Plateau at 7.5mg... now what?

ToneLady

ToneLady

Well-known member
I began using a compounded version of tirz in early fall, optimistic that it would assist me in shedding 50 lbs to please my doctor. Starting at 2.5mg, I was thrilled by the immediate disappearance of food cravings, improved appetite control, and resolution of my low blood sugar issues. When my compounded supply ran out, I switched to a grey market source.

I'm now consuming between 1100-1300 calories a day, walking about 10k steps, and using fiber and Mag0 for regularity. My diet consists primarily of lean protein and non-starchy vegetables. We've significantly reduced our grocery expenses because I no longer crave restaurant meals or snacks.

Initially, weight loss was gradual, around 4 lbs per month, but it ceased after I lost about 18 lbs. I increased my dose to 5mg and lost just 3 lbs over the next month. Assuming this meant I needed a higher dose, I've been on 7.5mg for nearly a month now. However, my weight has remained unchanged for the past 5 weeks, despite the increase.

I'm contemplating reverting to 2.5mg and focusing on the glucose control and appetite suppression benefits. After all, losing 18 lbs is still a significant achievement. My acid reflux has intensified, potentially due to the tirz. While I'd like to lose another 20 lbs to achieve a healthy BMI, and ideally 35 lbs for aesthetic reasons, I'm beginning to suspect this may be the limit of what this medication can do for me.

I'm still experiencing excellent appetite suppression and minimal food cravings. I can easily resist the temptation of birthday treats in the office.

Any advice? I'm wondering if introducing another peptide might jumpstart the process, but I'm hesitant and unsure if I should accept my current progress.

The plateau playbook walks through the dose-conversation steps if you want a roadmap
 
I'm not set on adding another medication; my inclination is to potentially reduce, not increase. It seems my body isn't responding, even after two dosage increases. It's possible that this peptide just isn't effective for everyone.

I don't want to overstimulate my receptors and develop a tolerance to the medication, potentially losing the appetite control and other benefits. I'd hate for that to happen.

Perhaps others have experienced prolonged plateaus? I could increase to 10mg after four weeks at 7.5mg, but I'm unsure if it will result in further weight loss. I'm starting to think, 'Maybe this is as good as it gets, and 18 lbs is still a good start. Should I consider maintenance now?'

For context, some friends are having success with 3.5mg and 5mg, so being at 7.5mg with no weight loss for over a month is concerning. I'm just unsure of what to do.
 
Ok, got it, you mentioned considering another med.

Obviously it's working since you've dropped a good amount of weight.

There's no receptor flooding, that's just not true.

The appetite control will fade over time, according to the main researcher.

More medication, more effect, to a point. 7.5mg isn't the end.

Stop comparing yourself to people. It's not helpful.
 
I understand what you mean. Even smaller stalls like that can make you think it's not working (even though some would say a true stall is more like 12 weeks of nothing). The next step should be to try 10mg if 7.5 isn't doing the trick.

I was dealing with the same thing at 7.5, and increasing to 10 worked. Maybe too well. I was starting to feel weirded out by not feeling real hunger for over two weeks, so I'm messing with reducing back to 7.5. Sometimes we just psych ourselves out with impatience and unrealistic expectations.

And yeah, forget what your friends are doing. Everyone is different. Some don't respond at all, some get bad side effects, etc. You've had a response, so keep going and titrate up.
 
My wife and I needed different amounts of tirz from the same source. 10mg/week was too much for me due to some side effects. I reduced back to 7.5mg/week and am almost at my weight loss target. My wife uses 15mg/week. Her side effects are minimal, but her weight loss has been slower than mine.

Don't rush it; you've already made good progress. What would you have done before you started to lose 20lbs?
 
Some people need higher doses to lose weight, which is fine. Look around online-- some people don't start losing until 7.5mg or 10mg! Not everyone is a super-responder. The recommendation is to increase every month. If you are not losing by then, up the dose. I wouldn't consider any other peptides unless you literally can't increase due to side effects.

What about your body composition? When I first stalled, it was driving me insane, but my body shape was just changing. I've got a waist again and my clothes fit better.
 
Thanks, everyone; this is all really helpful! I'm happy with the weight that's gone and don't have any complaints so far, other than some bad acid reflux. Increasing to 10mg at the end of this 7.5mg course seems like the right move, and I'll titrate up when it's time. I appreciate all the advice; it's really reassuring.
 
I started sema last spring with no response even after increasing the dose. Then I switched to tirz and was losing consistently but couldn't get the constipation under control. I seemed to be changing treatments every week. I did lose about 70 lbs, though. Stacking small amounts of both Reta and tirz fixed the bowel issue and I lost some additional weight. Now I’m just on Reta, only 5 mg. I was losing until recently, but the regain is only 5 lbs and I know it’s because I injured my knee so I'm not getting much exercise. Exercise also affects sides so that makes a difference too. I think I had a stall while on tirz, about a week but I don’t recall when now.

Try not to compare yourself to others- if it is working but the scale isn’t moving maybe you’re gaining muscle or bone. That’s the first thing I look at if I don’t show a loss- did the fat reading change? (My scale measures everything.. ). Anyway, good luck.
 
Fingers crossed your stall is done. I also like to keep my amounts low. I'm only on 3mg of something else and even with some cravings, I don't plan on increasing. How much do you weigh? 1100 calories is a very low number of calories, like a body builder prepping for a show. You may have slowed your metabolism. I've seen where people had to stop dieting for a few months because of this. I schedule diet breaks every six weeks. I normally cut 300 to 900 calories a day, then in week six, I go back to maintenance calories. I'm down 30lbs in about 4 months with no stalls and steady strength increases.
 
Have you tried combining medications? I would add something else gradually while staying at 5mg tirze. Start slow with the other med, as some people get side effects. I didn't. Maybe start at 0.25mg the first week, then 0.5mg the next, and stay there or go to 1mg. I wouldn't go higher than that, even though they suggest going up to much higher. 5mg tirze and 1mg of something else weekly will probably get you losing again.
 
I don't get why people are scared of the higher amounts. 7.5mg was the lowest amount used in most studies.

It's the compounding mindset carrying over - trying to stretch the money as long as you can, so riding lower amounts. That doesn't make sense when it's cheap.
 
There's also the idea that "less is more." I don't agree with that (for me) since GLP-1s help us in dose-dependent ways, not just with weight loss.

My doctor doses patients with a 2.5 mg increase per week as needed. So I went to 10 mg at week four. I'm staying there now but will go up if needed.

Part of the reason for the higher amount is any effects on inflammation, blood sugar, etc., not just the weight loss. I feel great and am exercising more. I'm starting week five and have lost 13 pounds so far.

Also: "We also identified a dose-dependent fashion in tirz reducing HbA1c and fasting blood glucose, and the dose of 15 mg once weekly showed the best efficacy."
 
Heartburn advice when using this stuff:

https://pmc.ncbi.nlm.nih.gov/articles/PMC9428923/

Eat smaller meals more often, avoid coffee, tea, spices, cola, fried foods, tomato, mint, chocolate, alcohol, soda, and don't lie down after eating.

Try a PPI.

Reflux is common in obesity. GLP-1s can make it worse because of delayed stomach emptying. Diet and PPIs usually help. It gets better as you lose weight, so you shouldn't need the PPIs forever.
 
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