Down 80lbs after a year on Tirz, switching to Reta next

[lessthanhalf]

RT0123 said:


Thank you, I appreciate the thoughtful response. I have not considered moving up from my current 15mg Tirz. dosage. I have a 2 month supply left and may try this on my next injection day. I am still losing weight but have been noticing an increase in hunger/food noise.

My highest weight was unfortunately 480lbs. Honestly, it’s saddening writing this and realizing how bad I let things get. I am a 6’2” male, retired football player. Still have good muscle mass which has been helpful with training and exercise. I’m weighing in at 399lbs as of this morning. I’d like to lose 150 more lbs.

Thanks again. I appreciate it.

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One caution I'd offer: if Reta ends up underdelivering for you, don't wait too long before going back to tirz. I'm guessing your weight loss pace has dipped somewhat along with the return of extra food noise? Reta does bring a modest bump in metabolic rate, but among most folks in this forum it hasn't matched tirz when it comes to quieting food noise.

These meds are being pushed past what they were originally meant to do. Tirz tops out around 25% weight loss, Reta averages about 29% at best, and right now you're at 17% (80/480), while aiming for 47% (230/480). So unless you happen to respond above average, chances are decent you'll eventually need doses above the standard maximum, or a combination of GLP drugs. My reasoning is simple: obesity at that level of severity harms health so badly that even the unknown possible downsides of higher doses or combos seem very unlikely to carry comparable risk.

Personally, I only began GLP drugs after most of the weight was already gone, and I use them to keep hunger in check so I don't regain. So far that's carried me to 55% below my starting weight of 145kg. I paired 5mg reta with 15mg tirz, and can't push higher without an unbearable odd skin sensation, so I also added 0.5mg cagri for extra help. I picked adding reta on top of tirz because tirz was already working well with very few side effects, and I didn't want to ruin that by swapping over to reta.

What makes sense from your current point likely hinges a lot on which side effects you've run into so far. Still, the paths are: switch to reta, raise tirz as high as you can tolerate or to 25mg?, slowly add low dose cagri, or stack reta onto tirz. I bring these up because my hunch is that sooner or later you'll probably need higher doses or combos regardless.

 

[Spork]

lessthanhalf said:


The only thing I would suggest being careful of is if it turns out reta does not work for you as well as you would like , to change back to tirz sooner rather than later. I am assuming the rate of weight loss has slowed a bit with the extra food noise? Reta does have the advantage of boosting metabolic rate a bit, but most people on this forum have found it is not as effective as tirz for food noise.

You are asking these drugs to do more than they were designed to do, tirz at best is 25% weight loss and reta at best is average of 29%, and so far you are down 17% 80/480 , but trying to get to 47% 230/480 . So unless you respond better than average, there is a good chance you might need higher than standard maximum doses or combinations of GLP drugs. My basic logic is that obesity of that degree of severity is so bad for your health, that even unknown possible adverse consequences of higher doses or combinations are very unlikely to be as risky.

I only started GLP drugs after losing most of the weight and am using them to control hunger to stop me putting the weight back on, but so far it is working to get me to 55% down from my start weight of 145kg. I added in 5mg reta to 15mg of tirz , and cannot go higher without intolerable skin sensation weirdness, and added in 0.5mg of cagri to help. I chose to add reta to tirz as it was working pretty well with very few side effects and I did not want to stuff that up by changing to reta.

Options from where you are now probably depend a fair bit on what side effects you have had so far, but either switching to reta, increasing the dose of tirz to as high as you tolerate or 25mg? , adding in low dose cagri slowly , or adding in reta to tirz. The reason I am suggesting this is my guess is at some point you are fairly likely to need higher doses or combos anyway.

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I'm wondering... if you lowered your tirz dose somewhat while raising the reta, would that unbearable skin feeling still be there?

I'm curious about what's behind the dysesthesia you're experiencing - does it come from the GLP-1, the GIP, or the Glucagon?

 

[lessthanhalf]

Spork said:


Curious... do you think if you stepped down your tirz dose a bit and upped the reta that you'd still have the intolerable skin sensation situation?

Like I wonder what the mechanism is that's causing your dysesthesia - is it the GLP-1, the GIP or the Glucagon?

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I've dug into the literature on this, but the studies simply don't cover it.

When semaglutide was tested at low doses, this reaction showed up rarely; at the higher doses, 7.2 and 16mg, it turned up very often. Since semaglutide only hits GLP-1 receptors, the effect almost has to come from GLP-1 activity. Yet that completely contradicts the fact that reta, more than the others, triggers it most at ordinary doses.

