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c/tirzepatide·posted 26 days ago by u/dario_vermeulen

my resting HR went from 58 to 66 on titration and settled back

Question Receipts ×8

my resting HR went from 58 to 66 on titration and settled back. Not a hot take, just something I have not seen said plainly here.

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

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.

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.

That is everything I have. The rest is opinion and I have tried to keep it out.

544 up / 128 down81% upvoted17 commentsid oyf4fw4 Jul 2026

17 comments

17 in this archive, depth 5

best — the order this archive was captured in

u/marta_dziedzic38 points·24 days 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/kaia_wojcik16 points·24 days ago

Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.

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u/dario_vermeulenOP9 points·23 days ago·edited

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

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u/zeynep_zielinski6 points·23 days ago

Week 65 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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u/sanne_novak11 points·23 days ago

Correction to my own post above — I said 10mg and I have been on 15mg since the spring. Same argument, wrong number.

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u/hugo_bergstrom22 points·24 days ago

Right. And the sema-to-tirz "conversion" people post is invented. There is no published equivalence.

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u/elin_ferrari12 points·24 days ago·edited

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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[removed]8 points·24 days ago

[removed by moderator]

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u/hana_pereira4 points·24 days ago

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

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u/dario_vermeulenOP3 points·24 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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u/curious_panel_only23 points·24 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/yusuf_ramos13 points·25 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/alcohol_aversion11 points·25 days ago

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.

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u/zeynep_ndiaye9 points·25 days ago

That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.

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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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