Stacking Tirz w/ CagriSema

[One_Tired_Lady]

Hello all!
I'm open to hearing different perspectives, so please feel free to share your experiences, opinions, and any words of caution you might have.
I had been on Tirz 2.5 for a while, and the loss was slow but happening. I wasn't feeling much hunger suppression, and while food noise had decreased, I felt it hadn't reduced enough. I titrated up to 3.5mg (about 5 weeks into treatment) and, after doing some heavy research, ordered a vial of Cagri and a vial of Sema.
I took my 3.5mg dose of Tirz on Saturday night, and the following Wednesday, I took 0.2mg of Cagri and 0.2mg of Sema, figuring I would gauge from there if I needed to reduce dosing further. Besides some very slight nausea the next day, there were no other adverse side effects. However, my hunger and food noise were truly suppressed for the next four days, with very little to no food aversion, so I could still eat as needed, just in much smaller amounts throughout the day. My weight loss picked up, and I was thrilled with the results, especially because of the lack of side effects. I was losing at exactly the rate I had hoped for.
This past Saturday, I took my Tirz back down to 3mg (I want to see if everything is as effective at the lowest possible dose), and on Wednesday, I intend to administer the same Cag/Sem dose as last week.
I see many differing opinions/protocols regarding whether or not to stack multiple GLP-1s. I understand there is a risk of gut paralysis with Sema, so I am going into this with caution but hope. Does anyone here have any personal experience, positive or negative, doing this same stack? Is there anything I should be doing differently?
I'd also like to add that I get plenty of protein (80-120g), fiber, and water (0.75-1 gallon daily), and I am pretty *regular* (gross, sorry). There are no telltale signs of hypoglycemia, either. Blood work done about 3 months ago came back completely normal except for low iron and D3, which I now take supplements for.
Starting weight of 313 lbs, down to around 292-ish as of today.
And one more thing (I promise) worth noting: I have been suffering from horrible inflammation that just made my entire body ache almost always. The knees and chest were particularly bad. As of these last few days, I have virtually no pain at all, and standing up from a sitting position, I brace myself each time for that horrific groaning pain in my knees, and each time, I pop right up with zero pain or resistance, and each time it takes me entirely by surprise lol. My hands and face are MUCH less puffy, too. The reason I wanted to bring this up is because I have been considering eventually adding in a blend (short-term) of either BPC-157/TB-500 or CJC-1295/Ipamorelin (no Tesa for me as I am on an SNRI) and I'd appreciate any insight or opinions on this as well!
I'm sorry for the novel. I just wanted to ensure I included any relevant information right from the beginning to prevent confusion. Thanks in advance!

 

[clevesand]

The Tirz is way too low to stack anything, in my opinion. The approved dose is 15mg and you're on 3 and already stacking stuff? If you're primarily concerned with appetite suppression I would stop Tirz and just take CagriSema. I honestly think Tirz is going to be a dead drug when CagriSema is approved. Nobody is going to want it anymore.

 

[Dionysian]

This is very interesting about the inflammation and I would love to experience that too. My thoughts are this: as others have told me, don’t be foolish enough to think you’re the exception to the studies showing that 7.5-15mg is the therapeutic window for Tirz. I also was hoping to stay low on my dose (was at about 3.5) and lamented about my app suppression at sub therapeutic “micro” dose and after my post with more experienced users chiming in I feel more confident that going up is just what’s needed. Maybe others can give you more insight about combining all 3 of those but I do wonder if your Tirz was simply too low to begin with. But we all do respond differently and if you’re having great results with low side effects on CagriSema no reason why you couldn’t dial back and drop Tirz.

 

[MrsRoper_1977]

I agree with @clevesand about not stacking the Tirz while you’re at such a low dose. I would ride it out to max dose, titrate as needed though. Sounds like Tirz is working for you, especially with the weight loss and the reduced inflammation. I too benefited from the reduced inflammation and continue to have relief now with Reta.

 

[One_Tired_Lady]

Thank you all!
It is not so much that I am afraid to go up in Tirz dose, it's more so that around the 5th day of the week I am absolutely ravenous and the cargrisema muted that overwhelming desire to constantly snack.
As for dropping the tirz, I am nervous to do so only because I worry that the inflammation might come back! (Not trying to argue at all btw, just trying to give some background on my though process).
Would it perhaps be better to split my Tirz dose to 3mg every 4/5 days, considering I am supposed to be a few weeks into 5mg dosing now?
Or perhaps drop the sema and keep tirz/cag?
It's just those last 2/3 days of the week that have me feeling insane!

 

[moonpies4misfits]

around the 5th day of the week I am absolutely ravenous

I had a similar experience so I just started dosing every 5 days instead of 7. A number of folks have tried the 5 day schedule with success.

