The Precision Medicine Economy

Retatrutide. Eli Lilly. Targets GLP-1, GIP, and glucagon simultaneously.

Here's what the TRANSCEND-T2D-1 trial showed over 40 weeks:

HbA1c dropped up to 2.0% on average. The highest dose group lost 16.8% of their body weight. And weight loss was still trending down when the study ended. Cholesterol and blood pressure improved too. Side effects were consistent with what we already see in the GLP-1 class.

This is a once weekly injection. In people who weren't on any diabetes medications. After only 40 weeks.

Read that again.

We went from single hormone GLP-1s to dual action with tirzepatide. Now we're looking at a triple agonist that hits GLP-1, GIP, and glucagon at the same time. Each generation is compounding the clinical impact.

But I need to say something that nobody else in this space seems willing to say.

There are already compounders making retatrutide. Right now. A drug that hasn't been FDA approved. Hasn't completed its full trial program. Doesn't have an established safety profile. Doesn't have standardized dosing. And someone is compounding it and selling it to patients.

That's not innovation. That's reckless.

There is no shortage to justify it. There is no FDA approved version to reference. There is no clinical basis for a compounding pharmacy to be producing a molecule that is still in clinical trials. If a compounder is offering you retatrutide today, that should tell you everything you need to know about how they operate.

Now back to the science. We are still very early. This is one Phase 3 trial. 537 people. 40 weeks. We don't know how it performs head to head against tirzepatide or semaglutide. We don't know the long term safety profile. We don't have pricing. We don't have an approval timeline.

But the trajectory is undeniable. The GLP-1 category is accelerating. And every new molecule that enters the pipeline raises the same question for prescribers and clinic operators: is your practice built to keep up with what's coming, or are you still figuring out what happened last year?

The clinics that are going to win in this space are the ones working with compounding partners who understand the difference between what's compliant and what's just available. That line matters. Especially right now.

Retatrutide isn't here yet. But the future it represents is closer than most people think.

TruthTides: Evidence Over Noise

I just spent half this newsletter talking about compounds coming off the restricted list and a triple agonist that's still in trials but already being sold by compounders who don't care about the rules.

That's the landscape right now. It's moving fast. The science is exciting. And the noise to signal ratio is terrible.

Prescribers are making formulary decisions based on podcast clips, Instagram infographics, and sell sheets from compounders who have a financial interest in you saying yes. That's not clinical decision making. That's marketing.

TruthTides exists to fix that.

32 compounds. 120+ indexed studies. Every claim locked to a peer-reviewed source. No manufacturer talking points. No cherry-picked data. No spin.

Look up a compound. See what the research actually supports. See where the gaps are. Make your own clinical decision based on evidence, not someone else's revenue target.

The platform is backed by a clinical advisory board because this isn't a blog. It's a clinical tool for prescribers who want to move with confidence as this space evolves.

14 peptides are coming back. New GLP-1 molecules are moving through the pipeline every quarter. The information gap between what's being marketed and what's been studied is getting wider, not smaller.

If you're a prescriber or clinic operator who wants access, its free, for now

I've spent the past decade building and scaling operations across clinics, telehealth platforms, and compounding pharmacies. I've seen practices succeed at 20 patients per month and break at 200. I've watched regulatory shifts reorganize entire markets overnight. I've built the infrastructure that determines whether modern therapies scale or stall.

This newsletter is about understanding how the system actually functions, where friction hides, and why some approaches compound over time while others don't.

If you're building, running, or participating in modern health in any real way, this layer matters more than most people realize.