Itching, nausea

Strawberrykitten

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I recently switched to tirz from Nexph and increased dosage to 10mg. Before that I was with Brello and actually saw no weight loss, no appetite suppression, lots of Sulphur burps ..etc

I took 3 weeks of 10 mg but week 2 and 3 has been terrible. The injection site gets inflamed and itchy. My whole body is super itchy, I have zero appetite. I'm forcing myself to eat a little but the nausea is so bad that I can only take a few bites. My entire body is just aching and all my joints hurt. This seems so weird. I'm thinking of lower the dosage but what else could I do?

I have PCOS and prediabetic so I'm trying to get it to help with other issues as well.
I would appreciate some insight. Thanks!
 
Strawberrykitten said:
I recently switched to tirz from Nexph and increased dosage to 10mg. Before that I was with Brello and actually saw no weight loss, no appetite suppression, lots of Sulphur burps ..etc

I took 3 weeks of 10 mg but week 2 and 3 has been terrible. The injection site gets inflamed and itchy. My whole body is super itchy, I have zero appetite. I'm forcing myself to eat a little but the nausea is so bad that I can only take a few bites. My entire body is just aching and all my joints hurt. This seems so weird. I'm thinking of lower the dosage but what else could I do?

I have PCOS and prediabetic so I'm trying to get it to help with other issues as well.
I would appreciate some insight. Thanks!
Click to expand...
It's a long shot but you may also want to have your thyroid checked if possible.

And tirz is tirz no matter whether you obtained it from Brello or Nexaph. Poptart is correct in asking about your previous dosing schedule. How much were you dosing before and for how long?
 
Last edited:
Strawberrykitten said:
I recently switched to tirz from Nexph and increased dosage to 10mg. Before that I was with Brello and actually saw no weight loss, no appetite suppression, lots of Sulphur burps ..etc

I took 3 weeks of 10 mg but week 2 and 3 has been terrible. The injection site gets inflamed and itchy. My whole body is super itchy, I have zero appetite. I'm forcing myself to eat a little but the nausea is so bad that I can only take a few bites. My entire body is just aching and all my joints hurt. This seems so weird. I'm thinking of lower the dosage but what else could I do?

I have PCOS and prediabetic so I'm trying to get it to help with other issues as well.
I would appreciate some insight. Thanks!
Click to expand...
Can you also share your math involved? What MG was previous vial, what MG current vial is? How much BAC did you use to reconstitute?
 
I get localized redness and itchy spot from tirz pin, saw suggested elsewhere to try Flonase topically and it does work much better than topical benadryl. Hope you are feeling better soon. xox
 
Strawberrykitten said:
I recently switched to tirz from Nexph and increased dosage to 10mg. Before that I was with Brello and actually saw no weight loss, no appetite suppression, lots of Sulphur burps ..etc

I took 3 weeks of 10 mg but week 2 and 3 has been terrible. The injection site gets inflamed and itchy. My whole body is super itchy, I have zero appetite. I'm forcing myself to eat a little but the nausea is so bad that I can only take a few bites. My entire body is just aching and all my joints hurt. This seems so weird. I'm thinking of lower the dosage but what else could I do?

I have PCOS and prediabetic so I'm trying to get it to help with other issues as well.
I would appreciate some insight. Thanks!
Click to expand...
What you’re describing goes wayyyyyy beyond typical GLP-1 side effects...... especially the full-body itching, inflamed injection sites, body/joint aches, and severe nausea with inability to eat. I would not push through that.
I'm guessing two very important things going on.....
  • Dose intolerance; 10mg is too high for you
  • A sensitivity/inflammatory reaction, you may be triggering inflammatory cytokines
I would not continue at 10 mg.
You can either pause or drop to a much lower dose.
Either pause until symptoms settle or drop to a much lower dose. For PCOS and prediabetes, consistency and tolerability matter more than high dosing, appetite suppression isn’t the goal, metabolic stability is.

If it was me, I would pause and let your immune system reset before restarting lower.

In the meantime, hydrate, use electrolytes, eat small protein-based meals, and consider antihistamine support. If itching, injection site reactions, or body aches persist even after pausing, I would let your doc know right away.

Bottom line: your body is giving you VERY real signals.
 
PopTart said:
What has been your dosing history so I can better understand your rate of titration?
Click to expand...
I followed the regular protocol of 2.5, 5, 7.5 (each dose I stayed on it for 4 weeks). I bought the 60 mg dose from Nexaph and used 3 ML of BAC water so I could have 6 (10 mg doses). I only used it 3 times (my husband uses it along with me and he hasn't had any issues. )

I had issues with itching all over before I started this but it was always associated with sugar consumption. Now that I have no cravings I''m not sure why the itching is coming back. It's worst when I first wake up in the morning. I've had all my lab work done. I see an endocrinologist and had my thyroid checked and it's all normal. The only issue I have is my CRP levels are high but so far no one has been able to figure out what's causing it.

