lastresort
Explorer
The clinical trial went as high as 12mg, and between 8 - 12 mg the benefits level off.
Has anybody in this community tried a dose above 12 mg?
Has anybody in this community tried a dose above 12 mg?
Anyone gone beyond 12 mg?
- Thread starter lastresort
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woundcarping
Explorer
There is no such thing.
lastresort
Explorer
In the clinical trial, weight loss reached 22.8% with 8mg and 24.2% with 12mg, so the dose dependent benefit starts to plateau.
woundcarping
Explorer
At 68 weeks, 9mg gave 26.4% versus 28.7% for 12mg.
That isn't a plateau — it's diminishing returns.
With higher doses you get diminishing returns, but the odds of being a high responder go up, meaning more people drop a larger percentage.
My goal is to shed 30-35% of my starting weight, and I'm choosing a higher dose to improve my chances of being a bigger responder without significant side effects.
BNLFL
Explorer
8mg is the top dose I've reached. I've only just begun it.
lessthanhalf
Explorer
Usually, when you raise the dose of a GLP medication, you get slightly more weight loss, but the side effect burden grows much faster. The only agent that has actually been tested this way is semaglutide, in the 7.2mg and 16mg trials, and those results matched that pattern exactly. So you are looking at diminishing returns plus additional side effects, yet nothing in the data flags new or unexpected harms at the higher end.
A study of tirzepatide at higher doses is underway, but nothing has been released, not even which doses are being used.
Posts on here about larger reta doses are quite scarce, so it is not a common practice.
There was a study that attempted to project possible weight loss across various higher doses of GLP drugs; I asked chatgpt to work out the expected weight loss for 20mg reta using the equations from that paper, and it came back with roughly the mid 30% range. I have attached it here.
What I believe remains unstudied, and ought to be studied, is higher dosing in people who shed below-average amounts of weight while already on the standard maximum GLP dose, provided side effects were not what capped the dose.
Right now there are plenty of anecdotal accounts of tirz pushed as high as 25mg/w, but if the goal is losing beyond 30% of body weight, adding low dose cagri on top of 12mg reta is probably the more sensible route. My view is that when reta or tirz gives you few side effects but also little weight loss, a higher dose trial is probably reasonable, as long as the reason is tackling severe obesity, where the risks of obesity outweigh those of a somewhat larger dose.
A study of tirzepatide at higher doses is underway, but nothing has been released, not even which doses are being used.
Posts on here about larger reta doses are quite scarce, so it is not a common practice.
There was a study that attempted to project possible weight loss across various higher doses of GLP drugs; I asked chatgpt to work out the expected weight loss for 20mg reta using the equations from that paper, and it came back with roughly the mid 30% range. I have attached it here.
What I believe remains unstudied, and ought to be studied, is higher dosing in people who shed below-average amounts of weight while already on the standard maximum GLP dose, provided side effects were not what capped the dose.
Right now there are plenty of anecdotal accounts of tirz pushed as high as 25mg/w, but if the goal is losing beyond 30% of body weight, adding low dose cagri on top of 12mg reta is probably the more sensible route. My view is that when reta or tirz gives you few side effects but also little weight loss, a higher dose trial is probably reasonable, as long as the reason is tackling severe obesity, where the risks of obesity outweigh those of a somewhat larger dose.
Whiynot20026
Explorer
Do you shine as brightly as the sun?
Bill
woundcarping
Explorer
This morning I dosed 9mg…
You think that’s the case? From Triumph, 39% dropped
≥30%, while 24% dropped ≥35%.
My plan: if it becomes necessary I’ll stack, but up to now the signs suggest I’ll hit a 30-35% loss in good time, maybe around ~10 months.
lessthanhalf
Explorer
What I'm referring to is average weight loss, not the maximum weight losses. In any large group of people, there will always be a spread of weight lost. The best figure I'm aware of is 29% for reta at 12mg over a bit more than a year, but 50% of those people will lose more and the other 50% will lose less. And 5-10% will end up with very little weight loss. Until you actually try it, there's no real way to know how you'll respond, though diabetes and being male do not help. The maximum weight loss seen in a group isn't a good indicator of probable weight loss.
If someone is GLP naive and trying to fix severe obesity with more than 35% overweight, the most logical approach is to start reta and see what happens, then adjust doses up depending on hunger and weight loss and side effects, and worry about what to do afterwards once you hit maximum tolerated dose, 12mg or stall.
If someone is GLP naive and trying to fix severe obesity with more than 35% overweight, the most logical approach is to start reta and see what happens, then adjust doses up depending on hunger and weight loss and side effects, and worry about what to do afterwards once you hit maximum tolerated dose, 12mg or stall.
woundcarping
Explorer
Let's say those are 3 paths in a sequence: “maximum tolerated dose, 12mg, or stall.” If tolerance weren't a problem, at which point would you quit raising the dose?
