ladyj779
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Stack tirz and reta, that's what I do 
Am I being impatient?
- Thread starter eternalyouth2
- Start date
eternalyouth2
New member
Thanks!ladyj779 said:
Stack tirz and reta, that's what I do
Click to expand...
lessthanhalf
New member
I think the reason it is hard to stop gaining weight or lose more is pretty simple, you have already lost over 30% of your body weight from ?185 to 125 lbs, now at 135. Even at 135 lbs that is more than the average expected weight loss from 15mg of tirz. You do actually have good evidence for what your maintenance drug and dose should be, tirz 15mg worked to get you there and from your description , it was not a struggle to maintain, but side effects were the problem you were trying to solve, or maybe hoping reta's slightly higher effectiveness would allow for smaller doses and then less side effects. You also already know that 10mg of tirz is not enough to stop you regaining weight.
Physiologically being down 30% is very different to starting on glp drugs as essentially all of the work of the drug is acting to try to stop you regaining weight.
I do not think there are easy simple solutions, to see if there is a maintenance dose of one or more GLP drugs that will give you the effectiveness of 15mg of tirz with less side effects, given that tirz is probably the one with the lowest side effect rates overall. Seeing as you have already switched over to reta, it would make most sense to keep increasing the dose till you either get to a point of too many side effects or it works to get you where you want, if that does not work or side effects become an issue before you get there, elora or cagri at low doses is an option, but I think it makes sense to find out your maximum tolerated dose of reta first, as that is just useful information to know to help you work out what is the best option long term. Otherwise you will never know for sure if reta or tirz is the best option for you. It is going to take long patient experimentation to work out the optimum solution. It might be that sub maximum doses of reta or tirz plus 3mg or so of elora might work well, in theory it should be one of the most effective combos with the lowest side effects, but data is very limited on elora so far.
In terms of health , none of this really matters, at a BMI of 23, getting thinner is not going to improve health, but I do understand the motivation to get where you want in terms of weight , given where you started, it can be very psychologically important to feel in control of the situation. It might be that you just cannot tolerate doses high enough to keep you at 125 lbs if you could not tolerate or did not feel comfortable on 15mg of tirz long term, but the only way to find out is by experimentation, as for this type of issue individual differences in responses are everything. At worst you get stuck at over 25% down from your start weight, and in or close to the normal weight range, which is still a major success.
Physiologically being down 30% is very different to starting on glp drugs as essentially all of the work of the drug is acting to try to stop you regaining weight.
I do not think there are easy simple solutions, to see if there is a maintenance dose of one or more GLP drugs that will give you the effectiveness of 15mg of tirz with less side effects, given that tirz is probably the one with the lowest side effect rates overall. Seeing as you have already switched over to reta, it would make most sense to keep increasing the dose till you either get to a point of too many side effects or it works to get you where you want, if that does not work or side effects become an issue before you get there, elora or cagri at low doses is an option, but I think it makes sense to find out your maximum tolerated dose of reta first, as that is just useful information to know to help you work out what is the best option long term. Otherwise you will never know for sure if reta or tirz is the best option for you. It is going to take long patient experimentation to work out the optimum solution. It might be that sub maximum doses of reta or tirz plus 3mg or so of elora might work well, in theory it should be one of the most effective combos with the lowest side effects, but data is very limited on elora so far.
In terms of health , none of this really matters, at a BMI of 23, getting thinner is not going to improve health, but I do understand the motivation to get where you want in terms of weight , given where you started, it can be very psychologically important to feel in control of the situation. It might be that you just cannot tolerate doses high enough to keep you at 125 lbs if you could not tolerate or did not feel comfortable on 15mg of tirz long term, but the only way to find out is by experimentation, as for this type of issue individual differences in responses are everything. At worst you get stuck at over 25% down from your start weight, and in or close to the normal weight range, which is still a major success.
Stace_wow
New member
I am wishing the best of luck to you!!!
DunningKruger
New member
^^ THIS!
This isn’t a drug thing. This is a diet and patience thing.
You have also escalated Reta from 2 mg to 7 mg in only seven weeks, a pace that does not even resemble the studied titration schedule. In the phase 2 trial, dose increases occurred every four weeks. You have barely allowed each dose enough time to assess its effects before deciding it has failed and moving higher.
I am your height, started at 135 lb, and stayed at 1, 2 and 3 mg to get to goal. Our biologies are different, so my dose is not automatically your dose, but blowing through milligrams this quickly may increase side effects and exhaust your dosing runway without solving the actual problem.