I've had all kinds of issues since I started (when I first started at 2.5 mgs - my periods were lasting all month long, I was told it's normal and things are regulating. Weight loss wasn't the goal for me so at first I saw no weight loss but i was hoping things were regulating. I don't know what's going on. I've done all the testing that can be done and no one has any answers for me. Meanwhile, the fatigue is so intense, I'm sleeping for 20 hours in a day and not being able to function.
 
Strawberrykitten said:
I've had all kinds of issues since I started (when I first started at 2.5 mgs
Click to expand...
I would heed Jfrick11’s advice. There’s no sense in punishing yourself, and perhaps making matters worse, if your body is telling you otherwise. Other options you might want to consider are to drop the tirz and switch to reta or figure out how to obtain metabolic stability without GLP-1s.
 
Strawberrykitten said:
I followed the regular protocol of 2.5, 5, 7.5 (each dose I stayed on it for 4 weeks). I bought the 60 mg dose from Nexaph and used 3 ML of BAC water so I could have 6 (10 mg doses). I only used it 3 times (my husband uses it along with me and he hasn't had any issues. )

I had issues with itching all over before I started this but it was always associated with sugar consumption. Now that I have no cravings I''m not sure why the itching is coming back. It's worst when I first wake up in the morning. I've had all my lab work done. I see an endocrinologist and had my thyroid checked and it's all normal. The only issue I have is my CRP levels are high but so far no one has been able to figure out what's causing it.

I've had all kinds of issues since I started (when I first started at 2.5 mgs - my periods were lasting all month long, I was told it's normal and things are regulating. Weight loss wasn't the goal for me so at first I saw no weight loss but i was hoping things were regulating. I don't know what's going on. I've done all the testing that can be done and no one has any answers for me. Meanwhile, the fatigue is so intense, I'm sleeping for 20 hours in a day and not being able to function.
Click to expand...
Thank you for explaining more, that helps a lot. Based on everything you’re describing, this really doesn’t sound like a simple or “normal” GLP-1 adjustment issue.

A few important things stand out:
  • You already had baseline itching and elevated CRP, which points to an underlying inflammatory or histamine-driven process.
  • Tirzepatide can amplify inflammation or histamine responses in some people, even when standard labs (thyroid, etc.) look normal.
  • The extreme fatigue (sleeping up to 20 hours/day), body aches, and worsening itching are not typical and not something to push through.
  • The prolonged bleeding early on suggests your system was under significant stress from the start.
One important thing I want to say clearly: it is not actually a requirement or “rule” to increase the dose every month. Increasing monthly often means forcing more medication when the body may not need it or tolerate it, especially when weight loss isn’t the only goal.

For PCOS and metabolic regulation, the right dose is the lowest dose that improves labs and symptoms, not the highest tolerated dose. Appetite suppression is not the goal, stability is.

Given how systemic and disabling these symptoms are, I would strongly consider stopping the medication entirely for now, not just lowering the dose, and allowing a full reset. If symptoms improve off it, that’s critical information. If they don’t, it suggests something else inflammatory is driving this that the medication is worsening or unmasking.

Even though your husband is doing fine, bodies can react very differently, especially with PCOS and baseline inflammation.

You’re not doing anything wrong, and you’re not imagining this. Your body is giving clear signals that something here isn’t right, and listening to that is the smart move.
 
Also, just confirming you took into account the COA fill volume, not the ordering 60mg for that vial? Nexa's vials are almost always overfilled, so if you were just titrating up to 10mg for the first time (after weeks at 7.5) and there was overfill not accounted for in your dosing, you actually took more than that 10gm, which is a bit of a jump.
 
I would like to second the recommendation to stop the tirzepatide for now at least. It sounds from your symptoms that there is something going on, ( the high crp says there is inflammation somewhere ) and given that you have been looked at by a doctor and had some blood tests done they are not sure what is going on. I do not know how recent this was, if not recent ( week or two? ) then you need to get checked out again. This is really not rare at all, sometimes things are hard to diagnose, and sometimes perfectly competent doctors cannot work out what is going on. The important thing in those situations is getting reviewed regularly, over time a clearer picture will emerge or a test will give some useful answers or even better it will just get better on its own, without ever having an answer, which is frustrating but still a very good outcome.

