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.

 

[Sun_Seeker]

I'd ramp up on tirzepatide before switching. You haven't even really hit therapeutic dose yet. I've (mostly) lived by wait the 4 weeks of the standard protocol before upping and then, as side effects allowed, increased. Although admittedly, sometimes I increased my dose by only a mg or two at a time with low and slow in mind. I'm "saving" reta and any other meds for later in my journey when I may hit a stall or for maintenance. I've lost over 60 lbs since May with this approach.

 

[Maryheartline0803@]

I have been on compound trizepatide for a year and in the last month switched to grey. My dosage was 2.5 for 4 weeks, 5.0 for 4 weeks and I increased because of food noise and not much weight loss. When I started the 7.5 dose I really noticed a difference in both food noise and weight loss. I stayed on this dose for 16 weeks because it was working. I titrated up to 10mg because of a stall and stayed on this dose for 16 weeks and just started 12.5mg and am losing again but slowly. My weight loss is 60 pounds and I only want to lose another 5 to 10 pounds. It seems the closer I get to goal the harder it is to lose. My thought is my body probably has got accustomed to the medicine. I have no plan to up my dose to 15.0mg but time will tell and if I don’t lose the last amount of weight I just might stay on the 12.5 dose for maintenance.
Good luck on your journey. It’s been a miracle drug for me and I am so grateful that I found the way to get it here because the cost of compound was going to force me to quit.

 

[lessthanhalf]

The only other thing it would be worth mentioning is that the peak time for side effects is about 2 to 4 months after starting, and especially after dose increases, for nausea or vomiting or other gut upsets, as these are by far the most common issues. Not everyone has these , but it is pretty common and usually gets better over time. If you do, either stop going up doses for a while, or if more severe, stop totally for a few weeks until it settles down, then restart at a lower dose and then increase doses more slowly.
It also depends on how well it is working, if you are losing weight and do not feel you are hungry all the time and sticking to the diet you want to follow is easy then there is probably no need to increase doses quickly, but I would probably aim for at least 10 mg per week for the other benefits of tirzepatide, reductions in risk of a huge number of health problems especially diabetes, cardiovascular disease, hypertension, several cancers etc. And as you are not going through a doctor for this make sure you have blood pressure, blood sugar and cholesterol checked.
I would not recommend trying retatrutide at this time, As you started on tirzepatide it makes more sense to try it properly and see how it works for you over 6 to 12 months and then work out what to do from there depending on weight loss, hunger and side effects.