I'm not in any kind of crisis—just after some intellectual back-and-forth, minus the endless low-and-slow worrywarts.
lessthanhalf
Explorer
How far you go up probably comes down mostly to the amount of weight you're aiming to drop. Say someone is only a few kilos above their target: 1mg of reta produced 9% weight loss across a year, so for overweight — though not truly obese — cases, smaller doses make plenty of sense. On the other hand, if the goal is shedding 25% or more, chances are you'll land at the top doses.
When a dose is giving you zero side effects, the scale is moving down at a rate that seems perfectly fine, and you aren't fighting to keep eating under control, then bumping it up has no strong justification. The one genuine case for pushing higher anyway rests on the long-term health protection the drugs themselves offer — independent of weight loss — against diabetes and heart disease. If someone begins with a BMI of 40, or possibly even 35, one could argue that the cardiovascular risk from weight alone is almost certainly high enough to warrant using GLP's as heart disease prevention, and higher doses have been shown to outperform lower ones for that purpose. That said, the long-term health advantages are established for sema and tirz when baseline risk is elevated — meaning existing cardiovascular disease or diabetes — yet they remain unproven for the broader population. It will almost certainly be demonstrated eventually, but because events like heart attacks are so much rarer in lower-risk groups, proving it demands a far larger and far longer trial. For reta these effects likewise aren't proven yet, though they seem fairly probable.
TLDR Starting from an obese point and wanting to drop 25-30% or more of your weight, I'd raise the dose gradually toward 12mg provided side effects stayed manageable — but never by sacrificing overly rapid weight loss or ending up drained and miserable.
woundcarping
Explorer
When I began GLP, my BMI sat at 36.5 — a fairly hefty guy — and back in 2018 I hit an all-time high of 39. Across the board, my labs came back decent or better. These days my BMI is around 29.
I've moved well beyond 12mg and haven't run into any side effects worth mentioning. I feel good, just cruising, though getting to sleep takes some work. I'm dropping roughly 1% w/w, and over the most recent 34lb the share of lean mass lost has stayed in the single digits. Monday brings a fresh round of blood work, and I've got another DEXA lined up within the next 2-4 weeks.
lessthanhalf
Explorer
That reply covers pretty much all the bases, honestly — past 12mg and barely any side effects at all, along with very little lean mass lost. I'd guess there's some resistance training behind those results? Plenty of folks mention that GLP's, reta in particular, mess with their sleep. That hasn't been something I've experienced.
BNLFL
Explorer
No — 8mg works for me at the moment, and I'm based in the "Sunshine State." As @woundcarping pointed out, side effects aren't an issue for me. They've simply faded. Friday is my injection day, and I'd typically get that full feeling plus heartburn when I got into bed. That's all gone now.
chewonmysac
Explorer
I’ve reached the maximum Tirz at 15mg and don’t really intend to reduce it. Down 99lbs. Next week marks one year. That will be my 52nd shot!
lessthanhalf
Explorer
Nice work. That chart is pretty interesting — it seems like things are only now beginning to taper off slightly, whereas before it had been tracking closer to a straight line, though at 191lbs you're probably pretty close to where you want to end up. And hitting the year mark lines up with it easing up some, even if you've only been at 15mg for a few months. Still, the trials didn't show much of a gap in weight loss when comparing 10mg with 15mg, and you've been above 10mg for quite a while.
Sid the SeaGull
Explorer
Question for the group: from what I understand, the trials went through doses of 2, 4, 6, 8, 9, 10, and 12, and after that the person stayed on that same dose for the rest of the trial, which I think runs another 12-18 months?
So after the initial titration, most of the time the participant is on the same dose?
From what I've read, most people on the forum take a more conservative route and aim for the lowest dose that gets results. That seems like a different strategy, and probably safer. But the results might not line up with the trial data, so in my opinion comparing them to the trial data could be hard.
I'm enjoying this thread and the discussion, thank you all.
So after the initial titration, most of the time the participant is on the same dose?
From what I've read, most people on the forum take a more conservative route and aim for the lowest dose that gets results. That seems like a different strategy, and probably safer. But the results might not line up with the trial data, so in my opinion comparing them to the trial data could be hard.
I'm enjoying this thread and the discussion, thank you all.
woundcarping
Explorer
2.5 months have gone by without a single gym visit from me, and what I used to do there was mostly cardio… getting back into it is something I keep telling myself I'll do, yet it keeps not happening.
If anything is doing the heavy lifting, it's probably TRT, and HMB-FA is said to help as well.
