What do to for last 20lbs on Tirz @ max dose

[Grogu]

Long story short, I'm about 15 months on tirzepatide and pinned 18mg this morning. I've lost 107lbs and weighed 228 this morning. I'd really like to get to 205, which would put me just into the "normal" weight category for my height. I started a small stack of sema at the end of November, and that seems to have continued my weight loss, but I stopped sometime in March when my sleep got all messed up. I'm thinking now it wasn't the sema.

I pinned 5mg of tirz mid-week this past Monday and it felt really good, but I think that that was kind of a crazy dose given that I've been pinning 17mg weekly.

I'm going to double down on the protein and up my exercise, but I'm wondering if anyone has advice on what I might try on these last 20-23lbs. All I have in the stockpile right now is tirz, sema, reta, and cagri. I was thinking I could get some maz or survo and do ghetto reta or would it be better to just transition to reta at this point? The only thing that scares me about reta is when people say there less food noise dampening. Should I go back to the sema stack and keep increasing the sema until I'm get to the max dose of sema? I was doing 1mg, but maybe pull back on the tirzepatide and go full steam ahead with the sema? I can order some max or survo, but that's going to take awhile. I'm just confused on the best path forward.

 

[Sasquatch]

I been doing 19.5mg total for two or three weeks. ( must be three, according to the vial count) 12.5 or 13mg on wed./Thurs. Then the remainder on Sat.

Initially I started losing a couple pounds a week, but went on vaca and everything went to hell. Gained back 5lbs. But I think if I behaved, ida been OK.

Similarly, imat 270, trying to get to 250. I'm giving myself 6 more months. If I make it OK. If I don't, I still lost 60/70lbs. Now, what I'll do in 6 months, I don't know?

 

[Grogu]

I been doing 19.5mg total for two or three weeks. ( must be three, according to the vial count) 12.5 or 13mg on wed./Thurs. Then the remainder on Sat.

Initially I started losing a couple pounds a week, but went on vaca and everything went to hell. Gained back 5lbs. But I think if I behaved, ida been OK.

Similarly, imat 270, trying to get to 250. I'm giving myself 6 more months. If I make it OK. If I don't, I still lost 60/70lbs. Now, what I'll do in 6 months, I don't know?

I could definitely do another 5mg next Monday and that would put me at 23mg weekly. My only side effect this past week on Monday, Tuesday or Wednesday was really no interest in food , but I was able to eat with no problem.

Based on the clincial trials for tirzepatide, I'm probably right at the point where weight loss on this medication is done. So, I'm not so sure if more tirzepatide is really the answer. I feel like I need to shake things up.

 

[Sasquatch]

Indeed, I like to refer to the studies/trials, as I don't have much else as far as real guidance. (No offense to our forum brethren) That's why I'm using a year and a half as a milestone.

Losing over 100lbs.! You've already won! It's all in the point of view. Reading this proactive/positivity based forum, you'd think everyone simply takes the stuff and simply drives to the desired weight. Bob's yer Uncle. Well, according to the "study" there's a large percentage of success, but it's still a percentage.

Honestly, I'm fucking old and getting older. I've lost quite a bit. It's not making me better looking. The last coat was pretty dry long before I started this shit. 20 more pounds would be nice, but percentage wise especially, won't amount to much. I wish I could say 15lbs. is just 3 healthy shits, but those were the days.

 

[Summer48]

Just done my 61th shot of tirz. Still got 14 lbs to go and I’ve lost 1/2 lb in 5 weeks. Just feels like I’m not taking it anymore food cravings coming back. But the last shot I’ve taken is 20mg instead of 15mg and definitely feel a difference no food cravings at all. I have tried 17.5mg before but didn’t feel any different from 15mg. Hope this doesn’t mean I have to keep going up and up and up. Who knows where it might lead

 

[staffn1]

Unless you have actually plateaus why not keep going with what you were doing? Try increasing exercise intensity (with intermittent high intensity training). Focus on muscle building and less on weight loss. The last lbs can be slow.

 

[woundcarping]

Halfway to your next tirz 17mg dose take 6mg of Reta. Drop your tirz to 12-15mg. Give it ~24-48 hours and decide how your food noise is before adding more tirz before your next Reta.

