Reta washout timeout
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They have me on Metoprolol 50mg and Lisinipril 10mg twice a day. I had AF due to some very bad pneumonia that put me in the hospital for 3 weeks, two of those ICU. Almost died, but I'm here. That was about 4 years ago. Been fine since, but my cardiologist is keeping on both just because, and it doesn't bother me at all. I see that slave driver once a year and he still bitches at me for having two beers a day. Good doctor though.
Hi all,
I would like to inform you on the progress of my health and I hope you would provide your opinion about what I will be going to do as next steps.
It is now 4 weeks that I am not taking any GLP1 or weight loss peptide, diarrhea has completely stopped (since 3 weeks at least), sinusal hearth rithm has been restored by electric cardioversion I had 2 days ago.
Because I am just in the middle of my weight loss journey, I am planning to start again GLP1 injection after the washout interval (maybe I will start again next sunday).
My idea is to start using Tirze at 2,5mg/week exactly as I started 1 year ago and titrated it up slower than how I did during last year.
Maybe I will add Cagri or Reta in the future months, I am thinking that I could add Reta to Tirze in a 2:1 ratio.
Thanks in advance to everybody will post suggestions or comments.
I would like to inform you on the progress of my health and I hope you would provide your opinion about what I will be going to do as next steps.
It is now 4 weeks that I am not taking any GLP1 or weight loss peptide, diarrhea has completely stopped (since 3 weeks at least), sinusal hearth rithm has been restored by electric cardioversion I had 2 days ago.
Because I am just in the middle of my weight loss journey, I am planning to start again GLP1 injection after the washout interval (maybe I will start again next sunday).
My idea is to start using Tirze at 2,5mg/week exactly as I started 1 year ago and titrated it up slower than how I did during last year.
Maybe I will add Cagri or Reta in the future months, I am thinking that I could add Reta to Tirze in a 2:1 ratio.
Thanks in advance to everybody will post suggestions or comments.
Glad to see your Afib is stopped for now. I had Afib for a year ( cardioversion twice that would help for a week and then back to Afib)
I can tell you if the Afib continues ask about ablation. It was the best move ever for me. 1 year symptom free. I know it can always creep back in but it truly changed my life.
Best of luck on your journey and thanks for the update!
I can tell you if the Afib continues ask about ablation. It was the best move ever for me. 1 year symptom free. I know it can always creep back in but it truly changed my life.
Best of luck on your journey and thanks for the update!
Yes ablation is the option I am evaluating for the future. I already booked for a specialistic cardiologic visit in order to decide.Nate2plate said:
Did you use GLP1 meds while AFIB was on?
I didn’t. I have been very tuned into my heart rates though while on them. I did have some tachycardia early on but those symptoms have subsidedBLASIUS said:
Just to add,
The cold symptoms, in my case, have disappeared. So perhaps you need time to adjust?
The cold symptoms, in my case, have disappeared. So perhaps you need time to adjust?
This is worth remembering.
Eli Lilly's Retatrutide Phase 2 and ongoing Phase 3 trials have strictly excluded participants who have:
A resting heart rate over 100 bpm
A history of prior atrial fibrillation or clinically significant tachyarrhythmias
Recent heart attacks or decompensated heart failure
AFib was virtually identical between those taking tirzepatide (0.79%) and those taking a placebo (0.83%). Based on this Study
Eli Lilly's Retatrutide Phase 2 and ongoing Phase 3 trials have strictly excluded participants who have:
A resting heart rate over 100 bpm
A history of prior atrial fibrillation or clinically significant tachyarrhythmias
Recent heart attacks or decompensated heart failure
AFib was virtually identical between those taking tirzepatide (0.79%) and those taking a placebo (0.83%). Based on this Study
That's an anit-coagulant--it is NOT treating AFib.BLASIUS said:
Talk to your cardiologist about starting a Beta Blocker like Metoprolol and / or an antiarrhythmic like Flecainide.
AFib is progressive. You tend to have more episodes as you age. But, I would say definitely talk to your cardiologist about adding medications that may help quiet the arrhythmias.
