Reta (+Cagri) stopped working

Eventually, I'd guess that as more research accumulates, larger doses will be deemed acceptable for those who respond below average and have few side effects — though it won't do anything for people whose dose is capped by side effects. So far the only completed trials are for semaglutide, at 7.2mg and at 16 mg, showing a modest amount of additional weight loss alongside considerably more side effects. A study of a higher tirzepatide dose is underway, but no information about it exists yet. What would be far more interesting is taking the 10 or 20 percent of people who lose little weight and don't get many side effects, and studying what higher doses do in that group; it will probably happen at some point, though not likely anytime soon. My suspicion is that you could achieve better results, but the only evidence available right now is anecdotal reports online, which are interesting yet not really a dependable data source.
 
There are plenty of solid suggestions in this thread, yet the most straightforward explanation hasn't been mentioned:

Should tesa be boosting your GH output, that might lead to a gain in muscle mass. It's quite plausible that fat loss is still happening, but the number on the scale stays put since your lean mass is going up. Apart from that, I'd say lessthanhalf already covered the other likely possibilities.
 
On an earlier thread about similar problems, someone posted a chart tracking body weight across time: the losses kept coming at a very steady pace, and then, right after drugs that modify hgh were introduced, the line went completely flat. So having a log or chart of how weight moved over time could be useful in working out what is happening here. If the drop in weight tapered off bit by bit until it hit zero, then most likely this is simply a below-average sensitivity to the weight loss effects of reta/cagri. But if weight was coming off consistently and then abruptly halted once tesa was added, that would point fairly clearly at the cause.
 
Calm Logic said:

RadicalCrimson said:

Calm Logic said:

One thing I appreciate about optional peptides that aren't GLP is that they serve as a nice diversion when things plateau, haha. I went ahead and bought a vial of PE-22-28 just to experiment for fun.

If your weight isn't climbing (aside from water retention caused by tesa), you might simply continue waiting it out, paying attention to body composition and lab results rather than the number on the scale. It sounds like you're already managing muscle gain or upkeep well.

Beyond cagri, sema is a common choice for combining with reta (tirz is too).

Gohengrin said:

(this was run through chatgpt for translation, so apologies if it reads oddly)

September is roughly when I started Retatrutide. Early on, results were great. Appetite was firmly suppressed, staying in a deficit was simple (300–500 kcal, at times 1000cal), and I dropped about 21 kg.

Weight at the start: 128kg. Weight now: 107kg.

For some time, though, things have not felt right.

At the moment I'm on 12 mg Reta, plus Cagrilintide at 1.2 to 1.5 mg, and truthfully it's as if I'm injecting nothing. The fullness I used to feel so clearly has more or less vanished. Hunger has returned, at times quite forcefully, and eating no longer comes to a natural halt. A dose usually lasts me 4 weeks.

It has always seemed to me that I require larger doses than other people to feel the same thing, and not only with this. At 6mg I could feel Reta.

Tesamorelin was also added a few weeks back, so I keep wondering whether it could be getting in the way.

A bit of background:

  • ~170 cm, right now ~106 kg
  • 38, male
  • protein around 170g each day
  • calories are logged, and adjusted every month if necessary
  • training 1-2 times per week.
  • since I'm on maternity leave I look after two small children. My wife helps, but it's very demanding.
  • sleep is okay-ish, roughly 6–7 hours a night
A plateau happened once before (roughly 6 weeks with no loss), yet this feels unlike that. It isn't merely progress that has stalled; it's as though the appetite/satiety system itself has quit responding.

Things I'm weighing as possible reasons:

  • receptor tolerance / adaptation after months on Reta
  • the body resisting after ~20 kg lost
  • Tesamorelin having an effect on hunger/metabolism
  • generally needing doses that are unusually high
Has this happened to anyone else, particularly when Reta + Cagri are combined?

Was there anything that truly resolved it?

A break, cycling, dropping one compound, pushing the dose higher, or some other route?
Click to expand...
Do you time your fasting around when you take tesa? Using GH peptides has pushed me toward intermittent fasting (even with some natural hunger), particularly when I divide the dose between bedtime and the morning.

Should you stick with tesa for the time being, reducing the dose, or following a 5 days on, 2 off schedule might ease any water buildup.
Click to expand...