If you stop the tirzepatide you can at least separate out any effects it is having in causing your symptoms, from whatever might be going on underneath, and make it easier to work out what is the underlying problem. If you are concerned that you are not well and your doctor is missing something or not as competent as you would like, then getting a second opinion on your symptoms is reasonable, but it is going to be very difficult from a medical perspective to work anything out if some or all of the symptoms might be coming from grey market peptides. The first thing they are going to blame for non specific systemic inflammation is the grey market or compounded peptides if you are still taking them , assuming you tell them, and in this situation not disclosing that kind of information makes their job harder.
 
Also if you have had an extended period of PV bleeding and are very tired, you need to have a blood count and iron levels checked, unless it has been done in the past few weeks. Iron deficiency sounds very likely in this situation.
 
Strawberrykitten said:
I recently switched to tirz from Nexph and increased dosage to 10mg. Before that I was with Brello and actually saw no weight loss, no appetite suppression, lots of Sulphur burps ..etc

I took 3 weeks of 10 mg but week 2 and 3 has been terrible. The injection site gets inflamed and itchy. My whole body is super itchy, I have zero appetite. I'm forcing myself to eat a little but the nausea is so bad that I can only take a few bites. My entire body is just aching and all my joints hurt. This seems so weird. I'm thinking of lower the dosage but what else could I do?

I have PCOS and prediabetic so I'm trying to get it to help with other issues as well.
I would appreciate some insight. Thanks!
Click to expand...
I am not a doctor nor do I have any medical training. I am just a mom in her 50s .. that being said .. It sounds to me that you have a contamination issue based on your symptoms. If it were me I would set the current batch aside and mix a new one up using fresh equipment being extra careful about cleanliness.

Now, I don't know what your current finances look like and maybe fresh equipment isn't in the cards .. if that is the case then at the very least boil your stuff or soak it in alcohol. Do what you can to safely disinfect. If the contents of your current vial is contaminated then I am afraid that there is no hope of saving it. Throw it away if making a new batch fixes the issue.
 
lessthanhalf said:
Also if you have had an extended period of PV bleeding and are very tired, you need to have a blood count and iron levels checked, unless it has been done in the past few weeks. Iron deficiency sounds very likely in this situation.
Click to expand...
I have seen a hematologist and got an iron infusion. I am no longer anemic based on the lab work done.
I've seen a sleep specialist and put on a cpap, I've seen gastro doc -done endo and colonoscopy, seen endocrinologist (checked for everything including cushings and have all normal labs), I'm seeing a 2nd obgyn now for the prolonged bleeding (it's been going on for 5 years) So I started taking the tirze as a last ditch effort to improve my insulin resistance issues. I've done gut detoxes, whole 30 diets..etc and with removing certain foods from my diet, I'm having more and more intolerances - can't eat gluten, dairy, pork..etc.
I've told every doc I'm on tirz (initially compounded from Brello so it wasn't grey market) and none of them thought it could be the cause.
 
Jfrick11 said:
Thank you for explaining more, that helps a lot. Based on everything you’re describing, this really doesn’t sound like a simple or “normal” GLP-1 adjustment issue.

A few important things stand out:
  • You already had baseline itching and elevated CRP, which points to an underlying inflammatory or histamine-driven process.
  • Tirzepatide can amplify inflammation or histamine responses in some people, even when standard labs (thyroid, etc.) look normal.
  • The extreme fatigue (sleeping up to 20 hours/day), body aches, and worsening itching are not typical and not something to push through.
  • The prolonged bleeding early on suggests your system was under significant stress from the start.
One important thing I want to say clearly: it is not actually a requirement or “rule” to increase the dose every month. Increasing monthly often means forcing more medication when the body may not need it or tolerate it, especially when weight loss isn’t the only goal.

For PCOS and metabolic regulation, the right dose is the lowest dose that improves labs and symptoms, not the highest tolerated dose. Appetite suppression is not the goal, stability is.

Given how systemic and disabling these symptoms are, I would strongly consider stopping the medication entirely for now, not just lowering the dose, and allowing a full reset. If symptoms improve off it, that’s critical information. If they don’t, it suggests something else inflammatory is driving this that the medication is worsening or unmasking.

Even though your husband is doing fine, bodies can react very differently, especially with PCOS and baseline inflammation.

You’re not doing anything wrong, and you’re not imagining this. Your body is giving clear signals that something here isn’t right, and listening to that is the smart move.
Click to expand...
Thanks for the input. I plan to stop for a bit and see what happens. In the meantime, I really don't know what to do. This was kind of a last minute resort on my part because I've been having issues for over 5 years and it's just getting worse. I've seen so many doctors and no one has been able to give me any answers. They just tell me to come back n 6 months.
 
