Switching from Reta to Tirz for Inflammation and Mast Cells

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CuttingEdgeScience

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I plan to move over to Tirz from Reta, since I keep coming across accounts from other people praising it as better for inflammation. Living with POTS, MCAS/MC, and similar issues, I've been stunned by how many foods I previously had to give up are now tolerable, yet I have a hunch that Tirz might bring about deeper shifts at the source of inflammation.

Does anyone know whether the dosing is different for the two? Once side effects kicked in at a higher titration, I ended up staying at 1.5 mg of Reta. Reta has cut down food noise a lot for me, but my weight hasn't moved much (I'm only slightly above the "normal" range, though I used to be lower before getting sick.)

Any input or observations would be welcome!
 
Tirz brought my inflammation down to nearly nothing—I took it for over 2 years—but eventually it quit working for me. I began Reta 6 weeks back; appetite suppression is only now showing up, while inflammation remains unaffected.. at least for now.
 
Just a thought—and I truly don't mean to dampen your excitement—but you may need to give the anti-inflammatory effect some time before you see it.

I mention this because of what some recent bloodwork of mine revealed.

Over the last 6 months, I went from 230 lbs. down to 170 lbs. on Tirz. My labs drawn on May 4 looked good overall, with 1 exception: inflammation. The results indicated my inflammation level was somewhat elevated, similar to what you'd see with an active infection.

I plugged the numbers into several AI engines, and every one of them landed on the same answer: fast weight loss caused inflammation—which is to be expected—and the hope was that those markers would normalize once my weight held steady at goal. I'll get retested in a few months.

So if you're still dropping weight at a fairly good pace, inflammation may stick around for a while.
 
CheesyPotato said:

Tirz brought my inflammation down to nearly nothing—I took it for over 2 years—but eventually it quit working for me. I began Reta 6 weeks back; appetite suppression is only now showing up, while inflammation remains unaffected.. at least for now.
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Appreciate the perspective — although it's rough to hear that it quit helping! Even at the tiniest microdoses of Reta, I noticed shifts in appetite.
 
CuttingEdgeScience said:

I plan to move over to Tirz from Reta, since I keep coming across accounts from other people praising it as better for inflammation. Living with POTS, MCAS/MC, and similar issues, I've been stunned by how many foods I previously had to give up are now tolerable, yet I have a hunch that Tirz might bring about deeper shifts at the source of inflammation.

Does anyone know whether the dosing is different for the two? Once side effects kicked in at a higher titration, I ended up staying at 1.5 mg of Reta. Reta has cut down food noise a lot for me, but my weight hasn't moved much (I'm only slightly above the "normal" range, though I used to be lower before getting sick.)

Any input or observations would be welcome!
Click to expand...
my guess is that tirz gets called "better" for inflammation simply because far more people are on it (it's prescribable and so on) compared to reta. possibly it's more about the situation than tirz actually being superior.

another possibility: does the glucagon activity of Reta get in the way a bit?

though honestly, every GLP-1 that hits the GIP receptor for inflammation brings down systemic inflammation.

for me, the sweet spot came from slowly titrating up to 4mg a week; after roughly a month at that dose i could eat properly while still getting the benefits i was after (lipids)

could adding TA1 or TB500 help with inflammation?
 
A few thoughts. A little Reta stacked on top of your Tirz is one route. Or Cagrilintide stacked on Tirz. Another: switch to Reta and test whether KPV helps with inflammation.
 
FartfulCodger said:

Just a thought—and I truly don't mean to dampen your excitement—but you may need to give the anti-inflammatory effect some time before you see it.

I mention this because of what some recent bloodwork of mine revealed.

Over the last 6 months, I went from 230 lbs. down to 170 lbs. on Tirz. My labs drawn on May 4 looked good overall, with 1 exception: inflammation. The results indicated my inflammation level was somewhat elevated, similar to what you'd see with an active infection.

I plugged the numbers into several AI engines, and every one of them landed on the same answer: fast weight loss caused inflammation—which is to be expected—and the hope was that those markers would normalize once my weight held steady at goal. I'll get retested in a few months.

