Dr.KarenChen said:

Back pain as a lean mass side effect: not from the medication itself, but from rapid body composition changes.

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 + 1.5g/kg protein. The lean mass discussion needs to include body comp data, not just scale weight.

Following on from Dr.KarenChen — and this may be the naive question:

How long did you give it before you decided it was working?

Dr.PathRoch said:

DEXA scan update relevant to lean mass: Scanned at months 0, 6, and 12.

Careful with the causal language. Two things moving together in a period when five things changed is not a mechanism, and stating it as one makes the thread less useful to somebody reading it later.

Happy to go further on any of that.

Dr.PathRoch said:

DEXA scan update relevant to lean mass: Scanned at months 0, 6, and 12.

True, and it depends on a baseline nobody has stated. Without knowing where someone started, the same number can be an excellent result or a disappointing one.

OP back with an update, since a thread like this is useless without one.

Reporting back for the archive rather than for the thread: I did the narrow version of what was suggested, gave it the full interval, and it settled. Posting it because threads without a follow-up are half a thread.