Dose: Side Effects vs Results

Rafagus

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Context:
  • Weight loss being the goal
  • Leaving out the important variable dosage rate of change.
  • Assuming any dose up to 15mg/week is available.
Review of SURPASS-5 clinical trial on NIH site mentions the dose dependent success of tz. 40 weeks with 5mg/week producing 5.4kg weight loss vs 15mg/week produced a 10.4kg weight loss. With this in mind should the dose be the highest one you can take where side effects are manageable? If the answer is yes, would you creep up to not manageable and back down?

Your thoughts please
 
Do you have a firm date for a Next Top Model audition, boxing match or military weigh-in?

If not I'd weigh the merits of slower versus rapid weightloss. What would be the result of the low dose study group at 60wks or 70wks? Will a 2 or 3 month delay to goal as a result a lower dose make a difference in your big picture? The upside of low and slow is getting to goal cheaper (gray) potentially maintaining on a lower dose (gray and cheaper), and maybe having tighter skin and a fuller head of hair while having experienced less severe side effects.

There's arguably a different mindset being in a study group (free meds). Seems people who are paying out of pocket and found their way to this forum have results meeting or exceeding the best results in studies.

Good luck and welcome to the forum!
 
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nonyabizznez said:
Do you have a firm date for a Next Top Model audition, boxing match or military weigh-in?

If not I'd weigh the merits of slower versus rapid weightloss. What would be the result of the low dose study group at 60wks or 70wks? Will a 2 or 3 month delay to goal as a result a lower dose make a difference in your big picture? The upside of low and slow is getting to goal cheaper (gray) potentially maintaining on a lower dose (gray and cheaper), and maybe having tighter skin and a fuller head of hair while having experienced less severe side effects.

There's arguably a different mindset being in a study group (free meds). Seems people who are paying out of pocket and found their way to this forum have results meeting or exceeding the best results in studies.

Good luck and welcome to the forum!
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The low dose plateaued at around the same time as the highest dose. With far less weight loss.
1735422747791.png
 
penewbie said:
The low dose plateaued at around the same time as the highest dose. With far less weight loss.
View attachment 4829
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The chart seems to indicate that you pretty much lose all that your going to lose in the first 60-72wks. What this chart doesn't tell you is how much people lose that titrate from 2.5-15mg over 48 or 60 weeks. Do they continue to lose beyond 60 weeks or would they still plateau? I think in this chart they did titrate the 10/15mg people up over the first several weeks.
 
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I'm intentionally going slow. I don't want to risk my gallbladder or pancreas, and I want the medication to work as long as possible. Supposedly your body also gets used to it, so you can just keep slowly going up until you hit the max dose.
 
chmuse said:
I'm intentionally going slow. I don't want to risk my gallbladder or pancreas, and I want the medication to work as long as possible. Supposedly your body also gets used to it, so you can just keep slowly going up until you hit the max dose.
Click to expand...
I'm doing the same to a point. I am not going to sit around in a two month stall, if no lose or change for 2-3 weeks, I'm movin on up. I am close to goal tho, if I still had 100lbs to lose I would probably titrate differently.
 
GimmeABreak said:
The chart seems to indicate that you pretty much lose all that your going to lose in the first 60-72wks. What this chart doesn't tell you is how much people lose that titrate from 2.5-15mg over 48 or 60 weeks. Do they continue to lose beyond 60 weeks or would they still plateau? I think in this chart they did titrate the 10/15mg people up over the first several weeks.
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It also indicates that going up to 10 is valuable while 10 to 15 is not worth it for most (most should just chill at 10)
 
rkl123 said:
It also indicates that going up to 10 is valuable while 10 to 15 is not worth it for most (most should just chill at 10)
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What we don't know is if the people that "flattened out" their loss on 10mg around week 60 then titrated up to 15mg would they have lost more than the people taking 15mg for the majority of the test period?

Only considering the chart/trial data would lead us to conclude no one loses after 60 weeks. I sincerely hope this isn't the case given the popular low-and-slow titration tendency of many in the Tirz pep community. If this turns out to be true, everyone should get up to 15mg as quickly as possible.
 
