Retatrutide at 8mg: bump the dose up or hold steady?

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BubbaZ

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I began on tirzepatide at 237 lbs and made it down to roughly 185, with 179 as my end target. Once I had dropped the bulk of that weight, I was stuck at basically the same spot for around 1.5 years, so a few months back I made the change to Reta. Through the switch and the ramp-up, I've put back on somewhere around 5-7 pounds.

My 5th 8mg Reta shot is due tonight, and my weekly 2.4mg Cagri dose comes tomorrow.

At 8mg the appetite suppression holds up well for roughly 5-6 days and the food noise is pretty much silenced. This Thursday I finally went under 190 for the first time in weeks, landing at 189.2. But Friday brought the hunger and food noise back with a vengeance, and as of today I'm up around 3 pounds. I realize a swing like that isn't fat, yet the timing lines up perfectly with the appetite returning.

So what I really want to know is: do I let 8mg ride a while longer, go up in dose, or split the dose to handle the appetite creeping back at the end of the week?

Anyone who's dealt with this have suggestions?
 
I'm new to Reta, and what ended up suiting me was dividing the dose and tightening the interval between shots. Around day 4 the food noise started returning, so I trimmed my dose a bit and moved to a 5-day schedule.
 
Splitting the dose isn't something I like, but as @woundcarping pointed out, it could be useful for the food noise you're dealing with. At my once-a-week dosing, that food noise never showed up for me. I stayed at 8mg for 6 weeks, then spent 1 week at 9mg before moving straight to 10mg. Put another way, my choice would be a 2mg increase.
 
BNLFL said:

Splitting the dose isn't something I like, but as @woundcarping pointed out, it could be useful for the food noise you're dealing with. At my once-a-week dosing, that food noise never showed up for me. I stayed at 8mg for 6 weeks, then spent 1 week at 9mg before moving straight to 10mg. Put another way, my choice would be a 2mg increase.
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I ran Tirz, not Reta, but I'm with you on the weekly schedule.

When there's 10lbs left to lose and you've still got 2 chances to go up by 2mg apiece, increasing the dose seems reasonable as long as no sides show up.

That said, if sides are giving you trouble, @woundcarping has done really well splitting it in a bunch of different ways, and the advice he gives is solid.
 
About 3 weeks into Tirz, the effects were fading around day 5, so I switched to split dosing. 38 weeks have passed since then, and I'm still using the split approach.
 
Shittersfull said:

If it were me, I'd go with 8mg every 6 days. It seems like 8mg packs enough of a punch — the problem is that it wears off too quickly.
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Personally, that's the reason I would move up to 10mg. That said, he never brought up being stalled.
 
Bruce Campbell said:

I'm new to Reta, and what ended up suiting me was dividing the dose and tightening the interval between shots. Around day 4 the food noise started returning, so I trimmed my dose a bit and moved to a 5-day schedule.
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Shittersfull said:

If it were me, I'd go with 8mg every 6 days. It seems like 8mg packs enough of a punch — the problem is that it wears off too quickly.
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Splitting the dose is a yes from me, and on top of that I want to try a schedule shorter than 7 days...I figure all it takes is a small adjustment and a little push to get things moving again...good luck
 
After I switched to dividing my dose across every 3.5 days, the side effects eased up and my weight loss stopped dropping as fast. Roughly 4 months have passed since then, and I have no regrets about the change.
 
Once you have been on the same dose for 5 weeks, your blood levels have maxed out, so waiting longer will not change anything. Side effects are not mentioned in your post; if they are a problem, the better route is splitting doses and moving to 5mg then 6 mg twice a week, while if they are not, 10mg then 12 if needed once a week is worth a try, or 8mg every 5 or 6 days. Should hunger control fade before the next dose even at higher doses, though, then split dosing is what solves it. Your goal is a 25% loss, so with 8mg of reta plus cagri at 2.4mg you are likely responding slightly below average. I see no benefit in leaving the reta dose at 8mg when it is not controlling appetite well enough, unless side effects are what is blocking further increases, in which case splitting the dose is the fix. Given what you are already taking, you are clearly not far from a maintenance dose, so most of the effect of these drugs is going toward stopping regain rather than losing more, and higher doses are the only way to change that.
 
BNLFL said:

Splitting the dose isn't something I like, but as @woundcarping pointed out, it could be useful for the food noise you're dealing with. At my once-a-week dosing, that food noise never showed up for me. I stayed at 8mg for 6 weeks, then spent 1 week at 9mg before moving straight to 10mg. Put another way, my choice would be a 2mg increase.
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What makes you dislike it? By splitting 5 mg of tirzepatide into a 3 mg and a 2mg dose on wednesdays and sundays, I dropped close to 25 kg.

Once progress halted, I raised the dose gradually to 10mg using split dosing, and honestly it barely helped. That is the reason I have switched to reta, which I also started splitting yesterday.

The change in food noise, though, is massive. Now I get it — this is probably why most of us will end up staying on these drugs for a very very long time, tapering down only very slowly. Until a few days ago I thought of myself as fairly strong willed and sure I could beat the food noise... yeah right.
 
oneiszero said:

What makes you dislike it? By splitting 5 mg of tirzepatide into a 3 mg and a 2mg dose on wednesdays and sundays, I dropped close to 25 kg.

Once progress halted, I raised the dose gradually to 10mg using split dosing, and honestly it barely helped. That is the reason I have switched to reta, which I also started splitting yesterday.