I can't take beta blockers or most antiarrhythmic medications because my resting heart rate is already quite low (50–55 bpm). These medications could lower it even further, so they are not considered suitable in my case. My current plan is to undergo catheter ablation in the hope of resolving the AFib permanently.QueenMuntha said:
Edit:
I add a screenshot of tonight heart rate from my smathwatch
[Imported image pending local asset: attachments-1785563483447-webp.33809]
My resting heart rate is quite low, typically around 50–55 bpm , and it often drops to around 40 bpm during the night .Just A Cat said:
My first episode of AFib occurred two years ago and was triggered by a severe episode of diarrhea due to gastroenteritis. My heart returned to normal sinus rhythm spontaneously after about three weeks.
I wasn't aware that people with a history of AFib were excluded from the clinical trials. I hope that exclusion was simply a precaution for participants with more severe or recurrent arrhythmias than mine.
Could you share the source of that information?
What an interesting study!chewonmysac said:
I wonder if there have been studies about directly measuring the GLP1 receptor resistance/tolerance over time, like insulin resistance.
ClinicalTrials.gov has some basic information for each trial, but it is a very brief overview with very little actual information.
The granular safety thresholds and exact exclusionary language for specific conditions like tachyarrhythmias remain locked within the formal, multi-page protocol pdf documents that has to be requested directly form Eli Lilly.
The granular safety thresholds and exact exclusionary language for specific conditions like tachyarrhythmias remain locked within the formal, multi-page protocol pdf documents that has to be requested directly form Eli Lilly.
There is a lot of information available. The short answer is GLP type medications improve insulin resistance.lastresort said:
Here is an easy explanation that covers insulin resistance at the 4 minute mark.
The SUSTAIN clinical trial program for semaglutide and the STEP 8 trial comparing semaglutide and liraglutide demonstrate significant drops in HOMA-IR scores and fasting glucose.
Hi,
I wanted to post an update on my decision regarding the washout period.
After two weeks completely off any GLP-1 medication, my diarrhea disappeared completely. I completed the washout period (four weeks in total) and then restarted with the initial dose of Tirze (2.5 mg/week). I’m currently in my third week at this dose and, so far, I haven’t experienced any side effects at all.
Regarding the AFib, I underwent electrical cardioversion three weeks ago, and so far I have remained in sinus rhythm.
Because of my low resting heart rate, I can’t take beta blockers or other medications to prevent AFib recurrence, so I’m planning to proceed with an ablation next month.
What I can say about the GLP-1 washout is that it was very effective in breaking the cycle of annoying gastrointestinal side effects. However, as is commonly reported, both food noise and cravings came back during the washout. Over the last three weeks, I have also gained around 2 kg.
For me, this confirms that GLP-1 cycling is probably not a valid strategy, and very likely not a good approach in general. However, a temporary washout period could be worth considering when side effects become difficult to manage and don’t improve through dose adjustments or other measures.
I’ll continue monitoring how I respond to Tirze at 2.5 mg/week and will post another update if anything changes.
I wanted to post an update on my decision regarding the washout period.
After two weeks completely off any GLP-1 medication, my diarrhea disappeared completely. I completed the washout period (four weeks in total) and then restarted with the initial dose of Tirze (2.5 mg/week). I’m currently in my third week at this dose and, so far, I haven’t experienced any side effects at all.
Regarding the AFib, I underwent electrical cardioversion three weeks ago, and so far I have remained in sinus rhythm.
Because of my low resting heart rate, I can’t take beta blockers or other medications to prevent AFib recurrence, so I’m planning to proceed with an ablation next month.
What I can say about the GLP-1 washout is that it was very effective in breaking the cycle of annoying gastrointestinal side effects. However, as is commonly reported, both food noise and cravings came back during the washout. Over the last three weeks, I have also gained around 2 kg.
For me, this confirms that GLP-1 cycling is probably not a valid strategy, and very likely not a good approach in general. However, a temporary washout period could be worth considering when side effects become difficult to manage and don’t improve through dose adjustments or other measures.
I’ll continue monitoring how I respond to Tirze at 2.5 mg/week and will post another update if anything changes.
I hope it works for you! I wanted to offer a suggestion for tiny titration and split dosing when you do try going up again - I'd bump just 0.5mg at a time as a split and let that settle for 4 weeks before you try it again. That's what I'm trying with similar gastro sides with Reta this time around and it seems to be working. I am currently tolerating 1mg reta (split into 0.5 twice a week) + 12.5mg tirz and am going to be bumping to 1.5mg reta total shortly.BLASIUS said:
It is a half possibility, but are you sure that your electrolytes are correct, had labs drawn and verified? Have the doctors looked at you for bradycardia-tachycardia syndrome or vagally-mediated AFib? If nothing else, you now have a research project. 
