Opinion/anecdote: Don't be afraid of increasing your dose

[lessthanhalf]

I've been in tirz for 2 years and still not made it to max dose and constantly fighting side effects. It has worked though as I am down over 200lbs or 47% and falling. like someone said, "it's a marathon, not a sprint."

It is great to hear of anyone who has succeeded in losing or maintaining that degree of weight loss. I lost just under 50% without medication but a year later was still really struggling with hunger and cravings for exactly the types of foods that I needed not to eat, high calories fat sugar carbs that at least to me are addictive like chocolate, ice cream, potato chips etc. Once I start eating those foods it is almost impossible for me to stop. And I knew I had lost weight and put it back on several times before. I knew glp agonists existed but the price was out of my reach.

Since starting Glp medications , initially prescription ozempic then both tirzepatide and retatrutide once I found this website, it has been much easier, less hunger, much more easily filled up with smaller meals and way less cravings for ice cream etc. But from my pretty extensive reading of the studies the best overall weight loss was around 25%, although the early phase 3 results for retatrutide were a bit better at 28%, none showed anywhere near 50%. So it is nice to hear of anyone removing that much weight and hopefully keeping it off.

 

[peppitypeppergirl]

I agree that obese people should approach reta use with a bit of aggression. .5mg/1mg should be test doses at best. People see higher/faster weight loss at higher doses.

I don’t think people should jump to high doses though. Do the +2mg every 4 week titration schedule until you’re satisfied with the results.

Edit: I reread your comment and realized we are saying the same thing. I completely agree. There’s a huge number of lean/fit people fear mongering everyone to use the smallest doses possible when obese people likely need more than that.

 

[keangkong]

It seems like overwhelmingly, no matter where I see GLPRA discussion, there is a great amount of advice to keep your dose as low as humanly possible and to start and stay at doses far below even the normal STARTING clinical trial values. I'm not sure how much of this is already lean and healthy bodybuilder types, but for people that the drug was actually designed for (overweight/obese/T2D) I would personally suggest (I am not a doctor) that you ignore most of that unless you find yourself being a super responder.

While the sentiment that if you are achieving healthy results that you are happy with you don't necessarily need to increase the dose on a rigid schedule I certainly agree with, I don't think being overly cautious about increasing dose (assuming side effects are tolerated) is going to help people trying to deal with obesity (the people the drug was meant for) provided that the doses and the titration are in line with the clinical trials. If you are obese and just happen to be a super responder losing all they weight they can dream of, I really am thrilled for you, and I don't want to make you change what you're doing. However, this advice is not for you.

To be clear, I don't mind that bodybuilders are taking drugs for obese people, people can do whatever they want with their bodies. Thin people can take whatever they want, but the needs of a thin, healthy person and an obese person are extremely different, and I strongly believe that the latter following the dosing examples/advice of the former can impede progress and be harmful. I would also strongly suggest not worrying about getting into stacking or changing your GLPRA before you have been on the maximum dose of your GLPRA of choice for at least a month or two without meaningful results.

This sort of stems from my anecdotal situation, where I saw little to no results from the early doses of reta. I was staying the same weight, occasionally gaining or losing a pound. I was even worried I might have gotten a bum shipment. However, when I started the maximum dose, I fairly quickly started to see strong results with manageable side effects. This has also been consistent across multiple shipments from multiple suppliers, so the quality or fill of the product does not appear to have been the issue.

Many folks won't see good results until they get to the higher doses.

 

[gulangaloid]

I agree that obese people should approach reta use with a bit of aggression. .5mg/1mg should be test doses at best. People see higher/faster weight loss at higher doses.

I don’t think people should jump to high doses though. Do the +2mg every 4 week titration schedule until you’re satisfied with the results.

Edit: I reread your comment and realized we are saying the same thing. I completely agree. There’s a huge number of lean/fit people fear mongering everyone to use the smallest doses possible when obese people likely need more than that.

Yes, I tried to make it as clear as possible in my post that I am not suggesting wantonly skipping to the biggest doses possible as quickly as possible, but simply following the protocols used for other GLPRAs and the ones currently being used in the clinical trials.

 

[MsGizmo]

Yes, I tried to make it as clear as possible in my post that I am not suggesting wantonly skipping to the biggest doses possible as quickly as possible, but simply following the protocols used for other GLPRAs and the ones currently being used in the clinical trials.

The problem with just strictly following the protocols is that they do not take side effects into consideration.

Using myself as an example I am currently taking 5mg of reta .. my target dose is 8mg, but I am getting the skin sensitivity side effect. My 2nd dose at 5mg was worse than my 1st. I am kind of dreading the next shot but also hoping that maybe my body might adjust. If it doesn't improve by the time I've had my 4th dose I don't think I will increase it because I don't think that I can take it if it gets worse again.

