I’ve reached the dose where side effects kick in

[Atlanatpr]

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

 

[Peotidethrowaway]

That’s rough. My sympathies

 

[Smiter]

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

So 32 pounds — over how many weeks, and what dose?

 

[lessthanhalf]

There is not nearly enough information here to offer real guidance about dosing, but nothing prevents you from pushing back the following dose until the side effects settle down, or lowering the amount.

 

[Chili777]

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

How quickly did those 32 lbs come off? Could be something other than your stomach.

 

[Grogu]

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

Normally, unwanted effects ease with continued use and tend to show up when the dose is being raised or right at the beginning of treatment. They don’t typically appear much later, after someone has already dropped 32 pounds. If you’ve shed 32 pounds, that points to having taken the medication for a while.

As @lessthanhalf points out, additional information would be useful. For example, which glp-1 you’re on, what dose you take, how long the stomach discomfort has been going on, where the pain is located, and so on.

 

[lessthanhalf]

I wasn’t sure if he might have a peptic ulcer, but without knowing the type of pain or its location in the gut, it’s difficult to even begin speculating.

According to the studies, gastrointestinal side effects reached their highest point between 2-4 months after starting, during the period when doses were being raised. So losing 32lbs over 4 months at 1kg per month is plausible, yet it would be unusual to have no side effects at all and then out of nowhere develop gut pain 4 months later as the sole symptom.

 

[Grogu]

lessthanhalf said:

I wasn’t sure if he might have a peptic ulcer, but without knowing the type of pain or its location in the gut, it’s difficult to even begin speculating.

According to the studies, gastrointestinal side effects reached their highest point between 2-4 months after starting, during the period when doses were being raised. So losing 32lbs over 4 months at 1kg per month is plausible, yet it would be unusual to have no side effects at all and then out of nowhere develop gut pain 4 months later as the sole symptom.

I doubt the idea that gastrointestinal side effects hit their “peak” somewhere around months 2 through 4. Looking at tirzepatide in particular, the biggest spike across essentially every symptom shows up right at the beginning of treatment. The Surmount appendix, shown below, backs this up.

With nausea and diarrhea, the trend is plainly downward as time passes. Vomiting is harder to pin down — it looks like a mixed picture. My guess is that it reflects a subset of people who keep having it long term. As for me, the constipation has never gone away.

Still, if “peak” means the highest point, then it wouldn’t land at 2-4 months after starting with zero side effects before that, which is what the OP describes. The data simply don’t support that reading.

 

[lessthanhalf]

I based that on a figure I recall from a study — it displayed a line rising toward a wide apex around 2-4 months and then falling off, and it concerned nausea or vomiting. That was 1 or 2 years back, so the chances of me locating it again are pretty slim, and it would mean digging through dozens of studies. Back then I was still taking ozempic and was not exactly thrilled by nausea that refused to let up. The figures shown above seem much more thorough and detailed than my hazy recollection of 1 study's curve shape, plus a short mention in it about side effects and when they occur. I am always glad to encounter solid data, perhaps especially when it shows I was mistaken and lets me fix gaps in what I know. Since I do not have to actually treat patients, having a fuzzy and largely correct memory of what I have read is typically enough, but after reading hundreds of papers across years, some memory errors and stale data are inevitable. And if I tracked down and cited sources for every remark I made, I would be more exact, but it would consume a great deal of time.

Still, I have questions about the timing in those figures. I located the surmount appendix and went through what is written beneath the figures. They began at 2.5mg and raised doses by 2.5mg every 4 weeks. Yet it does not state definitively whether the 15mg figure begins at the outset or only after that dose was reached. It would not really be logical for the figure to begin only once the top dose was attained, but I would have expected side effects to be more stretched out over time as doses climbed, and perhaps with some peaks every 4 weeks at each dose increase. For nausea and diarrhoea, though not vomiting, the timing does appear more spread out up to 24 weeks for 10mg, and less clearly so but for a longer period for 15mg. Even so, it remains evident that the highest odds of side effects come after the first dose for GI effects. That is helpful information, and it contradicts what I said earlier, since it implies early side effects could be a sensible signal of later side effects.

