Is titrating up too fast unsafe?

[dolph]

This is EXACTLY the compulsive behavior I want to change by taking Tirz. Soooo you're gonna stop overeating by overmedicating? You'll find that the efficacy drops sooner than the lbs and then I guess you'll just add more meds and be the guy in here saying I take max dose of Reta and Tirz together and now I also take these 6 other peps too. Why man? WHY???? Slow and steady will work to get it off just like it did to put the lbs on. Doesn't sound right to say I'm gonna increase until I'm sick and that will tell me when to stop. Bad plan that will yield bad results.

One new guy to another...RESTRAIN YOURSELF! I just took shot 6 Wednesday of Tirz. I'm at .50 and I've lost 26lbs in the past 5wks by changing the way I think and what I put in my mouth. I haven't even started working out yet. I'm a big guy too. Started at 386lbs and I'm now 360lbs and I'm 55yrs old and 6'2". My habits have changed and my mentality has too. That is the true accomplishment. Binge pinning is likely just as bad as binge eating. Change your thinking and you will safely go through this process and never go back to the old ways of viewing food and thinking more is better with everything.

All future dosages will be side effect dependent.
So far, zero. I'll change course if need be.

RS has lost over 100lbs in the past with Keto, intermittent fasting, sometimes week long fasting and OMAD and kept it off for about 5 years.

This may seem compulsive to you but this is methodical in my eyes.

 

[ColdSmoke]

I'll be increasing until there are symptoms in the RS.

Week 1: 2mg
Week 2: 2mg
Week 3: 4mg
Week 4: 4mg

Planned
Week 5: 6mg
Week 6: 6mg
Week 7: 6mg
Week 8: 8mg
Week 9: 8mg
Week 10: 8mg
Week 11: 8mg
Week 12: 8mg
Week 13: 10mg
Week 14: 10mg
Week 15: 12mg & continue indefinitely

View attachment 27283

That’s not how this works

 

[bogardbilla]

Reality is going to hit you like a train unless you're like 600lbs.

I don't think it necessarily will. My personal experience (6'5 male, ~330lbs starting weight) on this titration schedule:

Week 1: 1mg
Week 2: 2mg
Week 3: 4mg
Week 4: 6mg

I continued on 6mg for months on end, somewhat recently climbed up to 7.5mg weekly simply because I bought 30mg vials and 30/4=7.5.

The only side effects I've had were very slight constipation for about two weeks, nothing even close to dubious horror stories on Reddit, as well as a noticeable skin sensitivity in the upper arms that disappeared after about a month. Again, nothing catastrophic, but most importantly nothing worth reporting on Reddit and enjoying stranger sympathy either.

 

[birdwhacker]

I continued on 6mg for months on end, somewhat recently climbed up to 7.5mg weekly simply because I bought 30mg vials and 30/4=7.5.

Gahdamn. And this was your first time taking a GLP med?

Here I am at 4.66mg/wk in month 3 and having to bring the dose down after 6 weeks on.

 

[ContainHer]

The medicine has to build. You should stay at 2mg for 30 days. This is not cocaine.

"This is not cocaine"
This sent me into hysterics - and then I realized how boring I've become.

 

[dolph]

That’s not how this works

Well, that's how it's worked so far and RS is down 22lbs in 7 weeks.
I'm not trying to be bold or daring. I'm just saying that is my plan until it's not.

Also walking at least a mile every day, some weight training and changed eating habits.

 

[BNLFL]

That’s not how this works

Some just know everything.

 

[Skidude]

It has been my experience that so many people respond differently that you cant really know when you need to go up until it is time.
I hope this works out for you, but there is also something to be said about not losing too fast.

Marathon runners don't start off in a sprint.

 

[bogardbilla]

Gahdamn. And this was your first time taking a GLP med?

Yep, I've only ever taken Reta.

 

[birdwhacker]

Yep, I've only ever taken Reta.

Built different as fuck 💪🏻💪🏻💪🏻

Can I ask how heavy you were? Are you samoan by chance?

 

[Don]

I would build up slowly. You’re just gonna run into more side effects and less benefit honestly.

Let the drug slowly build up in your system. You can even pin every 5 days, even if the half-life is 6 days, as long as you keep the weekly dose average the same. For example, if you want to pin 2mg a week, pin 1.4mg every 5 days (2mg÷7days times 5), or you can split the dose with 3.5 days in between each 1mg shot.

