Expert Q&A

What's your pre-show drug of choice these days if you're on a GLP-1 like semaglutide or tirzepatide

Understanding Pre-Show Needs on GLP-1 Therapy

I've guided thousands through sustainable fat loss, especially those over 45 dealing with hormonal changes, joint pain, and failed diets. When clients use GLP-1 agonists like semaglutide or tirzepatide, their primary goal shifts from appetite control to preserving muscle and energy for competition or photoshoots. These medications reduce hunger dramatically but can lower energy, muscle glycogen, and metabolic rate if not managed correctly. Pre-show choices must avoid counteracting the GLP-1 benefits while supporting performance.

My Top Pre-Show Recommendation: Low-Dose Caffeine with Beta-Alanine

For most clients on 1.0-2.4mg weekly semaglutide or 5-15mg tirzepatide, my go-to is 100-150mg caffeine paired with 2-3g beta-alanine taken 45 minutes before stage or training. This stack provides clean energy without the jitters common in higher doses. Caffeine improves focus and fat oxidation by 10-15% during low-calorie phases, while beta-alanine buffers lactic acid, crucial when joint pain limits intense workouts. In my methodology outlined in "Sustainable Fat Loss After 40," I emphasize keeping stimulants minimal to protect sleep, which is already disrupted by hormonal shifts in perimenopausal and diabetic clients.

Alternatives and What to Avoid

Some prefer 200mg theacrine or 50mg synephrine as milder options that don't spike blood pressure, important for those managing diabetes alongside weight. I never recommend high-dose ephedrine or DNP on GLP-1s; these can dangerously suppress appetite further and strain the cardiovascular system. Yohimbine at 5-10mg works for stubborn fat but only in fasted morning sessions and never near bedtime. Always monitor blood glucose—tirzepatide users see greater insulin sensitivity, so pair any stimulant with 10-15g electrolytes to prevent cramps.

Integration with Your Daily Protocol

Combine your pre-show choice with 1.6-2.2g protein per kg bodyweight and resistance training 3-4 times weekly, even if joint pain makes it feel impossible. Start with bodyweight or resistance bands. Track waist measurements weekly rather than scale weight, as GLP-1s cause rapid initial loss that slows. Most clients lose 1-2lbs weekly sustainably when following this approach. Consult your physician before adding any compound, especially with blood pressure medications. This isn't about shortcuts but protecting the metabolic health you've rebuilt after years of yo-yo dieting.

💬 What the Community Says

The community shows cautious optimism around combining mild stimulants with GLP-1s like semaglutide and tirzepatide for pre-show prep. Many in the 45-55 age group report that low-dose caffeine plus beta-alanine gives steady energy without wrecking sleep or raising blood pressure, which is a common fear. A significant portion shares success stories of maintaining muscle on 10mg tirzepatide by adding electrolytes and theacrine, though some warn about increased heart rate during final contest cuts. Debates often center on avoiding anything that further kills appetite, with users swapping experiences about yohimbine for lower belly fat versus its side effects. Beginners frequently ask about joint-friendly alternatives, noting that while insurance rarely covers these protocols, most feel the combination helps them push through when every other diet has failed. Overall, lived experiences highlight careful titration and medical supervision as essential.
Cite this answer
Clark, R. (2026). What's your pre-show drug of choice these days if you're on a GLP-1 like semaglu. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/what-s-your-pre-show-drug-of-choice-these-days-if-you-re-on-a-glp-1-like-semaglutide-or-tirzepatide
Russell Clark, FNP-C, APRN, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