Whether the GLP is what's wrecking my sleep, I can't say for sure — it surely plays a part, but my sleep is still decent, above all when I actually make an effort. On its own, DSIP appeared to throw my sleep off; my ring already showed I was getting lots of deep sleep, but I wanted to give it a shot anyway. 5 days in I stopped, and since then getting my sleep debt back down to 0 and holding it there has been a struggle.
The rise and then the flat stretch across the past couple of weeks lines up with when creatine was added, which could lift my lean mass above what my first scan showed. The 10lb I lost on Tirz between 12/12-1/10 isn't in the graph, though the weight change data does include it.. an irritating quirk of Shotsy.
BNLFL
Explorer
That's the most recent info I came across regarding the Lilly trials: 2-4-6-8-10-12. I keep a close eye on Lilly trials, and we remain at 6mg for 6 weeks. I don't recall the 10mg being part of it. I'm currently taking 8mg.
lessthanhalf
Explorer
In the trials, every participant is obese — the minimum BMI is typically 30, and the mean tends to be considerably higher — so it makes complete sense that larger doses are used in that setting.
Here on this forum, though, likely over half of members are not obese. They are either in the overweight range with BMIs of 25 to 30, or sometimes already leaner with fairly low body fat percentages, pursuing aesthetic goals or extremely low body fat for bodybuilding and similar. For that population, 12mg doses are genuinely neither suitable nor necessary. A year of 1mg reta was sufficient to produce an average 9% weight reduction, so it follows that those looking to shed modest amounts can do so at low doses, typically below 4mg. These drugs were never intended for that use case, and the studies were not built around it either. I get that even people who are irritatingly thin still want to be thinner, and that is their call, but the risk-to-benefit calculus is vastly different. Severe obesity carries very high health risks, so serious adverse events, even if uncommon, can be acceptable; those same health risks do not exist for someone who is only mildly overweight, yet the serious adverse events remain just as probable. A bodybuilder chasing a bit less fat will not be pleased when NAION costs them an eye — whereas for treating severe obesity, a small risk like that is a tolerable trade-off.
I am aware there are more than 2 groups here — the severely obese and the bodybuilders / mildly overweight — but for the purposes of this issue, splitting things into 2 camps does seem reasonable.
A recurring problem on the forum is when people in this latter category try to project their dosing logic or personal experience — usually low and slow — onto those with severe obesity, where the situation is simply not comparable. Those individuals are generally better served by doses and schedules closer to what the studies used, aiming higher rather than lower, and pursuing maximum weight loss that may still fall short of their target weight or the normal range.
And I think the endlessly repeated low and slow mantra really does lodge itself in people's minds, so even someone with 50 or 100 kilos to lose will often try to stay at unrealistically low doses, then wonder why it is not working.
The reverse seems less common: people applying severe-obesity GLP logic to those who are trying to lose a little weight or fine-tune body fat percentages.
Here on this forum, though, likely over half of members are not obese. They are either in the overweight range with BMIs of 25 to 30, or sometimes already leaner with fairly low body fat percentages, pursuing aesthetic goals or extremely low body fat for bodybuilding and similar. For that population, 12mg doses are genuinely neither suitable nor necessary. A year of 1mg reta was sufficient to produce an average 9% weight reduction, so it follows that those looking to shed modest amounts can do so at low doses, typically below 4mg. These drugs were never intended for that use case, and the studies were not built around it either. I get that even people who are irritatingly thin still want to be thinner, and that is their call, but the risk-to-benefit calculus is vastly different. Severe obesity carries very high health risks, so serious adverse events, even if uncommon, can be acceptable; those same health risks do not exist for someone who is only mildly overweight, yet the serious adverse events remain just as probable. A bodybuilder chasing a bit less fat will not be pleased when NAION costs them an eye — whereas for treating severe obesity, a small risk like that is a tolerable trade-off.
I am aware there are more than 2 groups here — the severely obese and the bodybuilders / mildly overweight — but for the purposes of this issue, splitting things into 2 camps does seem reasonable.
A recurring problem on the forum is when people in this latter category try to project their dosing logic or personal experience — usually low and slow — onto those with severe obesity, where the situation is simply not comparable. Those individuals are generally better served by doses and schedules closer to what the studies used, aiming higher rather than lower, and pursuing maximum weight loss that may still fall short of their target weight or the normal range.
And I think the endlessly repeated low and slow mantra really does lodge itself in people's minds, so even someone with 50 or 100 kilos to lose will often try to stay at unrealistically low doses, then wonder why it is not working.
The reverse seems less common: people applying severe-obesity GLP logic to those who are trying to lose a little weight or fine-tune body fat percentages.