Reta/Cag vs Cagrisema for stacking with Tirz

druell235

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Tirz is starting to lose effectiveness earlier in the week. For those who have used one or both of these blends, which do you find stacks better with tirz.
 
Have you tried split dosing before adding something else? That's usually the best first tactic when you've been successful with a weight loss medication (efficacy; tolerable side effects) but after a while the positive effects aren't lasting the full week.
 
I had no luck with Reta. It didn't suppress my appetite and it gave me allodynia so I weaned myself off of it and went back to Tirz. But I added Cagri, slowly and cautiously, and it works great. I live in fear of the return of the appetite, because I believe calorie restriction has been responsible for 90% of my weight loss. I basically do OMAD fasting and add in some protein shakes and vitamins. It's a smooth ride.

So I am currently split dosing both Tirz and Cagri as the Reta slowly half-lifes its way out and the allodynia fades. I take Tirz at 12mg/week and Cagri at 2mg/week. Yes, it sounds like an aggressive Cagri dose, but I think I'm a poor responder. I had no bad side effects from it when I started at 0.2mg, so I gradually titrated up when I felt my appetite creeping back.
 
druell235 said:
Tirz is starting to lose effectiveness earlier in the week. For those who have used one or both of these blends, which do you find stacks better with tirz.
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Are you on 15mg /week of tirz? Start weight, age, general health, height, current weight, time to lose weight? All makes some difference as to what is reasonable or not once you are getting to the plateau stage?
If it is working fine, but seems less effective the day or 2 before the next dose then split dosing is a easy solution.
 
lessthanhalf said:
Are you on 15mg /week of tirz? Start weight, age, general health, height, current weight, time to lose weight? All makes some difference as to what is reasonable or not once you are getting to the plateau stage?
If it is working fine, but seems less effective the day or 2 before the next dose then split dosing is a easy solution.
Click to expand...
Yes I am on 15mg of tirz. Starting 446, current weight 297. Age 38, male, height 5'11. T2D and hypertension.
 
FartfulCodger said:
I had no luck with Reta. It didn't suppress my appetite and it gave me allodynia so I weaned myself off of it and went back to Tirz. But I added Cagri, slowly and cautiously, and it works great. I live in fear of the return of the appetite, because I believe calorie restriction has been responsible for 90% of my weight loss. I basically do OMAD fasting and add in some protein shakes and vitamins. It's a smooth ride.

So I am currently split dosing both Tirz and Cagri as the Reta slowly half-lifes its way out and the allodynia fades. I take Tirz at 12mg/week and Cagri at 2mg/week. Yes, it sounds like an aggressive Cagri dose, but I think I'm a poor responder. I had no bad side effects from it when I started at 0.2mg, so I gradually titrated up when I felt my appetite creeping back.
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How is your appetite? Any GI issues?
 
druell235 said:
How is your appetite? Any GI issues?
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Very minor GI issues. No pain or nausea, just inconsistent bowel movements. Appetite is dead during the morning. Sometimes it flares up a little in the afternoon, so I eat something tiny or have a protein shake, and it goes away. But if I'm hungry at dinnertime I make myself eat a regular balanced dinner meal, but a smaller portion, just for the sake of good nutrition and normalcy.

I do think I'm kind of a non-responder though. I've never had any hint of nausea with any of these meds (not with Tirz, Reta nor Cagri). But I've heard reports of nausea and GI issues with Cagri, even at small doses, so I'd advise easing into Cagri if you choose to go that route. Good luck in any case.
 
FartfulCodger said:
Very minor GI issues. No pain or nausea, just inconsistent bowel movements. Appetite is dead during the morning. Sometimes it flares up a little in the afternoon, so I eat something tiny or have a protein shake, and it goes away. But if I'm hungry at dinnertime I make myself eat a regular balanced dinner meal, but a smaller portion, just for the sake of good nutrition and normalcy.

I do think I'm kind of a non-responder though. I've never had any hint of nausea with any of these meds (not with Tirz, Reta nor Cagri). But I've heard reports of nausea and GI issues with Cagri, even at small doses, so I'd advise easing into Cagri if you choose to go that route. Good luck in any case.
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Thank you. That gives me some hope. Sema made me nauseous 24 hours after I took it when I started with it last year, but other than that I have never had any side effects from tirz, reta, cagri,(tried in the fall, but couldnt tell if it was doing anything so I stopped).
 
