Considering a change from Reta to Sema

kagami00

kagami00

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Hi, currently I'm on Reta at 3mg each week. When I first started at 1mg, things went really well and I could stretch out my weight loss progress for a long time!! But at this point it seems like I'm not getting any effect whatsoever, so I'm considering moving up to 4mg per week.

The problem is my resting heart rate climbed a lot, around 20, and I don't want that. So I'm thinking about making the switch to Sema once I begin my next diet. What dose would be best to begin with, and how does Sema compare to Reta in terms of what I should expect?

Thanks in advance!!
 
Reta isn't something I'm especially fond of in general — it's taxing on the body, and I believe it's more than what the majority of people actually require. There's a role for it, sure, but my sense is that Tirz suits most people better. Moving to Sema doesn't add up. You'd get more side effects with less benefit. Tirz looks like the better direction. There may be some rise in HR (or here, not exactly a full return to baseline), yet it's far smaller than with Reta, and studies appear to indicate it goes back to baseline across roughly 6 months. Compared with Sema, Tirz will almost certainly produce fewer sides for you.

I'd begin at a low dose — appetite suppression kicks in at a much lower dose than with Reta. If I were the one making that change, I'd likely start by bringing my Reta back down to 1mg and then adding 1mg of Tirz, adjusting from there. You could stay on the low doses of each if that works for you (I do believe Reta performs well in a stack), or keep lowering Reta while you move up on Tirz.
 
For most people, sema no longer seems worth it. It isn't actually less expensive, and compared to Tirz it delivers only half the effectiveness. The main scenario where it might still make sense is when there are problems related to GIP agonism — in certain individuals this could interfere with how well the contraceptive pill works, though the evidence on that isn't definitive yet.
 
Perhaps a different approach would be to combine reta and sema. Use reta at a level you can handle for the metabolic benefits, then add sema to help with appetite control. Reta has only a weak effect on GLP, but it is strong on GIP and Glucagon. Sema, on the other hand, is a potent GLP.
 
gusterbuster said:

Perhaps a different approach would be to combine reta and sema. Use reta at a level you can handle for the metabolic benefits, then add sema to help with appetite control. Reta has only a weak effect on GLP, but it is strong on GIP and Glucagon. Sema, on the other hand, is a potent GLP.
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That's exactly the reason I ended up here, and it's good to hear you mention it. I've used sema before and really like how it suppresses appetite. I'd think about gradually introducing R to try for the benefits of both, but I was unsure whether that would just be stacking GLP for no reason.
 
FunkyOtter said:

gusterbuster said:

Perhaps a different approach would be to combine reta and sema. Use reta at a level you can handle for the metabolic benefits, then add sema to help with appetite control. Reta has only a weak effect on GLP, but it is strong on GIP and Glucagon. Sema, on the other hand, is a potent GLP.
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That's exactly the reason I ended up here, and it's good to hear you mention it. I've used sema before and really like how it suppresses appetite. I'd think about gradually introducing R to try for the benefits of both, but I was unsure whether that would just be stacking GLP for no reason.
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For me it works really well. When I take larger amounts of reta, my sleep gets messed up and I get skin sensitivity. Adding Sema on top gives me extra appetite suppression.
 
When it comes to glp1s, people split into 2 groups. Either Reta or tirz. As for the rest, at this point they're either what gets prescribed, weaker nonsense, or the latest trendy thing people chase out of fomo. Lol
 
Among the newer GLP's, semaglutide ranks at the bottom for me: it produces the most side effects and the smallest amount of weight loss. I genuinely struggle to come up with a single situation where someone should pick it over reta or tirz.

As for an elevated heart rate—try tracking it across several days before concluding it has really climbed that much. The act of measuring alone can push it up, particularly when you're feeling on edge. Should it remain elevated for several days, a 20 bpm jump is fairly significant and less than ideal. It usually drifts back down gradually over an extended period after you start, but moving to tirz is a sensible choice. Every GLP has the potential to lift heart rate, though reta appears to be the only one that ever triggers real trouble.
 
Last Wednesday I added Sema on top of my usual Reta to deal with food noise.

Given how much Reta I've been exposed to without any side effects, my reasoning was to use .25mg 2x/week. These past couple of days I've been feeling pretty bleh, particularly last night. Bleh to the point that I held off on my usual Reta dose last night to let the feeling subside. This is the strongest and longest stretch of bleh I've experienced in 26.5 weeks on this GLP journey.

What I'll do next is still up in the air. A standard Reta dose plus .25mg of Sema is definitely not it. Perhaps lower my Reta and use .125mg of Sema. Perhaps keep Reta as usual and drop Sema. Perhaps Reta combined with a bit of Tirz. Perhaps return to my regular Reta only and figure it out from there. Perhaps Cagri rather than Sema or Tirz. Plenty of possibilities.
 
For roughly 1 year, even small amounts of ozempic left me feeling somewhat sick and queasy, until I learned other options existed. Low dose cagri sits much better with me. with tirz/reta
 
Semaglutide may have helped plenty of folks, but comparatively speaking it's garbage. As far as I can tell, the sole motivation anyone has for using it these days is that it's the one their insurance is willing to pay for.

