Does tirz really have an effectiveness window and should I try to dose up?

[DidntMakeBrownies]

So I have been doing 6 of tirz for 5 months now, down 35 lbs and would like to take off another 45 to get to goal-ish. I thought slow and steady was good because I lose at a consistent rate even if not a TON and I have almost no side effects. But then I saw somewhere that tirz weight loss tapers off after 72 weeks or so. If I’ve already eaten up a third of that window should I dose up to try to accelerate the weight loss? Add Reta if I can ever figure out how to order from China? I would hate to stall out…

 

[FartfulCodger]

I've never heard of the 72-week taper. I'd think that increasing the dose would make any taper happen earlier. One thing's for sure about these drugs: everyone is affected differently. Your taper, if there is one, might never happen, or might happen at a different time.

You're in the enviable position of losing weight at a nice rate while having room to increase your dose if necessary. I'd just stay in the course and let it play out. If you plateau, you increase the dose. If you plateau again, you've got other choices like Cagrilintide or Reta. I think you're in a good position and shouldn't worry.

 

[woundcarping]

There are no studies I've found that talk about increasing dose after a plateau causing meaningful increase in the efficacy of the peptide.

You didn't say your starting weight, but if you're wanting to drop 80lb that's not a low and slow goal for anyone with a typical weight. I'm down 53lb since December, still have ~40lb to go. I'm on Reta for a few reasons, one being the higher efficacy at dropping a higher percentage of starting weight.

On the high side ~40% of test subjects lost 25% or more of their starting weight at 15mg of Tirz and they still stall in the similar total time as the other legs of the studies. Only 12-15% lost 30% or more, taking 15mg of Tirz. For comparison, 24% lost 30% or more on Reta 12mg.

If you've lost 35lb in 5 months, that's roughly 1.6lb/week. Nothing wrong with that, but if you maintained that rate you have another 6-7 months to go and presumptively you'd have to be a high responder to drop that much percentage on Tirz.

Calculated can be your friend, I can't see a meaningful benefit to me going slower than dropping ~1% weight per week (~2.65lb/week)

 

[woundcarping]

I've never heard of the 72-week taper. I'd think that increasing the dose would make any taper happen earlier. One thing's for sure about these drugs: everyone is affected differently. Your taper, if there is one, might never happen, or might happen at a different time.

You're in the enviable position of losing weight at a nice rate while having room to increase your dose if necessary. I'd just stay in the course and let it play out. If you plateau, you increase the dose. If you plateau again, you've got other choices like Cagrilintide or Reta. I think you're in a good position and shouldn't worry.

You've never heard of plateaus in the studies?

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[chipsandsalsayall]

I've lost 95 lbs on straight tirz over the last 12 months. Still getting pretty good results (weight loss, noise suppression, app suppression, etc). But it has tapered off somewhat. I'm currently at 12.5mg and am split dosing every Mon and Thursday. IMO your still have some good mileage left with tirz without adding Reta.

Having said that I have some Cag ready to go in case a supplement is needed. I have about 25 lbs left to lose. Good luck to you!

 

[FlowerFairy]

So I have been doing 6 of tirz for 5 months now, down 35 lbs and would like to take off another 45 to get to goal-ish. I thought slow and steady was good because I lose at a consistent rate even if not a TON and I have almost no side effects. But then I saw somewhere that tirz weight loss tapers off after 72 weeks or so. If I’ve already eaten up a third of that window should I dose up to try to accelerate the weight loss? Add Reta if I can ever figure out how to order from China? I would hate to stall out…

If it stopped then many would be having difficulty. I don’t know that you need to increase, but if it’s been 4 weeks, increasing your dose would not be unreasonable.

I've never heard of the 72-week taper. I'd think that increasing the dose would make any taper happen earlier. One thing's for sure about these drugs: everyone is affected differently. Your taper, if there is one, might never happen, or might happen at a different time.

You're in the enviable position of losing weight at a nice rate while having room to increase your dose if necessary. I'd just stay in the course and let it play out. If you plateau, you increase the dose. If you plateau again, you've got other choices like Cagrilintide or Reta. I think you're in a good position and shouldn't worry.

Agreed.

 

[woundcarping]

If it stopped then many would be having difficulty...

Stopped working ≠ weight loss doesn't plateau and you're left maintaining. I've seen no evidence to suggest meaningful regain with maintained dose over time.. it keeps working, but it delivers you to a set point and there you are.

The set point's location seems to be largely dose dependent, and no studies indicate that increasing "low and slow" reach the same end point as the trialed data.

I haven't observed escalating at the rate sides allow have negative efficacy relative to the trials, however the opposite can't be said.

Again, my position is limited to the idea of big'ns like myself dropping considerable fat percentage, not someone wanting to drop 10lb from their 200lb frame (for example).

 

[FartfulCodger]

There's no studies I've found that talk about increasing dose after a plateau causing meaningful increase in the efficacy of the peptide.

If you don't believe titrating up can increase efficacy, how did you end up taking 21mg of Reta within an 18-day window?

 

[FartfulCodger]

There's no studies I've found that talk about increasing dose after a plateau causing meaningful increase in the efficacy of the peptide.

If you don't believe titrating up can , how did you end up taking 21mg of Reta with in an 18-day window? What study did you use to arrive at this schedule?

 

[woundcarping]

If you don't believe titrating up can increase efficacy, how did you end up taking 21mg of Reta within an 18-day window?

If you don't believe titrating up can , how did you end up taking 21mg of Reta with in an 18-day window? What study did you use to arrive at this schedule?