Researcher6076 said:


I am 71, gym rat, scientist, yoga teacher, lol. I alternate days of 2mg Tesa fasting in the mornings, with 200mcg Ipamorelin + 200mcg CJC-1295 NODAC fasted before bed. And one day a week off. It's more conservative than all Tesa, so no side effects. And cheaper. And mechanisticly Tesa 3 days at 2mg is more effective than 6 days are 1mg. The ipamorelin + CJC-1295 NODAC is giving me the flushing tingles, so it is probably doing a little.

Click to expand...
Click to expand...

Rather than following a 5/2 schedule, @Researcher6076 rotates Tesa 2mg 3 times per week with Ipa+CJC 200mg 3 times per week, reporting zero side effects.

That strikes me as a solid approach.
Click to expand...

Systemic reactions are something I'm concerned about:




Epi Pen resources?



Has anyone been able to purchase Epi Pens as a precaution against possible anaphylaxis? If so, how did you go about it? Is there a particular telehealth service that will write a prescription?

View attachment 11569


GLP1Chat.com
Click to expand...
Now I'm worried about those CJC allergic reactions, even after prolonged use.

If the goal is just to "keep the oven warm" regarding GH pulsing alongside Ipa on the days alternating with Tesa, wouldn't Sermorelin be much safer?
 

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RadicalCrimson said:

Calm Logic said:

RadicalCrimson said:

Calm Logic said:

One thing I appreciate about optional peptides that aren't GLP is that they serve as a nice diversion when things plateau, haha. I went ahead and bought a vial of PE-22-28 just to experiment for fun.

If your weight isn't climbing (aside from water retention caused by tesa), you might simply continue waiting it out, paying attention to body composition and lab results rather than the number on the scale. It sounds like you're already managing muscle gain or upkeep well.

Beyond cagri, sema is a common choice for combining with reta (tirz is too).

Gohengrin said:

(this was run through chatgpt for translation, so apologies if it reads oddly)

September is roughly when I started Retatrutide. Early on, results were great. Appetite was firmly suppressed, staying in a deficit was simple (300–500 kcal, at times 1000cal), and I dropped about 21 kg.

Weight at the start: 128kg. Weight now: 107kg.

For some time, though, things have not felt right.

At the moment I'm on 12 mg Reta, plus Cagrilintide at 1.2 to 1.5 mg, and truthfully it's as if I'm injecting nothing. The fullness I used to feel so clearly has more or less vanished. Hunger has returned, at times quite forcefully, and eating no longer comes to a natural halt. A dose usually lasts me 4 weeks.

It has always seemed to me that I require larger doses than other people to feel the same thing, and not only with this. At 6mg I could feel Reta.

Tesamorelin was also added a few weeks back, so I keep wondering whether it could be getting in the way.

A bit of background:

  • ~170 cm, right now ~106 kg
  • 38, male
  • protein around 170g each day
  • calories are logged, and adjusted every month if necessary
  • training 1-2 times per week.
  • since I'm on maternity leave I look after two small children. My wife helps, but it's very demanding.
  • sleep is okay-ish, roughly 6–7 hours a night
A plateau happened once before (roughly 6 weeks with no loss), yet this feels unlike that. It isn't merely progress that has stalled; it's as though the appetite/satiety system itself has quit responding.

Things I'm weighing as possible reasons:

  • receptor tolerance / adaptation after months on Reta
  • the body resisting after ~20 kg lost
  • Tesamorelin having an effect on hunger/metabolism
  • generally needing doses that are unusually high
Has this happened to anyone else, particularly when Reta + Cagri are combined?

Was there anything that truly resolved it?

A break, cycling, dropping one compound, pushing the dose higher, or some other route?
Click to expand...
Do you time your fasting around when you take tesa? Using GH peptides has pushed me toward intermittent fasting (even with some natural hunger), particularly when I divide the dose between bedtime and the morning.

Should you stick with tesa for the time being, reducing the dose, or following a 5 days on, 2 off schedule might ease any water buildup.
Click to expand...