 

[AndyPanda]

Thank you all!
It is not so much that I am afraid to go up in Tirz dose, it's more so that around the 5th day of the week I am absolutely ravenous and the cargrisema muted that overwhelming desire to constantly snack.
As for dropping the tirz, I am nervous to do so only because I worry that the inflammation might come back! (Not trying to argue at all btw, just trying to give some background on my though process).
Would it perhaps be better to split my Tirz dose to 3mg every 4/5 days, considering I am supposed to be a few weeks into 5mg dosing now?
Or perhaps drop the sema and keep tirz/cag?
It's just those last 2/3 days of the week that have me feeling insane!

Tirzepatide has a half-life of 5 days, per Eli Lilly, so at day five there will be 50% of the original dosage left in your body.

I began taking it every 5 days after moving to 10mg and building a little bit of a tolerance to it. I believe if I had done this sooner I would still be on a lower dose. Normal titration for Tirzepatide is 2.5/4/7.5/10/12.5/15mg. I do not think splitting your dose would have the desired efficacy.

​

 

[clevesand]

I had a similar experience so I just started dosing every 5 days instead of 7. A number of folks have tried the 5 day schedule with success.

This is the best advice. I only lasted 4 days on all doses of Tirz from 2.5 to 15. I kept thinking that increasing the dose would help, but it never did. I should have just changed to 5 days but didn't know enough at the time.

 

[MrsRoper_1977]

This is the best advice. I only lasted 4 days on all doses of Tirz from 2.5 to 15. I kept thinking that increasing the dose would help, but it never did. I should have just changed to 5 days but didn't know enough at the time.

Agree. I dose Reta every 5 days and it works for me. Never did the splits but many like it, so it is an option for some.

 

[One_Tired_Lady]

I had a similar experience so I just started dosing every 5 days instead of 7. A number of folks have tried the 5 day schedule with success.

Tirzepatide has a half-life of 5 days, per Eli Lilly, so at day five there will be 50% of the original dosage left in your body.

I began taking it every 5 days after moving to 10mg and building a little bit of a tolerance to it. I believe if I had done this sooner I would still be on a lower dose. Normal titration for Tirzepatide is 2.5/4/7.5/10/12.5/15mg. I do not think splitting your dose would have the desired efficacy.

​

This is the best advice. I only lasted 4 days on all doses of Tirz from 2.5 to 15. I kept thinking that increasing the dose would help, but it never did. I should have just changed to 5 days but didn't know enough at the time.

So, just to clarify, you are saying that taking the full dose of Tirz every 5 days is the way to go, as opposed to taking 2x half-doses over the course of a full week?
For example 5mg on a Monday night, and then again on Saturday night, then again on the following Thursday night, etc. As oppsed to 2.5mg on Monday night, then again on Thursday or Friday night, and then back to Monday night, rinse & repeat.

 

[moonpies4misfits]

So, just to clarify, you are saying that taking the full dose of Tirz every 5 days is the way to go, as opposed to taking 2x half-doses over the course of a full week?
For example 5mg on a Monday night, and then again on Saturday night, then again on the following Thursday night, etc. As oppsed to 2.5mg on Monday night, then again on Thursday or Friday night, and then back to Monday night, rinse & repeat.

Yep. I use colorful mini post-it notes on my wall calendar to keep track because I'm a space cadet and I'll forget

 

[AndyPanda]

So, just to clarify, you are saying that taking the full dose of Tirz every 5 days is the way to go, as opposed to taking 2x half-doses over the course of a full week?
For example 5mg on a Monday night, and then again on Saturday night, then again on the following Thursday night, etc. As oppsed to 2.5mg on Monday night, then again on Thursday or Friday night, and then back to Monday night, rinse & repeat.

That is my opinion and what has worked for me. Monday, Friday, Tuesday...

 

[One_Tired_Lady]

Yep. I use colorful mini post-it notes on my wall calendar to keep track because I'm a space cadet and I'll forget

Ooof... same

 

[Tomes]

The Tirz is way too low to stack anything, in my opinion. The approved dose is 15mg and you're on 3 and already stacking stuff? If you're primarily concerned with appetite suppression I would stop Tirz and just take CagriSema. I honestly think Tirz is going to be a dead drug when CagriSema is approved. Nobody is going to want it anymore.

i don't agree with this personally. both from a physiological and monetary perspective, staying on the lowest possible effective dose is always preferential. if you can get more impact from low-ish dose of tirz plus a low-ish dose of cagrisema (or perhaps just cagri), seems better than having to be on 15mg of tirz a week, or more.

it's also a pretty ridiculous thing to say that tirz is going to be a 'dead drug.' I would personally never touch sema given the extent of side effects, and reta is not my friend. tirz has been great to me, and based on the last poll taken here, the majority of people are on tirz.