That said, if you're already going gray, then the price gap separating tirz and sema is small enough that this whole concern basically disappears.

I suppose that leaves masochists who actually get a kick out of rougher GI side effects.
 
woundcarping said:

Last Wednesday I added Sema on top of my usual Reta to deal with food noise.

Given how much Reta I've been exposed to without any side effects, my reasoning was to use .25mg 2x/week. These past couple of days I've been feeling pretty bleh, particularly last night. Bleh to the point that I held off on my usual Reta dose last night to let the feeling subside. This is the strongest and longest stretch of bleh I've experienced in 26.5 weeks on this GLP journey.

What I'll do next is still up in the air. A standard Reta dose plus .25mg of Sema is definitely not it. Perhaps lower my Reta and use .125mg of Sema. Perhaps keep Reta as usual and drop Sema. Perhaps Reta combined with a bit of Tirz. Perhaps return to my regular Reta only and figure it out from there. Perhaps Cagri rather than Sema or Tirz. Plenty of possibilities.
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At some point it's possible to move over from cagri to elora, or you could even use cagri and elora together. Once E30 or higher is available, elora's pricing ought to become more sensible.
 
+3 for making the move to Tirz. I went that route myself due to RHR caused by Reta. Tirz beats Sema and is simpler to obtain. After 1 month, RHR came back down to normal
 
Calm Logic said:

woundcarping said:

Last Wednesday I added Sema on top of my usual Reta to deal with food noise.

Given how much Reta I've been exposed to without any side effects, my reasoning was to use .25mg 2x/week. These past couple of days I've been feeling pretty bleh, particularly last night. Bleh to the point that I held off on my usual Reta dose last night to let the feeling subside. This is the strongest and longest stretch of bleh I've experienced in 26.5 weeks on this GLP journey.

What I'll do next is still up in the air. A standard Reta dose plus .25mg of Sema is definitely not it. Perhaps lower my Reta and use .125mg of Sema. Perhaps keep Reta as usual and drop Sema. Perhaps Reta combined with a bit of Tirz. Perhaps return to my regular Reta only and figure it out from there. Perhaps Cagri rather than Sema or Tirz. Plenty of possibilities.
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At some point it's possible to move over from cagri to elora, or you could even use cagri and elora together. Once E30 or higher is available, elora's pricing ought to become more sensible.
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Yeah, but I don't currently have any, so that rules it out for now. I've gone back and forth on whether to grab some from the GB options that are running.

At this stage, combining Elora with Cag strikes me as an odd idea.
 
I'm puzzled by the folks calling semaglutide garbage. As a GLP-1 receptor agonist, it still acts on GLP-1, which is among the main pathways behind tirzepatide and retatrutide too. Semaglutide ranked among the earliest highly effective medications in this class, and it remains a very effective drug.

For maintenance, I personally view it as an excellent choice. Besides quieting food noise, it put a stop to my fingernail biting nearly right away, after I'd done it my whole life. That's just my own experience, of course, but many of my minor compulsive habits and behaviors appeared to dissolve almost instantly, and GLP-1, rather than the GIP or Glucga add-ons in the molecule, looks like the cause.

If losing weight is the only aim, current data indicate tirzepatide usually yields larger average weight loss than semaglutide, and a lot of people consider it a more powerful appetite suppressant.

In my own maintenance routine, I take semaglutide on Sundays plus a small morning dose of retatrutide on Wednesdays, and so far that has served me well.
 
UpDownLeftRightAS* said:

I'm puzzled by the folks calling semaglutide garbage. As a GLP-1 receptor agonist, it still acts on GLP-1, which is among the main pathways behind tirzepatide and retatrutide too. Semaglutide ranked among the earliest highly effective medications in this class, and it remains a very effective drug.

For maintenance, I personally view it as an excellent choice. Besides quieting food noise, it put a stop to my fingernail biting nearly right away, after I'd done it my whole life. That's just my own experience, of course, but many of my minor compulsive habits and behaviors appeared to dissolve almost instantly, and GLP-1, rather than the GIP or Glucga add-ons in the molecule, looks like the cause.

If losing weight is the only aim, current data indicate tirzepatide usually yields larger average weight loss than semaglutide, and a lot of people consider it a more powerful appetite suppressant.

In my own maintenance routine, I take semaglutide on Sundays plus a small morning dose of retatrutide on Wednesdays, and so far that has served me well.
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That's a completely reasonable point, but my guess is the people who rip on semaglutide tend to be folks in my shoes: they used it for weight loss, had a rough time, saw less weight loss than they wanted, bumped the dose up, and then dealt with awful GI side effects.

Those very people would move over to tirzepatide and discover it works better while producing fewer side effects.

Looking back, I wish I had begun this entire journey on tirzepatide, or most likely retatrutide.
 
The numbers show that 5-10 percent of patients had side effects severe enough that they stopped taking Sema. I'm not saying those experiences don't matter, but labeling Sema a shit drug goes too far.

What makes Sema appealing, in my view, is that it acts only on GLP, which means it combines really well with Reta or Tirz to add a bit more appetite suppression without any GIP overlap.
 
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