FlexNP
@rnflex.bsky.social
Jack of all trades nurse practitioner, trail runner photographer, coonhound rescuer, lover of glucagon agonism in the liver, kidney and pancreas, fascinated by obesity medicine, retatrutide fan boy
Maybe this trial will show something different. But I'd argue either they have to start with an even smaller starter dose to even approach tolerability. Then there's the fact that the high doses did show weight loss trends that suggested the weight loss was from side effects
November 25, 2025 at 1:09 PM
Maybe this trial will show something different. But I'd argue either they have to start with an even smaller starter dose to even approach tolerability. Then there's the fact that the high doses did show weight loss trends that suggested the weight loss was from side effects
2 years ago on a whim I planted the crown of a pineapple we bought from the store. In the last week it's finally showing signs it's about to bloom and create another pineapple!
November 22, 2025 at 6:27 PM
2 years ago on a whim I planted the crown of a pineapple we bought from the store. In the last week it's finally showing signs it's about to bloom and create another pineapple!
If you work as a primary care provider or really any medical speciality provider having your Epic in basket look like this is 🤌🤌
Savoring the fact that it'll look like this for maybe 30 minutes
Savoring the fact that it'll look like this for maybe 30 minutes
November 20, 2025 at 1:30 PM
If you work as a primary care provider or really any medical speciality provider having your Epic in basket look like this is 🤌🤌
Savoring the fact that it'll look like this for maybe 30 minutes
Savoring the fact that it'll look like this for maybe 30 minutes
Mine just gets in the corner of the couch and waits for the cat to join her. Every morning they cuddle for about an hour. #HiDolly #HiWallace
November 20, 2025 at 12:49 PM
Mine just gets in the corner of the couch and waits for the cat to join her. Every morning they cuddle for about an hour. #HiDolly #HiWallace
The whole place is basically one giant postcard. I'm not a beach person either but this place was amazing. And the scuba diving we did here was literally world class with that water clarity
November 19, 2025 at 12:26 AM
The whole place is basically one giant postcard. I'm not a beach person either but this place was amazing. And the scuba diving we did here was literally world class with that water clarity
8 years ago I was here. Fakarava in French Polynesia.
One of the most magical places I've ever been in my life.
One of the most magical places I've ever been in my life.
November 19, 2025 at 12:11 AM
8 years ago I was here. Fakarava in French Polynesia.
One of the most magical places I've ever been in my life.
One of the most magical places I've ever been in my life.
Help is on the way next year....(Tirzepatide probably does the same thing they just haven't tested it as such) Ask @eecklund.bsky.social it'll fix your knees up!
November 17, 2025 at 10:34 PM
Help is on the way next year....(Tirzepatide probably does the same thing they just haven't tested it as such) Ask @eecklund.bsky.social it'll fix your knees up!
Pulmonary medicine and Neurology/addiction medicine come on down. It's your turn for GLP1 medications! Eli Lilly(again!) has a new GLP1/GIP dual agonist on phase 2 & 3 trials for alcohol use disroder, smoking cessation and moderate asthma! @ryanmarino.bsky.social @proptermalone.bsky.social
November 17, 2025 at 4:17 PM
Pulmonary medicine and Neurology/addiction medicine come on down. It's your turn for GLP1 medications! Eli Lilly(again!) has a new GLP1/GIP dual agonist on phase 2 & 3 trials for alcohol use disroder, smoking cessation and moderate asthma! @ryanmarino.bsky.social @proptermalone.bsky.social
Always read the supplementary appendix because you find buried treasure. Phase 2 Eloralintide data from Eli Lilly
⏬ Aldosterone
⏬ UACR
⬆️Renin
And increased GFR over 48 weeks. What the heck is going on #NephSky?!
First it was Glucagon agonism and now Amylin may have some renal effect too?!
⏬ Aldosterone
⏬ UACR
⬆️Renin
And increased GFR over 48 weeks. What the heck is going on #NephSky?!
First it was Glucagon agonism and now Amylin may have some renal effect too?!
November 14, 2025 at 12:42 AM
Always read the supplementary appendix because you find buried treasure. Phase 2 Eloralintide data from Eli Lilly
⏬ Aldosterone
⏬ UACR
⬆️Renin
And increased GFR over 48 weeks. What the heck is going on #NephSky?!
First it was Glucagon agonism and now Amylin may have some renal effect too?!
⏬ Aldosterone
⏬ UACR
⬆️Renin
And increased GFR over 48 weeks. What the heck is going on #NephSky?!
First it was Glucagon agonism and now Amylin may have some renal effect too?!
So I dug deeper. I already knew retatrutide did this with reductions of 30mmhg SBP in patients with hypertension but it also holds true for semaglutide ~11mmhg SBP and tirzepatide ~19mmhg SBP!
I presume this has to be a combo of natriuresis effect + RAAS system? GLP1R is in VSMC & JGA in the kidney
I presume this has to be a combo of natriuresis effect + RAAS system? GLP1R is in VSMC & JGA in the kidney
November 12, 2025 at 1:40 AM
So I dug deeper. I already knew retatrutide did this with reductions of 30mmhg SBP in patients with hypertension but it also holds true for semaglutide ~11mmhg SBP and tirzepatide ~19mmhg SBP!