So if you're still dropping weight at a fairly good pace, inflammation may stick around for a while.
Click to expand...
I appreciate the perspective. What's strange is that my weight has barely budged, and I definitely still have fat I could stand to lose. I began Reta last autumn, so quite a bit of time has passed as well. I'd think that dropping weight would bring about at least temporary shifts in labs and inflammation.

That said, I began only in the overweight range and moved up gradually, going from 0.25 mg to a maximum of 2 mg. At that dose I experienced anhedonia and dysesthesia, so I stepped back down. Given how many inflammatory symptoms I deal with, predicting my response compared to other people is impossible.

My thinking is this: if other people who have mast cell conditions report that Tirz works better for them, then giving it a shot seems reasonable. There are those whose Tryptase levels have dropped, and mine has stayed elevated for many years, including throughout my time on Reta.
 
CuttingEdgeScience said:

I plan to move over to Tirz from Reta, since I keep coming across accounts from other people praising it as better for inflammation. Living with POTS, MCAS/MC, and similar issues, I've been stunned by how many foods I previously had to give up are now tolerable, yet I have a hunch that Tirz might bring about deeper shifts at the source of inflammation.

Does anyone know whether the dosing is different for the two? Once side effects kicked in at a higher titration, I ended up staying at 1.5 mg of Reta. Reta has cut down food noise a lot for me, but my weight hasn't moved much (I'm only slightly above the "normal" range, though I used to be lower before getting sick.)

Any input or observations would be welcome!
Click to expand...
Speaking as a person who has POTS and probably MCAS as well, my change from Tirz to Reta brought my appetite back. Food noise was completely silenced on Tirz, even at 0.250mg or 250 mcg.
 
drswole said:

CuttingEdgeScience said:

I plan to move over to Tirz from Reta, since I keep coming across accounts from other people praising it as better for inflammation. Living with POTS, MCAS/MC, and similar issues, I've been stunned by how many foods I previously had to give up are now tolerable, yet I have a hunch that Tirz might bring about deeper shifts at the source of inflammation.

Does anyone know whether the dosing is different for the two? Once side effects kicked in at a higher titration, I ended up staying at 1.5 mg of Reta. Reta has cut down food noise a lot for me, but my weight hasn't moved much (I'm only slightly above the "normal" range, though I used to be lower before getting sick.)

Any input or observations would be welcome!
Click to expand...
my guess is that tirz gets called "better" for inflammation simply because far more people are on it (it's prescribable and so on) compared to reta. possibly it's more about the situation than tirz actually being superior.

another possibility: does the glucagon activity of Reta get in the way a bit?

though honestly, every GLP-1 that hits the GIP receptor for inflammation brings down systemic inflammation.

for me, the sweet spot came from slowly titrating up to 4mg a week; after roughly a month at that dose i could eat properly while still getting the benefits i was after (lipids)

could adding TA1 or TB500 help with inflammation?
Click to expand...
It makes sense that Tirz has a much larger user base - here, I've come across several accounts from people with mast cell conditions who made the switch away from Reta. My own view is that for those of us already dealing with some form of POTS or Dysautonomia, the heart rate effects that come with Glucagon activation are a drawback. On top of that, I have ADHD, so anhedonia as a side effect might be one more thing to weigh in the balance.

At 2 mg of Reta I was already experiencing side effects, so I stepped back down, and my increases had been fairly gradual throughout. What's strange is that even low doses clearly affected my appetite, yet I wondered whether inflammation might be preventing the weight from coming off. I hoped to get up to 2.5 mg, but that didn't work out. Over a few weeks I went down to 1.5 mg, then to 1 mg. As I went, I felt better - my mood and other sensory problems appeared to diminish.

So yesterday I took my first 1 mg dose of Tirz. Something definitely felt different, and for now I'll say I can see what people have been describing. Breathing seems slightly easier. My pain is reduced, even though I didn't fall asleep until 4 AM, and today I received two new lots of IVIg for my infusion with almost no side effects, which is pretty uncommon.

My food noise hasn't really changed, but it's only been a day, and I'm likely still winding down from the 1.5 mg doses I was on before. Food tolerance remains fine, and if anything my GI system is calmer. Only time will show how this experiment turns out - I wanted to see the difference for myself before recommending anything either way to other friends in the chronic illness group.
 