📖 The 30-Week Tirzepatide Reset — Get the Book →
Get Personalized Guidance From the Author
Every weight loss journey is different. Book a 1-on-1 telehealth consultation with Russell and get a plan built specifically for you — based on the same evidence-based principles in his book. Available to patients in all 50 states.
Book Your Consultation →
Have a follow-up question?
More Questions 200 answered
▸ Why is my face more bulky and blocky on a ketogenic diet — how a functional medicine approach differs during the weight loss plateau phase? ▸ How did you stop your health anxiety — what do certified weight loss coaches recommend specifically for women over 40? ▸ What to expect on 50mg of Spironolactone for long-term maintenance (not just short-term): best practices and common mistakes to avoid? ▸ How I cured my bad breath. Especially helpful for people with sinus issues: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? 📖 Metabolic Stall — A plateau in weight loss often caused by hidden inflammation or hormonal adaptation, which we break using our specific 7… ▸ How do you guys manage stress — what does the research actually say: best practices and common mistakes to avoid? ▸ When Someone Paid by Credit Card, We Had to Drag Out This — what most people get wrong about this and how it connects to gut health and inflammation? ▸ Where to go from here? I lost 13kg on mounjaro, but I am doing the rest naturally. Advice? :) — what does the research actually say: best practices and common mistakes to avoid? ▸ Is there such a thing as eating too much fish fat for weight loss — what do certified weight loss coaches recommend while doing intermittent fasting? 📖 Hormonal Chaos — The internal state of imbalance caused by modern grains and refined carbs that overrides willpower and forces the body t… 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Can Maintenance Phase do an episode about pregnancy weight gain — what do certified weight loss coaches recommend if you're on a GLP-1 like semaglutide or tirzepatide? ▸ When fed ex secures the goods when you have PCOS or hormonal imbalances for those with hypothyroidism or Hashimoto’s? ▸ Gluten. I love it. How long to find out if it hates me: best practices and common mistakes to avoid if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Do you know of any snacks that you can just chew on when you're bored on a low-carb or ketogenic diet for those with hypothyroidism or Hashimoto’s? ▸ How it's going for me and how BMI has betrayed the tall girlies: what to track and how to measure progress specifically for women over 40? ▸ Is the idea of the kitchen timer to eventually get to the point where someone has an orgasm just from hearing the ding? Pavlov's orgasm and the role of cortisol and stress hormones while doing intermittent fasting? ▸ Weird psychological side effect — nausea triggered by the pen/alcohol smell when you have PCOS or hormonal imbalances for long-term maintenance (not just short-term)? 📖 Lectin-Free Living — Eliminating inflammatory plant proteins that damage the gut lining and trigger the autoimmune responses that often stall… ▸ How do you stop the "I already messed up today" spiral while doing intermittent fasting during the weight loss plateau phase? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Anyone else feel this way and the role of cortisol and stress hormones for those with hypothyroidism or Hashimoto’s? ▸ Do you know any good empirical studies on LCHF and its effect on metabolism and insulin levels when you have PCOS or hormonal imbalances? ▸ Lost weight then gained it back on keto: what to track and how to measure progress specifically for women over 40? ▸ I lost 100#s using cutting calories and exercising, 10 to 15,000 steps, and I soon plateaued and I was so hungry. 📖 Non-Scale Victories (NSV) — Improvements in energy, sleep, and disease reversal that matter just as much as the numbers on the scale during your tra… ▸ What to do with mg PCOS + Questions and how it connects to gut health and inflammation and how it connects to gut health and inflammation? ▸ Have you switched from Semaglutide to Tirzapatide? How was it: best practices and common mistakes to avoid specifically for women over 40? ▸ Depressive symptoms from non-stick air fryer — what do certified weight loss coaches recommend if you're on a GLP-1 like semaglutide or tirzepatide? ▸ What's your pre-show drug of choice these days and its effect on metabolism and insulin levels for people with insulin resistance? 📖 Inflammatory Markers — Clinical indicators like CRP that we monitor to ensure the body is moving from a state of disease to a state of vibrant … 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Not a whingeing post. Just looking for some guidance.. I started IF with great success. I felt energised & found making note of the fasting stages really motivational. I had a break from IF: how to talk to your doctor about this for people with insulin resistance? ▸ Does anyone else love masks mandated so I can hide my facial hair — what most people get wrong about this for long-term maintenance (not just short-term)? ▸ “You shouldn’t feel anything” while doing intermittent fasting specifically for women over 40? ▸ For those who took metformin, how soon did you see benefits: best practices and common mistakes to avoid on a low-carb or ketogenic diet? 📖 Phase 2: Aggressive Loss — A 40-day window of focused fat loss supported by low-dose medication and a specific lectin-free, low-carb nutritional fr… ▸ Paleo brownies/sweets that ship all over usa: how to talk to your doctor about this for long-term maintenance (not just short-term)? ▸ Being underweight, panic and anxiety. Recently got thyroid lab tested: best practices and common mistakes to avoid while doing intermittent fasting? ▸ How a few gut-focused changes (extra virgin olive oil, enzymes, and more) quietly transformed my health — what most people get wrong about this while doing intermittent fasting? ▸ Gaining tons of weight but normal levels — what does the research actually say — what the research actually says? ▸ Dark(ish) areas for stargazing during the weight loss plateau phase specifically for women over 40? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ How the heck do people with health anxiety handle anxiety med side effects: what to track and how to measure progress for people with insulin resistance? ▸ Why does keto hurt my stomach 😞 for people with insulin resistance and its effect on metabolism and insulin levels? 📖 Metabolic Efficiency — The state where your body processes fuel cleanly and maintains high energy levels without the need for constant snacking… ▸ Is there anyone who drink coffee after fatty carnivore meal — how a functional medicine approach differs and its effect on metabolism and insulin levels? ▸ Frustrated with lack of progress. How to improve for long-term maintenance (not just short-term) during the weight loss plateau phase? ▸ How did you stop your health anxiety — what do certified weight loss coaches recommend — what the research actually says? ▸ Is the carnivore diet the best WOE to lose weight while doing intermittent fasting during the weight loss plateau phase? 📖 Gut-Brain Axis — The complex communication network between your digestive system and your brain that controls satiety, mood, and metaboli… ▸ Can sugar free candy make a difference and how it connects to gut health and inflammation when you have PCOS or hormonal imbalances? ▸ When I want to lose weight fast I fast while doing intermittent fasting? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Stacking NMN with TMG, what's your morning fasted protocol look like for people with insulin resistance while doing intermittent fasting? ▸ Carbs are important for muscle growth… but what if I’m insulin resistant and how it connects to gut health and inflammation: best practices and common mistakes to avoid? ▸ One Medical for Lilly Direct on a low-carb or ketogenic diet during the weight loss plateau phase? ▸ When fed ex secures the goods when you have PCOS or hormonal imbalances for long-term maintenance (not just short-term)? 📖 Autophagy — The body's natural 'housecleaning' process that occurs during fasting or low-insulin states, promoted during our mainten… ▸ Can anyone help me with my pelvic ultrasound results ? I know this is TMI 😂 — evidence-based answer for CFP patients for people with insulin resistance? ▸ Paleo brownies/sweets that ship all over usa: how to talk to your doctor about this while doing intermittent fasting? ▸ What is a ‘normal’ value for dawn phenomena for you — how a functional medicine approach differs specifically for women over 40? ▸ Anybody else feel like this — what does the research actually say and its effect on metabolism and insulin levels? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ How I cured my bad breath. Especially helpful for people with sinus issues: what to track and how to measure progress: what to track and how to measure progress?