Tirz only so far — eyeing Sema and Reta for gentler side effects?

jafarrr61020

jafarrr61020

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I've been using tirz for more than 7 months, dosing low and increasing slowly, and the trade-off between unwanted effects and the effects I want still doesn't feel right to me; so I've been asking myself whether a different one of the usual glp1 options might suit me better.

Has anyone here dealt with poor sleep while on tirz — in particular not enough deep sleep, lower HRV, and a higher heart rate during the night — and then found another glp worked better? Or has anyone had those same problems, tried other options, and ended up concluding tirz was actually the best choice?

I'm thinking about giving sema a 1 month trial to see what changes, even though I've heard its anti-inflammatory effect isn't as strong, and inflammation is the main reason I'm on tirz (weight loss is a very welcome second). If that doesn't pan out, I'd return to my tirz baseline and then try reta for 1 month, though I doubt I'll respond well to it since HRV/hr are already issues for me. I'm also open to other glps if there's some magic one for sleep!

Any wisdom or experiences would be appreciated, thanks!
 
Tirz really does have an impact on inflammation. My 6-month labs came back and CRP had fallen 90%. As far as sides go, I doubt you'll find anything better. Sema generally has worse side effects across the board. Reta pushes your body harder, so my guess is you'd end up with more—not fewer—of the issues that are already bugging you.

My HRV took a hit but was mostly back by around 4 months. What helped was keeping dinner smaller and not too carb-heavy; otherwise my sleep fell apart. I figure slower gastric emptying was making my body work harder through the night. My advice would be to experiment with when you eat and your macros to see if that makes a difference.
 
Among the GLP options, Tirz has the fewest side effects. Sema ranks worst: the odds of nausea, vomiting, fatigue, and malaise are considerably greater. Reta sits nearer to Tirz, though on average it still brings more side effects. It's possible you'd be extremely fortunate and find one of them suits you better than Tirz, but that outcome is very unlikely. Compared with Tirz, Reta triggers noticeably more sympathetic nervous system activity, which raises heart rate. Aside from possibly reducing your dose when weight loss isn't a major concern, I don't have a better suggestion.
 
5byfive said:

Tirz really does have an impact on inflammation. My 6-month labs came back and CRP had fallen 90%. As far as sides go, I doubt you'll find anything better. Sema generally has worse side effects across the board. Reta pushes your body harder, so my guess is you'd end up with more—not fewer—of the issues that are already bugging you.

My HRV took a hit but was mostly back by around 4 months. What helped was keeping dinner smaller and not too carb-heavy; otherwise my sleep fell apart. I figure slower gastric emptying was making my body work harder through the night. My advice would be to experiment with when you eat and your macros to see if that makes a difference.
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Great to hear — inflammation is one area where I've seen genuinely good results too! That's exactly why I'm still sticking with it. Sadly, every food and lifestyle adjustment I've come across as a suggestion has been tried, and none of them made a real difference either way, so I figure blood sugar and digestion probably aren't the driving factors in my case.
 
lessthanhalf said:

Among the GLP options, Tirz has the fewest side effects. Sema ranks worst: the odds of nausea, vomiting, fatigue, and malaise are considerably greater. Reta sits nearer to Tirz, though on average it still brings more side effects. It's possible you'd be extremely fortunate and find one of them suits you better than Tirz, but that outcome is very unlikely. Compared with Tirz, Reta triggers noticeably more sympathetic nervous system activity, which raises heart rate. Aside from possibly reducing your dose when weight loss isn't a major concern, I don't have a better suggestion.
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Yep, that matches what I've picked up too. I figure in 20 years we'll have a much clearer picture of which factors make one option better than another for any given person, but right now I'm just after stories from folks dealing with the same issues as me, so I can steer my own trial and error. The catch is that I require the larger doses to keep inflammation in check.
 
My sleep is terrible, though I’m currently taking 20mg tirzepatide along with .5mg cagri. At night I use magnesium glycinate plus doxepin, which has given me some relief.

Setting aside sema or reta side effects, I’d warn people about “taking a break” from glp-1s. Clinical data is scarce, yet certain rat studies and anecdotal reports indicate that cycling off and back on may not be ideal. I don’t know of any research that follows tirz to sema and then back to tirz. Like @lessthanhalf, I think that if weightloss isn’t a problem, lowering your dose could be worth trying. Another option is splitting your dose; some users say side effects are milder that way. I haven’t tried it myself, but considering it, it might even ease my own sleep problems 🤔.
 
jafarrr61020 said:

I've been using tirz for more than 7 months, dosing low and increasing slowly, and the trade-off between unwanted effects and the effects I want still doesn't feel right to me; so I've been asking myself whether a different one of the usual glp1 options might suit me better.

Has anyone here dealt with poor sleep while on tirz — in particular not enough deep sleep, lower HRV, and a higher heart rate during the night — and then found another glp worked better? Or has anyone had those same problems, tried other options, and ended up concluding tirz was actually the best choice?

