The hard contraindications below are the same as full-dose GLP-1. The drug is the same molecule. Microdose changes side-effect intensity and use case, not safety class.
✓You are likely a fit if
Microdose is built for metabolic optimization, not weight loss. The right person isn't aggressively dieting, they're optimizing.
- BMI 22-27 with insulin resistance markers, elevated fasting insulin, HOMA-IR > 1.5, low SHBG.
- Visceral fat or recomposition goal at a normal-ish BMI.
- Strong "food noise" or eating-pattern issues without classic obesity.
- Athletes and lifters who want metabolic benefit without losing muscle, microdose preserves training intake.
- Anyone with poor tolerance to full-dose GLP-1 who still wants the metabolic effect.
- Long-term metabolic maintenance after a full-dose cycle.
×Hard contraindications, we will not prescribe
- Personal or family history of medullary thyroid carcinoma (MTC).
- Multiple Endocrine Neoplasia syndrome type 2 (MEN2).
- History of pancreatitis.
- Severe gastroparesis.
- Pregnancy or planning pregnancy in the next 2 months.
- Active eating disorder.
- Type 1 diabetes.
- Known hypersensitivity to semaglutide or tirzepatide.
!Conditions that require extra care
- BMI < 20, we'll have a conversation about whether GLP-1 is the right tool at all.
- Active gallbladder disease, risk is lower at microdose but not zero.
- Severe renal impairment, conservative titration.
- History of disordered eating in remission, we'll screen carefully.
- On insulin or sulfonylureas, lower risk than full-dose but still worth coordinating.
- Older adult with low muscle mass, protein and resistance training non-negotiable.
Pre-start labs we require
Same panel as full-dose. Microdose isn't an excuse to skip the screen.
| Lab | Why |
|---|
| HbA1c, fasting glucose, fasting insulin | Baseline metabolic state. |
| HOMA-IR (calculated) | The number microdose moves most. |
| CMP | Renal & liver baseline. |
| Lipid panel + apoB | Cardiometabolic baseline. |
| TSH | Thyroid mimics metabolic symptoms. |
| Lipase | Pancreatic baseline. |
| SHBG, total & free T (men) | Insulin resistance suppresses SHBG. |
What to disclose at intake
- Every medication and over-the-counter you take.
- Prior GLP-1 history, brand, dose, why you stopped.
- Family history of thyroid cancer or MEN2.
- Any history of pancreatitis or severe abdominal pain.
- Pregnancy plans within the next year.
- Eating disorder history, even in remission.
- Training and protein intake (we ask, because microdose works best with both intact).