The change in food noise, though, is massive. Now I get it — this is probably why most of us will end up staying on these drugs for a very very long time, tapering down only very slowly. Until a few days ago I thought of myself as fairly strong willed and sure I could beat the food noise... yeah right.
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It's good to see you staying humble about this : )

From what I can tell, the people who manage to come off it and do well are putting in an enormous amount of effort to keep things stable. For anyone like me who would rather put that time and energy into other parts of life, just continuing the medication is an obvious choice.
 
oneiszero said:

What makes you dislike it? By splitting 5 mg of tirzepatide into a 3 mg and a 2mg dose on wednesdays and sundays, I dropped close to 25 kg.

Once progress halted, I raised the dose gradually to 10mg using split dosing, and honestly it barely helped. That is the reason I have switched to reta, which I also started splitting yesterday.

The change in food noise, though, is massive. Now I get it — this is probably why most of us will end up staying on these drugs for a very very long time, tapering down only very slowly. Until a few days ago I thought of myself as fairly strong willed and sure I could beat the food noise... yeah right.
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None of that ever happened to me. Day 6 never brought hunger, and even going as high as 10mg I had no side effects. These days I'm in maintenance, sitting at 6 and 8mg, and I plan to stay there for as long as I can. At some point I may step down to 2-4mg, but that's only a maybe.
 
Appreciate all the feedback.

A bit of background: cold sensitivity is the only thing Reta does to me. There was some tingling in the skin on my back, but that went away. So bad side effects have never really been an issue for me.

Last night I went up to a 5mg split, and I'll still do my Cagri this morning. Then another 5mg on Thursday morning. Hopefully that gets things moving again. I've been trying to keep an eye on my eating and get workouts in during the week. Sooner or later something has to change! At this stage it's less about sitting at a “normal” BMI and more about showing myself that I'm capable of this.
 
Take that day or two as a chance to figure out how to handle food noise. When you already know food noise is coming a day or two before your next dose, teach yourself to handle it. If one day of food noise is more than you can manage, then discipline is the thing you need to work on. That's just how I see it.
 
Retaguy said:

Take that day or two as a chance to figure out how to handle food noise. When you already know food noise is coming a day or two before your next dose, teach yourself to handle it. If one day of food noise is more than you can manage, then discipline is the thing you need to work on. That's just how I see it.
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Or you could move over to liraglutide and pick up plenty of life lessons -- for example, that life sucks, haha. When it comes to handling reta and tirz, the lesson worth learning might be split dosing (for instance, dosing every four days rather than once a week), even if the total weekly amount stays unchanged:

MedicationElimination Half-LifeSplit Dosing Strategy & Half-Life ImpactSemaglutide (Wegovy / Ozempic)Approx. 1 week (~7 days)With a 7-day half-life, levels dip by days 6–7. Splitting into a 3.5-day interval (e.g., Monday morning and Thursday evening) keeps blood levels very flat, minimizing late-week cravings.Tirzepatide (Zepbound / Mounjaro)Approx. 5 days (~120 hours)Shorter half-life than semaglutide means levels drop more noticeably by days 6 and 7, triggering "food noise" and hunger spikes. A 3.5-day split is exceptionally effective here.Retatrutide (Investigational)Approx. 6 days (~144 hours)Similar to tirzepatide (~6-day half-life). A 3.5-day split helps smooth out peak side effects while preventing the end-of-cycle decline.

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On the other hand, for maintenance, every 2 weeks does the job for a few people, and that helps more when you're outside of grey and limited to single-injection pens.
 
Looking back at the weight you put on, do you figure it was fat? Was there any shift in your body composition? The following step — which can be frightening at times — involves the psychology of reaching your goal weight and no longer living in a permanent calorie deficit.
 
BubbaZ said:


I started at 237 lbs on tirzepatide and got down to about 185, with a final goal of 179. After losing most of the weight, I basically have stalled for about 1.5 years, so I switched to Reta a few months ago. During the switch and titration up, I’ve regained about 5-7 pounds.

Tonight will be my 5th - 8mg Reta dose, and tomorrow is my weekly 2.4mg Cagri dose.

At 8mg, appetite suppression is great for about 5-6 days and the food noise is basically gone. On Thursday this week, I finally dropped below 190 for the first time in weeks and hit 189.2. Then by Friday the hunger and food noise came back pretty hard, and today I am up about 3 pounds. I know that kind of jump isn’t fat, but the timing definitely matches the appetite coming back.

So my main question is: should I give 8mg more time, increase my dose, or try splitting my dose to deal with the end-of-week appetite return?

Suggestions from others who have been in this situation?

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Are you exercising on a regular basis? Do you go to the gym, play sports, walk? Any of it? Perhaps tesamorelin/semorelin is worth a try???

Have you had bloodwork done? At times, that can show you what you should be concentrating on.
 
Retaguy said:

Take that day or two as a chance to figure out how to handle food noise. When you already know food noise is coming a day or two before your next dose, teach yourself to handle it. If one day of food noise is more than you can manage, then discipline is the thing you need to work on. That's just how I see it.
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I get where you're coming from, but "work on your discipline" doesn't really give me anything to go on.

What I'm describing is an appetite bump that shows up like clockwork late in the week, right around when the medication appears to fade. That's a different animal from plain hunger that willpower can handle. These drugs change appetite on purpose, so once that effect tapers off, hunger can rebound strongly. Think of it like an OTC allergy pill: it keeps your symptoms down for most of the day, then it wears off and the allergies return. No one would tell you that you just need more discipline to stop sneezing. The medication just isn't doing the same job anymore.

I've been at this roughly two years, and I watch the patterns closely. That's how I spotted that it lands at essentially the same point each week. It's also why I raised the question to begin with. I was trying to work out whether splitting the dose, adjusting the dose, or something else made sense given what others have actually been through. Just telling me I need more discipline doesn't answer that.
 
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