Is there truly a tirz effectiveness window, and should I increase my dose?

[DidntMakeBrownies]

Wecandothis said:

DidntMakeBrownies said:

Wecandothis said:

DidntMakeBrownies said:

Wecandothis said:

DidntMakeBrownies said:

I've been on 6 of tirz for 5 months, have lost 35 lbs, and want to drop another 45 to get near my goal. I figured slow and steady was fine since my losses are consistent, even if not huge, and I barely get side effects. Then I came across something saying tirz weight loss levels off around 72 weeks. If a third of that window is already gone, should I raise my dose to speed things up? Add Reta if I can ever work out how to order from China? Stalling out is something I'd really hate…

I went through this exact situation previously. Once tirzepatide seemed to stop doing anything for me, I introduced a small amount of Reta. Then, as I moved the Reta dose upward, I brought the tirz dose downward. These days I sit under my goal weight, and Reta is what got me there.

Could you share how you started Reta? Did your heart rate go up? What dose were you on?

Yep, in the early days it caused skipped beats, and my resting heart rate went up — both while working out and when sitting still. I began at .5 and four days afterward put in the other .5. Tirz stayed in the mix, and whenever I raised Reta, I brought tirz down. Right now it's roughly 2 tirz alongside 6-8 Reta. The tirz is still necessary for me because of its anti inflammatory action.

Because I underwent a cardiac ablation to treat a heart arythmia, this makes me somewhat fearful.

I deal with known PVCs. My husband underwent an ablation a while back, and Reta has worked well for him. Still, it might be best to let your doctor weigh in on this. My own cardiologist is aware that I use it.

Did his heart rhythm change in any way because of it? The moment it receives FDA approval, I plan to ask my cardiologist — though I am somewhat scared of him.

 

[Wecandothis]

DidntMakeBrownies said:

Wecandothis said:

DidntMakeBrownies said:

Wecandothis said:

DidntMakeBrownies said:

Wecandothis said:

DidntMakeBrownies said:

I've been on 6 of tirz for 5 months, have lost 35 lbs, and want to drop another 45 to get near my goal. I figured slow and steady was fine since my losses are consistent, even if not huge, and I barely get side effects. Then I came across something saying tirz weight loss levels off around 72 weeks. If a third of that window is already gone, should I raise my dose to speed things up? Add Reta if I can ever work out how to order from China? Stalling out is something I'd really hate…

I went through this exact situation previously. Once tirzepatide seemed to stop doing anything for me, I introduced a small amount of Reta. Then, as I moved the Reta dose upward, I brought the tirz dose downward. These days I sit under my goal weight, and Reta is what got me there.

Could you share how you started Reta? Did your heart rate go up? What dose were you on?

Yep, in the early days it caused skipped beats, and my resting heart rate went up — both while working out and when sitting still. I began at .5 and four days afterward put in the other .5. Tirz stayed in the mix, and whenever I raised Reta, I brought tirz down. Right now it's roughly 2 tirz alongside 6-8 Reta. The tirz is still necessary for me because of its anti inflammatory action.

Because I underwent a cardiac ablation to treat a heart arythmia, this makes me somewhat fearful.

I deal with known PVCs. My husband underwent an ablation a while back, and Reta has worked well for him. Still, it might be best to let your doctor weigh in on this. My own cardiologist is aware that I use it.

Did his heart rhythm change in any way because of it? The moment it receives FDA approval, I plan to ask my cardiologist — though I am somewhat scared of him.

The guy I see was fully familiar with glp1s—I simply mentioned glp1s to him, and he didn’t probe any further. When my heart was skipping beats, I went through an echocardiogram and an ekg, and they weren’t worried

 

[deluge]

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

 

[woundcarping]

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

 

[deluge]

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

 

[woundcarping]

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

 

[Wecandothis]

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

For me, combining these two turned out to be the key. I introduced Reta alongside my tirz. Over time, I reduced the tirz and raised the Reta. Right now I'm sitting 3 pounds below my goal.

 

[deluge]

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

 

[Wecandothis]

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

Tirz leaves me feeling really cold, so raising the dose further is not something I could do

 

[deluge]

Wecandothis said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

Tirz leaves me feeling really cold, so raising the dose further is not something I could do

Last winter I dealt with something similar, and it wasn't easy. My hands especially took the brunt of it.

