Intro and pharmacokinetics:
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-1RA).  GLP-1Ras have been commercially available since 2005 with medications such as lixisenatide, exenatide, albiglutide, dulaglutide, and liraglutide.  Semaglutide was approved by the FDA for treatment of type 2 diabetes in 2017 (Ozempic) and for obesity management in 2021 (Wegovy).  Semglutide is currently the only GLP-1RA that is available in both a subcutaneously injectable and oral formulation.  
Semaglutide is structurally 94% homologous to native human GLP-1, with modifications at positions 8, 26, and 34 to prolong its half-life.  Semaglutide works by mimicking the GLP-1 hormone that causes your pancreas to release insulin, blocks your liver from making glucose, and slows down how quickly food leaves your stomach. It also works in the areas of the brain that regulate appetite and fullness. 
It has a mean time to reach maximum serum concentration (Tmax) of 36 hours (24-72 h) and a half-life (t ½) of 167±13.2 hours.  For this reason, it is typically dosed once weekly.
For comparison, naturally occurring GLP-1 has a half-life of approximately 2 minutes.

Dosing:
Dose Initial starting dose is 0.25mg/wk.  After that, the dose is increased to 0.5mg/wk.  The dose can be further increased to 1.0mg/wk and up based on an individuals response and speed of weight loss.
Oral semaglutide is administered once daily at doses of 7 and 14mg, with an initial introductory dose of 3mg for the first 30 days.

Side effects:
Side effects from semaglutide are usually rare and manageable, though can occur if the dose is advanced too rapidly.  This is why this medication is started at such a small dose to begin with.  
• nausea; 
• diarrhea; 
• constipation; 
• gas and bloating;
• fatigue
• pain where the medicine was injected.

In short:
In addition to reduced energy intake, likely mechanisms for semaglutide-induced weight loss included less appetite and food cravings, better control of eating and lower relative preference for fatty, energy-dense foods.  Essentially, when taking semaglutide, you don’t get hungry as often, you feel full quicker, and you have fewer cravings.
Average weight loss on semaglutide was 1-1.5 lbs per week.

Resources:
Tilinca MC, Tiuca RA, Niculas C, et al. Future perspectives in diabesity treatment: semaglutide, a glucagon‑like peptide 1 receptor agonist (Review). Exp Ther Med. 2021;22(open in a new window). doi:10.3892/etm.2021.10601
Lau J, Bloch P, Schäffer L, et al. Discovery of the once-weekly glucagon-like peptide-1 (GLP-1) analogue semaglutide. J Med Chem. 2015;58(open in a new window):7370–7380. doi:10.1021/acs.jmedchem.5b00726
Jensen L, Helleberg H, Roffel A, et al. Absorption, metabolism and excretion of the GLP-1 analogue semaglutide in humans and nonclinical species. Eur J Pharm Sci. 2017;104(open in a new window):31–41. doi:10.1016/j.ejps.2017.03.020
Blundell J, Finlayson G, Axelsen M, et al. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obes Metab. 2017;19(open in a new window):1242–1251. doi:10.1111/dom.12932
Nauck MA, Gallwitz B, Seufert J. Semaglutide- pharmacodynamic and pharmacokinetic characteristics of a new long-acting GLP-1-receptor agonist. Diabetol Stoffwechs. 2017;12(open in a new window):135–140. doi:10.1055/s-0043-104866


This is the monthly cost for our Semaglutide Weight Loss program.

Semaglutide "GLP-1 Injection" "Medical Weight Loss"

We have a great way to get ED medications cheaply, although it is a bit roundabout. We work with CostPlusDrugs, who will let you purchase 90 tablets for $15-20 total, which if you've ever bought ED meds before you'd know is crazy.  For us, we just charge $30 each time we send a script/refill Cialis as often as you run out (let us know), so that we can pay a provider to do it.

We have a great way to get ED medications cheaply, although it is a bit roundabout. We work with CostPlusDrugs, who will let you purchase 90 tablets for $15-20 total from them.

Cialis

For 0.2 mg/mL, 5 mL Vial: $95. For 1 mg/mL, 5 mL vial, $115. 

GONADORELIN injectable

If you're a member, this is free to send, simply message us from your profile. If you're not a member, this is the cost.

Once you pay this, we will contact you for the appropriate information needed via email.

If you're a member, this is free to send. If you're not a member, this is the cost.

Send a Local Lab Order

Expanded Deep Dive Testing Kit

 For most states: 24.25-25mg/daily 90 days: $335. 48.5mg-50mg/daily 90 days: $650.

Not available in AL, AK, AR, CT, GA, MS, MO, SC, NY, & TN 

Not available in all states, this is a 90 day supply.

Oxandrolone (Anavar)

This is our monthly cost for our Tirzepatide Weight Loss program. 

If you're already a TRT member, buying this will cause us to set up a free-consultation with you via email after.

If you're new to us & seeing this listing for the first time, instead get started here: https://www.alphamd.org/semaglutide

This is our monthly cost for our Tirzepatide Weight Loss program.

