Zeptide said:
I ran Tirz for 3 months, dropping 30 pounds. Wanting the glucagon agonist effect, I made the call to move over to Reta. Before doing anything, I put in a bunch of research on the right way to transition, and I weighed 3 paths: 1) a 2 week washout, which is what clinical trials call for 2) taper tirz down while ramping reta up, beginning at .5mg 3) swap over completely on the day my next tirz dose was due. Option 3 was my pick, since food noise isn't something I deal with and even at 5mg of tirz I had zero side effects (and yes, that's not a particularly high dose).
Because I was eager to reach an effective dose where glucagon would meaningfully kick in, I went with an aggressive titration schedule. Looking at the sigmoidal dosing curve for glucagon, as validated in the trials, I aimed for 3.5mg of reta.
How I titrated:
Day 0: 1mg
Day 5: 1mg
Day 10: 2mg
Day 15: 2.5mg
Day 20: 3mg
Day 25: 3.5mg
Day 32: 3.5mg
Maintain at 3.5mg weekly
Everything went smoothly, no side effects, until roughly a week after I reached 3.5mg, when dysesthesia showed up, which is that skin tingling and the sensation of a sunburn under your clothing. My guess is that titrating up too fast brought it on, though I see that 20% of trial participants get it. From what I read, it clears in about 2 weeks whether you quit reta or keep going, so I kept going. It has eased a lot, but about 2 weeks in it's still there.
My advice to others would be to titrate up more slowly than I did and give your body time to adjust to the new triple agonist. If anyone has gone through something similar or can speak to how long the dysesthesia took to resolve, I'd really like to hear it.