For added context, in addition to the food noise coming back earlier and earlier. These are my last few weights.
March 9th-299
March 16th-297.1
March 23rd -299.5
March 24th-297.6, I think I might have been retaining water the day before
March 30th-297.4

It's driving me crazy.
 
Given the starting BMI of 62, this is a situation where higher doses or combinations are actually reasonable to consider. The best so far is nearly 30% from reta , trying to lose more than that is unfortunately outside the scope of the research. You have already lost 33% , more than the average from any of the studies, options from there are unfortunately experimental, with the main source of information being unreliable anecdotal reports on forums.
Weight not changing for 1 month is not enough to be sure it is not fluctuations in fluid balance. I am guessing you have been on tirz for a while given the weight loss, congrats on that.
I assume you do get medically checked out sometimes. And no overt heart disease and reasonably controlled blood sugars.
One issue is are you on any other diabetes medications? Adding extra drugs or higher doses would have extra risks in that context especially of hypoglycemia. You would likely need to monitor blood sugars carefully if you tried adding drugs in. In a perfect world you could get expert medical advice on managing this but given none of the options are really studied or approved yet , no doctor is going to recommend reta or cagri. Ideally a doctor could still give good advice on reducing risks without agreeing it is a good idea, for the purposes of harm minimisation, but unfortunately most are not that mentally or legally flexible.
You mentioned nausea from semaglutide, given it probably has the worst nausea to weight loss ratio it is not the ideal choice, but low dose add ons of it have been used successfully,
Simplest option is increasing tirzepatide dose, not studied yet of course, but probably the lowest chances of side effects .
I would probably not use cagrisema , just as it is two extra drugs at once and would make it harder to interpret effects.
You could swap to reta, but an extra 5% is not likely to be enough to get you where you want to be.
Adding in small doses of cagri or reta are the other options, and increase slowly.
Doing any of these carries some risks, of side effects or unknown effects, there is no way to avoid this other than careful monitoring, and you have to balance that against reduction in long term risks from weight loss, which are probably very large effects.
I tolerated 15mg of tirz well so did not want to swap to reta, so added 5mg of reta, cannot increase dose higher as skin sensory issues start getting unpleasant. Added in 0.5 of cagri recently to see if it helped not sure yet. I did it backwards losing the weight first then starting glp's to try to reduce being permanently hungry, and they help a lot. currently 54% down bmi 24.
I am sure you are not perfectly happy with your current weight , I calculate bmi as 41, but it is still a huge achievement , and while not low enough to get risks down to normal levels is still much better to be high or very high risk than extreme risk with a bmi of 62. It may not be possible to get to normal BMI's, and part of the aim at his point must be to reduce the risks of putting weight back on as much as losing more to preserve what you have achieved.
 