Researcher6076 said:


I am 71, gym rat, scientist, yoga teacher, lol. I alternate days of 2mg Tesa fasting in the mornings, with 200mcg Ipamorelin + 200mcg CJC-1295 NODAC fasted before bed. And one day a week off. It's more conservative than all Tesa, so no side effects. And cheaper. And mechanisticly Tesa 3 days at 2mg is more effective than 6 days are 1mg. The ipamorelin + CJC-1295 NODAC is giving me the flushing tingles, so it is probably doing a little.

Click to expand...
Click to expand...

Rather than following a 5/2 schedule, @Researcher6076 rotates Tesa 2mg 3 times per week with Ipa+CJC 200mg 3 times per week, reporting zero side effects.

That strikes me as a solid approach.
Click to expand...

Systemic reactions are something I'm concerned about:




Epi Pen resources?



Has anyone been able to purchase Epi Pens as a precaution against possible anaphylaxis? If so, how did you go about it? Is there a particular telehealth service that will write a prescription?

View attachment 11569


GLP1Chat.com
Click to expand...
Now I'm worried about those CJC allergic reactions, even after prolonged use.

If the goal is just to "keep the oven warm" regarding GH pulsing alongside Ipa on the days alternating with Tesa, wouldn't Sermorelin be much safer?
Click to expand...
When it comes to IGF-1 effects, sermorelin is definitely the gentler and lower-risk option overall.

To give a rough sense of scale (though results differ a lot person to person, and men tend to respond more strongly):

Gemini said:


Estimated IGF-1 Response Comparison

Baseline IGF-1: 187 ng/mL

SubstanceDoseEst. % IncreaseEst. Point RiseProjected IGF-1Sermorelin250 mcg5–10%+10–20197–207Sermorelin500 mcg10–20%+20–40207–227Sermorelin1000 mcg (1mg)15–25%+30–50217–237Tesamorelin1 mg30–50%+60–90247–277Tesamorelin2 mg (FDA dose)50–100%+100–180287–367HGH1 IU40–70%+75–130262–317HGH2 IU80–120%+150–220337–407HGH3 IU120–180%+220–330407–517

Click to expand...
Click to expand...

Regarding immune reactions, it looks preferable to tesa and also preferable to ipa combined with CJC:

Gemini said:


In clinical trials for Geref (brand name Sermorelin), about 17% of patients developed anti-GRF antibodies. Most were asymptomatic, but systemic redness and urticaria (hives) were documented. While 17% developed antibodies, the studies noted that these antibodies often disappeared on their own and did not cause "generalized allergic reactions

The number of patients who developed antibodies to Tesamorelin (Egrifta) in clinical trials is surprisingly high—nearly 50%. In trials, 60% of patients who developed antibodies to Tesamorelin also developed antibodies that attacked their body's natural GHRH.

Click to expand...
Click to expand...

Based on what Gemini says, ipamorelin with CJC would fall somewhere between serm and tesa when it comes to antibodies. That said, no studies exist on this. From anecdotal reports, though, ipa w/ CJC is the one that raises the most concern among these options.

Because it carries "human" in its name, HGH is the least likely of these to trigger a systemic immune reaction. Only around 2 percent of children developed antibodies in 1 study.

I still haven't opened my 1 vial of ipa w/ CJC. Should I ever try it, I'd begin at very small doses. Possibly as little as 50 mcg haha. But at this point tesa worries me as well, and I haven't even started that yet.
 
Calm Logic said:

One thing I appreciate about optional peptides that aren't GLP is that they serve as a nice diversion when things plateau, haha. I went ahead and bought a vial of PE-22-28 just to experiment for fun.

If your weight isn't climbing (aside from water retention caused by tesa), you might simply continue waiting it out, paying attention to body composition and lab results rather than the number on the scale. It sounds like you're already managing muscle gain or upkeep well.

Beyond cagri, sema is a common choice for combining with reta (tirz is too).

Gohengrin said:

(this was run through chatgpt for translation, so apologies if it reads oddly)

September is roughly when I started Retatrutide. Early on, results were great. Appetite was firmly suppressed, staying in a deficit was simple (300–500 kcal, at times 1000cal), and I dropped about 21 kg.

Weight at the start: 128kg. Weight now: 107kg.

For some time, though, things have not felt right.

