If this was you, how would you proceed?

[hexagonal]

I think you hit the nail on the head with this- We are debating things that people believe to be 100% accurate, which is a challenge to their beliefs.

@hexagonal has been a valued contributor to the community and everything I have seen him comment on has been framed in a productive and respectful tone.
@FlowerFairy has worked hard at her program and has a direct understanding of what has effected her.

Scientifically the physics argument makes sense, anecdotally the FF contention seems accurate.
We are at an impasse.

What is curious, and worth trying to understand better, is what would cause the gains on restricted calories.

As Hex points out the articles about movement discuss the arbitrary reduction in daily activities that impact the massive burns of the hunt- netting a reduced daily calorie burn.
What unknown factors are occurring, albeit infrequent enough to not be common knowledge, that might allow someone to gain or not lose under the CICO model?
Is it a result of no CO (like the less walking between hunts) is it a result of the CI (maybe slowed digestion absorbing and turbo charging the calories, making them stronger).

This needs to be studied and understood better.
here is an example of one such study-

Science Reveals Why Calorie Counts Are All Wrong

Digestion is far too messy a process to accurately convey in neat numbers. The counts on food labels can differ wildly from the calories you actually extract, for many reasons

www.scientificamerican.com

Yup.

Not really much for me to add here - well said. There's a huge variety of factors that make both halves of the equation very different for different people and someone can be doing the exact same thing as a skinny person and have basically no results. It sucks. And anyone that acts like this is simple and easy is an asshole.

 

[hexagonal]

For most of human history, people did not know what a calorie was. So we don't need to think in terms of calories if we mostly avoid ultraprocessed foods and stick more or less to a traditional diet, such as the Mediterranean diet of mostly plants and whole-grain starches.

And there is a lot to be said for not gaining weight back (in net terms) during a stall. Which means someone and/or something is still doing more things right than anything else.

The only debate I have with myself: Do I stay at the same dose of tirz, raise it, or go down? And when do I switch to the reta in my freezer.

I don't even have to figure out why I stall anymore since staying the course or raising the dose will eventually break it. Before GLPs, I was gaining weight back sooner than later and every day I would be irritable or depressed from constantly restricting myself and feeling hungry.

Ultraprocessed foods are bad news for weight loss because they are extremely palatable and calorie dense. They also tend to have bad macros, so bad for your health for other reasons, but you can still lose weight with bad macros.

But people fail to lose weight even when eating whole foods with good macros, because their calories in are still higher than calories out.

It's awesome that you still have room to move up in dosage, or change to another GLP-1 that might be more efficacious to you! I'm not being snarky - that's one of the best times during this journey. But I already made the switch to reta from tirz. My RHR is as high as I am comfortable pushing it on 10mg of reta - I cannot go up to 12mg. I don't see any evidence that moving to another GLP-1 will help me. I am not comfortable adding cagrilintide because of the amylin fibril/oligomer concerns, and I already have to force myself to eat to hit my macro targets.

But I hit a stall a while back. I had two real choices remaining after eliminating those others: Sit tight and hope it eventually worked itself out, that I could keep doing the same thing and hope that results changed. I'm lifting 5 days a week, and the muscle mass being added between that and going from hypogonadal to within reference range would eventually raise my metabolic rate that I might see some progress... but we're talking minimal differences over long periods of time. I know that from research such as the one @Skidude referenced that increasing my CO by way of increasing exercise is actually unlikely to increase my actual total CO because my body will reduce it through other things to compensate. With no options on medication, and CO increases being unrealistic, I knew I had to adjust my CI. So I made changes there, and my weight loss resumed. I didn't start meticulously counting calories or change to a strict diet, but I acknowledged that I had some room to cut some things out that I liked eating and replacing them with healthier options, and made the change. And it worked. But if I had ignored the fact that CICO was a reality, I'd be 8lb heavier and still stalled.

 

[KevinNaka]

I inject 200mg of Glutathione with 250mg of Ascorbic Acid IV daily. Started subcutaneous, moved to IM and now I’m a regular ole Glutathione junky. My liver function numbers are great, skin looks 10 years younger, I never get sick, inflammation is down and it helps with energy. No matter what path I take with other peptides, I will take this for the rest of my life. Now, if I could find a good, affordable option for HGH I’d be set.

Hi, do you experience any side effects with glutathione such as bloating/flatulence? A friend of mine had actually recommended I add it to my kit because of its antioxidant properties. I read it also helps regulate blood sugar, but my stomach is very sensitive. So does taking it by SQ help me avoid any GI issues? As much as possible I want to avoid injections/needles but if it's a net positive, I'm willing to try.