I was gone for the majority of last winter, working in places with much warmer weather. The coming winter is going to be tough.

 

[woundcarping]

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

Split dosing wasn't something I'd thought about, though that's already my approach and I get no meaningful sides from it. What I had in mind was moving up to 11mg from 10mg, rather than jumping directly to 12mg.

 

[deluge]

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

Split dosing wasn't something I'd thought about, though that's already my approach and I get no meaningful sides from it. What I had in mind was moving up to 11mg from 10mg, rather than jumping directly to 12mg.

That approach is guaranteed to fail.

When it comes to my TV, the volume can only be 10 or 12—never 11. Odd numbers are off the table.

The strange part is my car's cruise control: 73 or 77 are fine, but 76 is not, and 75 is completely unacceptable as well.

Clearly, I have problems....

 

[woundcarping]

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

Split dosing wasn't something I'd thought about, though that's already my approach and I get no meaningful sides from it. What I had in mind was moving up to 11mg from 10mg, rather than jumping directly to 12mg.

That approach is guaranteed to fail.

When it comes to my TV, the volume can only be 10 or 12—never 11. Odd numbers are off the table.

The strange part is my car's cruise control: 73 or 77 are fine, but 76 is not, and 75 is completely unacceptable as well.

Clearly, I have problems....

A straightforward fix would be to adjust the reconstitution so that 11mg becomes a round 10 or 20ml. Either 10 or 20 seems far more reasonable than 12.

 

[deluge]

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Rather than jumping straight to the next full step, have you thought about raising it gradually?

Yes, I have.

Actually, I'm assisting a young MD through his grey journey. He hit the symptoms ahead of me. His solution was split dosing — 5mg 2x/wk.

I've thought about moving up to 12, but instead 6mg/2x/6D. Plenty of choices, I guess there's no single correct route.

I just found it interesting that my results landed almost exactly on that 10mg graph line you shared.

Split dosing wasn't something I'd thought about, though that's already my approach and I get no meaningful sides from it. What I had in mind was moving up to 11mg from 10mg, rather than jumping directly to 12mg.

That approach is guaranteed to fail.

When it comes to my TV, the volume can only be 10 or 12—never 11. Odd numbers are off the table.

The strange part is my car's cruise control: 73 or 77 are fine, but 76 is not, and 75 is completely unacceptable as well.

Clearly, I have problems....

A straightforward fix would be to adjust the reconstitution so that 11mg becomes a round 10 or 20ml. Either 10 or 20 seems far more reasonable than 12.

Fantastic! Your mind works just like someone with OCD — I tip my hat to you!

But honestly, that approach might actually do the trick.

Folks underestimate what OCD is really like, yet that's exactly how it goes...

 

[lessthanhalf]

deluge said:

woundcarping said:

deluge said:

woundcarping said:

FartfulCodger said:

The 72-week taper is not something I've come across. My guess is that bumping the dose up would just bring any taper on sooner. With these drugs, one thing holds true: responses vary from person to person. If you do have a taper, it could arrive at a different point, or possibly never.

You're sitting in a lucky spot — dropping weight at a solid pace, and still able to go higher on your dose if you need to. My take would be to remain on your current course and see how it unfolds. Should you hit a plateau, that's when you raise the dose. And if another plateau comes, you still have options such as Cagrilintide or Reta. In my view, you're well positioned and there's no need to fret.

Have plateaus really never come up in the research you've seen?





View attachment 11037

Wow. That chart is really well done.

It lines up exactly with the wall I've hit. I've been at 10mg of Tirz for 10 wks, and my loss has clearly stalled at 21%. That puts me right on the blue line.

I keep going back and forth on what to do next. I tried adding Cagri, and it didn't move much. Now I'm considering stacking Reta.

What's stopping you from simply raising the amount of the drug that has already shown it works for you?

On top of that, it matters where you began, where you stand now, and where you're aiming to finish.

Fair point. I don't want to hijack OP's thread—sorry ahead of time, OP!