 

[Grogu]

Just done my 61th shot of tirz. Still got 14 lbs to go and I’ve lost 1/2 lb in 5 weeks. Just feels like I’m not taking it anymore food cravings coming back. But the last shot I’ve taken is 20mg instead of 15mg and definitely feel a difference no food cravings at all. I have tried 17.5mg before but didn’t feel any different from 15mg. Hope this doesn’t mean I have to keep going up and up and up. Who knows where it might lead

Lilly is currently testing higher doses of tirzepatide in a clinical trial and they haven't cancelled the trial for safety reasons, and we've both survived higher doses , so clearly 15mg is not the highest dose. I told myself I'd be fine going up to 25mg , but not sure if that that is the best approach.

 

[Devilseye]

I mean if you were doing good with a sema stack I would just keep doing that. They compliment each other affinity wise. Tirz for GIP and sema for GLP1. I would just keep doing that until you reach your goal and then drop the sema and maintain on tirz alone.

Good luck! Those last few pounds can be the hardest.

 

[Grogu]

I mean if you were doing good with a sema stack I would just keep doing that. They compliment each other affinity wise. Tirz for GIP and sema for GLP1. I would just keep doing that until you reach your goal and then drop the sema and maintain on tirz alone.

Good luck! Those last few pounds can be the hardest.

There is definitely a point about going back to the sema. I felt pretty good on that and I now know that my sleep issue wasn't because of the sema. That could be a possible solution.

 

[Grogu]

Halfway to your next tirz 17mg dose take 6mg of Reta. Drop your tirz to 12-15mg. Give it ~24-48 hours and decide how your food noise is before adding more tirz before your next Reta.

tbh, the whole reason that I even stocked up on reta was I felt that at some point the tirz would stop working and I would need something else to get me to the finish line. So, I can definitely give reta a try, what am I stockpiling it for if not to use. Nothing is written in stone. I can also go back to stacking with sema if I don't like the reta. Do you think that the 6mg is too much for the first pin?

 

[cldfront]

Cagri? That's my next plan once I go from 15 to 20mg Tirz. Reta doesn't agree with me and the Survo stack was meh with sides.

 

[Grogu]

Cagri? That's my next plan once I go from 15 to 20mg Tirz. Reta doesn't agree with me and the Survo stack was meh with sides.

Looking back now, I think that's why I must have cagri in the toolbox. I ruled out Survo for some reason, but don't remember why. Then I read about the pH issue and fibrils issue with cagri and that kind of spooked me a little, but I'm going to look at cagri again.

 

[cldfront]

Looking back now, I think that's why I must have cagri in the toolbox. I ruled out Survo for some reason, but don't remember why. Then I read about the pH issue and fibrils issue with cagri and that kind of spooked me a little, but I'm going to look at cagri again.

Same/same. So I did some research and I copied this info from a post here because it appears to be "best practices", ordered some 0.6% acetic acid and pH strips on Amazon, and I'm about to give it a whirl (apologies I don't have the OP):

For those who truly love precision and want to perfectly mimic Novo Nordisk’s formulation, here’s a straightforward method:

Take your 10 mg vial or 5mg vial of cagrilintide and mix with 2 ml of standard BAC water. Gently swirl until fully dissolved—never shake vigorously.

Now, slowly add about 0.2 ml of 0.6% acetic acid solution (pharmaceutically sterile). This is a mild acid solution safe for injection.

Gently mix again and check pH with narrow-range pH strips (ideal is around pH 4.0–4.5).

If your pH isn’t quite low enough, add additional 0.05 ml increments of 0.6% acetic acid, checking pH each time. You’ll likely find the sweet spot around a total of .25-40 ml added.

This method is super easy once you’ve done it a few times. It ensures your peptide stays chemically stable and mimics the precise conditions Novo would use if they sold a standalone vial.

 

[Grogu]

Same/same. So I did some research and I copied this info from a post here because it appears to be "best practices", ordered some 0.6% acetic acid and pH strips on Amazon, and I'm about to give it a whirl (apologies I don't have the OP):

For those who truly love precision and want to perfectly mimic Novo Nordisk’s formulation, here’s a straightforward method:

Take your 10 mg vial or 5mg vial of cagrilintide and mix with 2 ml of standard BAC water. Gently swirl until fully dissolved—never shake vigorously.