 

[Calm Logic]

Now that we have the option of over-the-counter continuous glucose monitoring, I think we can learn more about stalls from studying that compared to the black box of CICO.

Even without diabetes, obesity specialists will sometimes add metformin, phentermine, or another medication (that insurance would approve) to help increase the effectiveness of a GLP. Generic Jardiance is available from India for cheap, mostly the cost of shipping.

 

[hexagonal]

Now that we have the option of over-the-counter continuous glucose monitoring, I think we can learn a lot more about stalls from studying diabetes than the black box of CICO. Generic Jardiance from India, for example, can help with weight loss stalls, with or without diabetes, but I have not tried it myself yet.

SGLT2 inhibitors are interesting for a myriad of reasons, including looking to be quite cardio and renal protective even in non-diabetics, but the amount of weight loss they help with is pretty dependent on how carb heavy your diet is, and even on the high side, it's not anywhere near the realm of GLP-1s. I am taking empagliflozin and it did not help with my stall. But the weight loss function is again based in CICO - it increases your CO by reducing the ability for glucose to be reabsorbed in your kidneys so it instead excreted out.

 

[Calm Logic]

I lost steadily on this journey until about 2-2.5 months ago. Now I bounce up and down. I was on Reta 4 mg until I stalled; I’m up to 10 mg. Still bouncing. No net loss. Do I continue to titrate up, stack with something else, if I stack, what should I stack with? I was thinking about Maz or Survo, but I’m just not sure what to do next.

My current regime is Reta 10 mg weekly, mots-c 5 mg Monday and Thursday, lipo-c 1 ml 3x/week, GHK-cu 2 mg daily, BPC157 600 mcg daily, ipamorelin 600 mcg/c 1297 300 mcg daily, NAD+ 75 mg daily, Glutathione 100 mg daily, MT-1 .5 mg daily.. plus I have to take a bone builder calcium daily, 50k Vitamin D3, 24K Vitamin A, and polysaccharide iron complex daily. I eat around 1500 calories a day, usually under, but I always hit my protein goals (well almost always- goal is 162 grams, worst I’ve done is 110).

Please don’t suggest cagri, I already have no appetite and nothing sounds good but coffee.

*Edit* I’m female, I’ll be 62 in July. Starting weight 320, current weight between 245-255, depending on the day, humidity, time, etc cetera. I have lipedema, malabsorption disorder, hypothyroidism, osteoporosis in one hip, GAD, ADHD, depression and afib that is super well controlled- stayed free of episodes going on 3 years now. Before that it was 4 years, but a very stressful job did it, and I found a new one. And I see the endocrinologist every 3 months.

Are you on any medications that have weight gain as a side effect?

As you probably know, ipamorelin can increase water weight and appetite to some degree:

Common Side Effects of Ipamorelin (and similar peptides) can include:
* Water retention/bloating
* Headaches
* Nausea
* Injection site reactions (redness, pain, itching)
* Temporary fatigue
* Increased appetite (due to its ghrelin-mimicking effect)
* Joint pain or stiffness (less common with Ipamorelin compared to some other GH secretagogues)

But one thing on the positive side (besides fat burning and muscle support), it may help with the lymphatic system: These results identify growth hormone as a novel lymphangiogenic factor.

 

[AndyPanda]

N

Hi, do you experience any side effects with glutathione such as bloating/flatulence? A friend of mine had actually recommended I add it to my kit because of its antioxidant properties. I read it also helps regulate blood sugar, but my stomach is very sensitive. So does taking it by SQ help me avoid any GI issues? As much as possible I want to avoid injections/needles but if it's a net positive, I'm willing to try.

I have never experienced any negative side effects from Glutathione by any route.

 

[zpped]

You realize that you are one of those people willing to risk your own overall health to drop numbers on a scale, right? You are taking multiple meds that haven't even been approved by the FDA, haven't even passed human trials yet, and are made and sourced by Chinese smugglers. Do you know what site you are on? Pot needs to quit calling the kettle black here, chickiepoo.

You are missing a lot of context.

I lost steadily on this journey until about 2-2.5 months ago. Now I bounce up and down. I was on Reta 4 mg until I stalled; I’m up to 10 mg. Still bouncing. No net loss. Do I continue to titrate up, stack with something else, if I stack, what should I stack with? I was thinking about Maz or Survo, but I’m just not sure what to do next.

