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c/tirzepatide·posted 5 months ago by u/certified_reference

[Question] dual agonist — what am I missing here

Question

The title is the whole question — dual agonist — what am I missing here — but here is why I am asking.

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.

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.

On comparing yourself with the trial number.

SURMOUNT-1 reported roughly 21% mean body weight change at 72 weeks on the highest arm. Three things get dropped every time that figure is quoted here. It is a mean, and the distribution around it is very wide. It is 72 weeks, which is a year and a half. And it is a trial population with trial support, which is not the same as a person with a spreadsheet.

Use it as a rough shape, not a benchmark. A 12% year is inside the ordinary range and people quit over it every week on this board.

Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.

407 up / 456 down47% upvoted14 commentsid 1r95qn4 Feb 2026

14 comments

14 in this archive, depth 4

best — the order this archive was captured in

u/customs_seizure_sid13 points·5 months 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/quiet_moderatorMOD8 points·5 months 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/hugo_bergstrom3 points·5 months ago

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

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u/spain_receta3 points·5 months ago·edited

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/emil_barros3 points·5 months 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/thyroid_tangent9 points·5 months ago

Did you come to this from sema, and if so how long was the gap?

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u/signe_villalobos3 points·5 months ago·edited

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/sten_bhattacharya2 points·5 months 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/vito_chowdhury2 points·5 months ago

Week 93 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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u/sten_palacios5 points·5 months 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/priya_guerrero1 point·5 months 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/ahmed_fonseca6 points·5 months ago

Does nausea follow the day after the shot, or is it spread across the week?

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u/certified_referenceOPQC3 points·5 months ago·edited

a lot of people plateau nicely at 10mg and never need 15

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[deleted]1 point·5 months ago

[deleted]

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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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