Now, slowly add about 0.2 ml of 0.6% acetic acid solution (pharmaceutically sterile). This is a mild acid solution safe for injection.

Gently mix again and check pH with narrow-range pH strips (ideal is around pH 4.0–4.5).

If your pH isn’t quite low enough, add additional 0.05 ml increments of 0.6% acetic acid, checking pH each time. You’ll likely find the sweet spot around a total of .25-40 ml added.

This method is super easy once you’ve done it a few times. It ensures your peptide stays chemically stable and mimics the precise conditions Novo would use if they sold a standalone vial.

Wow! Thanks so much for this. This sounds like really good advice about how to properly adjust the pH, which I think is a pretty good idea. That would definitely make me more comfortable.

 

[swimmer]

The last 10 lbs was a bitch for me too. When I stalled on 15 mg tirz, I went up to 20 mg. When I stalled on 20 I went to 20 every 6 days. Then 20 every 5 days for the last month. I had no negative side effects. For maintenance I am on 10 mg tirz and I sprinkle in 2.5 Mazdutide every once in a while. I have Cagri and Reta in the freezer if I ever need them.

 

[RadicalCrimson]

Same/same. So I did some research and I copied this info from a post here because it appears to be "best practices", ordered some 0.6% acetic acid and pH strips on Amazon, and I'm about to give it a whirl (apologies I don't have the OP):

For those who truly love precision and want to perfectly mimic Novo Nordisk’s formulation, here’s a straightforward method:

Take your 10 mg vial or 5mg vial of cagrilintide and mix with 2 ml of standard BAC water. Gently swirl until fully dissolved—never shake vigorously.

Now, slowly add about 0.2 ml of 0.6% acetic acid solution (pharmaceutically sterile). This is a mild acid solution safe for injection.

Gently mix again and check pH with narrow-range pH strips (ideal is around pH 4.0–4.5).

If your pH isn’t quite low enough, add additional 0.05 ml increments of 0.6% acetic acid, checking pH each time. You’ll likely find the sweet spot around a total of .25-40 ml added.

This method is super easy once you’ve done it a few times. It ensures your peptide stays chemically stable and mimics the precise conditions Novo would use if they sold a standalone vial.

When I did my first cagri I mixed 2mL BAC water and 1ml AA and pH was around 5, so I decided to do 50/50 next time. I’ve seen some people also recommend it.

I suppose it depends on your AA’s concentration, that’s why measuring is important.

This made me realize that this was 5 weeks ago, so time for a new vial next week, even though I only used 2mg out of the 5.

 

[lessthanhalf]

Starting at very different positions given I only started GLP's to control hunger after losing weight, but my logic was that reta was surprisingly good at low doses at causing weight loss, 9% at 1mg over a year, so I added a smallish dose of it to 15mg of tirz. Did not want to swap as I had very few side effects from it and had horrible side effects from ozempic. Ended at 15mg of tirz and 5mg of reta, and lost a further 13 kg from 79 to 66 kg over 9 months, but had only been on tirz for 1 month before adding in the reta. So I cannot say a lot about the difference between just tirz and tirz plus reta, other than I felt less hungry on both.

I figure you get a little more GIP and GLP-1 , plus the extra effect from glucagon with adding reta, plus possibly less side effects than higher doses of reta alone. Not very different to just higher tirz doses but with the added glucagon agonism.

Adding in low doses of cagri is the other option, probably slightly higher chances of nausea and fatigue, so might depend on how sensitive to those side effects from tirz you were, although I am not sure how well they correlate given it acts on different receptors in different parts of the brain.

My logic is the risks of higher than standard doses or combination therapies are probably lower than the risks of severe obesity, and if you have lost 107 lbs and want to lose another 20, then you likely started in that category. I would class the theoretical risks of cagri and fibrils in the same area, it might be significant , but losing and maintaining large amounts of weight loss has an enormous effect on long term health risks. The relative risks are likely different orders of magnitude.

 

[Grogu]

Unless you have actually plateaus why not keep going with what you were doing? Try increasing exercise intensity (with intermittent high intensity training). Focus on muscle building and less on weight loss. The last lbs can be slow.

Definitely at a plateau. Just checked and I’ve gone up and down, but I’m basically at the same weight I was at the start of March. That was about the time I stopped the sema stack.

 

[woundcarping]

Could always roll the dice on sleep and add Sema back…