My current regime is Reta 10 mg weekly, mots-c 5 mg Monday and Thursday, lipo-c 1 ml 3x/week, GHK-cu 2 mg daily, BPC157 600 mcg daily, ipamorelin 600 mcg/CJC 1297 300 mcg daily, NAD+ 75 mg daily, Glutathione 100 mg daily, MT-1 .5 mg daily.. plus I have to take a bone builder calcium daily, 50k Vitamin D3, 24K Vitamin A, and polysaccharide iron complex daily. I eat around 1500 calories a day, usually under, but I always hit my protein goals (well almost always- goal is 162 grams, worst I’ve done is 110).

Please don’t suggest cagri, I already have no appetite and nothing sounds good but coffee.

*Edit* I’m female, I’ll be 62 in July. Starting weight 320, current weight between 245-255, depending on the day, humidity, time, etc cetera. I have lipedema, malabsorption disorder, hypothyroidism, osteoporosis in one hip, GAD, ADHD, depression and afib that is super well controlled- stayed free of episodes going on 3 years now. Before that it was 4 years, but a very stressful job did it, and I found a new one. And I see the endocrinologist every 3 months.

Sounds like you're doing a good job.

My first question would be how sure are you about your calorie count?

Second, It sounds like you're setting your protein on the very high end. I don't know how tall you are but most women aren't going to need over 130g.

Also are you taking body measurements? Monthly tape measuring can help determine if you're leaning out without losing weight. But are you're current weight, you're unlikely to be gaining muscle at the rate you're losing fat.

Personally, I favor the approach of simplifying things over adding more. Remove unproven things, double down on weighing my food and cooking everything I eat, add an extra cardio session every week while re-committing to my daily step average.

 

[mousey]

Is it too late for you to look into HRT? Or is that not an option for you?

 

[FlowerFairy]

You are missing a lot of context.





Sounds like you're doing a good job.

My first question would be how sure are you about your calorie count?

I use My Fitness Pal. Only the verified nutrition info (the “blue seal”). I also tend to estimate on the high side because I know a lot of people will underestimate. I have a touch of OCD, so if I go to my bestie’s house, I chart the silly mixed drinks she likes me to make. So yeah, I’m pretty sure it’s accurate.

Second, It sounds like you're setting your protein on the very high end. I don't know how tall you are but most women aren't going to need over 130g.

I have been wondering about that; I used a calculator from a keto website (I lived on keto chow for years) I recently saw a formula from a nutritionist on another board so I was going to recalculate it. I’m 5’8” tall, currently 258 lbs

Also are you taking body measurements? Monthly tape measuring can help determine if you're leaning out without losing weight. But are you're current weight, you're unlikely to be gaining muscle at the rate you're losing fat.

I wasn’t, but I did buy a “perfect body” tape measure.. because all my brand new shorts and jeans need to be taken in because they have gone from fitting perfectly to falling off my hips once I’ve had them on a little while, so I’m curious.

Personally, I favor the approach of simplifying things over adding more. Remove unproven things, double down on weighing my food and cooking everything I eat, add an extra cardio session every week while re-committing to my daily step average.

Yeah I’m seriously thinking of going back on Factor or living on protein shakes again. I already do those things, but I need to clean out my refrigerator.. it’s not dirty/messy, but I keep grabbing high protein yogurt that expired in 12/2023 when I started using Tirz…. The dogs are eating good at least, but I’m not that brave.

I’m not sure much of what I’m using is unproven except the MOTS-C, and I’d already decided I was going to finish this kit and move on. It’s essentially GLOW’s components but not mixed plus ipamorelin. And the MT1, but I’m still not tan at all so I may drop that too. The rest is NAD +, Glutathione and Lipo-C. 🤷🏼‍♀️

I use my vibration plates (they really do build muscle and help balance) and I’ve been trying to take the dogs to the dog park more often; there is a path that’s 1/3 mile and it gets my steps in and the pups are happy.. and my old dog w/heart disease doesn’t overdo it trying to keep up w/his younger sisters (he has severe cardiomyopathy and has lost his endurance since his stroke).

 

[FlowerFairy]

Is it too late for you to look into HRT? Or is that not an option for you?

I’ve been post menopausal for around 18 years I think that ship has sailed. I’ll talk to my bestie’s doc- they aren’t in network for my insurance but she does wholistic care so it might be worth it to go out of pocket.

 

[pavlovs]

You are missing a lot of context.

This is the only context that was supplied by the OP

" But then, not sure I should be bothered by something said by someone willing to risk his overall health just to drop numbers on a scale.

My response was in response to someone who is also doing risky things (all of us are doing risky things) calling out someone else who is making risky choices. The only thing that a member here can comment on is the context that has been supplied.

