David smith said:
I alternate between the two so neither one becomes too familiar. Roughly every 3 months I make the change. My Sema dose was 2mg. With triz, I usually land somewhere from 10 to 12. Most weeks I take a single injection, though now and then I'll split it when I sense the need. My aim is to remain slightly under the highest dose.
In my view, that could be what's holding you back.
Building a tolerance may actually be a good sign, since it suggests the medication is doing its job.
I'm not aware of any data showing that tolerance develops, and plenty of people manage to lower their dose during maintenance.
What does appear problematic is cycling off and then restarting, because that can reduce how well the GLP1 works.
If 12mg Tirz was your ceiling, then moving to a higher dose seems logical.
Earlier studies capped at 15mg, and current research is looking at 25mg and above.
I don't have details on your starting point, total loss, or timeline, but at first glance your best option looks like increasing the dose, and if necessary adding sema at a very low dose (some people have done well with that combination).
For my part, I stuck to the protocol and dropped roughly 27% over 7 months, reaching my target weight.