 

[FamousGoodkitty]

I got the sunburn feel with my first pin of 1mg. I am just ignoring it as best I can. I'm at 5mg now its still at a bearable level .. but I do worry about what its going to be like at higher doses. Considering that I need to lose at least another 100 pounds I think that I will eventually need to get to 8mg - 12mg.

It took about 6 to 8 months, but that allodynia (the condition of the skin being supersensitive to even the lightest touch) went away as quickly as it appeared. One day I didn't have it - next day I did, had it for the 6 to 8 months and then one day it was gone. It might end up happening for you as well.

 

[gulangaloid]

The problem with just strictly following the protocols is that they do not take side effects into consideration.

Using myself as an example I am currently taking 5mg of reta .. my target dose is 8mg, but I am getting the skin sensitivity side effect. My 2nd dose at 5mg was worse than my 1st. I am kind of dreading the next shot but also hoping that maybe my body might adjust. If it doesn't improve by the time I've had my 4th dose I don't think I will increase it because I don't think that I can take it if it gets worse again.

Okay, so you didn't read the original post or the follow up which both said (assuming side effects are tolerated), bolded and italicized multiple times in the follow-up?

 

[desinr-gal]

Have you noticed that happening at any other dosages?

sorry I just saw this. I had a rise each time I've titrated up, but not like this.

I am staying at 1.2 each pin, evry 3 days, so 3mg per week, for now. It has been working well,

added to the same amount same schedule of Tirz one day after. I am almost at initial goal, and am at 21% percent loss so far.

 

[desinr-gal]

Too bad this is in the Reta section, only. Titration choices are a big deal for folks in general. (IMO) I like the terms like easy responders and resistant responders. Me being thick/dense skinned squatch. My doc, being the opposite. Im just glad he understands this. My scale didn't move for 120+ days. If that doesn't mess with your head. . . .

So give us thick folks a break too. 2 months to double check. 2 more months to slowly titrate up. This post better not have jinxed it.

I am not against titrating up as needed, just the idea of throwing caution to the wind. The range of variability in people's physical responses are an important consideration. Hospital visits are expensive and some side effects are life threatening.

 

[pavlovs]

I am not against titrating up as needed, just the idea of throwing caution to the wind. The range of variability in people's physical responses are an important consideration. Hospital visits are expensive and some side effects are life threatening.

I agree with this totally. OP, I am not sure why you are so angry about feedback on your post, I think that most people are only trying to point out that there are a lot more variables besides whether a person can tolerate a higher dose or not.

Of course this is anecdotal also, so I am not trying to apply it to every person struggling with obesity, but two months after beginning a GLP-1, I began feeling faint and weak, this led to fainting in a dangerous place. It turns out that I had lost weight so quickly thy my blood pressure had plummeted, and the medication for high blood pressure was no longer need (measured at 70/40 after the faint!) I am sure that losing weight quickly is health for most, but as you likely aren't a doctor, then making such a blanket statement can be a little alarming.

Fast weight loss at age 25 can look very, very different at age 25 than it does at age 55, or 75. In particular, women can struggle with side effects that have nothing at all to do with tolerating the medication. We store and produce estrogen in our fat cells, and when we lose fat quickly, we also lose estrogen quickly. This can lead to all kind of side effects that have nothing to do with gastro issues, or even heart rate. Quick loss of estrogen also leads to hair loss and sagging skin, the dreaded "Ozempic face."

I think that your post came from a good place, but it did not take into account the many, many variables from one person to the next.

Just an FYI, anecdotal of course, but I am 55, and lost weight intentionally very slowly, 60 pounds over 14 months. That amount of weight loss over that period of time has helped me keep my hair and I do not have sagging skin. That's just me, though. That was my experience, and I am not applying it to all.

 

[gulangaloid]

I agree with this totally. OP, I am not sure why you are so angry about feedback on your post, I think that most people are only trying to point out that there are a lot more variables besides whether a person can tolerate a higher dose or not.

Of course this is anecdotal also, so I am not trying to apply it to every person struggling with obesity, but two months after beginning a GLP-1, I began feeling faint and weak, this led to fainting in a dangerous place. It turns out that I had lost weight so quickly thy my blood pressure had plummeted, and the medication for high blood pressure was no longer need (measured at 70/40 after the faint!) I am sure that losing weight quickly is health for most, but as you likely aren't a doctor, then making such a blanket statement can be a little alarming.