At the moment I'm on 12 mg Reta, plus Cagrilintide at 1.2 to 1.5 mg, and truthfully it's as if I'm injecting nothing. The fullness I used to feel so clearly has more or less vanished. Hunger has returned, at times quite forcefully, and eating no longer comes to a natural halt. A dose usually lasts me 4 weeks.

It has always seemed to me that I require larger doses than other people to feel the same thing, and not only with this. At 6mg I could feel Reta.

Tesamorelin was also added a few weeks back, so I keep wondering whether it could be getting in the way.

A bit of background:

  • ~170 cm, right now ~106 kg
  • 38, male
  • protein around 170g each day
  • calories are logged, and adjusted every month if necessary
  • training 1-2 times per week.
  • since I'm on maternity leave I look after two small children. My wife helps, but it's very demanding.
  • sleep is okay-ish, roughly 6–7 hours a night
A plateau happened once before (roughly 6 weeks with no loss), yet this feels unlike that. It isn't merely progress that has stalled; it's as though the appetite/satiety system itself has quit responding.

Things I'm weighing as possible reasons:

  • receptor tolerance / adaptation after months on Reta
  • the body resisting after ~20 kg lost
  • Tesamorelin having an effect on hunger/metabolism
  • generally needing doses that are unusually high
Has this happened to anyone else, particularly when Reta + Cagri are combined?

Was there anything that truly resolved it?

A break, cycling, dropping one compound, pushing the dose higher, or some other route?
Click to expand...
Do you time your fasting around when you take tesa? Using GH peptides has pushed me toward intermittent fasting (even with some natural hunger), particularly when I divide the dose between bedtime and the morning.

Should you stick with tesa for the time being, reducing the dose, or following a 5 days on, 2 off schedule might ease any water buildup.
Click to expand...
That's right, stop eating at 7 pm and inject at 10 pm.
 
lessthanhalf said:

On an earlier thread about similar problems, someone posted a chart tracking body weight across time: the losses kept coming at a very steady pace, and then, right after drugs that modify hgh were introduced, the line went completely flat. So having a log or chart of how weight moved over time could be useful in working out what is happening here. If the drop in weight tapered off bit by bit until it hit zero, then most likely this is simply a below-average sensitivity to the weight loss effects of reta/cagri. But if weight was coming off consistently and then abruptly halted once tesa was added, that would point fairly clearly at the cause.
Click to expand...
Shotsy gives me a week-by-week weight record. Roughly 7 weeks back it flatlined, though Tesa only entered the picture around 5 weeks ago. From that point it climbs 0.5 kg, then drops 0.5 kg...just normal fluctuation.
 
RadicalCrimson said:

Given my age, IGF-1 level and Z score (57/181/0.7), going +100 is likely a reasonable starting cap.

Having used more than 12mg of reta alongside cagri, I've concluded that visceral abdominal fat is likely what I most need to address at this point.

My result on this measurement test was quite poor: https://www.lih.lu/en/visceral-fat-calculator/

So Tesa is the answer.
Click to expand...

That calculator hit me hard as well. It comes across as way too sensational. Still, for most of us it's probably the best free option to get a rough idea, together with those inexpensive digital smart scales whose accuracy is dubious.

Naturally, blood work gives a far more reliable picture of real health impacts:

Gemini said:


Visceral Fat Status: Objective Metabolic & Physical Hierarchy​

RankMetricClinical Accuracy for Visceral Fat1DEXA (VAT Scan)Direct: The ultimate way to see if your weight loss is coming from the "dangerous" internal stores or the "cosmetic" subcutaneous stores.

2Fasting InsulinCausal: High insulin is the "on switch" for storing visceral fat.3ALT (Liver Enzyme)Organ Fat: Elevated ALT is a direct proxy for fat inside the liver.4ApoB / VLDLLipid Export: VLDL is the "overflow" from a fatty liver; ApoB counts the total damage.5Blood PressureImpact: High visceral fat triggers hormones that spike BP.6Trig/HDL RatioMetabolic: Signals if the liver is "overflowing" fat into the blood.7Waist-to-HeightGeometric: At 5'9", your target waist should be <34.5".8Thigh Circum.Protective: Larger, muscular thighs act as a "metabolic sink."

Click to expand...
Click to expand...
 
