Please help me for the next steps

[BLASIUS]

Hi all,
I started using Tirz 6 weeks ago with the 2,5mg weekly dosage.
In the first 4 weeks I had a very high fat loss (6Kg in 4 week), in the last 2 week my weight is stalled (initial weight 119Kg current is 113Kg).
During all the 6 weeks I experienced food noise significant reduction, reduced appetite and almost no side effect.
Do you think it is time to move to a 5mg dosage or continue to use 2,5mg but every 6 days? Or maybe I could continue with the starting dosage (2,5mg/w) waiting for fat loss increase?

I bought a box of reta (10mg/vials), so I am thinking to switch to reta, but I am still a little bit undecided.

Thanks in advance to everyone will share his opinion or his esperience.

 

[lessthanhalf]

When you start losing weight , you will nearly always lose a significant amount of water with it over the first few weeks, eventually it will even out but is quite possibly the reason for the initial rapid weight loss then it slows down or stops for a while, then restarts more slowly. If how much you are eating has not changed, then this is almost certainly the explanation. You may have scales that measure fat percentage but as far as I understand they are not especially accurate anyway.
There is no reason not to increase the dose of tirzepatide to 5mg, unless you are having side effects, increasing more often than every 4 weeks can be a bad idea as blood levels take 4 weeks to get to the new maximum level, so side effects can be very delayed from dose increases, but you have already been on 2.5mg for 6 weeks. The standard recipe for starting tirzepatide is to increase the dose by 2.5mg every 4 weeks until you get to 15mg. Many people on this forum would recommend staying at as low a dose as possible for as long as possible, I would go with the official recommendations for doses as that has the best scientific evidence supporting it. How important it is to increase the dose depends a bit on your age, other health problems, and how overweight you are, and possibly how long you have been overweight. Without age and height I cannot tell.

 

[BLASIUS]

When you start losing weight , you will nearly always lose a significant amount of water with it over the first few weeks, eventually it will even out but is quite possibly the reason for the initial rapid weight loss then it slows down or stops for a while, then restarts more slowly. If how much you are eating has not changed, then this is almost certainly the explanation. You may have scales that measure fat percentage but as far as I understand they are not especially accurate anyway.
There is no reason not to increase the dose of tirzepatide to 5mg, unless you are having side effects, increasing more often than every 4 weeks can be a bad idea as blood levels take 4 weeks to get to the new maximum level, so side effects can be very delayed from dose increases, but you have already been on 2.5mg for 6 weeks. The standard recipe for starting tirzepatide is to increase the dose by 2.5mg every 4 weeks until you get to 15mg. Many people on this forum would recommend staying at as low a dose as possible for as long as possible, I would go with the official recommendations for doses as that has the best scientific evidence supporting it. How important it is to increase the dose depends a bit on your age, other health problems, and how overweight you are, and possibly how long you have been overweight. Without age and height I cannot tell.

Thank you.

I am a 60yo man, 1.80m heigth, initial weight 119Kg (BMI 36). My weight increased a lot during COVID period (increased 20Kg in 1 year, I have been able to loose 5kg with gym, before I decided to try Tirz).
I have no significant side effect with 2.5mg/w, and I am eating same amount and type of food (Low carb basically) since the first week on Tirz.
On next weadnesday I will inject the new dose, and I have a big dilemma, because I red somewhere, that it could be better to wait at least 4 weeks of stalled weight before to increase but somewhere else as you stated it is suggested to increase every 4 weeks if no side effect raises.

 

[latviantower]

My tirz experience started with compounded product supervised by an MD. The monthly questionnaire asked multiple questions designed to determine if you needed the next higher dose. So mainstream medicine is obviously designed to keep you on as low a dose that is effective for you. It took me eight months to get to 15 mg. Stalls were inevitable and temporary.

I would step it up, side effects permitting.

 

[BLASIUS]

My tirz experience started with compounded product supervised by an MD. The monthly questionnaire asked multiple questions designed to determine if you needed the next higher dose. So mainstream medicine is obviously designed to keep you on as low a dose that is effective for you. It took me eight months to get to 15 mg. Stalls were inevitable and temporary.

I would step it up, side effects permitting.

Thanks,
could you please share somehow the criteria included in the questionnaire?
In case I will decide to step up to 5mg dose, hoping that no additional side effects will raise, which could be the additional expectations: additional appetite reduction, increasing weight loss with same amount of food intake, other?

 

[byefatlicia]

During all the 6 weeks I experienced food noise significant reduction, reduced appetite and almost no side effect

I would absolutely go up (if it were me) bcuz I did (when it was me). It is the recommended thing to do, after all, for a reason.
But don't be impatient and think you can expect the same rapid loss as at first.
And IMO, you shouldn't change to Reta because of a 2 week stall at your starting dose. It sounds like the Tirz is working as it should for you.

 

[latviantower]

Thanks,
could you please share somehow the criteria included in the questionnaire?
In case I will decide to step up to 5mg dose, hoping that no additional side effects will raise, which could be the additional expectations: additional appetite reduction, increasing weight loss with same amount of food intake, other?

Sure (I’m doing this from memory, it’s been a few months):

• Are you experiencing any of the following: (checklist of common and not so common side effects)?
• How would you rate your appetite in the past month? (Answers range from “Starving all the time!” to “Seems like I’m never hungry.”)

Last question is something like “Do you think your current dose is sufficient?” Choices are Yes, I’m doing fine at the current dose, I think I need a stronger dose, or I’m never hungry, this dose might be too much.

There were other questions, but the three above stuck in my brain.

I titrated up every month except I stayed at 10 mg for 3 months. Was consistently losing 1-2 pounds per week, then stalled about 10 weeks into that dosage. Doc upped it so I was at 15 mg by the end of the 8th month. Now a year in and down 95 pounds. A1C down almost 2% points and weaned off 4 different blood pressure medications.

Best of luck with your next steps!

 

[BLASIUS]

Sure (I’m doing this from memory, it’s been a few months):

• Are you experiencing any of the following: (checklist of common and not so common side effects)?
• How would you rate your appetite in the past month? (Answers range from “Starving all the time!” to “Seems like I’m never hungry.”)

Last question is something like “Do you think your current dose is sufficient?” Choices are Yes, I’m doing fine at the current dose, I think I need a stronger dose, or I’m never hungry, this dose might be too much.

There were other questions, but the three above stuck in my brain.

I titrated up every month except I stayed at 10 mg for 3 months. Was consistently losing 1-2 pounds per week, then stalled about 10 weeks into that dosage. Doc upped it so I was at 15 mg by the end of the 8th month. Now a year in and down 95 pounds. A1C down almost 2% points and weaned off 4 different blood pressure medications.

Best of luck with your next steps!

Thank you, very interesting

 

[indolent]

I also started out with the "low and slow" mindset with tirzepatide ... before reading about what's called the GLP-1 60-week plateau. Then I switched to the official, scientifically tested protocol, which I wish I had embarked on from the start.

BTW, 2.5 mg isn't even considered a therapeutic dose of tirz ... it's part of a ramp-up, and to test for your own personal negative reactions to the drug.