What did I say to make you think I don't think increasing dose increases efficacy? My entire point is that low and slow relative to trials could be burning out the time runway before the dose runway, running into the ubiquitous flatline across weight loss peptides and their varying dosages.

21mg in 18 days across 12 shots while coming off tirz with no sides isn't particularly crazy. Daily microdosing to accelerate the loading phase to truncate the transition period from Tirz to Reta was the successfully achieved goal.

Accelerated loading strategies are common across a variety of compounds in medical practice.

 

[DidntMakeBrownies]

So…maybe like 8.5 mg? That still leaves room to go up?

 

[woundcarping]

So…maybe like 8.5 mg? That still leaves room to go up?

Well... 6mg is between the trial standard 5mg and 7.5mg. It doesn't seem "wrong" to me. Escalation is escalation.

There are people around taking Tirz beyond 15mg/week with minimal to no sides and trials at extended doses being tested (although dosing amounts haven't been disclosed).

What was your starting weight/height/age?

 

[lessthanhalf]

So I have been doing 6 of tirz for 5 months now, down 35 lbs and would like to take off another 45 to get to goal-ish. I thought slow and steady was good because I lose at a consistent rate even if not a TON and I have almost no side effects. But then I saw somewhere that tirz weight loss tapers off after 72 weeks or so. If I’ve already eaten up a third of that window should I dose up to try to accelerate the weight loss? Add Reta if I can ever figure out how to order from China? I would hate to stall out…

Just about all the studies show weight loss dropping off to or towards zero after about a year or a year and a bit, but not 72 weeks. But that is at a fixed dose. As far as I know there is no real evidence one way or the other that getting to that maximum weight loss dose slowly or quickly changes the total amount of weight lost in the end. There is also no real evidence either way that once stalled at a given non maximum dose that increasing doses works or does not work, but common sense and anecdotal evidence suggests that further weight loss will happen if doses are increased after a stall. I do not think the plateau at a year has anything to do with time as such , it is just how long it takes to get to maximum weight loss on a given dose.

The 72 weeks is just the longest follow up that has been done so far, and shows that the weight loss is maintained for that time if the person stays on the drug at the dose they used to lose the weight.

Without knowing your actual weight and height etc, if you are trying to lose a total of 80lbs, that sounds like at least 25% and likely more than that. Unless you respond extra well, you will probably need to increase doses to 15mg to get that much weight loss.

Losing weight rapidly does have disadvantages, like feeling awful mainly, so it also depends on the current rate of weight loss, how hungry you are, and what side effects you have at your current dose. And if you feel fine or tired and worn out. Making the process tolerable makes it more sustainable long term, and it is the long term maintenance of the weight loss that really matters.

So you probably do need to increase doses to or towards 15mg eventually, but how quickly really depends on the current situation.

 

[DidntMakeBrownies]

T

Just about all the studies show weight loss dropping off to or towards zero after about a year or a year and a bit, but not 72 weeks. But that is at a fixed dose. As far as I know there is no real evidence one way or the other that getting to that maximum weight loss dose slowly or quickly changes the total amount of weight lost in the end. There is also no real evidence either way that once stalled at a given non maximum dose that increasing doses works or does not work, but common sense and anecdotal evidence suggests that further weight loss will happen if doses are increased after a stall. I do not think the plateau at a year has anything to do with time as such , it is just how long it takes to get to maximum weight loss on a given dose.

The 72 weeks is just the longest follow up that has been done so far, and shows that the weight loss is maintained for that time if the person stays on the drug at the dose they used to lose the weight.

Without knowing your actual weight and height etc, if you are trying to lose a total of 80lbs, that sounds like at least 25% and likely more than that. Unless you respond extra well, you will probably need to increase doses to 15mg to get that much weight loss.

Losing weight rapidly does have disadvantages, like feeling awful mainly, so it also depends on the current rate of weight loss, how hungry you are, and what side effects you have at your current dose. And if you feel fine or tired and worn out. Making the process tolerable makes it more sustainable long term, and it is the long term maintenance of the weight loss that really matters.

So you probably do need to increase doses to or towards 15mg eventually, but how quickly really depends on the current situation.

Thanks, this is helpful perspective. I’m fine with the slow loss of 1.5 a week if it takes a long time to get to goal, but if I need to titrate up then that’s okay too. My next research topic is what role Reta could have.

 

[Sarsippius]

You're going to have about a year before you buildup a tolerance and your appetite returns. Plan accordingly.

 

[woundcarping]

You're going to have about a year before you buildup a tolerance and your appetite returns. Plan accordingly.

That would imply a loss of maintenance efficacy, which I haven’t seen anywhere in the trial data or anecdotally, aside from you.

 

[Sarsippius]

That would imply a loss of maintenance efficacy, which I haven’t seen anywhere in the trial data or anecdotally, aside from you.

Well, that's been my experience with Reta. It's starting to happen to my wife now too as she started after me. I've had to stack Cargi just to maintain my stall.

 

[woundcarping]

Well, that's been my experience with Reta. It's starting to happen to my wife now too as she started after me. I've had to stack Cargi just to maintain my stall.

Interesting!

What was your starting weight, maintenance weight, and maintenance dose?

 

[Sarsippius]

6'4" male, age 54. Starting weight 350 lbs. Maintaining at 225 lbs. 12 mg Reta every 7 days. 2.25 mg Cargri split dosed.

 

[woundcarping]

6'4" male, age 54. Starting weight 350 lbs. Maintaining at 225 lbs. 12 mg Reta every 7 days. 2.25 mg Cargri split dosed.

Interesting indeed.

Have you considered moving to Tirz?