 

[RedSkip]

@One_Tired_Lady You can utilize a GLP1Plotter.com or Steroidplotter.com to plot out your dosing schedule to see how much of the drug is in your RS at any given time.

Side note, I prefer Steroidplotter, in the comment section you can find a link to the pharmacokinetic data for various drugs which you can use to plot yourself if you wanted to build such a tool.

 

[RedSkip]

i don't agree with this personally. both from a physiological and monetary perspective, staying on the lowest possible effective dose is always preferential. if you can get more impact from low-ish dose of tirz plus a low-ish dose of cagrisema (or perhaps just cagri), seems better than having to be on 15mg of tirz a week, or more.

it's also a pretty ridiculous thing to say that tirz is going to be a 'dead drug.' I would personally never touch sema given the extent of side effects, and reta is not my friend. tirz has been great to me, and based on the last poll taken here, the majority of people are on tirz.

I think the issue is research hasn't been done at the clinical level for Triz & CagriSema stacks. They've been tested independently, but not together, and therefore you don't really know the effects on the RS.

 

[clevesand]

i don't agree with this personally. both from a physiological and monetary perspective, staying on the lowest possible effective dose is always preferential. if you can get more impact from low-ish dose of tirz plus a low-ish dose of cagrisema (or perhaps just cagri), seems better than having to be on 15mg of tirz a week, or more.

it's also a pretty ridiculous thing to say that tirz is going to be a 'dead drug.' I would personally never touch sema given the extent of side effects, and reta is not my friend. tirz has been great to me, and based on the last poll taken here, the majority of people are on tirz.

What people are on today is irrelevant. Phentermine is a "dead" drug today because there are better options but everyone was on in back in the day. Orlistat is a "dead" drug today because there are better options. None of us are shitting all over ourselves today but you can still buy it. Atripla saved hundreds of thousands of people from AIDS but is a "dead" drug today because there are better options with fewer side effects. History will say if I'm right or wrong, but I do believe that as soon as CagriSema and others is approved everyone will flock to it just like they did to Tirzepatide. The phase 3 studies are mind-blowing.

Finally, staying on the lowest possible dose so you can stack two totally different drugs is never "preferential."

 

[One_Tired_Lady]

@One_Tired_Lady You can utilize a GLP1Plotter.com or Steroidplotter.com to plot out your dosing schedule to see how much of the drug is in your RS at any given time.

Side note, I prefer Steroidplotter, in the comment section you can find a link to the pharmacokinetic data for various drugs which you can use to plot yourself if you wanted to build such a tool.

Thank you- I will definitely look into this!

 

[One_Tired_Lady]

Finally, staying on the lowest possible dose so you can stack two totally different drugs is never "preferential."

I completely understand what you are saying. However, for me personally, the stacking of two different items and staying at low doses of both is not due to cost nor is it my intention to stay on lowest dose purely so I can stack those two items.
I went into it with the understanding that while both drugs are essentially in the same category, they both provide different benefits. Sema is and cagri are both known to be far more effective at reducing hunger over Tirz, but generally with more side effects and, for a lot people, not anywhere near as effective Tirz in terms of shedding actual weight.
By combing the two at "low" doses(not on the same day, but 4 days apart), my hope was to benefit from what each had to offer, just as the effects of the one previously take began to wear off, while at the same time avoiding the worst of potential side effects.
Well, after doing this, it worked exactly as I had hoped it would. As explained in my original post, the worst I experienced was some very slight nausea for a couple of hours the following day.
Like I said, my intention is absolutely not to stack as many drugs as I can (did more than enough of that in my youth) and expect miraculous results. I am merely looking for a combination that will extend the benefits of the drugs, sustainably.

 

[MrsRoper_1977]

I completely understand what you are saying. However, for me personally, the stacking of two different items and staying at low doses of both is not due to cost nor is it my intention to stay on lowest dose purely so I can stack those two items.
I went into it with the understanding that while both drugs are essentially in the same category, they both provide different benefits. Sema is and cagri are both known to be far more effective at reducing hunger over Tirz, but generally with more side effects and, for a lot people, not anywhere near as effective Tirz in terms of shedding actual weight.
By combing the two at "low" doses(not on the same day, but 4 days apart), my hope was to benefit from what each had to offer, just as the effects of the one previously take began to wear off, while at the same time avoiding the worst of potential side effects.
Well, after doing this, it worked exactly as I had hoped it would. As explained in my original post, the worst I experienced was some very slight nausea for a couple of hours the following day.
Like I said, my intention is absolutely not to stack as many drugs as I can (did more than enough of that in my youth) and expect miraculous results. I am merely looking for a combination that will extend the benefits of the drugs, sustainably.

That’s the beauty of doing our own research. What works for one won’t work for another. And we have many tools with more on the way. Sounds like what you’re doing is working for you. The main thing is to do the research safely.