When to titrate up

[noggin]

Been dosing Tirz every 5 days at 1.8mg for a month but the suppression is starting to wane a little bit. I found the suppression very high and lost around 20 pounds in the last month (I tried to eat as much protein as possible and I know such fast weight loss is unhealthy but I struggled to prevent it) but now I haven't noticed any change in the last week. How much longer of a plateau should I wait for before titrating up? I would probably move up to 2.5mg / 5 days next.

 

[ZakAP]

I'm curious why you were taking it every 5 days if you found the "suppression very high" and were losing that much weight.
If you plan to try to sustain 20 lbs/month you might want to talk with Oyster.

 

[Brookie]

I lost 20 lbs in 6 months, I’m happy with that progress, so I can’t really relate to such fast progress, but I went up .5 every 3 weeks or so. I have about 15 lbs left to lose, I’m currently at 6. I just went up if I didn’t go down in the 3 weeks, I was giving my body time to adjust I guess. It worked, no side effects.

 

[noggin]

I'm curious why you were taking it every 5 days if you found the "suppression very high" and were losing that much weight.
If you plan to try to sustain 20 lbs/month you might want to talk with Oyster.

I found the suppression very high at the start of the week then extremely low at the end and didn't want constant spikes, but also didn't want to increase past 2.5 so lowered to 1.8 so that I was taking 2.5 per week anyway. I definitely do not want to sustain 20lb/month and would be perfectly happy with 2lb/week as is recommended. I was just unable to eat the first two weeks as much as I tried and just dropped off most of that weight (the increase in exercise probably didn't help the calorie deficit). Just wondering when others would recommend titration.

To add, during that two week period where the suppression was extreme I was dosing once per week, then on week three noticed my appetite swinging back heavily on day 5/6 so switched to once every 5 days (and I read that maintaining constant levels of serum leads to better results)

 

[ZakAP]

I don't know if I can give a good recommendation since everyone is different. I have seen it stated that a true "plateau" is more than 3 (or 4?) weeks of no weight loss. So you are not really at a "plateau." I would not use results or feelings of one week to determine dose changes. The lack of weight loss for a week may be because of the rapid weight loss when you started.

For me - I started at 2.5mg and ended up changing it to every 5 days. I also found it dropping off hard by around day 5 and definitely by day 6. I did that for 4 weeks which I felt very up and down with food noise. Then I did split-dosing of 2.5 mg 2x/week (so every 3 to 4 days) for a month. I now am doing 5 mg every 7 days and am finding that I feel more steady. I think it took a bit for the levels to get where I needed them to - but not increasing too fast to prevent GI side effects.

 

[Don Ligero]

Take as long as possible before titrating up. Play the LONG game. I started on the Mounjaro OG $25/ mo coupon. My doctor had me titrate up EVERY month so hit 15mg in the minimum time. All was great for a year on 15 and the weight loss stalled. I was losing BIG even at 7.5mg / week. Knowing what I know now, I would have stayed at levels much longer as long as I was losing weight. I really believe that I would have lost less during the peak period, but would have lost more in the following 6 months on 15mg per week. I have found that 1-2% bodyweight loss per month is a good pace. This is a marathon, not a sprint. My recommendation is to stay as long as you are still trending down. Good luck!

 

[scarywood75]

I may have a controversial opinion on this, but I'd say don't stress out and increase when you need it.

Why I say that? There's more and more GLP1s and alternatives day by day, you can always switch to something else if you get to the highest dose and it stops working

 

[penewbie]

I may have a controversial opinion on this, but I'd say don't stress out and increase when you need it.

Why I say that? There's more and more GLP1s and alternatives day by day, you can always switch to something else if you get to the highest dose and it stops working

For real.

Even for Tirz they're currently doing trials on 25mg and 20mg doses. All this worry about increasing dosage "too fast" seems misplaced to me.

Personally as soon as the food noise returns I increase my dose.

 

[scarywood75]

For real.

Even for Tirz they're currently doing trials on 25mg and 20mg doses. All this worry about increasing dosage "too fast" seems misplaced to me.

Personally as soon as the food noise returns I increase my dose.

Yeah, I feel it's ok to titrate slowly at the beginning of a new peptide, but once you know the side effect and all it's fine to go faster

 

[ZakAP]

For real.