GimmeABreak said:
What we don't know is if the people that "flattened out" their loss on 10mg around week 60 then titrated up to 15mg would they have lost more than the people taking 15mg for the majority of the test period?

Only considering the chart/trial data would lead us to conclude no one loses after 60 weeks. I sincerely hope this isn't the case given the popular low-and-slow titration tendency of many in the Tirz pep community. If this turns out to be true, everyone should get up to 15mg as quickly as possible.
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I mean, a lot of us also graduate to tirz from sema then to reta, and we also play with stacking and adding cagri. I'd imagine our results aren't anywhere near their clinical studies.
 
chmuse said:
I mean, a lot of us also graduate to tirz from sema then to reta, and we also play with stacking and adding cagri. I'd imagine our results aren't anywhere near their clinical studies.
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And there are so many variables such as other medications subject is on, sedentary or active, what are they eating, goal wt, starting body composition.... therefore it can't be 1 size fits all.
 
Valerie said:
And there are so many variables such as other medications subject is on, sedentary or active, what are they eating, goal wt, starting body composition.... therefore it can't be 1 size fits all.
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If I recall the numbers correctly, Dwight has already lost like 40% of his SW. I'm sure it's all highly variable.

I should look into what their controls were. Did they count calories, or just take the meds? Did they exercise? Etc
 
chmuse said:
I mean, a lot of us also graduate to tirz from sema then to reta, and we also play with stacking and adding cagri. I'd imagine our results aren't anywhere near their clinical studies.
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True, but most people taking Tirz aren't us. A friend of mine started branded Tirz, lost 70lbs, had a stroke, went off Tirz during recovery and then started again. I'm not sure what he regained but he probably has another 50-70lbs to lose. He as at 15mg and really not losing anything but keeps on pinning the same 15mg every week. I mentioned that there are "other options" but its a sensitive topic, when he didn't bite I dropped it.
 
I lost 70lbs in 44wks, 31%. I'm not bragging, I know how hard it can be for some and men generally lose weight easier. Is 1.6lbs/wk a super responder? (never went above 5mg)

I tend to take things more serious when I'm paying for it. I don't think people getting free meds in a study group are as serious. I say this from experience having been in study groups (some even compensated). Other than the Tirz what else did the study group have in common? Calorie limits or exercise requirements or alcohol restrictions? Were they diabetic? Honestly I don't know.

I think people who frequent this forum take their GLP-1 effort seriously. So any of y'all been in one of these Lilly/Novo study groups or perhaps a new medication coming down the pipeline?
 
A
nonyabizznez said:
I lost 70lbs in 44wks, 31%. I'm not bragging, I know how hard it can be for some and men generally lose weight easier. Is 1.6lbs/wk a super responder? (never went above 5mg)

I tend to take things more serious when I'm paying for it. I don't think people getting free meds in a study group are as serious. I say this from experience having been in study groups (some even compensated). Other than the Tirz what else did the study group have in common? Calorie limits or exercise requirements or alcohol restrictions? Were they diabetic? Honestly I don't know.

I think people who frequent this forum take their GLP-1 effort seriously. So any of y'all been in one of these Lilly/Novo study groups or perhaps a new medication coming down the pipeline?
Click to expand...
Excellent point about taking it more seriously when paying for it. I began out of pocket Zep 137.50 a week, therefore took it very seriously!
I tracked everything and was determined to make it work ! lol 😂
When I stalled I felt like I was wasting money and yes I slowly increased my dose weekly to help wt loss begin again. I switched to compound and ordered the max dose available even if that wasn't my dose.
If I was in "trial" getting it for freeeee I'm not sure I'd take it as seriously especially knowing I'd have to pay for it after the study was over and all I know is name brand prices knowing I can't afford that unless insurance paid for it.

I have seen comments in Reddit of couples part of Reta trials.
 
