Doctor discussion guide
How to talk to your doctor
about all of this.
Doctor discussion guide
- 10
- Short chapters
- 25+
- Questions to ask
- Bring it to your visit
Chapter 1
Before your visit
“Your doctor has about 15 minutes. Make every one count.”
The best appointments are the prepared ones. Bring the facts on paper so nothing gets forgotten.
- A list of everything you take: prescriptions, supplements, peptides, how much and how often. Be honest; your doctor can't protect you from what they don't know.
- Your last labs, or the doctor letter from the Bloodwork page so you can ask for the right ones.
- Your top 3 goals, for example: lose 30 pounds, more energy, fix my blood sugar.
- Your PepFit plan PDF, so your doctor can see the training and nutrition side.
Chapter 2
Questions worth asking
“Good questions get you a real plan, not just a prescription.”
Pick the ones that fit you. Write the answers down, or ask if you can record the visit.
Ask your doctor
- Based on my labs, what's the biggest risk to my health right now?
- What's a realistic goal for me in the next 3 months, and how will we measure it?
- Is there anything in my medicine or supplement list that worries you?
- Which labs should we repeat, and when?
- Is it safe for me to start strength training 3 days a week? Anything I should avoid?
Chapter 3
When your bloodwork comes back off
“A flagged number is a conversation starter, not a diagnosis.”
Lab ranges are built from averages, and a single result can be off because of sleep, food, a hard workout or illness.
Ask your doctor
- Is this result out of range enough to matter, or is it borderline?
- Could something like fasting, exercise, dehydration or a supplement have affected it?
- Should we repeat it before making any decisions?
- If it's real, what's the cause we should look for, and what can I change myself?
Tip: biotin (in many hair and nail supplements) can throw off thyroid and hormone tests. Ask whether to stop it a few days before your blood draw.
Chapter 4
Talking about insulin resistance
“Your blood sugar can look normal for years while insulin is working overtime.”
Standard panels often check only glucose. Insulin resistance shows up earlier in fasting insulin and HOMA-IR.
Ask your doctor
- Can we check fasting insulin along with glucose, so we can calculate HOMA-IR?
- What are my HbA1c and triglyceride-to-HDL ratio, and what do they say about insulin resistance?
- Would an oral glucose tolerance test with insulin make sense for me?
- If I am insulin resistant, what do you recommend first: lifestyle, metformin, a GLP-1, or a mix?
You can check your HOMA-IR score with the free calculator on the Calculators page and bring the number with you.
Chapter 5
Talking about GLP-1 medicines
“These are powerful, proven medicines. They work best with a plan around them.”
Semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro) are FDA-approved. In their main trials, people lost about 15% (semaglutide 2.4 mg, STEP 1) and up to about 20% (tirzepatide 15 mg, SURMOUNT-1) of body weight on average over about 16–17 months, alongside diet and activity.
- Common side effects: nausea, constipation, diarrhea, reflux and tiredness, mostly after dose increases.
- Less common but serious: gallbladder problems, pancreatitis and dehydration-related kidney problems. They carry a warning about a rare thyroid cancer (medullary) seen in rodents; they're not used if you or your family have had medullary thyroid cancer or MEN 2.
- Weight loss can include muscle. Strength training and enough protein help protect it.
Ask your doctor
- Am I a candidate, and which medicine would you choose for me and why?
- Can we go low and slow, staying longer on each dose if I have side effects?
- What should I do if I can't keep fluids down or get severe belly pain?
- How will we protect my muscle, and should we check my labs while I'm on it?
- What's the plan for when I reach my goal: keep going, lower dose or stop?
Chapter 6
Talking about investigational peptides
“Honesty beats hiding. Tell your doctor, even if you think they'll say no.”
Peptides like BPC-157, TB-500, MOTS-c, KPV or GHK-Cu (injected) are not FDA-approved for any use. Most of the research is in animals or cells, and products sold online are not checked for what's actually inside. FDA has flagged several of them, including BPC-157, as having possible safety risks.
- What's known: early lab and animal results, plus small or no human studies for most of them.
- What isn't known: safe human doses, long-term effects, and whether lab results happen in people.
- The real risks: contamination, wrong contents or dose, infections from injecting, and interactions nobody has studied.
Ask your doctor
- I've been reading about [peptide] for [reason]. What do you think of the evidence?
- Is there an approved treatment for my problem that we should try first?
- If I decide to use it anyway, which labs should we watch, and what signs should make me stop?
Your doctor may not be an expert in these. That's normal. The Peptide Index shows the evidence level for each one, so you can bring the facts.
Chapter 7
Proven vs. promising vs. unknown
“Not all “studies show” are equal.”
Ask what kind of evidence is behind a claim. Here's the ladder, from strongest to weakest:
- Human trials (randomized, controlled): the strongest. This is how GLP-1 medicines were approved.
- Human observational studies: show links, not proof of cause.
- Animal studies: useful clues, but most results don't carry over to people.
- Lab (cell) studies: early-stage ideas.
- Theory or anecdotes: before-and-after posts and testimonials aren't evidence.
Chapter 8
Labs to bring up
“Know your baseline, then check every 3 months while you're making changes.”
Ask which of these make sense for you:
- Metabolic: fasting glucose, fasting insulin (for HOMA-IR), HbA1c, lipid panel including triglycerides.
- Liver and kidneys: comprehensive metabolic panel (CMP), GGT, urine albumin.
- Inflammation: hs-CRP.
- Blood count and iron: CBC, ferritin.
- Thyroid: TSH, free T4 (and free T3 if symptoms).
- Vitamins: vitamin D, B12 (especially on metformin or a GLP-1 with low intake).
- Hormones if relevant: testosterone (total and free), estradiol, SHBG; IGF-1 if using growth hormone peptides.
Chapter 9
Interactions and safety checks
“Two safe things can be unsafe together.”
Ask your doctor or pharmacist to check these combinations:
- GLP-1 plus insulin or a sulfonylurea (like glipizide): higher risk of low blood sugar.
- Tirzepatide and birth control pills: it can make the pill less reliable. The label advises a backup or non-pill method for 4 weeks after starting and after each dose increase.
- Blood thinners (like warfarin) with vitamin K2, high-dose fish oil, ginkgo or turmeric.
- Thyroid medicine (levothyroxine) with calcium, iron or magnesium: take them at least 4 hours apart.
- Berberine with diabetes medicines: can add to the blood sugar-lowering effect.
- High-dose zinc (over 40 mg a day for months) can cause copper deficiency.
Chapter 10
You, your doctor and your coach
“The goal is a team, not a battle.”
Your doctor handles diagnosis, prescriptions and labs. Your coach helps with training, food, habits and keeping you consistent. You make the decisions, with the facts.
- Share your plan and results with both.
- If your doctor disagrees, ask why. Their reason may protect you.
- Never start, stop or change a prescription on your own.
Your visit script
Fill in the brackets and hand it to your doctor, or read from it.
HOW I'D LIKE TO USE THIS VISIT My goals: [1] [2] [3] What I take now (medicines, supplements, peptides, doses): [list] My main questions: 1. Based on my labs, what's my biggest health risk right now? 2. Can we check fasting insulin with glucose (HOMA-IR), HbA1c, lipids, hs-CRP, vitamin D and a CMP? 3. Is a GLP-1 medicine an option for me? If so, can we go low and slow? 4. Is anything in my list unsafe together? 5. When should we repeat my labs? Thank you!
More help: doctor letters for labs, a slower GLP-1 step-up and the evidence for each peptide.
Educational only, not medical advice. PepFit Coach does not diagnose, prescribe or recommend doses.