Reta/Cag vs Cagrisema when stacking alongside Tirz
- Thread starter druell235
- Start date
Before you stack another agent on top, have you given split dosing a shot? When a weight loss drug has been working for you — both in terms of efficacy and side effects you can tolerate — but its benefits start fading before the week is up, that's typically the first move worth trying.
woundcarping
Explorer
One more point in favor of dividing the dose.
By week 3 on Tirz I had moved to a split schedule; that was 13 weeks and 37lb in the past.
By week 3 on Tirz I had moved to a split schedule; that was 13 weeks and 37lb in the past.
FartfulCodger
Explorer
Reta didn't work out for me at all. My hunger wasn't curbed by it, plus allodynia showed up, so I tapered off and returned to Tirz. Cagri, though, I introduced gradually and with care, and the results have been excellent. The thought of my appetite coming back terrifies me, since I credit calorie restriction with 90% of the weight I've lost. My routine is basically OMAD fasting, supplemented with protein shakes and vitamins. Things are going smoothly.
At the moment I'm split dosing Tirz together with Cagri while the Reta works its way out via its half-life and the allodynia diminishes. My weekly amounts are 12mg of Tirz and 2mg of Cagri. I realize that Cagri dose sounds aggressive, but I suspect I respond poorly to it. Starting at 0.2mg produced no unpleasant effects for me, so I raised it step by step whenever my appetite began returning.
At the moment I'm split dosing Tirz together with Cagri while the Reta works its way out via its half-life and the allodynia diminishes. My weekly amounts are 12mg of Tirz and 2mg of Cagri. I realize that Cagri dose sounds aggressive, but I suspect I respond poorly to it. Starting at 0.2mg produced no unpleasant effects for me, so I raised it step by step whenever my appetite began returning.
agussie
Explorer
day 4: throw in some Survo 
lessthanhalf
Explorer
Are you taking tirz at 15mg per week? Your beginning weight, how old you are, overall health, how tall you are, what you weigh now, and how long you've been losing — all of these play into what counts as reasonable once you reach the point where progress stalls.
If things are still going well, but the effect seems to fade during the day or 2 before your next shot, then splitting the dose is a simple fix.
RoadRash
Explorer
That's awesome!!
DragonOfTheSea
Explorer
Huge congrats once more — that's an amazing amount of weight you've dropped!I'm also on board with giving split dosing a shot before anything else.
FartfulCodger
Explorer
GI problems are quite mild for me. There's no nausea or pain, only irregular bowel movements. My appetite disappears in the morning. Occasionally it stirs a bit later in the day, so I'll have a small bite or a protein shake, and that settles it. When dinner comes and I do feel hungry, I'll still sit down to a normal balanced meal, just a reduced serving, mainly to keep nutrition solid and feel some sense of routine.
That said, I suspect I'm something of a non-responder. None of these medications has ever given me even a trace of nausea (Tirz, Reta, and Cagri included). Still, I've come across accounts of nausea and GI trouble with Cagri, even at low doses, so my suggestion would be to start Cagri slowly if that's the path you take. Best of luck either way.
Appreciate that — it helps me feel a bit more optimistic. Back when I began sema last year, it left me feeling sick 24 hours after each dose. Aside from that, tirz, reta and cagri have never given me any side effects (I gave cagri a try in the fall, but since I couldn't tell whether it was having any effect, I quit).
Beyond the fact that food noise keeps returning sooner each time, here's some extra background. My recent weigh-ins:
March 9th-299
March 16th-297.1
March 23rd -299.5
March 24th-297.6, possibly water retention from the prior day
March 30th-297.4
It's making me insane.
March 9th-299
March 16th-297.1
March 23rd -299.5
March 24th-297.6, possibly water retention from the prior day
March 30th-297.4
It's making me insane.
lessthanhalf
Explorer
With a starting BMI of 62, wanting higher doses or a combination is genuinely a reasonable line of thinking. The strongest result anyone has recorded is close to 30% with reta, and pushing past that sits outside what the research can support. You're already down 33%, which beats the average across every study, and from here the options are experimental — mostly built on forum anecdotes that aren't reliable.
1 month of no movement doesn't prove much either; fluid balance alone can explain that. Given how much you've lost, I'd guess you've been on tirz a long while — congrats on that.
I take it you do get checked over medically now and then, with no obvious heart disease and blood sugars reasonably under control.
The thing I'd want to know is whether you're on any other diabetes medication. Layering other drugs or bigger doses on top carries extra risk in that setting, hypoglycemia especially. If you did add anything, careful blood sugar monitoring would be necessary. Ideally a specialist would guide this, but since none of these options are properly studied or approved, no doctor is going to sign off on reta or cagri. A good doctor could still advise on lowering the risks while disagreeing with the plan itself — harm minimisation, essentially — though most aren't flexible enough, mentally or legally, to do it.
On the nausea you had with semaglutide: it has probably the worst nausea-to-weight-loss ratio of the lot, so it isn't the natural pick, though small add-on doses of it have worked for some.
The least complicated route is simply raising your tirzepatide dose; unstudied, obviously, but likely the fewest side effects.
Cagrisema I'd avoid, purely because it's two additional drugs at once and makes the effects much harder to read.
Switching to reta is possible, but the extra 5% probably won't carry you far enough.
Small doses of cagri or reta alongside are the remaining options, titrated upwards slowly.
Any of these carries risk — side effects, or effects nobody understands yet. There's no way around that beyond watching yourself closely, and you have to weigh it against the long-term risk reduction that weight loss buys you, which is probably enormous.
