Tirzepatide tummy troubles - Sema a better bet?

3 months of feeling like crap on Sema and then switching to Tirz and feeling much better is the reverse of what the OP is dealing with. The individual variation in which direction causes more GI issues is genuinely unpredictable. Starting low and slow is the right advice regardless - 5mg on the second shot is a steep early entry.

Sema causing nausea and then having essentially no side effects from tirz, reta, and cagri is the opposite of what the OP is experiencing. The individual variation in which direction causes GI problems is genuinely unpredictable. 5mg on the second shot after starting is a steep early jump - what was the first shot dose?

The individual variation on nausea between sema and tirz is wide enough that general advice isn't very useful. The trial-and-see approach is genuinely the only way to find your personal response. If tirz was 10 days of nausea at 5mg, stepping back to a lower dose first would have been worth trying before concluding it doesn't work.

Sema hit me with rough GI issues, but Tirz has been noticeably gentler on the side effect front. Seems like a common pattern from what I've read from others too.

Always curious about this comparison. Started tirzepatide myself recently and the sides I noticed were limited to a bit of bloating and some brain fog the first couple days after each shot. Feels like tirz just comes with a lot going for it.

Started on Sema, worked up to the max recommended dose, then switched over to Tirz. Compounding pharmacy had me starting Tirz at 9mg coming off the 2.4 Sema. Weight started moving again, and I noticed way fewer side effects on Tirz. Sema gave me constant low grade nausea, Tirz gave me none, but bad constipation in the first weeks. Prunes daily fixed that within a short stretch. Still running Tirz, recently shifted from a seven day to a five day schedule trying to break through a stall, results still pending. Tirz was clearly the better fit for me, though everyone reacts differently. Personally think Tirz delivers more with fewer side effects.

Tirz made me sick. Haven't gotten sick on Sema yet, and I'm already up to 1.7mg there. Couldn't tolerate tirz once I hit .5 or whatever that second dose ended up being.

Would give tirzepatide a shot. Had brutal nausea all the way through 2.4mg on my previous medication. Switched over and had absolutely none.

Been on this myself, currently the third compound. My mom and two aunts run the single-pathway one, and just one aunt out of everyone got nauseated early on. Doesn't seem as common these days honestly. My husband started it, paused over bowel issues, later picked up a different GLP entirely, and hasn't had nausea on that one, nor was it an issue for him initially either. My close friend plus her kid and that kid's spouse all run the dual-action compound and none report nausea.

Not claiming it never happens though. Occasional random waves every few months that clear up quick with electrolytes.

Overall though, only one out of roughly eight people I personally know has experienced what I'd call genuinely extreme nausea. She's really sensitive to the medication and lost all her target weight at the two lowest doses. Early on she used to force herself to finish every plate, old habits from childhood, and once she finally stopped doing that, her nausea improved dramatically.