I presume this has to be a combo of natriuresis effect + RAAS system? GLP1R is in VSMC & JGA in the kidney
I presume this has to be a combo of natriuresis effect + RAAS system? GLP1R is in VSMC & JGA in the kidney
So gonna tag in some of #NephSky. There's an apparent class effect for GLP1 RA to potently lower BP in patients with existing hypertension. Seen here is orforglipron which Lilly is now trialing for high blood pressure(!!) @littlebiggloms.bsky.social @brianrifkin.bsky.social @hswapnil.medsky.social
November 12, 2025 at 1:40 AM
So gonna tag in some of #NephSky. There's an apparent class effect for GLP1 RA to potently lower BP in patients with existing hypertension. Seen here is orforglipron which Lilly is now trialing for high blood pressure(!!) @littlebiggloms.bsky.social @brianrifkin.bsky.social @hswapnil.medsky.social
Head to head vs Sema was much closer but still probably slightly better? But yeah it's interesting. I don't have problems drinking but once I started taking these meds it was like I just didn't care as much for alcohol, like I had no desire to even grab a beer anymore for a weekend BBQ
November 11, 2025 at 5:17 PM
Head to head vs Sema was much closer but still probably slightly better? But yeah it's interesting. I don't have problems drinking but once I started taking these meds it was like I just didn't care as much for alcohol, like I had no desire to even grab a beer anymore for a weekend BBQ
CC: @mikejohansenmd.medsky.social
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
November 11, 2025 at 5:04 PM
CC: @mikejohansenmd.medsky.social
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
In what might be one of the hilariously beneficial Kaplan Meier curves I've ever seen. TTE study of GLP1 meds and alcohol use disorder with the top left graph being incident of alcohol use tirzepatide vs DPP-4i
dom-pubs.onlinelibrary.wiley.com/doi/full/10....
Primary care is really really hard most days. But when you get notes like this. It makes everything worth it.
November 11, 2025 at 2:31 PM
Primary care is really really hard most days. But when you get notes like this. It makes everything worth it.
Definitely was pretty!
November 10, 2025 at 7:02 PM
Definitely was pretty!
That's the GLP-1 receptor shape!
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
November 9, 2025 at 3:30 PM
That's the GLP-1 receptor shape!
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
Here's the actual peptide, it should basically be a big slightly bent alpha helix with a fatty acid sticking off the side. But I just can't find a 3D model unfortunately.
I feel the same about this paper and presentation I saw at Obesity Week 2025. Mechanism with GLP1 reducing mortality is certainly more understandable than just fish oil but they are expensive as heck & getting a large RCT would be difficult.
pubmed.ncbi.nlm.nih.gov/40526425/
pubmed.ncbi.nlm.nih.gov/40526425/
November 9, 2025 at 12:21 PM
I feel the same about this paper and presentation I saw at Obesity Week 2025. Mechanism with GLP1 reducing mortality is certainly more understandable than just fish oil but they are expensive as heck & getting a large RCT would be difficult.
pubmed.ncbi.nlm.nih.gov/40526425/
pubmed.ncbi.nlm.nih.gov/40526425/
On an opposite note of data can be pretty, Lilly posted this post hoc analysis of cardiovascular risk improvements by weight loss percentage from Surmount 1 and the incremental improvements as you lose weight is just pretty to see graphed out
November 9, 2025 at 11:18 AM
On an opposite note of data can be pretty, Lilly posted this post hoc analysis of cardiovascular risk improvements by weight loss percentage from Surmount 1 and the incremental improvements as you lose weight is just pretty to see graphed out
I want to believe.
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
November 8, 2025 at 12:31 PM
I want to believe.
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
No benefit from GLP1 meds for movement disorders, but in this retrospective cohort there *is* a clear signal for a possible dementia benefit?!
Maybe? Maybe? First RCT on this question should have topline data in the next month or two
Chattanooga Whiskey again with the amazing stuff.
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
November 8, 2025 at 12:15 AM
Chattanooga Whiskey again with the amazing stuff.
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
Bourbon x Limecello.
It's like a sour key lime pie in a bottle in the best way. Great way for me and the wifey to relax after a long week for us both
My GI tract could never handle those even tho a few of the flavors are good!
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
November 7, 2025 at 7:03 PM
My GI tract could never handle those even tho a few of the flavors are good!
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
That being said at Obesity Week conference this week I had my visceral fat measured and uh, it barely exists. Only about 3 pounds of it out of 177lbs and normal skeletal muscle. 🔥🎉
(Visceral fat is extra bad for you)
Last day and literally the last lecture that I attended. Eli Lilly with Mazdutide(GLP1/Glucagon)Phase 2 dose finding study. 16mg dose is not viable. Too many side effects.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
November 7, 2025 at 4:06 PM
Last day and literally the last lecture that I attended. Eli Lilly with Mazdutide(GLP1/Glucagon)Phase 2 dose finding study. 16mg dose is not viable. Too many side effects.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
But the 10mg dose. Viable. Nearly 20% weight loss without plateau. 20% reduction in LDL cholesterol. Onward to phase 3 now.
Last day in Atlanta and I'm about to treat myself with some pain au chocolat y'all
November 7, 2025 at 1:01 PM
Last day in Atlanta and I'm about to treat myself with some pain au chocolat y'all
The 3/6/9 group appears to be the ticket. No plateau at 48 weeks. Definitely lower AE/SE on slow titration. Nice reductions in hsCRP, glucose and insulin. Probably a good alternative to GLP1 meds
November 6, 2025 at 1:58 PM
The 3/6/9 group appears to be the ticket. No plateau at 48 weeks. Definitely lower AE/SE on slow titration. Nice reductions in hsCRP, glucose and insulin. Probably a good alternative to GLP1 meds