I underestimated the dosing as well. I did 0.5mg on the first day, 0.5mg two days later, then 1mg 3–4 days later, and my next shot was 2mg. My body hit me hard after around 2 weeks because of the uneven dosing levels and the stupid low dose in the beginning. I got big anhedonia and fatigue, with normal hunger suppression. No crazy “I can’t eat anymore” feeling, just the normal benefit with 10x the side effects.

Build an even level in your body and titrate from there.

 

[bogardbilla]

Built different as fuck 💪🏻💪🏻💪🏻

Tbh I don't think it should be made into a competition. Maybe I need a bigger dose because I was metabolically more unhealthy? Who knows. But my personal experience definitely makes me suspicious of horror stories, I tend to think people are surprised by the feeling of side effects and then panic a little bit, make a mountain out of a molehill so to say.

 

[Kyli]

While I'm reading here, I just ask myself: Does 0,1 - 0,25mg matter for side effects? If there are no side effects at 1.5mg, why should be any at 0.1-0.25mg more?

 

[BNLFL]

While I'm reading here, I just ask myself: Does 0,1 - 0,25mg matter for side effects? If there are no side effects at 1.5mg, why should be any at 0.1-0.25mg more?

I really didn’t get any sides till 4mg. Definitely had some appetite suppression starting at 2mg. Some heartburn at bedtime on 4mg. 6mg made sleeping worse, same heartburn rarely. I’m now on 4 weeks/8mg and I’m awake at 4am and up at 5am. I’ll likely stay here until my goal and figure a maintenance dose. I recommend staying on a dose for 4 weeks and let the juice build up in your system. Good luck.

 

[WLBLD]

I really didn’t get any sides till 4mg. Definitely had some appetite suppression starting at 2mg. Some heartburn at bedtime on 4mg. 6mg made sleeping worse, same heartburn rarely. I’m now on 4 weeks/8mg and I’m awake at 4am and up at 5am. I’ll likely stay here until my goal and figure a maintenance dose. I recommend staying on a dose for 4 weeks and let the juice build up in your system. Good luck.

Have you tried taking magnesium? It helps me sleep better

 

[FLglpguy]

This is EXACTLY the compulsive behavior I want to change by taking Tirz. Soooo you're gonna stop overeating by overmedicating? You'll find that the efficacy drops sooner than the lbs and then I guess you'll just add more meds and be the guy in here saying I take max dose of Reta and Tirz together and now I also take these 6 other peps too. Why man? WHY???? Slow and steady will work to get it off just like it did to put the lbs on. Doesn't sound right to say I'm gonna increase until I'm sick and that will tell me when to stop. Bad plan that will yield bad results.

One new guy to another...RESTRAIN YOURSELF! I just took shot 6 Wednesday of Tirz. I'm at .50 and I've lost 26lbs in the past 5wks by changing the way I think and what I put in my mouth. I haven't even started working out yet. I'm a big guy too. Started at 386lbs and I'm now 360lbs and I'm 55yrs old and 6'2". My habits have changed and my mentality has too. That is the true accomplishment. Binge pinning is likely just as bad as binge eating. Change your thinking and you will safely go through this process and never go back to the old ways of viewing food and thinking more is better with everything.

I’m on 5mg. That was a typo. I’m following protocol. 2.5 then 5 mg etc…

 

[Huffingnpuffing]

For me, I don’t see a need to rush. Given many unknowns and expecting a longer term protocol - I’d rather play it conservatively. It’s easy to up a dose after a week or half a week but you can’t reverse effects of a high dose.
I often think that losing weight or applying a major internal operating shift as these tools allow us - too much or too quickly could be a shock to how our bodies operate normally, so there will likely be a fight for adjustment or return to baseline at some point. Rushing this or pushing harder might intensify this shock.
Of course, this is my opinion but even if mostly incorrect, still worth going slowly for me.

 

[AngieHolmes]

Thanks for posting this. I’ll say this here often, a ton of these new members with these low doses, just seem to make up their doses. I’ll ask where they got that info, but never answer. They likely have never read about GLP1’s or the studies. I’m no major expert, but drives me insane.

Pretty sure he wasn’t talking about you.

"Making up their doses" is exactly what I value about holding the syringe and vial myself.

I'm not in someone else's research study. I'm an N of 1, optimizing the dose strictly for my own purposes. If there's anything GLP1s have taught me it's that there's a lot of variability in how people respond to them. Not sure why that would drive you insane.

