Tirzepatide plus Cagri or Reta?
- Thread starter TeresaHip
- Start date
FRMN01
Explorer
I'd like some more information. What dosage is he on right now, what's his injection frequency, has he been dropping pounds, and does he get any adverse reactions?
HidingInPlainView
Explorer
Cag can be used on its own—it targets an amylin receptor, unlike GLP-1, GIP, and/or Glucagon receptor pathways. Sema, Tirz, and Reta all combine nicely with Cag.
Reducing food noise is what Cag is mainly for, though among the GLP-1's currently available, Tirz handles food noise best. Since it acts on a different pathway, stacking isn't impossible—I just wonder what his reason would be, unless he's already at the maximum dosing schedule.
On its own, Reta performs well, but based on the dosage you're transitioning from with another GLP-1, you might need to add more GLP-1's to either reduce side effects or address the specific problem you're targeting.
For me personally, I combined Reta and Cag because beyond a certain dose the side effects became unbearable and the food noise disappeared.
I use "was" because an upcoming surgery has made me pause. When I restart, I'll begin with Reta alone, then assess my reaction after two weeks off it.
So far, what has his journey been like?
Reducing food noise is what Cag is mainly for, though among the GLP-1's currently available, Tirz handles food noise best. Since it acts on a different pathway, stacking isn't impossible—I just wonder what his reason would be, unless he's already at the maximum dosing schedule.
On its own, Reta performs well, but based on the dosage you're transitioning from with another GLP-1, you might need to add more GLP-1's to either reduce side effects or address the specific problem you're targeting.
For me personally, I combined Reta and Cag because beyond a certain dose the side effects became unbearable and the food noise disappeared.
I use "was" because an upcoming surgery has made me pause. When I restart, I'll begin with Reta alone, then assess my reaction after two weeks off it.
So far, what has his journey been like?
Calm Logic
Explorer
I’ve mostly stayed on the sidelines, but this thread is practically begging for a push toward eloralintide ("cagri 2.0") and for shilling Uther, who claims elora will be available at the end of the month.
If he wants, his doc can help speed up the tirz titration schedule when he isn’t already at the approved 15 mg max. Or from here on just add reta, since returns start tapering after about 10 mg of tirz.
Whatever GLP or GLP stack I end up on (possibly just reta eventually) + elora once it’s out—that’s my plan.
If he wants, his doc can help speed up the tirz titration schedule when he isn’t already at the approved 15 mg max. Or from here on just add reta, since returns start tapering after about 10 mg of tirz.
Whatever GLP or GLP stack I end up on (possibly just reta eventually) + elora once it’s out—that’s my plan.
I really don't think that's the case! It was only a straightforward question. Why is it that people jump to the worst conclusion? I wasn't recommending cag at all! All I did was ask which option would suit him best.
He's had a really easy time of it, no adverse reactions at all. The tirz dose he's using is 10 mg. Switching him over to a different option isn't something I'm keen on, since he digs his heels in and getting him to try grey took plenty of convincing on my part.
Truth is, he moved up in dose quickly and it went smoothly the whole way.
Calm Logic
Explorer
I'm constantly advocating for elora whenever I can. There's a Lilly trial right now combining elora with tirz. So my point is, it surprises me that cagri is still the topic of conversation when it comes to buying a kit.
If it were up to me, I'd hold out for elora. At this stage I wouldn't purchase cagri, unless perhaps just 1 vial for $20. Elora delivers double the effectiveness of cagri while causing fewer side effects.
That said, because your spouse's risk profile differs from most people here, cagri comes across as the more cautious grey option in terms of track record, though it's less stable than elora (given the fibrils controversy surrounding cagri that never completely faded). So which one is truly safer remains up for debate, since the grey version of elora has no "field testing" behind it yet.
Like cagri, elora can be started at mcg doses. And both are well-suited to a conservative titration approach, particularly when stacking.
TooBigtoFail
Explorer
After I hit 10mg of tirz, the pounds stopped coming off as quickly. That's when I brought in Cag, starting at just 0.1mg and increasing the dose at a snail's pace (roughly 0.1mg each month). It bothered my stomach, yet it did suppress my hunger. I stayed on it 6 mths, tapered off gradually, and picked it back up not long ago (no longer on tz — now using reta). In my case, Cag shines when it comes to killing appetite. At one point I climbed to TZ 20mg/week, but beyond 10mg tz the extra loss was minimal. My read on it: TZ seemed to help me burn calories, while Cagri trims my appetite so skipping meals becomes effortless. I could be mistaken, but I belong to the slow-titration camp, since I had 100+ lbs to shed. Down 93# across 21 mths.
Calm Logic
Explorer
That's fine. I may have laid it on a bit thick, given that elora's price tag and launch date are still unknowns. As of now, Uther is the only one that has shared any timeline for when it will be out. Even if Uther is the sole option initially, at some point the cheaper single-vial resellers ought to make it easier for folks to get going.
