My labs came back: A1C finally down, HS-CRP up!

[jperiod]

Reta got started in our family back in May for me, DH-50 and DS-21, with my mom-74 following in June. The 3 of us began on tiny doses, dosing 2x a week, and moved up a step every 4 weeks. These days I'm at 2.8 mg weekly, DH at 2.4 mg, and DS on 1.6. I've dropped only about 5 lbs, whereas DH and DS are visibly down 20-30 lbs. My mom is about 5 lbs lighter and injects once a week. She moves up to 1.5 mg today.

Because I've been working on my thyroid and my overall health since 2024, I get bloodwork done every quarter. That's 30 lbs off compared with where I started in 2024. Getting my A1C below 5.7-5.9 was never possible before, and this round it landed at 5.5! My HS-CRP went the other direction and doubled since the previous draw. 4.3 in April, 9.1 now! To put that in context, my starting point was 13.2. Everything else came back exactly as it always does.

So a mixed bag. Why my CRP spiked is a mystery to me. Test after test it had only been falling. I haven't been sick and nothing else in my life is out of the ordinary. Still, that 5.5 makes me happy!

 

[Turbo-Farmer]

jperiod said:

Reta got started in our family back in May for me, DH-50 and DS-21, with my mom-74 following in June. The 3 of us began on tiny doses, dosing 2x a week, and moved up a step every 4 weeks. These days I'm at 2.8 mg weekly, DH at 2.4 mg, and DS on 1.6. I've dropped only about 5 lbs, whereas DH and DS are visibly down 20-30 lbs. My mom is about 5 lbs lighter and injects once a week. She moves up to 1.5 mg today.

Because I've been working on my thyroid and my overall health since 2024, I get bloodwork done every quarter. That's 30 lbs off compared with where I started in 2024. Getting my A1C below 5.7-5.9 was never possible before, and this round it landed at 5.5! My HS-CRP went the other direction and doubled since the previous draw. 4.3 in April, 9.1 now! To put that in context, my starting point was 13.2. Everything else came back exactly as it always does.

So a mixed bag. Why my CRP spiked is a mystery to me. Test after test it had only been falling. I haven't been sick and nothing else in my life is out of the ordinary. Still, that 5.5 makes me happy!

A seasonal spike is one possibility for the HS-CRP, or it might be the Reta doing it.

Reta is not a well-studied drug, and in my case I had to take the titration more slowly, since R brought on itching each time my dose went up.

 

[jperiod]

Turbo-Farmer said:

jperiod said:

Reta got started in our family back in May for me, DH-50 and DS-21, with my mom-74 following in June. The 3 of us began on tiny doses, dosing 2x a week, and moved up a step every 4 weeks. These days I'm at 2.8 mg weekly, DH at 2.4 mg, and DS on 1.6. I've dropped only about 5 lbs, whereas DH and DS are visibly down 20-30 lbs. My mom is about 5 lbs lighter and injects once a week. She moves up to 1.5 mg today.

Because I've been working on my thyroid and my overall health since 2024, I get bloodwork done every quarter. That's 30 lbs off compared with where I started in 2024. Getting my A1C below 5.7-5.9 was never possible before, and this round it landed at 5.5! My HS-CRP went the other direction and doubled since the previous draw. 4.3 in April, 9.1 now! To put that in context, my starting point was 13.2. Everything else came back exactly as it always does.

So a mixed bag. Why my CRP spiked is a mystery to me. Test after test it had only been falling. I haven't been sick and nothing else in my life is out of the ordinary. Still, that 5.5 makes me happy!

A seasonal spike is one possibility for the HS-CRP, or it might be the Reta doing it.

Reta is not a well-studied drug, and in my case I had to take the titration more slowly, since R brought on itching each time my dose went up.

Seasonal doesn't ring true to me. I've had quarterly testing running for 2 years now, and each round came in lower than the one before. As for reta, I've had no bad side effects from it.

 

[woundcarping]

I began Reta on 1/10 and began tracking hs-CRP from then on. On my lab's report the top of the reference range sits at 3mg/L. Tomorrow I'm back in for labs.

hs-CRP moves around a lot: it climbs within hours, tops out a day or two later, then trails off once whatever triggered it is gone, with a half life of roughly 19 hours.

Reta's side effects are one thing that could push hs-CRP upward — GI trouble, poor sleep, dehydration, and so on.

 

[Bioexplorer]

jperiod said:

Turbo-Farmer said:

jperiod said:

Reta got started in our family back in May for me, DH-50 and DS-21, with my mom-74 following in June. The 3 of us began on tiny doses, dosing 2x a week, and moved up a step every 4 weeks. These days I'm at 2.8 mg weekly, DH at 2.4 mg, and DS on 1.6. I've dropped only about 5 lbs, whereas DH and DS are visibly down 20-30 lbs. My mom is about 5 lbs lighter and injects once a week. She moves up to 1.5 mg today.

Because I've been working on my thyroid and my overall health since 2024, I get bloodwork done every quarter. That's 30 lbs off compared with where I started in 2024. Getting my A1C below 5.7-5.9 was never possible before, and this round it landed at 5.5! My HS-CRP went the other direction and doubled since the previous draw. 4.3 in April, 9.1 now! To put that in context, my starting point was 13.2. Everything else came back exactly as it always does.

So a mixed bag. Why my CRP spiked is a mystery to me. Test after test it had only been falling. I haven't been sick and nothing else in my life is out of the ordinary. Still, that 5.5 makes me happy!

A seasonal spike is one possibility for the HS-CRP, or it might be the Reta doing it.