 

[AngieHolmes]

For me, I don’t see a need to rush. Given many unknowns and expecting a longer term protocol - I’d rather play it conservatively. It’s easy to up a dose after a week or half a week but you can’t reverse effects of a high dose.
I often think that losing weight or applying a major internal operating shift as these tools allow us - too much or too quickly could be a shock to how our bodies operate normally, so there will likely be a fight for adjustment or return to baseline at some point. Rushing this or pushing harder might intensify this shock.
Of course, this is my opinion but even if mostly incorrect, still worth going slowly for me.

I agree with you. I shudder to think of my body reacting with vomiting or other signs of having made myself sick. Seems like an unnecessary and unfruitful shock to the system. Not to mention more severe reactions that could be avoided by taking things slowly.

I plan to stay on a GLP1 for as long as it takes to keep the food noise away. I'd much rather be doing that with 1 - 2 mg a week than 10 or 12. If it takes me a few extra months up front to get to the weight my body wants to be, I'm cool with that. I love that I don't have to adopt Lilly's or Novo's schedule, which would result in having to take multiples of my working dose forever. Cha-ching!

 

[Huffingnpuffing]

Being cynical - I can’t help but think of the misaligned incentives in the studies - they have a goal to be as aggressive as possible - get the highest, fastest results to market. Any side effects are seen as a way to define limitations, less so about the effect or impact to an individual.
I see the benchmarks then as less of something to follow - or start with, but the maximum I could safely push to. If I could get results with lower - in my mind, a better option.

 

[RetCurious]

Am I being too impatient and just need to give the drug time to work?

Yes.
Treat your body with the respect and gentleness it deserves.
Learning to disrespect ourselves can be one of the symptoms that drove us to where we are.
Recklessly blasting max doses with no regard to the established protocols is not treating yourself kindly, it sounds more like abusive self violence.
At least give yourself a full month for your blood concentration to peak so you at least have an idea where you are on the spectrum of responders. You may well be someone who needs higher doses but it's probably a good idea to not blindly jump off the cliff.
Good luck what ever you decide.

 

[BNLFL]

"Making up their doses" is exactly what I value about holding the syringe and vial myself.

I'm not in someone else's research study. I'm an N of 1, optimizing the dose strictly for my own purposes. If there's anything GLP1s have taught me it's that there's a lot of variability in how people respond to them. Not sure why that would drive you insane.

It’s called an opinion. I can tell already.

 

[BNLFL]

Have you tried taking magnesium? It helps me sleep better

What is it, and where do you get it?

 

[AngieHolmes]

Being cynical - I can’t help but think of the misaligned incentives in the studies - they have a goal to be as aggressive as possible - get the highest, fastest results to market. Any side effects are seen as a way to define limitations, less so about the effect or impact to an individual.
I see the benchmarks then as less of something to follow - or start with, but the maximum I could safely push to. If I could get results with lower - in my mind, a better option.

Also being cynical, if the drugmakers know we'll need to stay at our last dosage for maintenance, it makes $ sense (for them, not us!) to have that number be as high as possible. Why have people maintaining at 1mg when you could extract more from them if they kept increasing to the highest dose? ; )

 

[TooGood76]

I'll report back my findings. 6mg starts next Monday.

you know what? Fuck it this guy has the spirit.

Just send it throw your ass in the deep end sink or swim.

 

[bada bing]

One thing that the extension of the Triumph One study on Reta from 80 weeks to 104 weeks and also titrating even the people in the placebo arm up to max tolerated dose seems to indicate is there are a lot of paths to the same endpoint. You can run Reta @4mg a week for 80 weeks, and if you want then titrate up to 12mg/week and arrive at virtually the same point another 6 months later as someone taking 12mg/week for the entire 2 years.

My take from that is it reinforces my opinion that slow and deliberate is the best course for titrating these drugs. If you are consistent, you can get to the same endpoint eventually.

 

[lessthanhalf]

Also being cynical, if the drugmakers know we'll need to stay at our last dosage for maintenance, it makes $ sense (for them, not us!) to have that number be as high as possible. Why have people maintaining at 1mg when you could extract more from them if they kept increasing to the highest dose? ; )

The way I see it is it does not matter at all what you think would be a maintenance dose that works for you, whether that is lower or higher doses, the only thing that matters in the end is, is weight stable long term on that maintenance dose, and does it feel sustainable long term, without a lot of mental effort to restrict eating. I think the evidence in general supports the dose used to lose the weight but there is no harm in dropping doses to see if it works as well, so long as you do not end up regaining a lot of weight before increasing the dose if needed.