Fast weight loss at age 25 can look very, very different at age 25 than it does at age 55, or 75. In particular, women can struggle with side effects that have nothing at all to do with tolerating the medication. We store and produce estrogen in our fat cells, and when we lose fat quickly, we also lose estrogen quickly. This can lead to all kind of side effects that have nothing to do with gastro issues, or even heart rate. Quick loss of estrogen also leads to hair loss and sagging skin, the dreaded "Ozempic face."

I think that your post came from a good place, but it did not take into account the many, many variables from one person to the next.

Just an FYI, anecdotal of course, but I am 55, and lost weight intentionally very slowly, 60 pounds over 14 months. That amount of weight loss over that period of time has helped me keep my hair and I do not have sagging skin. That's just me, though. That was my experience, and I am not applying it to all.

it's more incredulity than anger, people are replying to me without reading what i am writing; they're just imagining what they think i said and replying to it arbitrarily. seems like you didn't really either, to be honest

 

[MsGizmo]

it's more incredulity than anger, people are replying to me without reading what i am writing; they're just imagining what they think i said and replying to it arbitrarily. seems like you didn't really either, to be honest

If so many people are "misunderstanding" then the apparent answer is that you did not word your statement correctly.

 

[pavlovs]

it's more incredulity than anger, people are replying to me without reading what i am writing; they're just imagining what they think i said and replying to it arbitrarily. seems like you didn't really either, to be honest

I read it and I felt like it came from a good place I stick to my opinion that "I think that most people are only trying to point out that there are a lot more variables besides whether a person can tolerate a higher dose or not."

One of the things that I really appreciate about this forum is the stress that many of us put on harm reduction and caution. What works for some may not be applicable to all. Please do keep sharing your thoughts and opinions but expect that there may be times when others may have differing opinions and differing experiences.

 

[gulangaloid]

If so many people are "misunderstanding" then the apparent answer is that you did not word your statement correctly.

you "read" me write (assuming side effects are tolerated) multiple times and then made the very novel and insightful reply "The problem with just strictly following the protocols is that they do not take side effects into consideration."

care to comment on that? any way i could've worded that better?

 

[gulangaloid]

Your personal response is exactly that: personal. If someone is getting good response (1-2 pounds per week) on half the amount you are taking, there’s no data-driven reason to up the dose.

The advice to start low and slow is coupled with watching how the body is reacting. It’s not standalone advice.

from the original post: "While the sentiment that if you are achieving healthy results that you are happy with you don't necessarily need to increase the dose on a rigid schedule I certainly agree with"

did you simply not read what i wrote before responding?

 

[Sasquatch]

I think we have an inability to move on. Do you want cuss-words with this?

 

[gantou]

I'm definitely a fan of low and slow. I've lost 100 pounds of tirzepatide staying mostly below 5mg. I'm starting the move to Reta and I've accepted that I may have to move higher, but I will still go low and slow as much as I can.

 

[gulangaloid]

I'm definitely a fan of low and slow. I've lost 100 pounds of tirzepatide staying mostly below 5mg. I'm starting the move to Reta and I've accepted that I may have to move higher, but I will still go low and slow as much as I can.

While the sentiment that if you are achieving healthy results that you are happy with you don't necessarily need to increase the dose on a rigid schedule I certainly agree with

 

[yrrdead]

I mean we read what you said. You conveniently left out what I would consider the pertinent parts of your original statement.

It seems like overwhelmingly, no matter where I see GLPRA discussion, there is a great amount of advice to keep your dose as low as humanly possible and to start and stay at doses far below even the normal STARTING clinical trial values. I'm not sure how much of this is already lean and healthy bodybuilder types, but for people that the drug was actually designed for (overweight/obese/T2D) I would personally suggest (I am not a doctor) that you ignore most of that unless you find yourself being a super responder.

And the next part of your original post that you left out of the above quote.

I don't think being overly cautious about increasing dose (assuming side effects are tolerated) is going to help people trying to deal with obesity (the people the drug was meant for) provided that the doses and the titration are in line with the clinical trials.

And this one in your 3rd paragraph;

To be clear, I don't mind that bodybuilders are taking drugs for obese people, people can do whatever they want with their bodies. Thin people can take whatever they want, but the needs of a thin, healthy person and an obese person are extremely different, and I strongly believe that the latter following the dosing examples/advice of the former can impede progress and be harmful.

Those are the main points in your original post that I (and apparently others) disagree with.

 

[gulangaloid]

I mean we read what you said. You conveniently left out what I would consider the pertinent parts of your original statement.

And the next part of your original post that you left out of the above quote.

And this one in your 3rd paragraph;

Those are the main points in your original post that I (and apparently others) disagree with.

Like I said, if your advice is to start and remain under the minimum clinical dose forever, I'm happy you are a super responder and it works for you, but I would not try to apply this to most obese people if they can tolerate higher doses.