When I first titrated up to 10mg every 6 days, side effects hit me. Tinnitus (I've had it all my adult life from too many range sessions, but the injection makes it worse), plus that "hypersensitivity" of skin and hair—the feeling like your arm has been hanging out the car window on the highway for an hour. At times it can be borderline painful with certain shirts or fabrics.

So I stepped back down to 7.5mg every 6 days for a few more weeks. When I tried raising it again, the symptoms were milder. I'm reluctant to push higher and stir that up again, so I'm weighing other possibilities.

At the start: 60 yrs old, 226lbs, BMI 40.0. Now, 5 mo's in: 178lbs, BMI 31.5. Goal is 170lbs/BMI 30.0 (the line between Overweight and Obesity Level 1). I've been stalled the last 4-5 weeks. The stall doesn't worry me too much; when I'm working there's no alcohol for months at a time, and over the years that has always been a big factor in whether my weight loss succeeds.

Yet another case of tinnitus getting worse on tirzepatide! That has to be the strangest side effect I have ever experienced. Luckily, it barely affects me.

I deal with the skin sensitivity thing too. It showed up once when I bumped tirz up to 15mg/w, and after I introduced reta at 5mg a week it became more steady, though mild and mostly ignorable. Still, trying to nudge reta up by even 0.5mg/w is enough to make it bothersome. I also gave tirz a 1mg increase and got the same skin sensory weirdness. That means it can cap how much tirz/reta I can combine, so my ceiling is tirz 4.5mg plus reta 1.4mg, both every second day. I have not attempted weekly dosing, but I am pretty confident it would be worse.

A few people on this forum have said that side effect gets better with time, so not being able to handle higher doses before does not automatically mean you never will after a few months.

On the bright side, you are not too far from your goal when these dose-limiting side effects are hitting.

 

[myopicmystic]

DidntMakeBrownies said:

I've been on 6 of tirz for 5 months, have lost 35 lbs, and want to drop another 45 to get near my goal. I figured slow and steady was fine since my losses are consistent, even if not huge, and I barely get side effects. Then I came across something saying tirz weight loss levels off around 72 weeks. If a third of that window is already gone, should I raise my dose to speed things up? Add Reta if I can ever work out how to order from China? Stalling out is something I'd really hate…

I suspect I'm dealing with the same situation.

For 15 weeks now I've been injecting a very small amount of tirz. Side effects scared me so much that I began at 0.50mg and moved up in 4-week steps, which puts me at 1.5mg per week today. That fear came from not knowing any better — I hadn't grasped that the folks reporting problems were using far bigger doses.

Across those weeks I've dropped roughly 35lbs, which works out to about 12%. Even so, there's still a minimum of 40-50lb left before I'm done. Which makes me ask myself whether beginning at a higher dose would have been smarter, or whether I've already ruined my chances of reaching my target.

So the feeling is familiar, but I've got nothing to suggest:/

 

[Tinkerbell2222]

DidntMakeBrownies said:

I've been on 6 of tirz for 5 months, have lost 35 lbs, and want to drop another 45 to get near my goal. I figured slow and steady was fine since my losses are consistent, even if not huge, and I barely get side effects. Then I came across something saying tirz weight loss levels off around 72 weeks. If a third of that window is already gone, should I raise my dose to speed things up? Add Reta if I can ever work out how to order from China? Stalling out is something I'd really hate…

Suggested dosing plan:

4 weeks at 2.5 mg

4 weeks at 5 mg

4 weeks at 7.5 mg

4 weeks at 10 mg

4 weeks at 12.5 mg

15 mg continuing until goal weight is reached

A number of individuals respond very strongly and remain at the lower doses without ever needing to titrate up. That said, the schedule listed above is the medically prescribed one for weight loss. As for me, I stayed at or below 10 mg until the final 10 pounds, at which point I used 15 mg for 1 month to get to goal. It took me 18 months to lose 90 pounds.

 

[woundcarping]

myopicmystic said:

DidntMakeBrownies said:

I've been on 6 of tirz for 5 months, have lost 35 lbs, and want to drop another 45 to get near my goal. I figured slow and steady was fine since my losses are consistent, even if not huge, and I barely get side effects. Then I came across something saying tirz weight loss levels off around 72 weeks. If a third of that window is already gone, should I raise my dose to speed things up? Add Reta if I can ever work out how to order from China? Stalling out is something I'd really hate…

I suspect I'm dealing with the same situation.

