Tirz plateau - switch to reta?

If someone is having issues with nausea, ondansetron (Zofran) can be prescribed to help with that.

Charlie1989 said:

Sharing my experience because I was worried about losing muscle. I've been increasing Reta while cutting back on Tirz. Every two weeks, I lower tirz by 1mg and increase Reta by 1mg. Still losing weight though.
Hope this helps.

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That is an interesting approach. Are you tracking your body composition to see if you are maintaining muscle while losing weight? I'd be interested to know the results.

I saw a post from someone who had gastric sleeve surgery and regained the weight. They're now on a low dose of semaglutide. It sounds like the sema is helping them with the 'food noise' aspect that the sleeve didn't address.

Stick with Tirz if it's still moving for you. No rush to switch until you actually plateau. That's my take anyway.

Congratulations Dwight! Seven months, 100 day plateau, jumped 12.5mg tirz. First months drop impatient. Waiting hardest.

Tirz has done wonders for my skin. Switched to KLOW now, but I'll mix it up after this round.

The glucagon receptor being the likely driver of blood sugar stability on Reta is plausible - glucagon normally raises blood sugar, but Reta's modulatory effect on glucagon signaling can smooth out the irregular spikes some people experience outside of clinical diabetes thresholds. If Tirz doesn't show the same stabilizing effect, it would support the glucagon mechanism hypothesis since Tirz doesn't have glucagon receptor activity. The experiment is worth running carefully.

If the stall is recent and you're near goal, finishing the tirz first is the lower-risk call - reta's wash-in time is 3-4 weeks regardless, so switching now doesn't buy speed.

Sounds like a solid plan overall.

Began on tirz and gradually worked reta into the mix once I hit a wall. Took the exact same cautious, slow approach to reta that you're describing. That pacing served me well.

Dropped from a straight 15mg Tirz weekly routine to combining 10mg Tirz with 5mg Reta each week instead. Zero issues so far. Once my weight drops further over the next month or two, planning to ease down further to 7.5mg Tirz paired with 5mg Reta.

There's really no clean formula for converting between tirz and reta doses. Based purely on weight-loss effect, something like 15mg tirz roughly lines up with 10mg reta. But reta brings side effects tirz mostly spares you from, mainly sympathetic nervous system stuff, elevated pulse, trouble sleeping, plus odd skin sensations like allodynia. Tirz leaves glucagon receptors alone while reta engages them, largely explaining that gap, and tirz hits GIP harder too, which blunts GLP-1's nausea and vomiting, so reta brings more of that as well.

Jumping straight to 10mg is genuinely risky, could leave you fighting rough side effects for a week or longer, and plenty of people here have reported trouble switching even at a modest 6mg mark.

Probably wiser to cap your first reta dose at 4mg and see how it goes, though ramping faster than the usual 4-week gap isn't inherently dangerous, just remember mild side effects tend to worsen as doses climb.