I handled 15mg of tirz fine and didn't want to move to reta, so I layered 5mg of reta on top; I can't go higher because skin sensory issues turn unpleasant. I added 0.5 of cagri recently to see whether it does anything — too early to say. I did the whole thing in reverse: lost the weight first, then started GLP's to stop being permanently hungry, and they help enormously. currently 54% down bmi 24.
You clearly aren't content at your present weight — I work it out as bmi 41 — but that's still a massive achievement. It isn't low enough to bring risks back to normal levels, yet sitting at high or very high risk beats the extreme risk that comes with a bmi of 62 any day. Reaching a normal BMI may simply not be on the cards, and at this stage part of the goal has to be protecting what you've already won — keeping the weight from creeping back, not only losing more.
1 month of no movement doesn't prove much either; fluid balance alone can explain that. Given how much you've lost, I'd guess you've been on tirz a long while — congrats on that.
I take it you do get checked over medically now and then, with no obvious heart disease and blood sugars reasonably under control.
The thing I'd want to know is whether you're on any other diabetes medication. Layering other drugs or bigger doses on top carries extra risk in that setting, hypoglycemia especially. If you did add anything, careful blood sugar monitoring would be necessary. Ideally a specialist would guide this, but since none of these options are properly studied or approved, no doctor is going to sign off on reta or cagri. A good doctor could still advise on lowering the risks while disagreeing with the plan itself — harm minimisation, essentially — though most aren't flexible enough, mentally or legally, to do it.
On the nausea you had with semaglutide: it has probably the worst nausea-to-weight-loss ratio of the lot, so it isn't the natural pick, though small add-on doses of it have worked for some.
The least complicated route is simply raising your tirzepatide dose; unstudied, obviously, but likely the fewest side effects.
Cagrisema I'd avoid, purely because it's two additional drugs at once and makes the effects much harder to read.
Switching to reta is possible, but the extra 5% probably won't carry you far enough.
Small doses of cagri or reta alongside are the remaining options, titrated upwards slowly.
Any of these carries risk — side effects, or effects nobody understands yet. There's no way around that beyond watching yourself closely, and you have to weigh it against the long-term risk reduction that weight loss buys you, which is probably enormous.
I handled 15mg of tirz fine and didn't want to move to reta, so I layered 5mg of reta on top; I can't go higher because skin sensory issues turn unpleasant. I added 0.5 of cagri recently to see whether it does anything — too early to say. I did the whole thing in reverse: lost the weight first, then started GLP's to stop being permanently hungry, and they help enormously. currently 54% down bmi 24.
You clearly aren't content at your present weight — I work it out as bmi 41 — but that's still a massive achievement. It isn't low enough to bring risks back to normal levels, yet sitting at high or very high risk beats the extreme risk that comes with a bmi of 62 any day. Reaching a normal BMI may simply not be on the cards, and at this stage part of the goal has to be protecting what you've already won — keeping the weight from creeping back, not only losing more.
Appreciate it! To give you the short version: my first GLP-1 was compounded semaglutide, which I began last year and stayed on through May, reaching a maximum of 2.5. After that I moved to compounded tirz at 10 and kept increasing the dose from there. Later I found grey, tried reta for just a few weeks during the fall, but since I couldn't tell whether it changed anything, I chose to remain on tirz for as long as I can.
On the prescription side, metformin 1000mg daily is part of my routine. According to my doctor, I've shed enough pounds and my two most recent A1Cs came back at 4.5 and 4.7, so stopping metformin would be fine if I chose to. Even so, I opted to continue it. Lisinopril HCTZ, Amlodipine, and atorvastatin are also in the mix (the statin is mostly preventive). When I last spoke with my doctor, I told him I was using a compound, which was accurate at the time, and he has labs drawn every three months.
My current weight isn't exactly where I want it, yet compared to before it's a massive step forward. Looking back at how large I once was, and noticing how much simpler ordinary life has become, honestly amazes me. Last week I had to sprint to catch a bus, and I survived it without being badly winded. An hour of walking each day is now something I genuinely look forward to. Still, I sense there's more left to accomplish, and I don't want to remain stuck at this point. I also still have a vial of Hallandale semaglutide that expires next month, so adding it in is my plan for next week.
lessthanhalf
Explorer
Metformin typically does not bring on hypoglycemia, and it could contribute a bit of extra weight loss, so it is generally safe. Even so, watching blood sugar—particularly for lows—seems wise since the hb1ac is excellent. Hypoglycemia is not a usual effect of any of these medications on their own, but because combinations have not been well studied, caution is reasonable.
skeptick
Explorer
Could you share how long this weight loss took? Thanks
If I had to pick between the two for stacking alongside tirz, my preference goes to Cagri rather than CagriSema. The main reason is that CagriSema brings sema into the mix as well, which muddies the picture when you're trying to figure out which component is responsible for what.
Socalgirl97
Explorer
I started taking Reta in March, and a little while back I introduced cargrilintide at 0.50mg because the food noise was getting to me. It's been effective in my case. I'm also T2D and taking metformin 2000mg, though I suspect I'll need to reduce that dose before long. Ever since I began the Carg 2 weeks ago, my blood sugar readings have been sitting between 124-140
No problem. My sema journey began last January via a compounding pharmacy, and the scale didn't budge until late May once I reached the higher doses — though I'll admit I wasn't tracking calories or taking the nutrition side of things seriously back then. Last June I made the switch to compound tirz, began tracking, and the pounds started coming off at about 3 pounds per week. August is when I added regular walking: initially 30 minutes 3 times weekly, and these days it's an hour 6 days a week. Below is my shots timeline. Also, I managed to break the stall that prompted this post.