I have no comment on anyone else's choices and what they do in the attempt to get healthier, and I think we all need to be kinder to each other and respect everyone's choices, even if we don't agree with them.

There's a lot of ways to skin a cat. I appreciate your response.

 

[zpped]

This is the only context that was supplied by the OP

" But then, not sure I should be bothered by something said by someone willing to risk his overall health just to drop numbers on a scale.

My response was in response to someone who is also doing risky things (all of us are doing risky things) calling out someone else who is making risky choices. The only thing that a member here can comment on is the context that has been supplied.

I have no comment on anyone else's choices and what they do in the attempt to get healthier, and I think we all need to be kinder to each other and respect everyone's choices, even if we don't agree with them.

There's a lot of ways to skin a cat. I appreciate your response.

Yeah, like I said, you're missing a lot of context that isn't written in this thread.

 

[JuneBug1956]

I lost steadily on this journey until about 2-2.5 months ago. Now I bounce up and down. I was on Reta 4 mg until I stalled; I’m up to 10 mg. Still bouncing. No net loss. Do I continue to titrate up, stack with something else, if I stack, what should I stack with? I was thinking about Maz or Survo, but I’m just not sure what to do next.

My current regime is Reta 10 mg weekly, mots-c 5 mg Monday and Thursday, lipo-c 1 ml 3x/week, GHK-cu 2 mg daily, BPC157 600 mcg daily, ipamorelin 600 mcg/CJC 1297 300 mcg daily, NAD+ 75 mg daily, Glutathione 100 mg daily, MT-1 .5 mg daily.. plus I have to take a bone builder calcium daily, 50k Vitamin D3, 24K Vitamin A, and polysaccharide iron complex daily. I eat around 1500 calories a day, usually under, but I always hit my protein goals (well almost always- goal is 162 grams, worst I’ve done is 110).

Please don’t suggest cagri, I already have no appetite and nothing sounds good but coffee.

*Edit* I’m female, I’ll be 62 in July. Starting weight 320, current weight between 245-255, depending on the day, humidity, time, etc cetera. I have lipedema, malabsorption disorder, hypothyroidism, osteoporosis in one hip, GAD, ADHD, depression and afib that is super well controlled- stayed free of episodes going on 3 years now. Before that it was 4 years, but a very stressful job did it, and I found a new one. And I see the endocrinologist every 3 months.

I am not on Reta. I have hit my goal weight on Tirz 10 mg weekly with Sema 2 mg weekly and Cagri 2 mg weekly. I also take Tesofensine 250 mcg once a week. If I am below 1500 calories I can easily maintain my weight. If I go over I slowly creep up 2 lbs or so. I swim a mile 2-3 times a week and weight lift twice a week ( Les mills body pump at my YMCA.) I am 5’5”” and weigh 143-145. I lost 105 lbs doing this. I also eat very low carb almost Keto. I love my stack because I don’t think about food. It is always in the background now and sustains me. To break a stall I had to go up on my doses to max. Now have backed down figuring out how to maintain. I can break a stall with less calories about 1300. I can break a stall with more swimming. I can break a stall with no carb day. We are all so different. Sounds like you need to increase the Reta which may have the more ketosis effect for you. You are in a tough spot with your lymphedema and hypothyroidism must hold a lot of fluid in/on your body. That could easily blunt your efforts. Don’t give up, keep experimenting. You will get there.

 

[zpped]

I use My Fitness Pal. Only the verified nutrition info (the “blue seal”). I also tend to estimate on the high side because I know a lot of people will underestimate. I have a touch of OCD, so if I go to my bestie’s house, I chart the silly mixed drinks she likes me to make. So yeah, I’m pretty sure it’s accurate.

I have been wondering about that; I used a calculator from a keto website (I lived on keto chow for years) I recently saw a formula from a nutritionist on another board so I was going to recalculate it. I’m 5’8” tall, currently 258 lbs

I wasn’t, but I did buy a “perfect body” tape measure.. because all my brand new shorts and jeans need to be taken in because they have gone from fitting perfectly to falling off my hips once I’ve had them on a little while, so I’m curious.

Yeah I’m seriously thinking of going back on Factor or living on protein shakes again. I already do those things, but I need to clean out my refrigerator.. it’s not dirty/messy, but I keep grabbing high protein yogurt that expired in 12/2023 when I started using Tirz…. The dogs are eating good at least, but I’m not that brave.