I went roughly 6 months without my brand-name tirz (Zepbound), and only then did it hit me: during the nearly 1 year I had been taking it, my back never once went out. Once I stopped, for around 6 months, it kept going out roughly every 2 weeks, which forced me to fall back on other prescriptions I had lying around — muscle relaxers, anti-inflammatories, etc. At the time I assumed it was just lifestyle changes, until I began researching the grey. About 3 months back I restarted it, and since then I have not had even 1 episode. knock on wood So I will say I am on this for life, for no other reason than the anti-inflammatory effects. I have also begun new lifestyle changes to support that goal, and started experimenting with other peps just to get the most out of it.
 
FartfulCodger said:

Just a thought—and I truly don't mean to dampen your excitement—but you may need to give the anti-inflammatory effect some time before you see it.

I mention this because of what some recent bloodwork of mine revealed.

Over the last 6 months, I went from 230 lbs. down to 170 lbs. on Tirz. My labs drawn on May 4 looked good overall, with 1 exception: inflammation. The results indicated my inflammation level was somewhat elevated, similar to what you'd see with an active infection.

I plugged the numbers into several AI engines, and every one of them landed on the same answer: fast weight loss caused inflammation—which is to be expected—and the hope was that those markers would normalize once my weight held steady at goal. I'll get retested in a few months.

So if you're still dropping weight at a fairly good pace, inflammation may stick around for a while.
Click to expand...

What dosage were you using to drop from 230 down to 170 over six months? That's incredible. Were weights part of your routine? Did you stick to 3 meals daily? Feel free to share whatever specifics you're comfortable with.
 
Hotlongs said:


I will say as someone with POTS and also likely MCAS, switching from Tirz to Reta allowed me to actually feel hunger again. Even at 0.250mg or 250 mcg, I had food noise snuffed out on Tirz.

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Ha - someone else from the chronic illness crowd. I noticed your signature - my CYP2D6 situation is reversed: one allele is a non-processor and the other has very low activity, so nearly anything metabolized by it harms me.

It's fascinating how varied the responses to these drugs are. Starting with my very first Reta doses (also 0.25 mg), my food noise was strongly suppressed.

I haven't come across any journal article examining Reta's effects on the microbiome - however, the Tirz studies offer a plausible explanation for its anti-inflammatory action. There's a rise in anti-inflammatory Butyrate production, an increase in Akkermansia that repairs the gut barrier, a decrease in pathogenic species, and modulation of immune signaling pathways, such as less activation of mTOR and NF-kB.

Plus, mast cells are stabilized through their GLP-1 receptors, and excess mast cells may be reduced via autophagy-driven cytoreduction.

Tirz and Microbiome 1

Tirz and Microbiome 2
 
SoCalGirl said:

FartfulCodger said:

Just a thought—and I truly don't mean to dampen your excitement—but you may need to give the anti-inflammatory effect some time before you see it.

I mention this because of what some recent bloodwork of mine revealed.

Over the last 6 months, I went from 230 lbs. down to 170 lbs. on Tirz. My labs drawn on May 4 looked good overall, with 1 exception: inflammation. The results indicated my inflammation level was somewhat elevated, similar to what you'd see with an active infection.

I plugged the numbers into several AI engines, and every one of them landed on the same answer: fast weight loss caused inflammation—which is to be expected—and the hope was that those markers would normalize once my weight held steady at goal. I'll get retested in a few months.

So if you're still dropping weight at a fairly good pace, inflammation may stick around for a while.
Click to expand...

What dosage were you using to drop from 230 down to 170 over six months? That's incredible. Were weights part of your routine? Did you stick to 3 meals daily? Feel free to share whatever specifics you're comfortable with.
Click to expand...
I leaned hard into the way it killed my appetite. Most days I'd barely eat anything at all, and honestly it didn't bother me one bit. Come dinner, I'd take just a modest serving. I was strict about hitting 10k steps daily. Protein, though — I'm aware I fell short there. Doing it this way probably wasn't ideal, but patience isn't my strong suit. On top of that, my Tirz came compounded (pricier than grey), and I had no interest in shelling out for yet another three-month plan!
 
