Have you noticed Tirz tolerance developing over time?

[Superchicken1]

My impression was that many on oral AAS avoid statins, especially as a preventative, because they know oral AAS can be toxic to the liver. And they take other things like reta or supplements to help cholesterol instead. Not to mention that statins are not the best for muscle health.

Nah, they keep statins and other pharmaceuticals on hand. They do use glp/gip meds though for stuff like liver, blood sugar, weight control.

My husband is on it alongside ezetimibe, and his dr was impressed with its profile. He was shocked when he told him the harm reduction steroid forum is where he learned of it. I learned more about health and treatment from them than any dr lol They’re pretty smart.

 

[Superchicken1]

Thanks. I looked it up at Drug Induced Liver Injury Rank (DILIrank 2.0) Dataset, https://www.fda.gov/science-researc...induced-liver-injury-rank-dilirank-20-dataset. You're right. The numbers (5 or 3) indicate the seriousness of the injury that might result.

View attachment 8590

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To use another source, Livertox [https://www.ncbi.nlm.nih.gov/books/NBK548236/] ranks atorvastatin as an A:

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Livertox [https://www.ncbi.nlm.nih.gov/books/NBK548065/] ranks pitavastatin as a D. View attachment 8592

I have stopped taking the statin and told the cardiologist by an electronic, email-like message that I did so. Assuming the Lipitor turns out to be the cause, as I believe it will be, then I can discuss with the cardiologist whether with my reduced weight and a past history of having statin-induced liver injury, it's medically advisable to still take a statin. If he recommends taking a different statin, I'd likely do so.

There are other options for cholesterol control. My husband uses ezetimibe, clinically has about a 20% reduction in LDL. It’s what he started on before adding the pita, and it worked, but 20% wasn’t enough. Now he’s using the pita 3x a week and he’s good. I knew he wouldn’t push for the ezetimibe on his own and just sourced it from India pharma. There are also pcsk9 inhibitors and bempedoic acid. Sometimes insurance can be obnoxious on coverage for these things, and want you to fail all other statins first. Filling the rx, then “developing a side effect” until you meet the requirements for coverage is a workaround. The other option is to use telehealth for the rx, then an in person dr is more likely to go along with it if it’s a med you’re established on.

Just throwing ideas out.

 

[thelastistaken]

Geez. Makes sense about the Lipitor being the culprit, but it is a wake-up call since it is such a popular drug. (For a similar reason, guys on oral AAS seem to avoid statins.)

I would disagree that AAS users avoid statins. AAS users who care about their bloodwork take red yeast rice, essentially the same thing. Commenting as someone who has been in this realm for the past decade.

 

[BigGuy]

Talking out my ass, but my feeling on tolerance is that tirz counteracts the signals my body is normally giving with regards to hunger, and those signals increase with every pound I lose. So it seems like if I did not change weight, the effect would stay the same -- i.e. not tolerance per se, at least not the way it works with many other drugs.

So based on my unscientific theory, Dwight's body is giving such strong "FEED ME" signals due to the amazing weight loss that it is difficult to get enough effect from tirz to adequately counteract it.

Personally, I am not quite at a plateau yet but I think I'm close. I've gone from 284 to 201, and I've been sitting around at 201-204 for the past couple weeks. The trend still looks like it is headed down, but veeeeery slowly. I've been doing 5mg twice a week, until this morning when I ratcheted it up a little to 5.5mg. I feel like my appetite suppression has been basically okay, and if I overeat just a little I still pay dearly with nausea (pulling off a Dwight-style 6000 Calorie day would probably put me in the hospital right now), just not really losing like I was. Still have 25 lbs to lose, for sure, so I'd like to keep chipping away at it.

Congrats on the 80+ loss! I am in the same boat where splitting 10mg is boarding on not being enough but I’ve only lost 45ish. I really don’t want to keep going up and max out too early but, in the same breath, I don’t want to waste time, money and meds sitting on 10. Looking into (and already researching some) stacking but will likely just upping old faithful. Then come up with a new plan when the hard stall hits.

 

[texmexpep]

I stacked by adding reta to my tirzepatide. But now my ALT levels are 10 times the upper limit of normal. While the doctor believes that reta is probably not the cause of my increased ALT levels, I agree and am following his recommendation to stop taking reta until my levels return to normal. My hepatologist and I both believe that Lipitor (atorvastatin) is the likely cause of my liver problems. I stopped taking Lipitor But considering my liver problems, I'm not going to continue risking things by taking reta, an unapproved drug. If my ALT levels return to normal, I will start start reta again and see what happens.

Thank you for sharing your research!

 

[Calm Logic]

I would disagree that AAS users avoid statins. AAS users who care about their bloodwork take red yeast rice, essentially the same thing. Commenting as someone who has been in this realm for the past decade.

A lot of gym bros are not the well-read kind visiting forums like Meso. They are getting bro science in person from other gym bros. They aren't usually doing lab tests on their own either, or at least not often.

As I already clarified, many AAS users are at least reluctant to use statins (as are many people in general), given the fear of (overstated?) muscle-related side effects and the fear of liver effects, as many are already rightly worried about oral AAS affecting their liver. Statins can also slightly lower testosterone levels.

Regarding pravastatin, it is not only gentler on the liver, it is also less likely to cause muscle pain.

Many AAS users are on reta, likely decreasing the need for statins anyway, or at least the higher doses of statins. OTOH, some AAS users/abusers prefer an LDL below 70, so they can feel more comfortable with the cardiovascular risks of steroid ab/use.

While we are on the subject, it is at least a little crazy to optimize lipid values only to potentially wreck the entire cardiovascular system with chronic steroid use outside of TRT. Yes, statin use would be harm reduction, but true harm reduction is to avoid the steroids, or at least to avoid chronic, long-term use. Calcium scoring is also important, but I think there may be damage that evades many of these tests, even an echocardiogram. A cardiac MRI would be ideal.