Ret or cag?
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FRMN01
GLP-1 Enthusiast
Need more details. What's the current dose, how often he pins, is he loosing weight, side effects?
HidingInPlainView
GLP-1 Apprentice
Cag doesn't have to be run alone as it works on an amylin receptor compared to GLP-1, GIP, and/or Glucagon receptor pathway. Cag pairs well with Sema, Tirz, and Reta.
Cag's primary purpose is food noise reduction, however Tirz is the best of the GLP-1's currently for food noise. I'm not saying you can't stack it since it does work on a different pathway, but I am curious why he would unless he's already reached peak dosing schedule.
Reta is great by itself, but depending on the dosage you are coming from on another GLP-1 you may find the need to pair it with additional GLP-1's to minimize side effects or target the issue you are chasing.
I personally was on Reta and Cag as the side effects above a certain dose were unbearable and the food noise faded.
I say was because I have paused due to an upcoming surgery. I will resume Reta only first when I resume, but I'll see how I react after two weeks off of it.
What has his journey looked like so far?
Cag's primary purpose is food noise reduction, however Tirz is the best of the GLP-1's currently for food noise. I'm not saying you can't stack it since it does work on a different pathway, but I am curious why he would unless he's already reached peak dosing schedule.
Reta is great by itself, but depending on the dosage you are coming from on another GLP-1 you may find the need to pair it with additional GLP-1's to minimize side effects or target the issue you are chasing.
I personally was on Reta and Cag as the side effects above a certain dose were unbearable and the food noise faded.
I say was because I have paused due to an upcoming surgery. I will resume Reta only first when I resume, but I'll see how I react after two weeks off of it.
What has his journey looked like so far?
Calm Logic
GLP-1 Specialist
I have been trying to just be a lurker, but this thread screams for pushing eloralintide ("cagri 2.0") and shilling for Uther, who says end of month for elora to be available.
If desired, doc can help accelerate tirz titration schedule if not already at approved max of 15 mg. Or just add reta from now on since diminishing returns after 10 mg or so of tirz.
My plan is whatever GLP or GLP stack (maybe eventually just reta) + elora when available.
If desired, doc can help accelerate tirz titration schedule if not already at approved max of 15 mg. Or just add reta from now on since diminishing returns after 10 mg or so of tirz.
My plan is whatever GLP or GLP stack (maybe eventually just reta) + elora when available.
He's so fortunate and has no side effects. He's on 10 mg tirz. I don't want to switch him to something else because he's stubborn and it took me awhile to talk him into grey.HidingInPlainView said:
He actually titrated up fast with no issues.
Calm Logic
GLP-1 Specialist
I am the one trying to push elora every chance I get. Lilly has a trial now of elora with tirz. So I am surprised we are still talking about cagri, is what I mean, for purchasing a kit.TeresaHip said:
Personally, I would wait for elora. I would not buy cagri at this point except for maybe a single vial for $20. Elora is twice as effective as cagri with only less side effects.
But since your spouse has a different risk profile than most here, cagri is the more conservative grey choice as far as previous usage, except it is less stable than elora (with the whole fibrils controversy with cagri that never fully went away). So it's debatable what is actually safer, with no "field testing" yet for the grey version of elora.
As with cagri, elora can be dosed in mcg to start. And both lend themselves to conservative titration, especially when stacking.
TooBigtoFail
GLP-1 Enthusiast
Once I reached tirz 10mg, my weight loss slowed down, so I added Cag at very low dosage, 0.1mg, and very slowly titrated up (like up 0.1mg/month). Made my stomach upset but it did cut my appetite. Use for 6 mths, slowly stopped, and restarted recently again ( am off tz, and using reta). For me, Cag is great for appetite suppression. I did go up to TZ 20mg/week at some point but weight loss past 10mg tz was marginal. My impression is that TZ was helping me burn calories, whereas Cagri cuts my appetite so I can easily skip meals. I may be wrong but I am in the camp of titrating up slowly, as I needed to loose 100+ lbs. Down 93# in 21 mths.TeresaHip said:
Calm Logic
GLP-1 Specialist
TeresaHip said:
No problem. I was being more dramatic than usual since we still don't know how much elora will cost and exactly when it will be available. So far, only Uther has disclosed future availability. Even if it is just Uther at the start, eventually some of the affordable single vial resellers should help with getting people started.
Tirz/reta + elora will be the most wanted/popular stack sooner or later. Some posts at Reddit by elora trial participants:
quoted said:
Calm Logic said:
I’m super excited about Eloralintide too, but these reddit threads illustrate the current issue. One thread has 2 comments from 7 months ago and the other thread is over a year old with 10 comments. And since grey manufacturers haven’t produced any Elora yet, it’s also impossible to get feedback from the community.