Even for Tirz they're currently doing trials on 25mg and 20mg doses. All this worry about increasing dosage "too fast" seems misplaced to me.

Personally as soon as the food noise returns I increase my dose.

I may have a controversial opinion on this, but I'd say don't stress out and increase when you need it.

I agree with both here. I do not use the scale as the measure for when to increase. Food noise - yes. I only caution on moving up "too fast" bc of potential side effect/GI issues with increased dose especially with just starting out.

 

[noggin]

I may have a controversial opinion on this, but I'd say don't stress out and increase when you need it.

Why I say that? There's more and more GLP1s and alternatives day by day, you can always switch to something else if you get to the highest dose and it stops working

Yeah you're probably right about other options and dosing abilities, but I see where other people are coming from too. Also with a higher dose comes a higher cost. I'm probably going to take a middle ground approach and just see if I lose anything over the next two weeks (last week of stall included) and if not titrate up since I'm already behind schedule regarding dosing. I'm already doing better than I expected since as I've heard most males don't respond to 2.5mg.

 

[ZakAP]

I wouldn't think of it as "behind schedule."
Personally - I would not take 1 week of no weight loss as a "stall."
My recommendation is read through some posts of other's experiences. From what I have read is every week can be different. Just because one week looks or feels a certain way does not mean that something is wrong or needs to be changed. Look at patterns.

 

[scarywood75]

Yeah you're probably right about other options and dosing abilities, but I see where other people are coming from too. Also with a higher dose comes a higher cost. I'm probably going to take a middle ground approach and just see if I lose anything over the next two weeks (last week of stall included) and if not titrate up since I'm already behind schedule regarding dosing. I'm already doing better than I expected since as I've heard most males don't respond to 2.5mg.

Yeah, we all have our point of view, to me taking something that does not give me results is kinda throwing money in the garbage

 

[Don Ligero]

Yes, there are other compounds et al, but I fear there is a possibility of long term resistance to GLP-1's and like peptides. Once I maxed out and stalled on 15mg, I have gone to splitting doses, switched to Sema, also gone to Reta and my 'stall' has remained the same.

Now, my weight has stalled, but I am a heavy lifter and have added 20 lbs of lean mass in the past 12 months (measured with fit3dscan).

But, I fear I may have maxed the effectiveness of glp1 agonists. The one thing I have NOT tried is upping my Tirz dose. Seriously considering going to 20mg after hearing about the 20 and 25mg trials.

 

[noggin]

Yes, there are other compounds et al, but I fear there is a possibility of long term resistance to GLP-1's and like peptides. Once I maxed out and stalled on 15mg, I have gone to splitting doses, switched to Sema, also gone to Reta and my 'stall' has remained the same.

Now, my weight has stalled, but I am a heavy lifter and have added 20 lbs of lean mass in the past 12 months (measured with fit3dscan).

But, I fear I may have maxed the effectiveness of glp1 agonists. The one thing I have NOT tried is upping my Tirz dose. Seriously considering going to 20mg after hearing about the 20 and 25mg trials.

I mean as I understand it these GLP1 agonists are working on the glucose metabolism pathways to signal to the body it has enough energy, altering our energy storage balance or "weight set-point homeostasis" (interesting article on set-point theory). Once your body has reached a certain weight below its original set-point, it now believes it's in homeostasis, or more accurately the counteracting forces of metabolism and hunger are preventing the current dose of peptide from lowering your weight further. Switching compounds might not do much until you reach a point of receptor agonism that exceeds your current Tirz dose (except in the case of Reta where you are activating the glucagon pathways and forcefully increasing energy expenditure, but even then you'll need to reach a dose that works similarly on GLP1/GIP receptors). Your only working choices might be stacking or increasing dose further unless you're happy at your current stall weight.

 

[penewbie]

Yes, there are other compounds et al, but I fear there is a possibility of long term resistance to GLP-1's and like peptides. Once I maxed out and stalled on 15mg, I have gone to splitting doses, switched to Sema, also gone to Reta and my 'stall' has remained the same.

Now, my weight has stalled, but I am a heavy lifter and have added 20 lbs of lean mass in the past 12 months (measured with fit3dscan).

But, I fear I may have maxed the effectiveness of glp1 agonists. The one thing I have NOT tried is upping my Tirz dose. Seriously considering going to 20mg after hearing about the 20 and 25mg trials.

Cagri works on different receptors, might want to give that a try.