Valerie said:
Excellent point about taking it more seriously when paying for it. I began out of pocket Zep 137.50 a week, therefore took it very seriously!
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FWIW, I take the weight loss wayyyy more seriously than the money the meds cost. If it was free (and I suppose I am privileged enough to kinda feel that it is, with the current cost of grey?) I'd still be working all the angles and reading all the things. This is the first thing that has ever worked for me like this and it feels like a priceless vial every single time, even though in reality it's only a few bucks. I wouldn't underestimate what this means to people that respond to it.
 
nonyabizznez said:
I tend to take things more serious when I'm paying for it. I don't think people getting free meds in a study group are as serious. I say this from experience having been in study groups (some even compensated). Other than the Tirz what else did the study group have in common? Calorie limits or exercise requirements or alcohol restrictions? Were they diabetic? Honestly I don't know.
Click to expand...
That is a super interesting comment/observation. If the participants in these studies keep up their diet of McD's, pizza and nachos there would definitely be a different outcome than a person that exercised, counted calories and daily protein.

There is a user over on The Swiss that is part of one of the Reta studies, I am going to ask him/her/they about the study dietary/exercise or other parameters. From past comments, he/she/they tend to be pretty reserved when mentioning the study but I will see if I can find anything out.
 
GimmeABreak said:
That is a super interesting comment/observation. If the participants in these studies keep up their diet of McD's, pizza and nachos there would definitely be a different outcome than a person that exercised, counted calories and daily protein.

There is a user over on The Swiss that is part of one of the Reta studies, I am going to ask him/her/they about the study dietary/exercise or other parameters. From past comments, he/she/they tend to be pretty reserved when mentioning the study but I will see if I can find anything out.
Click to expand...
Sometimes in these studies participants are encouraged NOT to change their diet/lifestyle. They are studying the effects of a drug, not the limits of your willpower or gym motivation.
 
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Valerie said:
A

Excellent point about taking it more seriously when paying for it. I began out of pocket Zep 137.50 a week, therefore took it very seriously!
I tracked everything and was determined to make it work ! lol 😂
When I stalled I felt like I was wasting money and yes I slowly increased my dose weekly to help wt loss begin again. I switched to compound and ordered the max dose available even if that wasn't my dose.
If I was in "trial" getting it for freeeee I'm not sure I'd take it as seriously especially knowing I'd have to pay for it after the study was over and all I know is name brand prices knowing I can't afford that unless insurance paid for it.

I have seen comments in Reddit of couples part of Reta trials.
Click to expand...
So I reconstituted a 15mg vial last week and while waiting for it to dissolve knocked it to the floor. It broke and I lost the Tirz.

$1586 woulda been my loss at my initial retail! (6 doses 2.5mg Mounjaro) There's a couple people selling off their stock by the vial on discord at $1.00/mg shipped. So with ship I could have replaced it with a vial for under $20 shipped (3 for $55!) or got a whole kit of T15 shipped for $95 or so.

Just like the unserious in studies I'm not as serious with loss in gray, a few bucks dropped on the floor or lost in Crapto trying to make a purchase.
 
nonyabizznez said:
So I reconstituted a 15mg vial last week and while waiting for it to dissolve knocked it to the floor. It broke and I lost the Tirz.

$1586 woulda been my loss at my initial retail! (6 doses 2.5mg Mounjaro) There's a couple people selling off their stock by the vial on discord at $1.00/mg shipped. So with ship I could have replaced it with a vial for under $20 shipped (3 for $55!) or got a whole kit of T15 shipped for $95 or so.

Just like the unserious in studies I'm not as serious with loss in gray, a few bucks dropped on the floor or lost in Crapto trying to make a purchase.
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So true, on the reddit compound forums everyone was talking about removing the tops of vials to get every last drop. Yeah, I hold it upside down and get most of it, but good enough for me.
 
