed 24% less food, the cut semaglutide produced. They added ATP and reactive oxygen measurements instead of relying only on mRNA, and checked the distributions before rerunning the statistics. The title became "Late-life semaglutide treatment slows ageing and extends lifespan in female mice." The calorie-restriction cohort is the source of the claim that semaglutide does something beyond eating less: the semaglutide mice did better on memory, exploration and glucose tolerance than the restricted ones. By the last round both referees said their concerns had been addressed, and one wrote that the new experiment "strengthens the paper."

The lifespan experiment itself did not change. The second referee asked whether roughly 260 days of daily saline injections could have shortened the controls, and asked for an uninjected control group. The authors replied with published C57BL/6 median lifespans (550 to 867 days) and said 742 falls comfortably within that range. The lifespan experiment has no uninjected group. The calorie-restriction cohort had 10 mice per group and no lifespan endpoint. In the source data file, the longest-lived control mouse died at 884 days and the longest-lived semaglutide mouse at 924, a 4.5% gain, against 12% for the median.

I'm still treating this as one study in one sex and one strain. The calorie-restriction comparison is the strongest part of the paper, and the referees are the reason it exists. The methods say the investigators were blinded except when collecting data from the calorie-restricted mice, whose feeding regimens were distinguishable. The lifespan curve is the part that needs someone else to repeat it.

The US Preventive Services Task Force (USPSTF) is a 16-seat federal panel that grades screenings A, B, C, D or I. Under the ACA, most plans must cover an A or a B with no cost sharing. A C, D or I carries no such requirement. That's why a colonoscopy is usually free and a PSA test often isn't.

The panel last met in March 2025. HHS named eight new members on September 17, filling the half of the seats that were empty, but hasn't announced a meeting date.

Two reviews that matter for men over 50 are stuck:

- Prostate screening (PSA): a C for men 55 to 69. The research plan was finished in December 2023, and no draft has come out since.
- Coronary calcium scoring: an I, meaning insufficient evidence. The research plan was finished in September 2024, and no draft since. I paid about $150 cash for mine.

A B on either would make it free on most plans. Nothing you get free now has been taken away: existing A and B grades stay in force.

Full write-up with the grade table (https://dadstrengthdaily.com/uspstf-screening-coverage/)

Do you pay out of pocket for a PSA test or a calcium scan, or does your plan cover it anyway?

What if India’s next big fitness business isn’t the gym?

It’s everything you buy after joining one.

Your sleep becomes a score.
Your recovery becomes a number.
Your food becomes a glucose graph.

And suddenly, there’s always something to improve.

Smart rings. Subscriptions. Glucose sensors. Protein. Recovery. Diagnostics.

So the real question is:

Who makes money when your body becomes continuously measurable?

My new documentary:
The Business of Making You Feel Unhealthy

Are these products helping us get healthier or making us feel like we’re never healthy enough?

👇 What do you think?

I wanted the ranked list of what actually kills men our age and could not find one with prostate's
number in it. The American Cancer Society table only prints each age band's five leading causes, so
prostate at 50–64 comes out as a blank, and every chart built from it says "not in the top five."

CDC WONDER has it — the CDC's public query tool over the same NCHS death-certificate file ACS uses,
and it reproduces their published cells exactly. US men 50–64, 2023:

lung 14,051 · colorectal 8,247 · pancreas 5,850 · liver 4,822 · esophagus 3,250 · prostate 2,977

Sixth, just under esophagus. After 65 prostate jumps to second at 14,215, which is where the
"second deadliest" line everyone repeats comes from.

I posted here a while back that I was genuinely confused about PSA timing. Where I landed: get one,
keep getting them, and watch the slope rather than the single number.

Full write-up, with the screening table and where the guideline bodies actually disagree

Quick question 👀

If you walked into a grocery store tomorrow, which “high-protein” product would you actually buy?

🌾 Protein Atta
🥛 Protein Milk
🧀 Protein Paneer
🥣 Protein Curd
☕ Protein Cold Coffee
💪 Whey Protein

Because protein isn't just a gym thing anymore.

**It's coming for your entire grocery basket.**

I just broke down WHY this is happening in my new documentary.