lessthanhalf said:
Given the starting BMI of 62, this is a situation where higher doses or combinations are actually reasonable to consider. The best so far is nearly 30% from reta , trying to lose more than that is unfortunately outside the scope of the research. You have already lost 33% , more than the average from any of the studies, options from there are unfortunately experimental, with the main source of information being unreliable anecdotal reports on forums.
Weight not changing for 1 month is not enough to be sure it is not fluctuations in fluid balance. I am guessing you have been on tirz for a while given the weight loss, congrats on that.
I assume you do get medically checked out sometimes. And no overt heart disease and reasonably controlled blood sugars.
One issue is are you on any other diabetes medications? Adding extra drugs or higher doses would have extra risks in that context especially of hypoglycemia. You would likely need to monitor blood sugars carefully if you tried adding drugs in. In a perfect world you could get expert medical advice on managing this but given none of the options are really studied or approved yet , no doctor is going to recommend reta or cagri. Ideally a doctor could still give good advice on reducing risks without agreeing it is a good idea, for the purposes of harm minimisation, but unfortunately most are not that mentally or legally flexible.
You mentioned nausea from semaglutide, given it probably has the worst nausea to weight loss ratio it is not the ideal choice, but low dose add ons of it have been used successfully,
Simplest option is increasing tirzepatide dose, not studied yet of course, but probably the lowest chances of side effects .
I would probably not use cagrisema , just as it is two extra drugs at once and would make it harder to interpret effects.
You could swap to reta, but an extra 5% is not likely to be enough to get you where you want to be.
Adding in small doses of cagri or reta are the other options, and increase slowly.
Doing any of these carries some risks, of side effects or unknown effects, there is no way to avoid this other than careful monitoring, and you have to balance that against reduction in long term risks from weight loss, which are probably very large effects.
I tolerated 15mg of tirz well so did not want to swap to reta, so added 5mg of reta, cannot increase dose higher as skin sensory issues start getting unpleasant. Added in 0.5 of cagri recently to see if it helped not sure yet. I did it backwards losing the weight first then starting glp's to try to reduce being permanently hungry, and they help a lot. currently 54% down bmi 24.
I am sure you are not perfectly happy with your current weight , I calculate bmi as 41, but it is still a huge achievement , and while not low enough to get risks down to normal levels is still much better to be high or very high risk than extreme risk with a bmi of 62. It may not be possible to get to normal BMI's, and part of the aim at his point must be to reduce the risks of putting weight back on as much as losing more to preserve what you have achieved.
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Thank you! Briefly, I started on compound semaglutide last year and used that until May and maxed out at 2.5. I then switched to compound tirz at 10 and titrated up from there. Since then I discovered grey, briefly did reta for a few weeks in the fall and could not determine if it was making a difference so decied to stick to tirz for as long as possible.

As for medications, I'm on 1000mg of metformin a day. My doctor said I've lost enough weight and my last two a1cs were 4.5 and 4.7, so I could go off the metformin if I wanted to, but I decided to keep it. I'm also on Lisinopril HCTZ, Amlodipine, and atorvastatin (thats more a preventative thing). I told my doctor I'm on compound, which was true when I told him last year, and he orders labs every three months.

I am not perfectly happy with my current weight, but its still a huge improvement. I really can't beilieve how big I used to be and how much easier every day life is. I had to run for a bus last week and didn't die and wasn't even that out of breath. I walk an hour a day and actually enjoy it. I just feel there is more to do and I don't want to get stuck here. I still have vial of Hallandale semaglutide that expires next month so I will try adding that in next week.
 
At least metformin is not normally a cause of hypoglycemia, and may have additional minor weight loss effects, but still probably not a bad idea to keep an eye on sugars mainly for lows, given the hb1ac is excellent. None of the medications typically cause hypoglycemia, but combinations are not really studied so it is probably better to be careful.
 
Between those, I'd lean Cagri over CagriSema for stacking with tirz, mostly because CagriSema adds sema too and makes it harder to tell what is doing what.
 
I’ve been on Reta since march and recently added cargrilintide 0.50mg to help with the food noise. It works for me. Im also T2D and on metformin 2000mg but I think I need to drop to a lower dose soon. My blood sugar have been between 124-140 since I added the Carg 2 weeks ago
 
skeptick said:
Please tell us about your time line for this weight lose. ThanX
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Sure thing. I started sema through a compounding pharmacy last Janurary and did not lose any weight until late May when I got to the higher doses, though this may have also been due to not tracking my calories and taking the nutrition part of this journey very serious. I switched to compound tirz in last June and started tracking and the weight started falling off at a rate of 3 pounds a week. I also started walking regularly in August. At first it was 30 minutes 3 times a week, now its an hour six days a week. Here's my shots timeline. Also I did break the stall that caused this post.
 

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druell235 said:
Sure thing. I started sema through a compounding pharmacy last Janurary and did not lose any weight until late May when I got to the higher doses, though this may have also been due to not tracking my calories and taking the nutrition part of this journey very serious. I switched to compound tirz in last June and started tracking and the weight started falling off at a rate of 3 pounds a week. I also started walking regularly in August. At first it was 30 minutes 3 times a week, now its an hour six days a week. Here's my shots timeline. Also I did break the stall that caused this post.
Click to expand...
fantastic
 
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