 

[Atlanatpr]

Smiter said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

So 32 pounds — over how many weeks, and what dose?

Began Jan 22, and come Monday I’m switching up to 10mg because 8mg isn’t doing as much anymore

 

[Atlanatpr]

Grogu said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

Normally, unwanted effects ease with continued use and tend to show up when the dose is being raised or right at the beginning of treatment. They don’t typically appear much later, after someone has already dropped 32 pounds. If you’ve shed 32 pounds, that points to having taken the medication for a while.

As @lessthanhalf points out, additional information would be useful. For example, which glp-1 you’re on, what dose you take, how long the stomach discomfort has been going on, where the pain is located, and so on.

Smiter said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

So 32 pounds — over how many weeks, and what dose?

January 22 was my start date, and since 8mg isn’t doing as much anymore, Monday I’ll switch up to 10mg. Triz is what I take, and the pain isn’t really a throbbing kind of thing. What I’d call it is painful in flashes—not lasting long stretches—though it does fade as well, and honestly it’s definitely fine. It’s worth it. My start was January 22.

 

[Atlanatpr]

Smiter said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

So 32 pounds — over how many weeks, and what dose?

My start date was Jan 22, and because 8mg has become less effective, I'm switching to 10mg on Monday. I take triz

 

[Grogu]

Atlanatpr said:

Grogu said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

Normally, unwanted effects ease with continued use and tend to show up when the dose is being raised or right at the beginning of treatment. They don’t typically appear much later, after someone has already dropped 32 pounds. If you’ve shed 32 pounds, that points to having taken the medication for a while.

As @lessthanhalf points out, additional information would be useful. For example, which glp-1 you’re on, what dose you take, how long the stomach discomfort has been going on, where the pain is located, and so on.

Smiter said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

So 32 pounds — over how many weeks, and what dose?

January 22 was my start date, and since 8mg isn’t doing as much anymore, Monday I’ll switch up to 10mg. Triz is what I take, and the pain isn’t really a throbbing kind of thing. What I’d call it is painful in flashes—not lasting long stretches—though it does fade as well, and honestly it’s definitely fine. It’s worth it. My start was January 22.

So your start date was Jan 22, and only now are you getting a symptom for the first time?

That seems more like gas or something that isn’t tied to the tirzepatide. Still, watching it closely is smart.

 

[Atlanatpr]

Grogu said:

Atlanatpr said:

Grogu said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

Normally, unwanted effects ease with continued use and tend to show up when the dose is being raised or right at the beginning of treatment. They don’t typically appear much later, after someone has already dropped 32 pounds. If you’ve shed 32 pounds, that points to having taken the medication for a while.

As @lessthanhalf points out, additional information would be useful. For example, which glp-1 you’re on, what dose you take, how long the stomach discomfort has been going on, where the pain is located, and so on.

Smiter said:

Atlanatpr said:

To be honest, the side effects aren’t severe—just occasional stomach pain—and given that I’ve dropped 32 pounds so far, it’s worth it. Without this, I’d likely have put on 32 pounds instead.

So 32 pounds — over how many weeks, and what dose?

January 22 was my start date, and since 8mg isn’t doing as much anymore, Monday I’ll switch up to 10mg. Triz is what I take, and the pain isn’t really a throbbing kind of thing. What I’d call it is painful in flashes—not lasting long stretches—though it does fade as well, and honestly it’s definitely fine. It’s worth it. My start was January 22.

So your start date was Jan 22, and only now are you getting a symptom for the first time?

That seems more like gas or something that isn’t tied to the tirzepatide. Still, watching it closely is smart.

Lower doses barely gave me anything — just 1 instance of vomiting after the initial shot. The symptoms only showed up once I moved to higher doses. Nausea happens too, though it comes and goes quickly and doesn’t last long.