GimmeABreak said:
So true, on the reddit compound forums everyone was talking about removing the tops of vials to get every last drop. Yeah, I hold it upside down and get most of it, but good enough for me.
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And if it looks a bit cloudy (even if it's probably condensation) I'll toss it and pull a new vial from the freezer. Basically how I use to treat ice cream, except for the tossing part 🍨
 
nonyabizznez said:
Sometimes in these studies participants are encouraged NOT to change their diet/lifestyle. They are studying the effects of a drug, not the limits of your willpower or gym motivation.
Click to expand...
Those taking the study still eating fast food; I can't imagine McDonalds would stay down as easily it did before the glp 😟🫢🤢🤮
 
GimmeABreak said:
That is a super interesting comment/observation. If the participants in these studies keep up their diet of McD's, pizza and nachos there would definitely be a different outcome than a person that exercised, counted calories and daily protein.

There is a user over on The Swiss that is part of one of the Reta studies, I am going to ask him/her/they about the study dietary/exercise or other parameters. From past comments, he/she/they tend to be pretty reserved when mentioning the study but I will see if I can find anything out.
Click to expand...
Update, the user is actually on The RoundTable. He is a nurse practitioner and is a participant in one of the Rita phase 3 trials. He said they are encouraged to exercise but not held to a standard (like XXX minutes per week). They meet with a dietician every 2 months and review 6 days worth of his food intake that he has to keep track of his food in a food log. The dietician encourages heavy protein intake but thats it. He also estimated that Reta would be approved in about 20 months.

He said the Tirz trials were similar and didn't start a diet/exercise intense trial until after it was clear that Tirz would work well for obesity.
 
Has anyone had tirz fall off hard suddenly? since we are talking about dosing here.

I was going strong on just 2.5mg for weeks, decided to dose heavy since I was going on a trip and wouldnt have my tirz with me to pin, did like 5mg, didnt feel anything afterward, and have not felt anything after returning and pinning another 5mg just to see if it would work?

The gnawing hunger has really started to return, and I dont feel full anymore after eating.

My bottle of tirz is like 10 weeks old at this point, it was a 60mg bottle that was compounded on like 10/15. What are the chances it has degraded in that time? Enough that 5mg wouldnt even feel like 2.5mg? Also started getting ISR's.

Wondering if its resistance to the drug, or if the drug went bad.
 
FreeSpectator8 said:
Has anyone had tirz fall off hard suddenly? since we are talking about dosing here.

I was going strong on just 2.5mg for weeks, decided to dose heavy since I was going on a trip and wouldnt have my tirz with me to pin, did like 5mg, didnt feel anything afterward, and have not felt anything after returning and pinning another 5mg just to see if it would work?

The gnawing hunger has really started to return, and I dont feel full anymore after eating.

My bottle of tirz is like 10 weeks old at this point, it was a 60mg bottle that was compounded on like 10/15. What are the chances it has degraded in that time? Enough that 5mg wouldnt even feel like 2.5mg? Also started getting ISR's.

Wondering if its resistance to the drug, or if the drug went bad.
Click to expand...
If it isn't cloudy and doesn't have floaters it should be fine.

Just to confirm, you were dosing a little over 4 units (2.5mg) and you upped it to a little over 8 units (5mg)? You said you had a 60mg vial and they are normally compounded with 2ml.
 
GimmeABreak said:
If it isn't cloudy and doesn't have floaters it should be fine.

Just to confirm, you were dosing a little over 4 units (2.5mg) and you upped it to a little over 8 units (5mg)? You said you had a 60mg vial and they are normally compounded with 2ml.
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Compounded with 3ml, was a full 3ml vial, was instructed to use 12.5 units for 2.5mg. Which throwing the numbers into a quick calculator says that is correct. I was pinning 12.5 for about 7 weeks, on week 8 pinned 20 units. week 10 now and pinned about 20 units again because I dont want to accelerate my dosage more than I need to.
 
FreeSpectator8 said:
Compounded with 3ml, was a full 3ml vial, was instructed to use 12.5 units for 2.5mg. Which throwing the numbers into a quick calculator says that is correct. I was pinning 12.5 for about 7 weeks, on week 8 pinned 20 units. week 10 now and pinned about 20 units again because I dont want to accelerate my dosage more than I need to.
Click to expand...
Ok, so you went from 2.5mg to 4mg, you should "feel" the results. I would give it a little more time and then try 5mg on your next pin if you're still not feeling anything.
 
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