Seeking guidance on stacking options

Mademoiselle

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I could use some input from others here.

My current Tirzepatide dose is 7 mg, and I’m not planning to go up, since larger doses took a toll on my mental health. So I’m thinking about layering in a second compound. Elora would be my first pick, but I’m not confident about how safe it is. Cagrilintide was the one I first had in mind, yet Retatrutide now seems like it might be the stronger choice.

When it comes to adverse effects and what it costs, what would you suggest?

As for where I am now: 85 kg on the scale. Since November I’ve dropped 18 kg. That may not sound impressive, but a great deal of fat is gone and I’ve put on substantial muscle. These days, though, things have slowed down a lot, and my goal is to shed another 18–20 kg.
 
When my tirz dose was 8mg, I began pinning cagri alongside it because food noise was starting to return. Since I was still losing weight at that dose, I didn’t increase the tirz. My cagri starting point was 100mcg, and I titrated upward gradually. The combination has been part of my routine for 2 years now. These days I’m on 15mg tirz plus 3mg cagri. Once elora is easier to find on the grey market, I intend to make the switch.

As for stacking tirz with reta, I’m not sure what you’d really get beyond the glucagon receptor. It might make more sense to move over to reta on its own first, so you can see how it affects your mental health, and only then think about combining the two.
 
When you mention that larger tirz doses hurt your mental health, what exactly do you mean? Before you went up, how long were you on the lower dose, what was the size of the increase, and how long did you remain at that higher amount? Since returning to 7 mg, how long has it been and what has shifted in terms of effects?

Regarding your comment that progress has slowed, could you clarify? Is weight still coming off, just at a reduced pace, or has it stopped entirely? If it has stopped, how many weeks or months has that been the case? How would you describe the appetite suppression and other effects you feel at your current dose?

Past side effects from a dose increase don't mean you'll necessarily get them again (though it's certainly possible, and the risk call is yours to make). By now your system might tolerate 7mg better than it did when you last attempted to go higher. Splitting the dose is another route if you haven't given it a try (for instance, 4mg two times per week rather than 7mg once weekly).

I haven't personally stacked other GLPs with tirz, so I can't speak from experience on that. One thing to remember: reta hits the same receptors as tirz, so if a bigger tirz dose would still bring side effects for you, reta could produce them too. Elora and cagri operate through different mechanisms, but side effects from those remain a possibility as well.
 
For the lowest cost, I’d introduce cagri at a small dose. It wasn’t very enjoyable during the short time I tried it, which is why I switched to elora.

What suits me in my present combination may not suit you—everyone’s ideal mix is different. Exploring and testing is where the enjoyment lies 🙂
 
BBA1969 said:

For the lowest cost, I’d introduce cagri at a small dose. It wasn’t very enjoyable during the short time I tried it, which is why I switched to elora.

What suits me in my present combination may not suit you—everyone’s ideal mix is different. Exploring and testing is where the enjoyment lies 🙂
...incorporating Sema would cost the least...from what I gather, Sema is also quite effective at suppressing appetite.
 
Ich habe über einen längeren Zeitraum 5 mg genommen. Als die Wirkung nachließ, habe ich alle vier Wochen um 0,5 mg gesteigert. Vor meinem 60. Geburtstag wollte ich möglichst viel Gewicht verlieren. Da dieser Geburtstag nun vorbei ist, gehe ich es ruhiger an. Bei 7,0 mg – gespritzt alle sechs Tage – war ich ein oder zwei Tage sehr emotional; wegen jeder Kleinigkeit kamen mir die Tränen, und auf der Arbeit war mir das schnell peinlich. Deshalb bin ich wieder auf 6,5 mg heruntergegangen. Danach habe ich die Dosis langsam wieder hochgefahren – zuerst 6,85 mg, dann 7,0 mg – und sie im Abstand von sieben Tagen injiziert. Diesmal fiel es mir leichter; es hielt nur einen Nachmittag an, und das an einem Sonntag. Beim Gewicht geht es nicht voran – mal sind 0,5 kg weg, mal kommt etwas dazu. Ich traue mich nicht, die Dosis in größeren Sprüngen zu erhöhen.
 
Flash-BCR said:

BBA1969 said:

For the lowest cost, I’d introduce cagri at a small dose. It wasn’t very enjoyable during the short time I tried it, which is why I switched to elora.