Now you are considering raising Reta again or adding Cag. That is impatiently piling more experimental pharmacology onto a problem you have not yet demonstrated is pharmacological.
At 5'4" and 135 lb, you are already relatively light. “Eating healthy,” exercising and following an 80/20 rule do not prove that you are in a consistent calorie deficit. Do you weigh and log everything? If not, you do not actually know whether your diet is dialled in.
Are you prepared to temporarily say no to alcohol, processed foods, snacks, sugar, restaurant meals and nights out or dinners with friends and family? You may not need to eliminate every carbohydrate or dairy product, but you do need to identify where calories are slipping through and become much more structured.
If your goal is an athletic body, that body must be built. It requires accurate nutrition, sufficient protein, progressive resistance training, hard conditioning, recovery and consistency. Medication can reduce hunger; it cannot replace structure or override an energy surplus.
Stop adding variables. Hold the dose, audit the diet honestly, track weekly averages and measurements, and assess body composition rather than chasing every five-pound fluctuation with another compound. Consider getting a DEXA scan, preferably a package of two so you can compare your progress over time. At your size, it is wise to know your lean mass versus fat mass, because the number on the scale is just a number.
eternalyouth2
New member
I haven’t had any side effects on Reta- except for elevated heat rate, which is normal. I switched from15mg Tirz. I’ve been on glps for 4.5 years. I don’t think you read my other responses, my main issue is the appetite suppressant is not what it was. So I was asking for advice on next step.
Edit to add: I stopped drinking alcohol when I started sema February 2022.
DunningKruger
New member
If appetite suppression has waned after 4 years on GLP-1s, we unfortunately don’t have strong evidence-based ways to restore it. It happens in many long-term users, and right now it’s more of an unanswered question than one with a proven solution.
Try Cagri, but be conservative with your titration. I don’t think the solution is blowing your receptors out even more so.
You’re also supposed to have an appetite. Though, notice when you are hungriest. During stress? After a phone call from a partner, family, or high-maintenance friend? During your luteal phase? After a hard workout? And what was your diet like that day, or the day before you notice yourself most hungriest? I notice that I subconsciously open the fridge when my bf calls, or when a work project is dull or too intellect intensive. That awareness stopped that pattern.
I’m sorry that the last stubborn pounds are stressing you out. They are difficult to drop.
Try Cagri, but be conservative with your titration. I don’t think the solution is blowing your receptors out even more so.
You’re also supposed to have an appetite. Though, notice when you are hungriest. During stress? After a phone call from a partner, family, or high-maintenance friend? During your luteal phase? After a hard workout? And what was your diet like that day, or the day before you notice yourself most hungriest? I notice that I subconsciously open the fridge when my bf calls, or when a work project is dull or too intellect intensive. That awareness stopped that pattern.
I’m sorry that the last stubborn pounds are stressing you out. They are difficult to drop.
professorpeppy
New member
this is the wayladyj779 said:
Stack tirz and reta, that's what I do
Click to expand...
lessthanhalf
New member
There is a very clear reason the OP is having less appetite reduction, one is the lower dose of reta relative to the previous 15mg of tirzepatide and 2 is the large percentage of weight already lost - 30%+, it took 15mg of tirz to keep weight stable in maintenance , but there were issues with side effects, so she tried reta instead.
In this situation most of the work of the glp drug is just counteracting the natural tendency to regain the weight, but has effectively nothing to do with the drug becoming less effective over time or receptors blowing out, neither of which have any real basis in evidence. ( On the dose used to lose the weight people on average stayed at that weight for another 4 years, if tolerance was happening , weight regain would have occurred and it did not. )
Finding a long term maintenance dose or doses to keep the weight off with the least side effects can be difficult, I have had to use tirz15mg/reta6mg /cagri0.5mg to stay 55% lower than my start weight, which unfortunately is not free from side effects, but is the best I have worked out so far.
mbishopski13
New member
Same for me. I actually gained a pound 6 weeks in. I am doing 3mg 2-3 times a week or every 3 days. Moving up to 4mg in a couple of weeks. If nothing, I will go back to Tirz. I just dont feel like Reta is as good for food noise. I am trying to let it run its course but the skin issue is getting old especially with no weight loss. And yes, I have three different sources and even had the one I am on now tested on my own dime.