I've experimented with raising both tirz and reta, and even tiny bumps in either one aggravate it. Taking doses every other day, going from 4.5mg to 5mg of tirz, or 1.4mg to 1.6 of reta, produces a noticeable change. I haven't made a real attempt at lowering the tirz/reta ratio; the 1 or 2 times I tried, the skin sensations got worse.

 

[Spork]

lessthanhalf said:


I have tried to research this, but there really is nothing in the studies.

In the low dose semaglutide trials it was rare, in the high dose, 7.2 and 16mg studies it was very common. So given it only acts on GLP-1 receptors it more or less has to be a GLP-1 effect, totally fails to explain why it is most common at normal doses with reta rather than the others.

I have tried increasing doses of tirz and reta and even very small dose increases of either make it worse, so on second daily doses from 4.5mg of tirz to 5mg or for reta from 1.4mg to 1.6 is noticeable. I have not seriously tried dropping tirz/reta ratio, once or twice i tried and the skin sensations were worse.

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Oh no, that's rough!

What's unfortunate is that even the drugmakers who sank all that cash into studying these medications don't appear to have a complete grasp of their mechanisms.

I sure wish my body had responded like a super-responder, but it looks like that just isn't how it's going to go for me. When I began tirzepatide my BMI was 45+, so I get how hard that road is.

I'm planning to bring retatrutide into the picture to see whether I can get more progress out of this, but your experience means a lot to me, since it's going to make me proceed far more carefully.

 

[RT0123]

lessthanhalf said:


The only thing I would suggest being careful of is if it turns out reta does not work for you as well as you would like , to change back to tirz sooner rather than later. I am assuming the rate of weight loss has slowed a bit with the extra food noise? Reta does have the advantage of boosting metabolic rate a bit, but most people on this forum have found it is not as effective as tirz for food noise.

You are asking these drugs to do more than they were designed to do, tirz at best is 25% weight loss and reta at best is average of 29%, and so far you are down 17% 80/480 , but trying to get to 47% 230/480 . So unless you respond better than average, there is a good chance you might need higher than standard maximum doses or combinations of GLP drugs. My basic logic is that obesity of that degree of severity is so bad for your health, that even unknown possible adverse consequences of higher doses or combinations are very unlikely to be as risky.

I only started GLP drugs after losing most of the weight and am using them to control hunger to stop me putting the weight back on, but so far it is working to get me to 55% down from my start weight of 145kg. I added in 5mg reta to 15mg of tirz , and cannot go higher without intolerable skin sensation weirdness, and added in 0.5mg of cagri to help. I chose to add reta to tirz as it was working pretty well with very few side effects and I did not want to stuff that up by changing to reta.

Options from where you are now probably depend a fair bit on what side effects you have had so far, but either switching to reta, increasing the dose of tirz to as high as you tolerate or 25mg? , adding in low dose cagri slowly , or adding in reta to tirz. The reason I am suggesting this is my guess is at some point you are fairly likely to need higher doses or combos anyway.

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Both true and not true. On one hand, the food noise has gone up; on the other hand, the scale is still moving down. My target is 250lbs. Thanks to what I've picked up from so many people here, I plan to stack 2mg of Reta on top of my existing Tirz routine. No side effects or bad reactions so far. It's just that the food noise is creeping back after a year on it, plus I'm lifting far heavier now than I was before dropping the first 80lbs. I suspect that's playing a part in my appetite going up lately. I've raised my protein and ended the week down 3lbs. Thanks for your thoughts! Best of luck to you!

 

[Spork]

lessthanhalf said:


I have tried to research this, but there really is nothing in the studies.

In the low dose semaglutide trials it was rare, in the high dose, 7.2 and 16mg studies it was very common. So given it only acts on GLP-1 receptors it more or less has to be a GLP-1 effect, totally fails to explain why it is most common at normal doses with reta rather than the others.

I have tried increasing doses of tirz and reta and even very small dose increases of either make it worse, so on second daily doses from 4.5mg of tirz to 5mg or for reta from 1.4mg to 1.6 is noticeable. I have not seriously tried dropping tirz/reta ratio, once or twice i tried and the skin sensations were worse.

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A number of folks have said Claritin — sold under the Claratyne name in Australia — might actually help with the skin sensation issue. Has that ever been something you've tried?