Reta is not a well-studied drug, and in my case I had to take the titration more slowly, since R brought on itching each time my dose went up.

Seasonal doesn't ring true to me. I've had quarterly testing running for 2 years now, and each round came in lower than the one before. As for reta, I've had no bad side effects from it.

The TRIUMPH-3 readout from ELs a few weeks back carried hs-CRP data as well. In the 12mg arm they put the hs-CRP drop at 51.2%. No other GLP-1 that's been studied has shown a bigger reduction than that.

You're still sitting on a fairly low dose. Titrate upward and give it time. With your fairly modest weight loss, why stay that low? Are side effects an issue?

No hard and fast rules exist for a titration schedule, but a sensible place to begin is 1mg or 2mg/week and either doubling or at minimum adding a mg every four weeks, carrying on until side effects become unacceptable or too much weight comes off. Plenty of people slow down past 4mg though.

After roughly 4+ months I'm only at 5mg, but that's deliberate: I want to lose slowly while I rebuild strength following an injury and surgery. Were that not the case I'd likely be on 8mg by now, chasing a pound a week.

So don't hold back from titrating up, keep going until you land on your sweet spot.

 

[tubby]

With so little of the picture in front of us, it's tough to say anything definite. I'm not fishing for extra detail, I just want to point out how uncommon it is for someone to begin a GLP and change nothing else about how they eat (beyond eating less) or live.

If nothing else in your routine can explain a persistently raised inflammatory marker, and you begin to suspect reta is behind it, keep in mind that there are additional GLP choices worth looking at — I doubt you'd want to give up the A1c gains. Among the GLPs people talk about most, Reta holds the biggest AVERAGE weight loss, though that doesn't guarantee it will produce a bigger loss for you than the others would.

I wouldn't be shocked if somebody with results like yours did better on a higher dose, or on a different GLP altogether.

 

[Turbo-Farmer]

jperiod said:

Turbo-Farmer said:

jperiod said:

Reta got started in our family back in May for me, DH-50 and DS-21, with my mom-74 following in June. The 3 of us began on tiny doses, dosing 2x a week, and moved up a step every 4 weeks. These days I'm at 2.8 mg weekly, DH at 2.4 mg, and DS on 1.6. I've dropped only about 5 lbs, whereas DH and DS are visibly down 20-30 lbs. My mom is about 5 lbs lighter and injects once a week. She moves up to 1.5 mg today.

Because I've been working on my thyroid and my overall health since 2024, I get bloodwork done every quarter. That's 30 lbs off compared with where I started in 2024. Getting my A1C below 5.7-5.9 was never possible before, and this round it landed at 5.5! My HS-CRP went the other direction and doubled since the previous draw. 4.3 in April, 9.1 now! To put that in context, my starting point was 13.2. Everything else came back exactly as it always does.

So a mixed bag. Why my CRP spiked is a mystery to me. Test after test it had only been falling. I haven't been sick and nothing else in my life is out of the ordinary. Still, that 5.5 makes me happy!

A seasonal spike is one possibility for the HS-CRP, or it might be the Reta doing it.

Reta is not a well-studied drug, and in my case I had to take the titration more slowly, since R brought on itching each time my dose went up.

Seasonal doesn't ring true to me. I've had quarterly testing running for 2 years now, and each round came in lower than the one before. As for reta, I've had no bad side effects from it.

What you may be reacting to is something in the formulation itself, producing a low-grade inflammation - which is exactly why some people get worse ISRs from one supplier's peptides and none at all once they switch.

The bulk of the puck sitting in your vial isn't the active compound.

Mannitol is a bulking agent found in a great many peptide vials.

In a subcutaneous (SQ) formulation - lyophilized (freeze-dried) biologics, peptides or vaccines, for instance - mannitol appears as an inactive excipient, where its job is to act as a tonicity agent (keeping osmolality in balance) or as a bulking agent/stabilizer.

Mannitol is used widely and is generally well tolerated in that role, yet under certain conditions it can still be behind localized injection site reactions (ISRs).

1. Mechanisms: How Excipient Mannitol Can Cause Reactions

In SQ formulations the concentration of mannitol sits far below what therapeutic intravenous infusions use, and even so it can set off a local reaction:

Osmotic Discomfort & Stinging: Subcutaneous tissue responds to tonicity. Use mannitol in excess, or end up with a reconstituted solution that is slightly hypertonic, and it pulls intracellular water out of the tissue around it - pain, stinging or a burning feeling at the injection site is the result.

Local Histamine / Mast Cell Response: sugar alcohols and carbohydrates such as mannitol are occasionally able, in sensitive people, to set off non-allergic local mast cell degranulation. Histamine is released locally for a short time, without the picture of a full systemic allergic reaction.

True Allergic Hypersensitivity (Rare): Rare though it is, genuine Type I (IgE-mediated) or Type IV (cell-mediated) hypersensitivity to mannitol does happen, and shows up as hives that persist, localized contact dermatitis, or marked swelling.

 

[jperiod]

It doesn't worry me, it just seems odd for it to double out of nowhere. For 20 years my CRP has come back high without me ever learning the reason, and I've never had a serious health event come of it. Maybe it connects to the recent sudden death in the family and all the estate paperwork I've been handling, but my stress doesn't feel any worse than it has at other periods of my life — particularly next to another family death last year that hit me hard (my numbers didn't climb back then). On top of that I have 2 kids with special needs, so calling me "chronically stressed" would probably be fair, and that alone could explain the high readings across the years.

We'll find out what my dr makes of it. He was keen for me to give reta a try and my a1c will please him, so I doubt he'll be worried at this stage.