Purely from my own experience: I began with Tirz, then moved over to Reta, titrated up to 6mg, and eventually returned to Tirz because every bit of my pain and inflammation flared back up while on Reta. These days my routine is mainly Tirz, plus 1-3mg of Reta a few days out during certain weeks; on other weeks I add 2mg of Tirz in its place. Whenever I run Reta without Tirz, KPV is non-negotiable for me!
 
For anyone who tends to be sensitive to side effects, tirz is best started at a low dose and increased gradually. At 2.5mg I experienced every side effect there was, and after a month, bumping up to 4 was truly awful. I dropped back slightly to 3.5 and stayed there for a while until things settled. It took nearly 3 months before I reached the 5mg I'm on now, and only then did my side effects finally clear up.

When it comes to inflammation, tirz has worked like a miracle in my case and I won't ever be without it. I've got 14 years' worth of 5mg stashed in my freezer! I can't compare the food noise to reta, but I have to remind myself to eat, and that's been true since roughly 2 hours after my very first dose.

Wishing you the best of luck!
 
FartfulCodger said:

Just a thought—and I truly don't mean to dampen your excitement—but you may need to give the anti-inflammatory effect some time before you see it.

I mention this because of what some recent bloodwork of mine revealed.

Over the last 6 months, I went from 230 lbs. down to 170 lbs. on Tirz. My labs drawn on May 4 looked good overall, with 1 exception: inflammation. The results indicated my inflammation level was somewhat elevated, similar to what you'd see with an active infection.

I plugged the numbers into several AI engines, and every one of them landed on the same answer: fast weight loss caused inflammation—which is to be expected—and the hope was that those markers would normalize once my weight held steady at goal. I'll get retested in a few months.

So if you're still dropping weight at a fairly good pace, inflammation may stick around for a while.
Click to expand...
Is it possible that your peptide plays a role in this? I looked into unexplained inflammation caused by endotoxins.
 
Aterna13 said:

FartfulCodger said:

Just a thought—and I truly don't mean to dampen your excitement—but you may need to give the anti-inflammatory effect some time before you see it.

I mention this because of what some recent bloodwork of mine revealed.

Over the last 6 months, I went from 230 lbs. down to 170 lbs. on Tirz. My labs drawn on May 4 looked good overall, with 1 exception: inflammation. The results indicated my inflammation level was somewhat elevated, similar to what you'd see with an active infection.

I plugged the numbers into several AI engines, and every one of them landed on the same answer: fast weight loss caused inflammation—which is to be expected—and the hope was that those markers would normalize once my weight held steady at goal. I'll get retested in a few months.

So if you're still dropping weight at a fairly good pace, inflammation may stick around for a while.
Click to expand...
Is it possible that your peptide plays a role in this? I looked into unexplained inflammation caused by endotoxins.
Click to expand...
Sure, that could be a factor. Every AI engine I consulted acted like inflammation at that level was simply "normal" when rapid weight loss is involved, though that doesn't mean your theory is wrong. It's plausible that toxins made the inflammation worse. The problem is I've also been using several other peptides, so pinpointing a single culprit isn't something I can do. I'm curious what the bloodwork I have scheduled in a couple months will show.

I appreciate you putting this theory forward. I plan to look into which other markers in my blood endotoxins would have influenced. As for my liver markers, they came back just peachy, FWIW.
 
I deal with lupus along with ongoing pain. Since so many people praised reta, I dropped my tirz dose a lot a few weeks back and introduced reta. That was the biggest error I've ever made! My inflammation and pain returned much worse and triggered a lupus flare. I stopped it and raised my tirz dose back up. These days I take a small amount of cag when needed.
 
I don't know what your MCAS looks like, but in my case the main symptom is itching unless I keep it controlled with antihistamines.

Try not to pin all your hopes on tirz or reta fixing every problem. Yes, they'll help you drop weight, and that alone improves a lot of things, and it's possible they bring down certain inflammatory biomarkers and could even help with arthritis.

Still, based on what you're describing, adding BPC (which has specific uses for MCAS) along with KPV seems like it would serve you better.
 
For years I took a prescription anti-inflammatory. Once I'd been on Tirz for about 2 months, I stopped that medication completely, with my doctor's sign-off. Tirz works so well as an anti-inflammatory in my case that the previous prescription simply wasn't needed anymore.
 
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