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c/tirzepatide·posted 10 days ago by u/kaia_cabrera

[Discussion] "tirz is stronger than sema" needs a comparator dose or it means nothing

Discussion Receipts ×4 Slow Clap ×2

"tirz is stronger than sema" needs a comparator dose or it means nothing. Making the case below, and I expect to lose some of it in the comments.

Came off sema and onto tirz with a two-week gap. The first month was flat and I assumed I had made a mistake. Month two it moved.

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

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.

Happy to answer the boring questions. Those are usually the ones worth asking.

1,111 up / 210 down84% upvoted60 commentsid 1pg1ko20 Jul 2026

60 comments

20 in this archive, depth 4

best — the order this archive was captured in

u/dexa_twice_yearlyMOD68 points·9 days 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/slow_logbook_ftw45 points·9 days ago

the appetite effect is blunter than sema, in a good way, most weeks

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u/kaia_cabreraOP-37 points·9 days ago

Have you held a step for longer than the four-week minimum at any point?

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u/kaia_cabrera56 points·9 days ago

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

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u/mikkel_ogunleye25 points·9 days ago

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

kaia_cabrera is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.

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[removed]17 points·9 days ago

[removed by moderator]

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u/vito_chowdhury64 points·8 days ago

Research-use-only material is not approved for human use. Anything in this thread about how a research vial "should" titrate is a discussion about chemistry, not a plan.

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u/fatima_wojcik40 points·8 days ago·edited

Research-use-only material is not approved for human use.

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/aksel_kjaer13 points·8 days ago

dual agonist, so the GIP arm is doing something the sema threads will not tell you about

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u/laila_yilmaz5 points·8 days ago

switching from sema is not a dose conversion, there is no clean equivalence

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u/graph_it_gary43 points·8 days ago·edited

What step are you on and how long have you been there?

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u/mikkel_ogunleye15 points·8 days ago

if 7.5 is working, 10 is not automatically better

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u/tidy_vialdrawer_pls10 points·8 days 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/slow_logbook_ftw34 points·8 days ago

hold the dose that works, the ladder is not a leaderboard

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u/titration_marshalmod · c/semaglutide20 points·10 days ago·edited

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/kaia_cabreraOP14 points·9 days ago

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

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u/search_before_post13 points·10 days ago

The step schedule question, answered properly, because it comes up weekly.

The label sets a minimum interval of four weeks between increases. That is a floor on how fast you may go, and it exists because tolerability, not efficacy, is what limits most people. There is nothing in the pharmacology that says you must increase at four weeks, or at eight, or ever.

What decides it in practice is whether the effect you want is still there. If appetite is quiet and the trend is going the right way, the dose is doing its job. If both have genuinely gone flat for six weeks or more, that is a conversation worth having with someone who knows your history.

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u/line_petrov0 points·8 days ago

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

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u/blunt_coldbox291 point·8 days ago

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.

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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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