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c/tirzepatide·posted 2 years ago by u/aksel_kjaer

is it normal to get early fullness at week 69

Titration Well Actually ×9 Sourced ×1 Receipts ×1

Check-in as promised in the title: is it normal to get early fullness at week 69.

Switching from semaglutide, since three people asked in this thread alone.

There is no published dose equivalence between the two. The conversion tables that circulate are somebody’s arithmetic, not data. What people report here is that the first month after a switch is often flat, that the appetite effect feels differently shaped rather than simply stronger, and that starting at the bottom of the ladder again is the common approach.

None of that is a recommendation. It is what the threads say, and the threads are not a clinic.

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

Would rather be corrected in public than confident in private.

6,108 up / 1,898 down76% upvoted54 commentsid 1684lv18 Aug 2023

54 comments

30 in this archive, depth 6

best — the order this archive was captured in

u/matias_salgado383 points·2 years ago

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

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u/tarek_lokken87 points·2 years ago

Not sure that follows. You went up a step and changed your training in the same fortnight.

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u/aksel_kjaerOP52 points·2 years ago

Not sure that follows.

This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.

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u/quiet_moderatorMOD218 points·2 years ago

Removed the conversion table. There is no published equivalence between the two molecules and posting one as fact is exactly the kind of thing that gets copied for years.

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u/throwaway_wl2026100 points·2 years ago

sulphur burps are the signature complaint and they are not dangerous

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u/incretin_ivypharmacology498 points·2 years ago·edited

Agreed, and the trial number is a mean of a very wide distribution — the tails are enormous and nobody posts from the middle.

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u/certified_referenceQC252 points·2 years ago

I would separate the two claims. That the GIP arm exists is uncontroversial; that it explains your reflux pattern is a guess.

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u/nordic_pricing123 points·2 years ago

Push back: "gentler than sema" is a population statement. Plenty of people on this board have the opposite experience and they are not doing it wrong.

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u/piotr_nascimento214 points·2 years ago

Held 7.5 for five months. Everyone kept asking when I was going to 10. The answer was never, because 7.5 was working.

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u/adnan_nascimento176 points·2 years ago

Same experience with the appetite effect being flatter across the week rather than front-loaded.

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u/zeynep_zielinski140 points·2 years ago

if 7.5 is working, 10 is not automatically better

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u/cato_girard84 points·2 years ago

7kg over 17 weeks, never went past 10mg, and injection-site soreness stayed mild the whole way. Posting because the loud threads are all 15mg.

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[deleted]38 points·2 years ago

[deleted]

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u/slow_logbook_ftw18 points·2 years ago

Careful with "everyone tolerates it better". The people it did not suit stop posting, which makes this board look calmer than the drug is.

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u/zaid_balogun56 points·2 years ago

The 21% figure is a 72-week mean on the highest arm. Quoting it as what someone should expect by week 65 is not a fair reading.

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u/hub_opssite staff37 points·2 years ago

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.

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u/tidy_vialdrawer_pls108 points·2 years ago

Cosigning the four-week thing. It is a minimum interval, and treating it as a schedule to keep up with is how people end up miserable at 12.5.

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u/ignacio_vanhecke-19 points·2 years ago

the four-week step schedule is the label, not folklore

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u/rania_marchand110 points·2 years ago

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

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u/tidy_vialdrawer_pls92 points·2 years ago

Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state. Judging a new step at day five is judging noise.

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u/yusuf_ramos58 points·2 years ago

Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state.

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

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u/aksel_kjaerOP33 points·2 years ago

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

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u/discount_math_dm9 points·2 years ago

week 9 is early to draw any conclusion at all

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u/aksel_kjaerOP71 points·2 years ago

Weekly dosing again, half-life in the same neighbourhood as sema, so a step change takes about a month to reach steady state.

Saving this one. It is the clearest statement of the stall problem I have read here.

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u/cato_girard99 points·2 years ago·edited

Vials and pens carry the same molecule; what differs is fill volume, device tolerance and whether you are doing your own arithmetic. Neither is inherently more accurate.

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u/cormac_pereira123 points·2 years ago

pens and vials are the same molecule, the price is the difference

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u/aurel_lindqvist69 points·2 years ago

The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.

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u/hub_opssite staff21 points·2 years ago

2.5 is the starter dose and it is not meant to be the dose that works

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u/throwaway_titration82 points·2 years ago

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

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u/spain_receta32 points·2 years ago

Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.

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About c/tirzepatide

Tirzepatide-specific discussion: the dual-agonist pharmacology, the 2.5 → 15mg ladder, the appetite profile people describe as different from semaglutide, and the SURMOUNT/SURPASS trial programme. Comparisons with semaglutide are welcome as long as they are specific about dose equivalence being unknown.

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