Now I will always remind everyone to do your own research. The topic of GLP diarrhea is being actively investigated, much more data than I expected to find is out there. I have a multi page of documents and an active discussion going on on this subject and it is interesting.
GLP diarrhea is often a microbiome imbalance.
Since I understand the human need for an easy answer I will give you this research shortcut. Look for any information on "Is the Florastor that I can find in the store possibly a valid option for GLP induced diarrhea?" Florastor acts as an Emergency Response Team for a gut inbalance / microbiome issue.
Once you have stabilized the diarrhea you can try slowly starting a gentle pre-biotic such as SunFiber and after a few weeks SunFiber supplementing, consider upping the game with a clinical grade pro-biotic.
The reason you are having some success currently is the fact the given time, the microbiome attempts to heal itself. The GLP washout gave your body that time needed to start the natural and very slow natural gut microbiome healing process.
Hope this helps get you going (bad pun) and don't forget... do your research. Don't blindly trust some random post on the net.
Now I will always remind everyone to do your own research. The topic of GLP diarrhea is being actively investigated, much more data than I expected to find is out there. I have a multi page of documents and an active discussion going on on this subject and it is interesting.
GLP diarrhea is often a microbiome imbalance.
Since I understand the human need for an easy answer I will give you this research shortcut. Look for any information on "Is the Florastor that I can find in the store possibly a valid option for GLP induced diarrhea?" Florastor acts as an Emergency Response Team for a gut inbalance / microbiome issue.
Once you have stabilized the diarrhea you can try slowly starting a gentle pre-biotic such as SunFiber and after a few weeks SunFiber supplementing, consider upping the game with a clinical grade pro-biotic.
The reason you are having some success currently is the fact the given time, the microbiome attempts to heal itself. The GLP washout gave your body that time needed to start the natural and very slow natural gut microbiome healing process.
Hope this helps get you going (bad pun) and don't forget... do your research. Don't blindly trust some random post on the net.
Thanks,cldfront said:
my idea is to titrate up very slowly and stack reta or cagri with Tirze, my idea is to consider a ratio of 2:1 of tirze to reta or a 10:1 Tirze to Cagri.
I will update the thread periodically.
I had some concern about electrolytes, I am quite sure that when the first time AFIB started, my electrolytes were completely out of range, but I am not sure about the second time it happened.Just A Cat said:It is a half possibility, but are you sure that your electrolytes are correct, had labs drawn and verified? Have the doctors looked at you for bradycardia-tachycardia syndrome or vagally-mediated AFib? If nothing else, you now have a research project.
Now I will always remind everyone to do your own research. The topic of GLP diarrhea is being actively investigated, much more data than I expected to find is out there. I have a multi page of documents and an active discussion going on on this subject and it is interesting.
GLP diarrhea is often a microbiome imbalance.
Since I understand the human need for an easy answer I will give you this research shortcut. Look for any information on "Is the Florastor that I can find in the store possibly a valid option for GLP induced diarrhea?" Florastor acts as an Emergency Response Team for a gut inbalance / microbiome issue.
Once you have stabilized the diarrhea you can try slowly starting a gentle pre-biotic such as SunFiber and after a few weeks SunFiber supplementing, consider upping the game with a clinical grade pro-biotic.
The reason you are having some success currently is the fact the given time, the microbiome attempts to heal itself. The GLP washout gave your body that time needed to start the natural and very slow natural gut microbiome healing process.
Hope this helps get you going (bad pun) and don't forget... do your research. Don't blindly trust some random post on the net.
Anyway in the last time I am taking electrolyte supplements and drinking a lot.
I tried many remedies (including prebiotic pills) to treat the diarrhea, but none of them completely eliminated it; it remained dormant. Only after the washout did it finally go away.
The one that seemed to give the best results was the use of psyllium husk, but it still only managed to alleviate the symptoms.
I never used Florastor neither SunFiber, I will take them in consideration for the future but I hope I will not need them
.Thank you for the suggestion
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