Strawberrykitten said:
Thanks for the input. I plan to stop for a bit and see what happens. In the meantime, I really don't know what to do. This was kind of a last minute resort on my part because I've been having issues for over 5 years and it's just getting worse. I've seen so many doctors and no one has been able to give me any answers. They just tell me to come back n 6 months.
Click to expand...
I’m really sorry you’re dealing with this. I can hear how frustrated and worn down you are, especially after trying for so long and not getting real answers. 😢
I truly think stopping for a bit and letting your immune system and hormones calm down is the right move. Sometimes pushing harder just makes things worse, even when the medication can be helpful for PCOS in the long run.
If you do decide to try GLP-1s again later, I’d really suggest low and slow...... like a crawl. Tiny dose, long time between increases, and focusing on metabolic stability instead of rushing results.
I know it feels hopeless when doctors just say “come back in 6 months,” but you deserve someone to really look deeper. Even taking this pause is information about what your body needs right now.
You’re not broken, and you’re not out of options. This just might be a season where rest and stabilization come first. 😊
 
OP I'm just going to hop in here and point out what's already been mentioned:

Nexa vials are always overfilled. Sometimes a little (my 6 mg Reta was 6.54), sometimes a moderate amount (my 60 mg Tirz was 65.xx) and possibly a lot (100mg GHK-cu was 150; I know GHK is a notorious overfiller but point is still there).

Please look at the COA for that batch. You could potentially be pushing 12 mg with a 3 ml recon. I also think you should just stop Tirz for the time being, but the concentration is worth investigating.
 
Not_Your_Dad said:
OP I'm just going to hop in here and point out what's already been mentioned:

Nexa vials are always overfilled. Sometimes a little (my 6 mg Reta was 6.54), sometimes a moderate amount (my 60 mg Tirz was 65.xx) and possibly a lot (100mg GHK-cu was 150; I know GHK is a notorious overfiller but point is still there).

Please look at the COA for that batch. You could potentially be pushing 12 mg with a 3 ml recon. I also think you should just stop Tirz for the time being, but the concentration is worth investigating.
Click to expand...
My Reta 48 kit I got from them was actually Reta 58! Thank god my first pin was only 1 mg before I got the COA.
 
Strawberrykitten said:
I just checked and it was 65 so it was probably more than I could handle. I'm just going to stop for now and try to see how I feel.
Click to expand...
That 65 almost had you skipping your 10 mg pin and going right to 12.5. It sounds like you might be sensitive to the higher doses of Tirz anyway and that was a large step.

Hope you get better soon!
 
Strawberrykitten said:
I followed the regular protocol of 2.5, 5, 7.5 (each dose I stayed on it for 4 weeks). I bought the 60 mg dose from Nexaph and used 3 ML of BAC water so I could have 6 (10 mg doses). I only used it 3 times (my husband uses it along with me and he hasn't had any issues. )

I had issues with itching all over before I started this but it was always associated with sugar consumption. Now that I have no cravings I''m not sure why the itching is coming back. It's worst when I first wake up in the morning. I've had all my lab work done. I see an endocrinologist and had my thyroid checked and it's all normal. The only issue I have is my CRP levels are high but so far no one has been able to figure out what's causing it.

I've had all kinds of issues since I started (when I first started at 2.5 mgs - my periods were lasting all month long, I was told it's normal and things are regulating. Weight loss wasn't the goal for me so at first I saw no weight loss but i was hoping things were regulating. I don't know what's going on. I've done all the testing that can be done and no one has any answers for me. Meanwhile, the fatigue is so intense, I'm sleeping for 20 hours in a day and not being able to function.
Click to expand...
Side effects were very similar during my first 12 weeks of compounded T. Intense itching and welts on my torso esp where my skin was compressed by waistband and bra strap. Severe fatigue and sleepiness and hair loss. Constipation, no appetite, yet minimal weight loss. Dermatologist was unable to diagnose, but gave me 2 weeks of anti-histamine and prednisone, a miracle drug that seemed to solve everything. But, once my bowel function resumed, I had rapid weight loss!!! Retrospectively, I believe my adipose was transformed to a massive circulating volume of free fatty acids in my bloodstream that were being excreted through my lungs, kidneys, bowels and SKIN ! Hence the “ketosis rash!” What gave me relief: soaking/scrubbing in the bathtub’s hottest water, topical Vaseline, then aerobic bicycling 60 minutes, Vitamin C megadoses, NSAIDs, and anti-histamine pills. Since that time I’ve reached my goal weight and experienced reversal of co-morbidities and side-effects, so I’m at a lower dose of T to sustain my appetite suppression. I believe the ketone bodies irritated the pores of my skin most severely where it was compressed by my clothing.