I'm thinking about giving sema a 1 month trial to see what changes, even though I've heard its anti-inflammatory effect isn't as strong, and inflammation is the main reason I'm on tirz (weight loss is a very welcome second). If that doesn't pan out, I'd return to my tirz baseline and then try reta for 1 month, though I doubt I'll respond well to it since HRV/hr are already issues for me. I'm also open to other glps if there's some magic one for sleep!

Any wisdom or experiences would be appreciated, thanks!
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This brings to mind a lot of Reddit discussions regarding adverse effects.

For each of them, the dosing plan follows a monthly cadence. The reason is that GLP1s require that much time to accumulate within the body. Tirzepitide has a half-life of 5 days, meaning that by day 7, when the next dose is due, roughly 40% of the previous dose remains in your system.

If you switch or increase the dose too quickly, side effects are almost guaranteed.
 
Tirzepatide (Mounjaro) is what I'm on right now by prescription, and retatrutide is something I've given a try as well. A month-long stretch on retatrutide, after I came off tirzepatide, brought on a faster heartbeat, elevated fasting glucose, and really rough GI problems — this was with a low dose too. Once that month was up, I went back to tirzepatide and every one of those problems went away. My glucose readings leveled out, my pulse went back to its usual rate, and the digestive side effects were gone.
 
I started Reta in January, and the month before that I was on tirz. Then last Thursday I introduced .25mg of Sema… it looks like it’s producing the result I was after.

For most people, I doubt Reta is the better option when it comes to sleep.
 
jafarrr61020 said:

I've been using tirz for more than 7 months, dosing low and increasing slowly, and the trade-off between unwanted effects and the effects I want still doesn't feel right to me; so I've been asking myself whether a different one of the usual glp1 options might suit me better.

Has anyone here dealt with poor sleep while on tirz — in particular not enough deep sleep, lower HRV, and a higher heart rate during the night — and then found another glp worked better? Or has anyone had those same problems, tried other options, and ended up concluding tirz was actually the best choice?

I'm thinking about giving sema a 1 month trial to see what changes, even though I've heard its anti-inflammatory effect isn't as strong, and inflammation is the main reason I'm on tirz (weight loss is a very welcome second). If that doesn't pan out, I'd return to my tirz baseline and then try reta for 1 month, though I doubt I'll respond well to it since HRV/hr are already issues for me. I'm also open to other glps if there's some magic one for sleep!

Any wisdom or experiences would be appreciated, thanks!
Click to expand...
I'm making the move from sema over to tirz for much the same reasons. I went with tirz ahead of reta because I'm a bit of a scaredy cat lol! Still, sema gave me fantastic sleep — I even managed to taper off a sleep med I'd taken for 20 years! GI issues were mild once I hit around a year in. Now I just want to see what tirz can do for inflammation and food noise.
 
Grogu said:

My sleep is terrible, though I’m currently taking 20mg tirzepatide along with .5mg cagri. At night I use magnesium glycinate plus doxepin, which has given me some relief.

Setting aside sema or reta side effects, I’d warn people about “taking a break” from glp-1s. Clinical data is scarce, yet certain rat studies and anecdotal reports indicate that cycling off and back on may not be ideal. I don’t know of any research that follows tirz to sema and then back to tirz. Like @lessthanhalf, I think that if weightloss isn’t a problem, lowering your dose could be worth trying. Another option is splitting your dose; some users say side effects are milder that way. I haven’t tried it myself, but considering it, it might even ease my own sleep problems 🤔.
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20mg sounds insane to me. At 10mg, the first few days hit me hard.

As for the OP, tirz is generally the mildest of the GLP1s when it comes to side effects, which matches what others have said. If it were me, sema wouldn't even be on the table. I'd focus on fine-tuning your dose. I've also been on tirz for seven months, and I've dropped 14% of my body weight. Slow and steady, around 1.5 lbs per week. My starting weight was quite high, though. Has your experience been similar?
 
ColdSmoke said:

Grogu said:

My sleep is terrible, though I’m currently taking 20mg tirzepatide along with .5mg cagri. At night I use magnesium glycinate plus doxepin, which has given me some relief.

Setting aside sema or reta side effects, I’d warn people about “taking a break” from glp-1s. Clinical data is scarce, yet certain rat studies and anecdotal reports indicate that cycling off and back on may not be ideal. I don’t know of any research that follows tirz to sema and then back to tirz. Like @lessthanhalf, I think that if weightloss isn’t a problem, lowering your dose could be worth trying. Another option is splitting your dose; some users say side effects are milder that way. I haven’t tried it myself, but considering it, it might even ease my own sleep problems 🤔.
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20mg sounds insane to me. At 10mg, the first few days hit me hard.

As for the OP, tirz is generally the mildest of the GLP1s when it comes to side effects, which matches what others have said. If it were me, sema wouldn't even be on the table. I'd focus on fine-tuning your dose. I've also been on tirz for seven months, and I've dropped 14% of my body weight. Slow and steady, around 1.5 lbs per week. My starting weight was quite high, though. Has your experience been similar?
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It seems tirzepatide agrees with me really well. Over the course of 18 months I've worked my way up to 20mg, and the biggest issue I've run into is constipation. Nothing at all going on in my upper GI. Meanwhile, a relative of mine can't go above 2mg 🤷🏻‍♂️.
 
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