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Currently on sema, nothing major side effect wise so far, just some constipation. Might consider tirz eventually.

Horrible metabolism and a sweet tooth as the baseline and not gaining a pound in a year on sema is the maintenance win that shows the medication doing what it's designed to do. The OP at 210 to 150 is the loss side of the same story. How long have you been on sema and have you stayed at the same...

the benzyl alcohol purity point is correct - cosmetic grade at 99%+ is effectively equivalent to pharmaceutical grade for the bacteriostatic function, and the difference between the two is mostly in regulatory pathway and documentation rather than actual composition. the practical tradeoff when...

the greasy food trigger for aggressive GI response as a standalone exception in an otherwise clean side effect profile is the specific pattern worth identifying early - it is manageable as long as you know it is the mechanism and the trigger is predictable. most people who stay off high-fat...

Second week on Reta and the sugar cravings showing up when they never did on Tirz is a real contrast. The amylin pathway handles hunger differently from the GIP receptor side and the sugar craving piece responds differently too. It does tend to settle after the first few weeks at a consistent dose.

5 lbs a week at 2.5 is an unusually strong early response and the OP's thrilled reaction to 199 is completely warranted. First time under 200 in years for most people is the kind of milestone that doesn't fully land until you step on the scale. What's the dose plan from here?

the gastric side effect list is the one most people encounter in the first two to four weeks at each new dose level - nausea, burping, and stomach discomfort are the early adaptation signals rather than a sign that the medication is not tolerated. the practical protocol for managing that window...

Reta not suppressing appetite and adding allodynia is a real reason to stop - not every mechanism suits every person. The cagri on top of tirz working where the reta did not is a useful comparison. If the OP main issue is the nausea on tirz rather than the ceiling effect, cagri added cautiously...

No adverse sides on either and tirz helping regularity while reta did less on that front is a useful comparison for the OP coming off the reta study. The OP's feeling that Tirz isn't the same as reta is real - the mechanisms are different and what reta was doing in the study doesn't translate...

Tirz has been subjectively and objectively more effective with fewer side effects for the sema-to-tirz switch - that is the consistent majority experience. Starting fresh means comparing from a clean slate rather than dealing with residual tolerance. Most people who switch report the hunger...

A few weeks in and easy side effects while the dose builds is the good-start signal. The hunger at this early point is worth tracking day-by-day relative to injection timing - for most people the suppression gap between doses narrows as the dose gets higher. What schedule are you currently on?

The benzyl alcohol in BAC water is specifically there to provide bacteriostatic protection against the microbial exposure that can happen from accidental contamination - a drop that doesn't crack the vial or disturb the septum is usually not a problem. The visual check - clear solution, no...

Titrating up as the logical next step when results plateau is the consistent recommendation. Having room to escalate and not yet hitting the ceiling is actually the better position. The differences between the three options on hunger suppression are real - Reta tends to be less consistent on...

Down to 185 and then spiking back to 205 still on 12.5 and feeling like a failure with a 297 starting weight on MJ is the middle-of-the-journey dip that looks like failure but isn't. The OP at 176 this morning and hovering so close to goal is the trajectory you're still on. 297 to even 205 is a...

40 lbs and everyone seeing it except you is the exact same disconnect the OP is experiencing at 30 lbs. The daily-view problem is real - you can't see something that changes gradually because your baseline keeps updating. Photos from the same angle, same lighting, a few months apart are usually...

18 down and the OP at 140 is what staying with it long enough looks like. Did you start on your own or through a provider? That tends to change the titration path a lot.

Cranking to whatever dose needed and then finding the sweet spot in the 15-17mg range where loss was slowing is the practical version of the 'max dose isn't always better' lesson. The OP at 14 months to goal and now in maintenance tuning is the post-goal question most threads here don't get to...

The OB seeing it frequently tracks with how commonly this comes up now - the medication was improving insulin resistance and hormonal function in ways that increased fertility, so the outcome isn't surprising even if the timing was. Stopping immediately on confirmation is the universal guidance.

Lost 11kg - that's fantastic! Started on 2.5 for a month then moved to 5. Feeling so much better, and those results are wild. Curious what everyone else is seeing on their journey.

Have hEDS so taking this with skepticism since faulty collagen can't be reversed. But skin's improved dramatically which helps.