Tirz to Reta... advice?

BaconSlayer-Vegas said:

Has he mentioned whether Tirz had impacted his appetite at all?

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He says it has a little, but not like it does for me!

Started tirzepatide in October 2024. At this point it's mainly for binge eating since I've shed what I needed to. Been running on empty though, not my usual self. Always had some dizziness standing up, but a few months in I actually blacked out and hit my head hard. Labs came back solid except glucose was too low - need to retest fasting and A1C. Not certain tirz is the culprit but I can't stop it since I've battled binge eating my whole life without success on anything else. How do I fix the glucose piece?

Agree with the above guidance. If you stack with tirzepatide, pick something that hits different receptors.

The transition from Tirz to Reta is a real reset - even after years on one, you start fresh on the other. The electrolyte thing is huge, especially in the early weeks. I keep magnesium and potassium on hand and front-load them around my injection days. Protein stays high the whole time. The hunger coming back initially can be disorienting but it settles once you find your Reta dose.

55 lbs since May is strong responder territory. Reta makes sense for a non-responder - different receptor profile.

The crossover direction matters - going into reta with tirz still active in the system blunts the initial response, so a week or two of gap gives a cleaner read on whether it's working.

Brand Tirz supply narrowing is a real friction point for the switch - compounded Reta doesn't have that issue, which makes the transition easier right now.

No real loss at 7.5mg after 4 months suggests tirz isn't his mechanism - Reta often works where tirz doesn't. Short washout before switching is standard.

Non-response to tirz at 7.5mg after 4 months while active and eating well is a real phenomenon. Reta's triple agonist profile (GLP-1/GIP/glucagon) sometimes reaches where tirz doesn't, and a wash-out period before switching isn't required.

Nothing to report side-effect-wise yet, but this is only ten weeks in and titration's still ongoing.

Currently at the top tirz amount weekly, prescribed by a doctor, and reta started at a small amount for two weeks, then doubled for two weeks, then tripled for six weeks. Just moved up again for the first week, all while holding tirz steady. After several more weeks at this level, a reassessment happens. If reta needs to climb further past this point, tirz would probably come down instead. That bridge gets crossed when reached.

If you've already been running tirz beyond a year, expect having to climb pretty high on reta before it registers, at least 6-8mg held for a few weeks. I've mostly parked around 10mg reta these days just trying to hold my weight loss steady.

Started early on this one. Was at a moderate tirz amount when the second compound got added at a small level. Currently at a higher tirz amount and moderate second compound level. Tirz began in late January, the second compound sometime around late March. Lost over sixty pounds since mid-February.

Yeah, 6mg's way too aggressive to start reta with, regardless of prior tirz experience. Better cautious than sorry, particularly given the glucagon component in reta. Personally wouldn't go above 2mg for that first reta dose since splitting the week into two doses works fine (or even dosing daily in tiny amounts). That way you could layer in an extra 1mg toward the back half of the week should 2mg appear to do nothing initially. That said, some GI side effects might take up to five days before showing.

Worst case scenario, better to plan on holding weight steady rather than chasing further loss, at least through this initial transition, focusing on body composition instead helps take attention off the scale.

Biggest culprits behind switch-related problems tend to be either cutting tirz too aggressively (rushing the reta transition) or ramping reta too fast (since it can hit differently). So low and slow tends to be the safer bet, as usual. But dosing multiple times weekly gives you more room to fine-tune along the way.

Always possible to increase reta down the road, whether that's within the same stretch or the following week, adjusting gradually as time goes on. Rarely, some people experience extreme reactions to reta, projectile vomiting or persistent hiccups, even after a careful, gradual approach to

Been on a solid weekly amount for close to eight months now. Dealt with the tingling side effect for a few months early on, barely notice it anymore. Started this after losing a large chunk of weight on a different medication over about a year and a half. Down further since switching, though admittedly not being as strict with diet lately since feeling more comfortable in this current weight range.

The suggestion seems to be that a specific dose is the sweet spot, but the data referenced actually seems to show continued improvement as the amount increases further. Seems like the real takeaway should be something like, hit at least that amount, then keep going as needed for a healthy loss rate without side effects severe enough to want to quit. Missing something here?