I feel much more comfortable about using Cagrilintide at this point, even though it doesn’t appear as effective, but as a stack I think it’s effective enough. I’ve done the deep dive on the fibril issue and think it’s likely a nothing burger.
Calm Logic
GLP-1 Specialist
Yeah, I agree. I dropped a vial of cagri and then used that as an opportunity to shake it agressively and repeatedly. No visible aggregation or anything like that. And no lasting foam as you would expect with something fragile and prone to denaturation like HGH.Grogu said:
Calm Logic
GLP-1 Specialist
And I would still be very conservative with elora since it has about a 2-week half-life (twice as long as cagri, which is both a plus and a minus). Dosing frequency is the same (weekly).
On the positive side, elora's two-week half-life helps with more stable levels for tolerability. On the negative side, you are obviously stuck with any sides for a longer period of time (though still less sides than with cagri). Elora is currently starting phase 3.
On the positive side, elora's two-week half-life helps with more stable levels for tolerability. On the negative side, you are obviously stuck with any sides for a longer period of time (though still less sides than with cagri). Elora is currently starting phase 3.
FRMN01
GLP-1 Enthusiast
I started with added cagri 0.1mg twice a week. Now doing 6mg tirz, 0.5 cagri on Mondays. 6mg reta, 0.5mg cagri on Fridays.TeresaHip said:
MakeNoPeaceWithEvil
GLP-1 Apprentice
If he's morbidly obese, doc is cool with grey, then why not reta?
lessthanhalf
GLP-1 Specialist
Really need more detail to give a good answer, like start weight, current weight, length of time on tirzepatide and current rate of weight loss as well as age, height and overall health.
Given morbid obesity , so BMI 40+ and 10mg of tirzepatide every 6 days with no side effects, the lowest friction option is to increase tirz dose to 15mg / week, lowest risk of new side effects.
Adding reta or cagri is an option , main argument against doing that before increasing tirz first is the risk of new side effects. Reta might not be the best option if there is heart disease, due to the extra increase in heart rate from reta.
It mainly depends on what is currently happening, has weight loss slowed or stopped on current dose? Is hunger or food noise a problem that makes sticking to a lower calorie intake difficult? If the current rate of weight loss is stable and reasonable , it may not be required to increase dose, losing weight too fast is not ideal, but he will require at least 15mg of tirz/week to get to a more reasonable plateau weight, and adding extra drugs at that point definitely makes sense, assuming weight is still too high.
Given morbid obesity , so BMI 40+ and 10mg of tirzepatide every 6 days with no side effects, the lowest friction option is to increase tirz dose to 15mg / week, lowest risk of new side effects.
Adding reta or cagri is an option , main argument against doing that before increasing tirz first is the risk of new side effects. Reta might not be the best option if there is heart disease, due to the extra increase in heart rate from reta.
It mainly depends on what is currently happening, has weight loss slowed or stopped on current dose? Is hunger or food noise a problem that makes sticking to a lower calorie intake difficult? If the current rate of weight loss is stable and reasonable , it may not be required to increase dose, losing weight too fast is not ideal, but he will require at least 15mg of tirz/week to get to a more reasonable plateau weight, and adding extra drugs at that point definitely makes sense, assuming weight is still too high.
Calm Logic
GLP-1 Specialist
If/when he does want to try reta or cagri, he can do so easily with little investment by getting a single vial, including shipping, for about $30.
Single vials are connotated with being very expensive per mg, but that is not necessarily the case, at least with some domestic vendors on TG. And when starting out, the doses can be quite low, like with reta I started at 1 mg and later 2 mg. So a single vial can easily last a month or two.
For reta, a single vial of R10 to R30 can be found reasonably for about $20 plus about $10 USPS shipping. R30 singles can be priced surprisingly well now (like $23 or 77 cents per mg by a domestic TG vendor I have used, who always does Jano M&P testing with two vials).
A reasonable price for cagri 5 mg is up to $20 for a vial, but one can easily stay at 250-300 mcg for 4+ weeks. So a 5-mg vial of cagri can easily last two months.
Single vials are connotated with being very expensive per mg, but that is not necessarily the case, at least with some domestic vendors on TG. And when starting out, the doses can be quite low, like with reta I started at 1 mg and later 2 mg. So a single vial can easily last a month or two.
For reta, a single vial of R10 to R30 can be found reasonably for about $20 plus about $10 USPS shipping. R30 singles can be priced surprisingly well now (like $23 or 77 cents per mg by a domestic TG vendor I have used, who always does Jano M&P testing with two vials).
A reasonable price for cagri 5 mg is up to $20 for a vial, but one can easily stay at 250-300 mcg for 4+ weeks. So a 5-mg vial of cagri can easily last two months.
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