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what changed for me between month 6 and month 14

Lab Long Haul ×9 Slow Clap ×2 Clean Column ×2

what changed for me between month 6 and month 14. Searched first, found three threads that contradict each other, hence the post.

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

24kg over 93 weeks, never went past 10mg, and fatigue stayed mild the whole way. Posting because the loud threads are all 15mg.

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.

Would rather be corrected in public than confident in private.

12,124 up / 307 down98% upvoted63 commentsid tf07503 Nov 2024

63 comments

30 in this archive, depth 6

best — the order this archive was captured in

u/incretin_ivypharmacology1.6k points·1 year 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/ignacio_vanhecke551 points·1 year ago

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

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u/kaia_cabrera384 points·1 year ago

Correction to my own post above — I said 5mg and I have been on 5mg since the spring. Same argument, wrong number.

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[removed]218 points·1 year ago

[removed by moderator]

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u/coring_the_stopper1.6k points·1 year ago

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.

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u/nz_unfunded820 points·1 year ago

Are you comparing yourself with the trial mean or with the people who post the most?

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u/nabila_ogunleye-14 points·1 year ago

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

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u/kofi_balogun1 point·1 year ago

Pen or vial? The step sizes available differ and it changes this answer.

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u/thyroid_tangent1 point·1 year ago·edited

Pen or vial?

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/rania_diallo1 point·1 year ago·edited

This.

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

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u/rania_marchand-20 points·1 year 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/emil_barros1 point·1 year ago

Came off sema and onto tirz with a two-week gap.

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

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u/ferritin_low1 point·1 year ago

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

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u/adnan_nascimento1 point·1 year ago·edited

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/throwaway_wl2026343 points·1 year ago

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

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u/line_petrov147 points·1 year ago

Right.

Agreed, with one qualifier: that is the mean of the top arm and the spread around it was enormous.

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u/search_before_post399 points·1 year ago

zepbound and mounjaro are the same compound with different labels

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u/tove_vasquez1.1k points·1 year ago

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

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u/customs_seizure_sidOP600 points·1 year ago

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

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u/zeynep_ndiaye0 points·1 year ago

Agree. The GIP component is the interesting half and it barely gets discussed outside c/glp1science.

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u/rania_diallo617 points·1 year 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/titration_marshalMOD505 points·1 year ago

Trial identifiers corrected in the title. SURMOUNT and SURPASS are different programmes.

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u/customs_seizure_sidOP397 points·1 year ago

SURMOUNT-1 landed around 21% at 72 weeks on the top arm

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u/sten_bhattacharya320 points·1 year 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/crosspost_bot_no118 points·1 year 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/ahmed_fonseca140 points·1 year 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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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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