Creatine kinase elevations on GLP-1 — looking for input

Dr.SurgeonPGH said:

There is also a quality change that the scan cannot see.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

BethLabQueen said:

Two DEXA scans eleven months apart: down 24kg total, of which the scan says 6kg was lean.

DEXA scan update relevant to lean mass:

Scanned at months 0, 6, and 12. Here are the body comp numbers:

Lean mass preserved — actually GAINED 1-2 lbs thanks to progressive overload + 1.4g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.

Dr.NutriCornell said:

I think this board over-worries about lean mass.

Regarding lean mass: I accidentally injected my dose intramuscularly instead of subcutaneously last week (went in at wrong angle, too deep). Called my pharmacist — they said it's not dangerous but may absorb faster, potentially causing more GI effects.

Sure enough, had worse nausea that day. Lesson learned: pinch the skin properly and use the right needle length for your body composition.

A narrower follow-up, since the general answer is now clear:

Whether resistance training and protein change the ratio or only the absolute amount?

Closing the loop on my own question.

Follow-up: I dropped the cardio to two easy sessions and put the effort into three real lifting sessions. The scale slowed and the scan improved.