What suits me in my present combination may not suit you—everyone’s ideal mix is different. Exploring and testing is where the enjoyment lies 🙂
...incorporating Sema would cost the least...from what I gather, Sema is also quite effective at suppressing appetite.
Sema isn't something I've tried before. Based on what I've come across, its side effects seem harsher compared to Tirz.

Also, combining it with Tirz—would that be excessive?
 
BBA1969 said:

Flash-BCR said:

BBA1969 said:

For the lowest cost, I’d introduce cagri at a small dose. It wasn’t very enjoyable during the short time I tried it, which is why I switched to elora.

What suits me in my present combination may not suit you—everyone’s ideal mix is different. Exploring and testing is where the enjoyment lies 🙂
...incorporating Sema would cost the least...from what I gather, Sema is also quite effective at suppressing appetite.
Sema isn't something I've tried before. Based on what I've come across, its side effects seem harsher compared to Tirz.

Also, combining it with Tirz—would that be excessive?
Many individuals have taken sema in a way similar to how cagril would be used—whether as a single instance or as a consistent element of a GLP stack...I possess some sema yet have not tried it...Likewise with cagril...I acquired both to break through a plateau or curb hunger...It's simply one more possibility...
 
Sema wasn't on my radar until now, and it probably wouldn't be my top pick. Another route could be 4 mg of Tirz taken every four days. Elora is something I'm still waiting on. On top of that, I'd like to work in GHK-Cu, and maybe BPC as well.
 
Mademoiselle said:

I could use some input from others here.

My current Tirzepatide dose is 7 mg, and I’m not planning to go up, since larger doses took a toll on my mental health. So I’m thinking about layering in a second compound. Elora would be my first pick, but I’m not confident about how safe it is. Cagrilintide was the one I first had in mind, yet Retatrutide now seems like it might be the stronger choice.

When it comes to adverse effects and what it costs, what would you suggest?

As for where I am now: 85 kg on the scale. Since November I’ve dropped 18 kg. That may not sound impressive, but a great deal of fat is gone and I’ve put on substantial muscle. These days, though, things have slowed down a lot, and my goal is to shed another 18–20 kg.
I also started with tirz alone, but once the dose went up I ran into quite a few side effects. So I brought Reta into the mix, and so far it’s going smoothly with less trouble than tirz by itself. Right now I’m at 2.5mg tirz plus 1.5mg Reta
 
If this is useful to anyone:

Post at 3:48pm (English): For quite a while I stayed at 5 mg; once it stopped working, I moved up by 0.5 mg every 4 weeks. My goal was to drop as much weight as possible before turning 60. With the birthday now behind me, I'm taking things slowly. At 7.0 mg, injected every 6 days, I spent a day or 2 feeling very emotional; tiny things set me off, and at work I got embarrassed easily. So I went back down to 6.5 mg. After that I raised it gradually – 6.85 mg first, then 7.0 mg – and dosed every 7 days. That round was milder; it only lasted an afternoon, and it happened on a Sunday. Weight loss has stalled – at times I've dropped 0.5 kg, at times I've put a little back on. I don't feel confident enough to raise the dose in bigger steps.

Post at 4:19pm (English): Sema hadn't crossed my mind yet; it wouldn't be my first pick. Tirz at 4 mg every 4 days could also work. And I'm waiting on Elora. I'd also like to add GHK-Cu and maybe BPC.

Mademoiselle said:

I could use some input from others here.

My current Tirzepatide dose is 7 mg, and I’m not planning to go up, since larger doses took a toll on my mental health. So I’m thinking about layering in a second compound. Elora would be my first pick, but I’m not confident about how safe it is. Cagrilintide was the one I first had in mind, yet Retatrutide now seems like it might be the stronger choice.

When it comes to adverse effects and what it costs, what would you suggest?

As for where I am now: 85 kg on the scale. Since November I’ve dropped 18 kg. That may not sound impressive, but a great deal of fat is gone and I’ve put on substantial muscle. These days, though, things have slowed down a lot, and my goal is to shed another 18–20 kg.
Right now Elora is certainly the priciest route, and because it's still in testing/trials, anecdotal safety data is limited, but these threads share some useful first hand experiences:




Elora - My experience after 3 weeks



Each week I currently take 10 mg of Tirz. Prior to that I was on Reta at 12 mg per week, but the side effects were bad for me. With Tirz things are improving. Still, I'm putting weight back on and wanted to move to Elora rather than Cagri (since that didn't really work). I've been on it for...