Tirzepatide "GLP-1 Injection" "Medical Weight Loss"

Basic Testosterone Testing Kit

Typically sent as a 3 month supply to take daily.

GONADORELIN RAPID DISSOLVE (SPEARMINT)

Oxytocin Nasal

In most states: 5ml 200mg/ml: $130, 10ml 200mg/ml: $170.

In AL, AK, AR, CT, GA, MS, MO, SC, NY, & TN: 5ml 200mg/ml: $215, 10ml 200mg/ml: $300.

Price may increase in certain states, but this is the most common.

Nandrolone (Deca-Durabolin)

We have a great way to get ED medications cheaply, although it is a bit roundabout. We work with CostPlusDrugs, who will let you purchase 90 tablets for $15-20 total, which if you've ever bought ED meds before you'd know is crazy. For us, we just charge $30 each time we send a script/refill Cialis as often as you run out (let us know), so that we can pay a provider to do it.

Viagra

SERMORELIN ("Next Generation" Ipamorelin / CJC-1295)

Human Chorionic Gonadotropin (hCG) is a luteinizing hormone (LH) analog.  This means that it attaches to the LH receptors, mimicking it’s function.  It has a much stronger binding affinity to the receptors than naturally occurring LH, which means that it will overcome any LH currently in the system.  It has a mean (± SD) time to reach maximum serum concentration (t max) of 20.78 ± 9.68 h, and the half‐life (t ½) was 33.55 ± 4.14 h.  For this reason, it is typically dosed 2-3 times weekly.

For comparison, the half life of naturally occurring LH is 25-30 minutes.

Dosing protocols vary, but studies show that weekly doses of hCG totaling 250-375IU/wk is enough to maintain ITT levels at 75% of normal, 93% of normal on 500-750IU/wk, and 126% of normal on 1500IU/wk.  All doses tested were enough to maintain fertility and prevent testicular atrophy while on TRT.

Interestingly, all studies on hCG have shown that loss of fertility and atrophy can be reversed even after years of solo TRT use.  This means that hCG does not have to be used for the entirety of the time a man is on TRT.  It can be added at any time with expected recovery of his baseline testicular function and fertility.

hCG is known to aromatize at a higher rate than exogenous testosterone.  The higher estradiol levels that can sometimes come with hCG use can lead to the following common side effects:
•	headache, depression;
•	feeling restless or irritable;
•	swelling;
•	breast tenderness or swelling; or
•	pain where the medicine was injected.

In short:
In the past, the thought was that luteinizing hormone was needed for testosterone production, and follicle stimulating hormone was needed for sperm production.  Newer studies have proven that the most important aspect of fertility and sperm production is not FSH levels, but intratesticular testosterone (ITT) levels.  Testosterone made outside of the testicles cannot enter the testicles, so the best way a man can maintain normal ITT levels (and therefore fertility) while on TRT is to add hCG.  
hCG is also used in assisting with recovery of testicular function in men who are stopping use of TRT or anabolic steroids.
It has also been used as a monotherapy to raise natural testosterone levels in men who are unable to use TRT.

Resources:
Low-dose human chorionic gonadotropin maintains ITT in normal men with testosterone-induced hypogonadism: https://pubmed.ncbi.nlm.nih.gov/15713727/
Prevention of azoospermia and maintenance of fertility in hypogonadal men on TRT with low dose: https://pubmed.ncbi.nlm.nih.gov/23260550/
Low levels of hCG increase ITT concentrations and serum testosterone levels: https://pubmed.ncbi.nlm.nih.gov/20484472/


Supply duration depends on dosing, includes injection supplies & shipping.

AlphaMD Shop

Semaglutide "GLP-1 Injection" "Medical Weight Loss"

Cialis

GONADORELIN injectable

Send a Local Lab Order

Expanded Deep Dive Testing Kit

Oxandrolone (Anavar)

Tirzepatide "GLP-1 Injection" "Medical Weight Loss"

Basic Testosterone Testing Kit

GONADORELIN RAPID DISSOLVE (SPEARMINT)

Oxytocin Nasal

Nandrolone (Deca-Durabolin)

Viagra

SERMORELIN ("Next Generation" Ipamorelin / CJC-1295)

HCG (Human Chorionic Gonadotropin)

Testosterone

AlphaMD Shop

Alpha MD Shop

Semaglutide "GLP-1 Injection" "Medical Weight Loss"

Cialis

GONADORELIN injectable

Send a Local Lab Order

Expanded Deep Dive Testing Kit

Oxandrolone (Anavar)

Tirzepatide "GLP-1 Injection" "Medical Weight Loss"

Basic Testosterone Testing Kit

GONADORELIN RAPID DISSOLVE (SPEARMINT)

Oxytocin Nasal

Nandrolone (Deca-Durabolin)

Viagra

SERMORELIN ("Next Generation" Ipamorelin / CJC-1295)

HCG (Human Chorionic Gonadotropin)

Testosterone