For 15 weeks now I've been injecting a very small amount of tirz. Side effects scared me so much that I began at 0.50mg and moved up in 4-week steps, which puts me at 1.5mg per week today. That fear came from not knowing any better — I hadn't grasped that the folks reporting problems were using far bigger doses.

Across those weeks I've dropped roughly 35lbs, which works out to about 12%. Even so, there's still a minimum of 40-50lb left before I'm done. Which makes me ask myself whether beginning at a higher dose would have been smarter, or whether I've already ruined my chances of reaching my target.

So the feeling is familiar, but I've got nothing to suggest:/

TLDR: Your path looks strong, the trend is steady, and you have lots of room to adjust safely. Stay the course, move the dose up when it is needed, and take it in.

At 2.3 lb each week, starting near 290 lb, you are at .8% weekly; as your weight falls, that week-over-week percentage will climb (.9% at your current 255 lb). If that pace holds, you have another 20 weeks to hit the middle of your target (usually the loss slows as weight drops and the deficit shrinks). That brings you to 35 weeks, comfortably within a realistic schedule and with a good safety buffer.

Tirz mainly acts by curbing appetite, so what you are doing is working, so keep at it. Feel free to titrate upward when needed to protect a calorie deficit, but I would not raise the dose only because the trial calendar says it is time. I also would not wait through weeks of an unexplained weight stall without doing something.

 

[lessthanhalf]

myopicmystic said:

DidntMakeBrownies said:

I've been on 6 of tirz for 5 months, have lost 35 lbs, and want to drop another 45 to get near my goal. I figured slow and steady was fine since my losses are consistent, even if not huge, and I barely get side effects. Then I came across something saying tirz weight loss levels off around 72 weeks. If a third of that window is already gone, should I raise my dose to speed things up? Add Reta if I can ever work out how to order from China? Stalling out is something I'd really hate…

I suspect I'm dealing with the same situation.

For 15 weeks now I've been injecting a very small amount of tirz. Side effects scared me so much that I began at 0.50mg and moved up in 4-week steps, which puts me at 1.5mg per week today. That fear came from not knowing any better — I hadn't grasped that the folks reporting problems were using far bigger doses.

Across those weeks I've dropped roughly 35lbs, which works out to about 12%. Even so, there's still a minimum of 40-50lb left before I'm done. Which makes me ask myself whether beginning at a higher dose would have been smarter, or whether I've already ruined my chances of reaching my target.

So the feeling is familiar, but I've got nothing to suggest:/

What you're going through is, in many respects, the ideal scenario. Your weight is coming off at a very sensible pace, side effects are almost nonexistent, and it's all happening on minuscule doses — which basically makes you a super responder. The main upside there is that you'll probably hit your target before you stall out or max out your loss at the highest doses. Since you're aiming to drop 75-85 lbs, that matters, because there's no assurance these medications will always be strong enough to get you there.

As for the idea that creeping doses up slowly, or losing weight gradually on these drugs, changes your eventual maximum weight loss — I don't think there's much evidence for that at all. It simply hasn't been researched. Broadly speaking, people on these drugs quit losing after roughly a year or a bit more at their top dose, minus a few months of titration, and that's because that's how long the weight takes to come off — not because the drug stops working after a while. To my knowledge, nobody has studied keeping a person at a low dose for a year or longer and then raising it to see what happens. Long-term follow-up does show weight holding steady at the weight-loss dose for as long as 4 years.

Generally, I'd say most folks in this forum are far too cautious with dosing and would do better just following the manufacturer's schedule. That said, if small doses are doing the job — you're shedding weight and, more crucially, you're not constantly hungry, meaning the drug is actually working rather than you white-knuckling a normal diet on an ineffective dose — then there's no issue. You've got plenty of headroom to go up if loss slows or you want stronger appetite control.

The one situation where I'd suggest nudging doses up gradually toward 15mg is if you have obesity-linked health conditions — elevated blood sugar, high blood pressure, high lipids, heart disease — and particularly if you're over 45 or 50, where preventing cardiovascular disease and other obesity-related problems long term comes into play, and higher doses tend to outperform lower ones for that.