Sooner or later, tirz/reta + elora is going to be the most wanted/popular stack. A few Reddit posts from people in the elora trial:
Eloralintide has me really enthusiastic as well, but the reddit discussions right now show what the problem is. In 1 of those threads there are only 2 comments, and they're 7 months old; the other one is more than a year old and has 10 comments. On top of that, no grey manufacturer has made any Elora yet, so getting community feedback is not possible either.
At this stage I'm far more at ease with Cagrilintide, even if it looks less potent, but when used as a stack I believe it does enough. I've gone deep into the fibril question and my take is that it's probably a nothing burger.
Calm Logic
Explorer
Yep, same here. I once fumbled a cagri vial, and figured I'd take the chance to shake the hell out of it over and over. Nothing clumped up that I could see. Also, it didn't leave any foam hanging around, which is what you'd get from something delicate that falls apart easily, like HGH.
Calm Logic
Explorer
Elora would still get a very cautious approach from me, given its half-life sits around 2 weeks — that's double cagri's, which cuts both ways. You'd still dose it once a week, same as before.
The upside of that 2-week half-life is steadier blood levels, which tends to make it easier to tolerate. The downside is that if side effects show up, they hang around longer (even so, fewer sides than cagri brings). Elora is in phase 3 right now.
The upside of that 2-week half-life is steadier blood levels, which tends to make it easier to tolerate. The downside is that if side effects show up, they hang around longer (even so, fewer sides than cagri brings). Elora is in phase 3 right now.
FRMN01
Explorer
My initial approach was cagri at 0.1mg, taken 2 times per week. These days I take 6mg tirz alongside 0.5 cagri each Monday, plus 6mg reta and 0.5mg cagri each Friday.
MakeNoPeaceWithEvil
Explorer
If someone's morbidly obese and the doctor doesn't mind grey, then what's stopping reta?
lessthanhalf
Explorer
To give a solid recommendation, a lot more information would help: starting weight, where he is now, how long he has been on tirzepatide, how quickly he is currently losing, plus his age, height and general health.
With morbid obesity, meaning BMI 40+, and 10mg of tirzepatide every 6 days without side effects, the path with the least resistance is raising the tirz dose to 15mg / week, since that carries the smallest chance of introducing new side effects.
Stacking reta or cagri is possible, but the primary reason not to go there before first pushing tirz higher is the possibility of new side effects. If heart disease is present, reta may be a poor choice because it adds a further rise in heart rate.
What matters most is the present situation: has weight loss slowed or stalled at the current dose? Is hunger or food noise making it hard to keep calorie intake lower? When the current rate of weight loss is steady and sensible, a dose increase may not be needed, since dropping weight too quickly is not desirable, yet reaching a more reasonable plateau weight will require at least 15mg of tirz/week, and at that stage adding other drugs clearly makes sense, provided weight remains too high.
With morbid obesity, meaning BMI 40+, and 10mg of tirzepatide every 6 days without side effects, the path with the least resistance is raising the tirz dose to 15mg / week, since that carries the smallest chance of introducing new side effects.
Stacking reta or cagri is possible, but the primary reason not to go there before first pushing tirz higher is the possibility of new side effects. If heart disease is present, reta may be a poor choice because it adds a further rise in heart rate.
What matters most is the present situation: has weight loss slowed or stalled at the current dose? Is hunger or food noise making it hard to keep calorie intake lower? When the current rate of weight loss is steady and sensible, a dose increase may not be needed, since dropping weight too quickly is not desirable, yet reaching a more reasonable plateau weight will require at least 15mg of tirz/week, and at that stage adding other drugs clearly makes sense, provided weight remains too high.
Calm Logic
Explorer
If he ever decides to give reta or cagri a shot, it's cheap to test the waters — just one vial, shipping included, runs roughly $30.
People often assume single vials carry a terrible price per mg, yet that isn't always true, particularly from certain domestic TG sellers. Plus, early doses tend to be small; with reta, for instance, I began at 1 mg and then moved to 2 mg. That means one vial can stretch across 1-2 months without trouble.
With reta, an R10 to R30 single vial can typically be had for around $20, plus roughly $10 for USPS shipping. R30 singles now go for shockingly good rates (for example, $23, or 77 cents per mg, from a domestic TG vendor I've bought from, who consistently runs Jano M&P testing on two vials).
For cagri, a fair price on a 5 mg vial is up to $20, and someone can comfortably remain at 250-300 mcg for 4+ weeks. That means a 5-mg cagri vial can last 2 months with ease.
People often assume single vials carry a terrible price per mg, yet that isn't always true, particularly from certain domestic TG sellers. Plus, early doses tend to be small; with reta, for instance, I began at 1 mg and then moved to 2 mg. That means one vial can stretch across 1-2 months without trouble.
With reta, an R10 to R30 single vial can typically be had for around $20, plus roughly $10 for USPS shipping. R30 singles now go for shockingly good rates (for example, $23, or 77 cents per mg, from a domestic TG vendor I've bought from, who consistently runs Jano M&P testing on two vials).
For cagri, a fair price on a 5 mg vial is up to $20, and someone can comfortably remain at 250-300 mcg for 4+ weeks. That means a 5-mg cagri vial can last 2 months with ease.