My doctor just told me to stack Tirz and Sema

[Vacation4us]

Just saw my endocrinologist yesterday. I am currently on Zepbound 15 mg ( actually taking amopure T60 while I stockpile). BMI is 25 and he wants me under. Since switching from Wegovy to Zepbound it’s slow going. So he offered me a sample pen of Oz to add .25 mg and titrate up as needed to achieve some more weight loss.

I'm told him I had leftover 2.4 mg Wegovy pens and we discussed me cracking open those pens and using them.

Just thought those stacking or thinking of stacking might be interested.

 

[flannel]

Considering that sema has such a higher affinity for GLP-1, it's not crazy, but it's also not a great first suggestion on his behalf. Metformin increases intrinsic GLP-1 activity while lowering your sugar/insulin and appetite... Bupropion would increase your metabolism and decrease your appetite while increasing energy levels. There's a ton of augmentation you can do before going off the reservation.

 

[Vacation4us]

I’m 15 months in, was on Metformin in the beginning. It gave me excruciating knee pain ( thought it was the statin) Md said nope, it’s the Metformin and discontinued no more knee pain.

I was also on Wegovy and Contrave ( which has Bupropion for those that don’t know) for months, didn’t help and I still have 6 months worth unused. Switched to Zepbound in July.

The closer I get to a normal BMI the slower it goes. MD expectation at this point is a pound a month.

I’m a nurse and this Endocrinologist is literally the best, most knowledgeable, most thorough MD I have ever had the privilege to know. He is 100% NOT a mow, blow, and go provider. I trust him completely. He also trusts that I have the skill and knowledge to crack open those pens and dose myself safely.

 

[Kjm1960]

I’m 15 months in, was on Metformin in the beginning. It gave me excruciating knee pain ( thought it was the statin) Md said nope, it’s the Metformin and discontinued no more knee pain.

I was also on Wegovy and Contrave ( which has Bupropion for those that don’t know) for months, didn’t help and I still have 6 months worth unused. Switched to Zepbound in July.

The closer I get to a normal BMI the slower it goes. MD expectation at this point is a pound a month.

I’m a nurse and this Endocrinologist is literally the best, most knowledgeable, most thorough MD I have ever had the privilege to know. He is 100% NOT a mow, blow, and go provider. I trust him completely. He also trusts that I have the skill and knowledge to crack open those pens and dose myself safely.

Mow, blow and go . You must of been in the business

 

[Vacation4us]

Mow, blow and go . You must of been in the business

Just wish my gardener would spend more time pulling the weeds!

Most doctors think a full physical assessment is listening to the lungs and heart for a hot second and then done. My Endocrinologist actually did a Full assessment, palpated my thyroid, looked at my skin including my elbows, he even took a dang tuning fork to my feet. Ordered a CT scan of my lungs, ultrasound of my thyroid and breast did so much lab work. He is literally my every thing doctor now since I can’t seem to find a decent PCP. The last quack just wanted to sell me vitamins.

As a nurse I feel like I am a good judge of what a good doctor should be. Mow, blow, and go is an apt description for most.

 

[dionysos]

Most doctors think a full physical assessment is listening to the lungs and heart for a hot second and then done. My Endocrinologist actually did a Full assessment, palpated my thyroid, looked at ... The last quack just wanted to sell me vitamins.

As a nurse I feel like I am a good judge of what a good doctor should be.

Very likely that you are! My speculation is that your ENDO is canny and very well aware that Sema has much better appetite suppression than Tirz or Reta.

I stalled out of Semaglutide use after 10 months or so. That led to my "GLP1 Grand Tour" (posted on this site and soon to be made into a major motion picture) which was basically an attempt to recreate the freedom from appetite that Sema gave.

I finally have come to near-Maintenance with a combination of 12mg Retatrutide and a low dose of Cagrilintide 3.5 days following. It may be necessary for me to cease Retatrutide; I had an atrial ablation iand a pacemaker installed on August 2023 and there is some suspicion that Reta is now elevating my heart rate.

If that's so I will try Sema again. Being off that med for 9 months or more would likely have allowed the relevant hormone receptors to restore themselves and make Sema once again effective for me. Or so I think, Nurse