Calm Logic said:

RadicalCrimson said:

Given my age, IGF-1 level and Z score (57/181/0.7), going +100 is likely a reasonable starting cap.

Having used more than 12mg of reta alongside cagri, I've concluded that visceral abdominal fat is likely what I most need to address at this point.

My result on this measurement test was quite poor: https://www.lih.lu/en/visceral-fat-calculator/

So Tesa is the answer.
Click to expand...

That calculator hit me hard as well. It comes across as way too sensational. Still, for most of us it's probably the best free option to get a rough idea, together with those inexpensive digital smart scales whose accuracy is dubious.

Naturally, blood work gives a far more reliable picture of real health impacts:

Gemini said:


Visceral Fat Status: Objective Metabolic & Physical Hierarchy​

RankMetricClinical Accuracy for Visceral Fat1DEXA (VAT Scan)Direct: The ultimate way to see if your weight loss is coming from the "dangerous" internal stores or the "cosmetic" subcutaneous stores.

2Fasting InsulinCausal: High insulin is the "on switch" for storing visceral fat.3ALT (Liver Enzyme)Organ Fat: Elevated ALT is a direct proxy for fat inside the liver.4ApoB / VLDLLipid Export: VLDL is the "overflow" from a fatty liver; ApoB counts the total damage.5Blood PressureImpact: High visceral fat triggers hormones that spike BP.6Trig/HDL RatioMetabolic: Signals if the liver is "overflowing" fat into the blood.7Waist-to-HeightGeometric: At 5'9", your target waist should be <34.5".8Thigh Circum.Protective: Larger, muscular thighs act as a "metabolic sink."

Click to expand...
Click to expand...
Click to expand...
For the very first time, my Withings scale gave me a "healthy" lean mass score of 78% today — and yet the number on the scale has barely budged over the past 7 days.

PURE SORCERY!!!
 
The water percentage has climbed as well. I share your skepticism about the “questionable value”.

Last night I did administer my initial Tesa 1mg+Ipa 100mcg dose, though I’m not counting on miracles.
 
Calm Logic said:

RadicalCrimson said:

Given my age, IGF-1 level and Z score (57/181/0.7), going +100 is likely a reasonable starting cap.

Having used more than 12mg of reta alongside cagri, I've concluded that visceral abdominal fat is likely what I most need to address at this point.

My result on this measurement test was quite poor: https://www.lih.lu/en/visceral-fat-calculator/

So Tesa is the answer.
Click to expand...

That calculator hit me hard as well. It comes across as way too sensational. Still, for most of us it's probably the best free option to get a rough idea, together with those inexpensive digital smart scales whose accuracy is dubious.

Naturally, blood work gives a far more reliable picture of real health impacts:

Gemini said:


Visceral Fat Status: Objective Metabolic & Physical Hierarchy​

RankMetricClinical Accuracy for Visceral Fat1DEXA (VAT Scan)Direct: The ultimate way to see if your weight loss is coming from the "dangerous" internal stores or the "cosmetic" subcutaneous stores.

2Fasting InsulinCausal: High insulin is the "on switch" for storing visceral fat.3ALT (Liver Enzyme)Organ Fat: Elevated ALT is a direct proxy for fat inside the liver.4ApoB / VLDLLipid Export: VLDL is the "overflow" from a fatty liver; ApoB counts the total damage.5Blood PressureImpact: High visceral fat triggers hormones that spike BP.6Trig/HDL RatioMetabolic: Signals if the liver is "overflowing" fat into the blood.7Waist-to-HeightGeometric: At 5'9", your target waist should be <34.5".8Thigh Circum.Protective: Larger, muscular thighs act as a "metabolic sink."

Click to expand...
Click to expand...
Click to expand...
7Waist-to-HeightGeometric: If you are 5'9", then the waist you should aim for is under 34.5".8Thigh Circum.Protective: Thighs that are bigger and more muscular function as a "metabolic sink."

The Luxembourg calculator takes these same measurements as its inputs.

What on earth is the AI getting at with “metabolic sink”?
 
It seems I’ll be running Tesa+Ipa alone, without CJC and without any rest days, ramping the dose to 2000/250, until the number on my waist tape drops.

A CGM is on my arm these days, which is entertaining.
 
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