051f0e2f5b7f6ffbb4a2f10b404546ba44b6197464dfbacec1b043fb189c69a3.png



GLP1Chat.com




Elora research update month



I'll say this stuff either hits people fast or takes weeks to kick in I went through a whole vial in 3 days because i assumed it would be like cagri but nope the next week i was like maybe its the 80mg of triz or maybe its the sema stack but nope that elora hit me out of nowhere like a bag of bricks. so i did...

051f0e2f5b7f6ffbb4a2f10b404546ba44b6197464dfbacec1b043fb189c69a3.png



GLP1Chat.com

Based on the newest tirz+elora trial, weight loss appears to speed up a lot with the stack (look for the blog The Incretin Space...it's a few posts down.) I've only just begun adding elora to tirz, so the only thing I can report is that it really cut down my day-before-tirz-shot-day munchies. (So far I've taken just one micro dose, but this week I'll begin at the most common starter dose, 3mg. My hope is to stay there and only raise tirz when needed, since it's expensive and the only vendor I'd really trust right now is Uther because they've had good testing, including ring structure. That said, @skaylife has been getting good results from elora from "Fat Cat Ella" as he says!

Cagri and reta are pretty cheap nowadays, and many people stack one or the other with tirz. Cagri appears to come with some harsh side effects, and everything I've read says the key to easing them is going very low and very slow, but based on your experience, I'd suggest titrating up any stackable in small increments since that's what has worked best for you with tirz.

Sorry about the weepiness and low mood. Hugs! I'm glad you managed to pinpoint your dose as the cause!
 
Mademoiselle said:

Ich habe über einen längeren Zeitraum 5 mg genommen. Als die Wirkung nachließ, habe ich alle vier Wochen um 0,5 mg gesteigert. Vor meinem 60. Geburtstag wollte ich möglichst viel Gewicht verlieren. Da dieser Geburtstag nun vorbei ist, gehe ich es ruhiger an. Bei 7,0 mg – gespritzt alle sechs Tage – war ich ein oder zwei Tage sehr emotional; wegen jeder Kleinigkeit kamen mir die Tränen, und auf der Arbeit war mir das schnell peinlich. Deshalb bin ich wieder auf 6,5 mg heruntergegangen. Danach habe ich die Dosis langsam wieder hochgefahren – zuerst 6,85 mg, dann 7,0 mg – und sie im Abstand von sieben Tagen injiziert. Diesmal fiel es mir leichter; es hielt nur einen Nachmittag an, und das an einem Sonntag. Beim Gewicht geht es nicht voran – mal sind 0,5 kg weg, mal kommt etwas dazu. Ich traue mich nicht, die Dosis in größeren Sprüngen zu erhöhen.

wow - i imagine you're aware that your dose adjustments were far smaller than what the clinical trials used, so it's notable that a difference was still noticeable to you in that situation.

do you keep track of what you eat? the only other factor i can think of that could play a role would be low blood sugar, if your eating drops a lot during the day or two following an injection, and that can definitely impact mood.

it sounds like some mood-related side effects are still present even after you eased up on the dose changes, just less intense. that might be a reason to consider a split dose, which could help even out the highs and lows somewhat.

adding a different medication on top is also fine. both look like sensible choices. i'm curious what you decide & how it turns out. good luck!
 
fatjacked said:

wow - i imagine you're aware that your dose adjustments were far smaller than what the clinical trials used, so it's notable that a difference was still noticeable to you in that situation.

do you keep track of what you eat? the only other factor i can think of that could play a role would be low blood sugar, if your eating drops a lot during the day or two following an injection, and that can definitely impact mood.

it sounds like some mood-related side effects are still present even after you eased up on the dose changes, just less intense. that might be a reason to consider a split dose, which could help even out the highs and lows somewhat.

adding a different medication on top is also fine. both look like sensible choices. i'm curious what you decide & how it turns out. good luck!

Great observation!

I only wanted to add that I experienced the very same problem — some days I wouldn't eat anything until the afternoon or evening. My mood would crash, and it was awful.



For our bodies to work properly they need fuel, and our mental wellbeing is tied in part to that.
 
I found myself exploring the same path you're on, except in my case it was reta that I couldn't push past a certain dose. That's when I brought tirz into the mix. The pairing has worked really well for me, and tirz seems to sit fine with my system.
 
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