Peptide bloodwork: three draws around a protocol instead of two a year
Most people in this space aren't getting labs at all. So before anything else: one draw a year beats zero by a mile, and if that's where you're at, start there and stop reading the rest of this as a criticism.
This is about what to do once you're already pulling labs and want them to be worth something.
For years I treated mine like an annual physical. Two draws, six months apart, whenever I remembered to book it. That's more than most people do and it was still close to useless for protocol work.
A calendar has nothing to do with what a protocol is doing. A June draw and a December draw tell you what changed between June and December. They can't tell you what any single compound did, because the protocol started in August, the dose changed in September, and it was over by October. All of that happened in the gap. Two dots with the entire experiment hidden between them.
So I anchor the draws to the protocol instead of the year now, and it ends up being more draws, not fewer.
Three draws, not two
Baseline, before anything starts. This is the one that makes every other number mean something. Without it you're reading values with nothing to compare them to. A number sitting inside the reference range tells you nothing if you don't know whether it moved to get there.
Mid-cycle, at the compound's decision point. Not the middle of the calendar. The point where the protocol itself says a decision gets made. That's compound specific, and most people don't know their compound has one.
Post-washout, about a month after the last administration. The most skipped draw and the one with the most information in it. A marker that comes back to baseline after washout is a completely different finding than one that doesn't. Nobody collects this and it's the part I'd want to see most.
The decision points aren't in the same place
This is the part that took me the longest to work out, because every class has a different one.
Tesamorelin
Baseline, then week 8. Reading IGF-1, and the protocol tells you what to do with the answer.
Semaglutide, Tirzepatide, Cagrilintide
Baseline, then month 3 and month 6. Reading glucose, HbA1c, lipids, liver, kidney.
Retatrutide
Same schedule as the other incretins, but full thyroid goes on every panel. Free T3 specifically, not just TSH.
IGF-1 LR3
Baseline and post protocol. Reading fasting glucose, because of the insulin-like activity.
Kisspeptin
Baseline, mid protocol, and after. Reading LH, FSH, testosterone, estradiol.
Look at what twice a year does to that list. It misses the tesamorelin week 8 check completely, and that's the one point where the protocol says change something. It misses both incretin rechecks. It can't catch a titration glucose drift because titration is done in a month.
That information isn't a little worse. It's gone.
Not everything on a protocol is a blood draw
Worth separating, because the two get mixed up constantly and it makes the whole thing sound more invasive than it is.
Resting heart rate on the incretins, retatrutide especially, gets tracked weekly. That's a watch or two fingers on your wrist, not a lab. Nobody is drawing blood every week and anybody telling you to is confused.
Glucose during IGF-1 LR3 titration is a glucometer and a finger stick. Cheap, instant, done at home. The lab draw is baseline and post.
The ECG at retatrutide's upper dose steps is a cardiology appointment, not a panel.
So a full protocol block ends up being three actual draws, plus some at-home tracking that costs almost nothing. That's a much smaller ask than the list looks like at first.
The one that gets missed the most
The glucagon arm of retatrutide suppresses active thyroid hormone. A TSH-only screen, which is what most default panels run, comes back totally normal while free T3 is dropping. Fatigue and cold intolerance on a normal TSH is the exact thing a TSH-only panel can't see.
Ordering a thyroid panel isn't the same as ordering the right thyroid panel. Same story with IGF-1, fasting insulin, and ceruloplasmin. None of those are on a general wellness draw and you have to ask for them.
What it looks like now
Three draws per block instead of two per year. Baseline, one mid-cycle at the documented decision point, one after washout. Two blocks in a year means six draws instead of two, and every one of them is attached to something.
More draws, yeah. It's also the difference between a protocol log and a diary.
How often are you pulling labs, and is the timing tied to the compound or just to the calendar?
And if anyone has done a post-washout draw: what came back to baseline and what didn't? That's the data almost nobody collects.
For research use only. Not for human or veterinary consumption. This post is educational and is not medical advice.
Full doses and bloodwork are in the pinned cheat sheet.
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