Stacking Reta and Tirz??

Who isn't stacking these days?! I'm taking a break right now because I have surgery coming up next week. But previously, when I was actively losing weight and then during maintenance, I was stacking them. I was doing about 1mg of each for maintenance, and it felt like I was getting benefits from both. Easy weight maintenance, minimal cravings, and I spaced the injections about 72 hours apart.
 
I've been stacking for over six months. Reta at 8 mg, split into two doses, and Tirz at 6 mg on the 6th day.
 
Started Tirz last October, gradually increasing to 7.5mg. During the Black Friday sales, I bought a 60mg kit of Reta but didn't use it right away. In late January, I reconstituted a vial, planning to slowly increase Reta while decreasing Tirz. I've only reduced Tirz to 6mg so far and have been at 6mg of Reta for several weeks. I think this is a good balance; I'm still losing fat, and my muscle mass is stable (verified by DEXA). I'll probably finish this 60mg vial and then re-evaluate. I might be close to maintenance by then.
 
I'm using 15.75mg of Tirz plus 5mg of Reta. On 15mg of Tirz, I was still a little hungry but had very few side effects. So, instead of switching medications and risking side effects, I added Reta, which helped. Trying to maintain a 54% weight loss. I don't see much point in using both unless you're at the maximum dose of one. Even then, a higher dose of the single med might be better. The stronger GIP action of Tirz might help with Reta-induced nausea. If side effects aren't a problem, higher doses or adding Cagrilintide probably make more sense.
 
I'm also stacking. I recently had to lower my dosages because I started back up after a 3-week break, and wow, I couldn't eat for a while. I'm down 95+ pounds and haven't felt actually hungry in months. I *want* food, but I'm not *hungry* for it. Stacking 6mg of Tirz and 5mg of Reta, 3 days apart, is enough. The pounds are melting off, and I can still eat fruits, vegetables, and some protein.
 
I get mixing them for people who've used them separately to balance hunger and side effects. They're similar but not identical. It'll take a while to understand the different effects, maybe impossible if you take them together without trying them individually first. It's common to mix low doses of Reta and Tirz, which I've never understood. Also, I'm confused about everyone saying Reta suppresses appetite less than Tirz. The increased metabolic rate from Reta doesn't seem high enough to explain more weight loss if people were actually eating more.
 
How long do you think you'll be off for surgery, In_The_Making? I've been looking into this topic, but there isn't much solid info. My surgeon said he'd love to prescribe Mounjaro, but he won't because there's no data on how it affects soft tissue or bone growth. Any insights?
 
I tried this! I was doing 2mg of Reta on day one, then 2mg of Tirz on day 4. Reta made me crave sweets and upped my appetite. Now, I do 2mg Reta and maybe a bit of Tirz every other week to curb appetite and control inflammation. Cagri didn't work for me.
 
There are numerous studies about GLP-1 use before surgery and its effects. Results vary, but overall post-op complications are often less likely. Knowing the surgery type helps. Or just Google Scholar search 'glp-1' plus the procedure or 'surgery'.
 
Thanks, Sema_Sister, that's helpful. My wife's doc stopped her Ozempic 2 weeks before and after gallbladder surgery (she takes it for diabetes). I had a compound fracture in my right leg above the ankle in June 2025, didn't bear weight for 16 weeks and now I'm getting more surgery. Tibia shattered, fibula snapped, and nerve damage. Gained a lot of weight! I will look for those articles, thanks!
 
I was on Tirz 15mg, and now I'm on Reta 1mg every three days. I want to add Tirz back because I'm not seeing any effects, positive or negative, on Reta alone. I've been eating a whole bag of chips between injections. Ugh. 😣
 
Haha, you called me out, ZepBoundAndDown! This is my 3rd surgery since starting GLP-1s. I don't have a fancy MD answer. We know what GLP-1s do: help us lose weight, control sugars, and some potentially good side effects. My surgeon's concern is likely the lack of protein, calcium, and other nutrients because of reduced eating while on a GLP-1 and they're worried about soft tissue and bone growth. Research current peer reviewed research about the Tirz, and present a plan of action to avoid any shortcomings.
 
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My ENT and neurosurgeon made me stop Reta two weeks before surgery and told me not to restart it for at least two weeks after. It wasn't needed, though, because I was on a very restricted hospital diet and lost about 8lbs in a week in the ICU. Very restrictive fluid intake!
 
Thanks for the info, In_The_Making! I appreciate the straight talk. I don't want to wait another 3-4 months after the 8 months I've already waited since my accident to start losing weight. Good luck with your shoulders!
 
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