The exception to this where higher doses are a good idea if side effects are not a problem is in people with severe obesity or obesity related medical problems, and with increasing age
where the drugs themselves as well as the weight loss reduce the risks of many different obesity related illnesses. Almost everyone with more severe obesity is at high absolute cardiovascular risk, and GLP drugs reduce those risks, and do so better at maximum doses.

 

[Kyli]

---

As someone who also tends to rush things, let me explain my reasoning.

I'm too lazy to look up the exact numbers right now, but according to the studies, people on reta lost roughly 3–5% in their first month on 2 mg, 5–8% in the second month on 4 mg, and 9–13% in the third month on 8 mg—give or take a few percentage points.

Why? Because we're dealing with a drug that works on three receptors. For glucagon, a minimum number of receptors needs to be triggered to produce any effect at all. So if you don't increase your reta dose and stay at 2–4 mg, you get no real benefit compared to triz.

And whenever I talk to people, they say the weight loss in the first month is mainly water.

So you have to reach or exceed 4 mg to get any effect beyond what triz offers—like addressing fatty liver.

What I also don't understand: why is it fine for some people to take the study data and make a sharp jump from 4 mg to 8 mg—or even to 6 mg—instead of titrating up slowly? Same with the once-weekly injection schedule. To me, it seems designed to be as simple and painless as possible, rather than as an individualised medical treatment.

 

[lessthanhalf]

---

As someone who also tends to rush things, let me explain my reasoning.

I'm too lazy to look up the exact numbers right now, but according to the studies, people on reta lost roughly 3–5% in their first month on 2 mg, 5–8% in the second month on 4 mg, and 9–13% in the third month on 8 mg—give or take a few percentage points.

Why? Because we're dealing with a drug that works on three receptors. For glucagon, a minimum number of receptors needs to be triggered to produce any effect at all. So if you don't increase your reta dose and stay at 2–4 mg, you get no real benefit compared to triz.

And whenever I talk to people, they say the weight loss in the first month is mainly water.

So you have to reach or exceed 4 mg to get any effect beyond what triz offers—like addressing fatty liver.

What I also don't understand: why is it fine for some people to take the study data and make a sharp jump from 4 mg to 8 mg—or even to 6 mg—instead of titrating up slowly? Same with the once-weekly injection schedule. To me, it seems designed to be as simple and painless as possible, rather than as an individualised medical treatment.

In general what you are saying is not consistent with the research or how reta works.

People taking 1mg of reta a week for a year lost an average of 9% bodyweight, 4mg a year nearly 20% and 2mg a year somewhere in between. It takes a year or so on these drugs to see the full effect of a given dose on weight and after that time usually there is no more weight loss unless the dose is increased. So reta is actually unusual in that it actually works well and much much better than any other GLP at low doses, which is useful for people with less severe obesity, who may well achieve their aims on lower doses with lower rates of side effects as a result. And in that situation may be a much better choice than tirz as lower doses can be used with less side effects.

Yes a lot of initial weight loss is water, but assuming you are eating less some will be fat as well. And given these drugs take a year to work judging their effects on the first few months of weight loss is not really the right time frame. Effects on fatty liver disease are greater at higher doses as are effects on energy expenditure, but they do not just start at a particular dose, and these effects are a lot to do with why 1mg of reta produces much more weight loss than 1mg of tirz.

I am not sure there are too many who would think going from 4mg to 8 of reta suddenly is a good idea, the drug company plan is 2, 4, 6, 9, 12. 4 to 8 would have good odds of significant side effects. The drug companies want the dosing plans to be simple so people do not mess it up and overdose themselves. And to have reasonably low rates of severe sudden side effects without taking forever to increase doses. People using grey GLP's are much more likely to make dosing errors, there are a lot of stories on here and many papers written on it.

 

[Clavicular's Hammer]

What are the risks of titrating up too fast on reta? I’m a big guy with super severe craving. My first week I pinned 1mg. Second week I did 2mg. Aside from one day feeling more full than normal, I have not had any real effects - good or bad.

What risks am I running if I were too inject 3mg for my third shot? Am I being too impatient and just need to give the drug time to work?

I’ll tell you that what people say about it building up is true.

So it is important to take it slowly.

That said you should be feeling something. Many people on here have been feeling effects on first doses of .5mg. I was 1mg.

So it could be you need to move up. But just know that it has been my experience and most others that this stuff builds up so that by the 3-4 week mark you are still processing parts of that first pin along with every pin since.

Which is why it’s been standard to only move up every 4 weeks.

Now that said the people giving this advice are usually already feeling, something.