I’m not sure much of what I’m using is unproven except the MOTS-C, and I’d already decided I was going to finish this kit and move on. It’s essentially GLOW’s components but not mixed plus ipamorelin. And the MT1, but I’m still not tan at all so I may drop that too. The rest is NAD +, Glutathione and Lipo-C. 🤷🏼‍♀️

I use my vibration plates (they really do build muscle and help balance) and I’ve been trying to take the dogs to the dog park more often; there is a path that’s 1/3 mile and it gets my steps in and the pups are happy.. and my old dog w/heart disease doesn’t overdo it trying to keep up w/his younger sisters (he has severe cardiomyopathy and has lost his endurance since his stroke).

How often do you test your estimate with a gram scale?

Given your height and age. I'd set the protein between 145-155. 1g/lb of your ideal bodyweight. If you were a lot younger, you could target as low as 130-135 but I'm sure you're aware that a bit of extra weight is healthier.

 

[FlowerFairy]

Are you on any medications that have weight gain as a side effect?

No. A few that cause water retention, but it’s minor so long as I use the vibration plate.

As you probably know, ipamorelin can increase water weight and appetite to some degree:

Not sure I remembered that, but I knew something was doing it. It’s a new issue. Strangely, mostly on weekends.

But one thing on the positive side (besides fat burning and muscle support), it may help with the lymphatic system: These results identify growth hormone as a novel lymphangiogenic factor.

I thought about growth hormone but wanted to do more research first. Growth hormone is one of those things that are “steroid adjacent” to me.. gotta be careful.

 

[FlowerFairy]

How often do you test your estimate with a gram scale?

Well.. not often since it’s mostly protein powders and bars. I weigh my vegetables but my steaks and chicken are single serving packed so I use the weight on the label..

Given your height and age. I'd set the protein between 145-155. 1g/lb of your ideal bodyweight. If you were a lot younger, you could target as low as 130-135 but I'm sure you're aware that a bit of extra weight is healthier.

Yeah.. something happened to my app- I was going by custom settings and suddenly today it says the basic generic setting of 83 grams. Yesterday it was my custom setting of 170 gms.. which was hard to meet.. but I was..

 

[Calm Logic]

I am not on Reta. I have hit my goal weight on Tirz 10 mg weekly with Sema 2 mg weekly and Cagri 2 mg weekly. I also take Tesofensine 250 mcg once a week. If I am below 1500 calories I can easily maintain my weight. If I go over I slowly creep up 2 lbs or so. I swim a mile 2-3 times a week and weight lift twice a week ( Les mills body pump at my YMCA.) I am 5’5”” and weigh 143-145. I lost 105 lbs doing this. I also eat very low carb almost Keto. I love my stack because I don’t think about food. It is always in the background now and sustains me. To break a stall I had to go up on my doses to max. Now have backed down figuring out how to maintain. I can break a stall with less calories about 1300. I can break a stall with more swimming. I can break a stall with no carb day. We are all so different. Sounds like you need to increase the Reta which may have the more ketosis effect for you. You are in a tough spot with your lymphedema and hypothyroidism must hold a lot of fluid in/on your body. That could easily blunt your efforts. Don’t give up, keep experimenting. You will get there.

I would agree with possibly raising the reta.

Personally, I would go to like to 10.5 or 11 first. That may sound overly cautious, but the case of 24/7 reta hiccups scared the hell out of me, partly since my sides were much worse (though bearable) on the higher end of tirz.

The story of the non-stop rita hiccups:

22 days straight hiccups. Multiple doctors appointments. 3 changes in medications. CT and Ultrasound scans of my brain, chest, and abdomen. ER visit. Gastroenterologist and neurologist appointments. Then on day 23 when the Gastroenterologist went to do my endoscopy my hiccups stopped completely. The endoscopy did find a hiatal hernia but he said it was too small to be the cause of the hiccups. He blamed the GLP and later said the hiccups stopped because the medication finally left my system completely.

It was a nightmare that finally ended.

 

[FlowerFairy]

I would agree with possibly raising the reta.

Personally, I would go to like to 10.5 or 11 first. That may sound overly cautious, but the case of 24/7 reta hiccups scared the hell out of me, partly since my sides were much worse (though bearable) on the higher end of tirz.

The story of the long bout of hiccups on reta:

https://glp1forum.com/threads/gyc-reta-50-gb.3151/

I’m waiting at least a week before going up again… they say to give it 4 weeks before increasing, so I do.

 

[zpped]

I’m waiting at least a week before going up again… they say to give it 4 weeks before increasing, so I do.

Correct, you won't even be fully loaded on this dose until you get that far in. I'd then give it a few more weeks to see if your indicators start to move again.