Everyone has their own thoughts, here's my observations/experiences:
What was your Tirz dose?
I started Zep 12/12/25, I moved to compounded Tirz and was at 2.5mg 2x weekly until 1/10 when I moved to Reta. I took 7mg of Reta in total across 6 doses my first week. I've had 6 doses of Tirz since I started the bridge, totaling 14mg. I've had a total of 34 doses of Reta totaling 143mg. That averages 11.6mg/week with a chunk of that being getting my blood levels up using numerous small doses so I wouldn't overshoot and run into sides I had to wait out.
I moved to Reta for the GCGR signaling to boost BMR and presumptively spare lean mass better than Tirz.
GCGR signaling is dose dependent. Titrating Reta based on appetite/food noise is incorrect for reta, correct for Sema, Tirz, or Cagri. I titrated based on aversion to sides with the goal to get to or above 8mg/week levels for meaningful GCGR signaling.
I take Tirz PRN mainly to control food noise more so than hunger... my long term issue has been noise/brain side more than hunger/stomach side. I'll still take a bump if I expect the probability for trouble (like the 2.5mg dose in early March since I was traveling to either side of the country and back in 8 days).
Down 33lb since 1/10/25, 272lb to 239lb, practically all fat according to DEXA scans.
Had no meaningfully adverse sides.
Split dose, 2x weekly.
16mg/week with split dosing keeping my peaks only 15% higher than 12mg/once weekly (7mg 2x weekly has the same peaks).
RHR average hit a valley low of 58bpm on Tirz and is currently averaging 69-70bpm. This is inside my comfort level.
I don't expect 16mg to be magical over 12mg, but I do expect it to move my equilibrium point down ~10lb. That doesn't sound like much, but arguably that would be the hardest 10lb to lose. I chose to escalate my dose based on my sides and metrics including labs, fitness tracking, and sleep. I chose to do it now while I'm still resilient to the added stress vs later when systemic stress fatigue could be presenting.
Writing this post, I realized I failed to get labs on Lipase and Amylase to check my pancreas directly. My other labs suggest I'm doing fine, but gallstones/pancreatitis is my most likely hiccup. I'll get those labs drawn in the morning and report back if there's anything noteworthy.
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