Yet, I’m so glad I continued my GLP despite these side effects. A slower dose titration would have been better tolerated, for sure. It’s likely that my dosage titration was too fast for my body’s metabolic changes. If I had recognized the signals my body was giving, I could have reduced or avoided my discomforts.
 
Thanks for the medical info update. It sounds like you have enough doctors looking after you, it is really hard to guess at what is going on with a tiny percentage of the full story on a forum. Unfortunately not all medical issues have straightforward diagnoses and treatments that always work, and everyone just has to muddle along as best they can. But most problems do get better over time. I would still be inclined to stop the tirzepatide for a while at least to try to separate out if it is causing some of the tiredness etc. I certainly had nausea and a low grade generally unwell feeling for about a year on semaglutide, which thankfully I don't get on tirzepatide, but side effects seem very variable and individual. And if and when you want to restart it going extra low and slow with dosing would be a good idea.
 
Good-Heart6425 said:
Side effects were very similar during my first 12 weeks of compounded T. Intense itching and welts on my torso esp where my skin was compressed by waistband and bra strap. Severe fatigue and sleepiness and hair loss. Constipation, no appetite, yet minimal weight loss. Dermatologist was unable to diagnose, but gave me 2 weeks of anti-histamine and prednisone, a miracle drug that seemed to solve everything. But, once my bowel function resumed, I had rapid weight loss!!! Retrospectively, I believe my adipose was transformed to a massive circulating volume of free fatty acids in my bloodstream that were being excreted through my lungs, kidneys, bowels and SKIN ! Hence the “ketosis rash!” What gave me relief: soaking/scrubbing in the bathtub’s hottest water, topical Vaseline, then aerobic bicycling 60 minutes, Vitamin C megadoses, NSAIDs, and anti-histamine pills. Since that time I’ve reached my goal weight and experienced reversal of co-morbidities and side-effects, so I’m at a lower dose of T to sustain my appetite suppression. I believe the ketone bodies irritated the pores of my skin most severely where it was compressed by my clothing.

Yet, I’m so glad I continued my GLP despite these side effects. A slower dose titration would have been better tolerated, for sure. It’s likely that my dosage titration was too fast for my body’s metabolic changes. If I had recognized the signals my body was giving, I could have reduced or avoided my discomforts.
Click to expand...
Everything you are describing here is pretty much what I'm going through minus constipation. I think I'm not constipated because of the magnesium glycinate I take every night. The itching is intense when I undress so that makes sense. I'm going to take a break for a few weeks though because I just feel like junk right now, I'll have to try back at a lower dose and see how I do. Thanks again for sharing
 
Strawberrykitten said:
Everything you are describing here is pretty much what I'm going through minus constipation. I think I'm not constipated because of the magnesium glycinate I take every night. The itching is intense when I undress so that makes sense. I'm going to take a break for a few weeks though because I just feel like junk right now, I'll have to try back at a lower dose and see how I do. Thanks again for sharing
Click to expand...
I think the uticaria [“ketosis rash”] is considered to be very rare. My skin type is very pale, never tans, no melanin, aka FitzPatrick one. Dermatologist did not recognize my symptoms, but I did not share my recent history of months of self injected T. That was >6 months ago. Still taking daily low dose of antihistamine . Now have titrated down to maintenance T dose for appetite suppression
 
Strawberrykitten said:
Everything you are describing here is pretty much what I'm going through minus constipation. I think I'm not constipated because of the magnesium glycinate I take every night. The itching is intense when I undress so that makes sense. I'm going to take a break for a few weeks though because I just feel like junk right now, I'll have to try back at a lower dose and see how I do. Thanks again for sharing
Click to expand...
Additionally, my belief is that similar to my torso skin, my scalp pores were irritated by the exiting ketone bodies as well. A lot of hair fell out . Now it’s growing back ; hooray,farewell alopecia!
 
Good-Heart6425 said:
I think the uticaria [“ketosis rash”] is considered to be very rare. My skin type is very pale, never tans, no melanin, aka FitzPatrick one. Dermatologist did not recognize my symptoms, but I did not share my recent history of months of self injected T. That was >6 months ago. Still taking daily low dose of antihistamine . Now have titrated down to maintenance T dose for appetite suppression
Click to expand...
Well I'm Indiam so lots of melanin and I've brown skin so that's not similar
 
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