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

[Discussion] we are measuring GIP at the wrong time and calling it noise

Discussion Clean Column ×9 Sourced ×2 Slow Clap ×1

Posting this as a discussion rather than a claim: we are measuring GIP at the wrong time and calling it noise.

16kg over 37 weeks, never went past 10mg, and constipation 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.

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.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

15,573 up / 5,309 down75% upvoted56 commentsid 14u6lf24 Sep 2023

56 comments

16 in this archive, depth 4

best — the order this archive was captured in

u/elin_ferrari938 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/customs_seizure_sid-17 points·2 years ago

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

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u/mikkel_ogunleye1 point·2 years ago

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

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u/two_mil_or_one1 point·2 years ago

Week 94 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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u/nz_unfunded644 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 62 is not a fair reading.

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u/hub_opssite staff453 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/zeynep_ndiaye377 points·2 years ago

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

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u/b12_baseline284 points·2 years ago

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

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u/nabila_ogunleye174 points·2 years ago

That percentage is body weight change, not body fat.

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

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u/hair_shed_hannah48 points·2 years ago

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

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u/taper_off_tabitha303 points·2 years ago

This matches mine. Milder injection-site soreness than I expected, and what there was settled inside a fortnight of each step.

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u/teodor_szabo89 points·2 years ago

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

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u/ghrp_history22 points·2 years ago

zepbound and mounjaro are the same compound with different labels

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u/kian_ekstrom208 points·2 years ago

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.

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u/samir_falk135 points·2 years 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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u/swirl_dont_shakereconstitution109 points·2 years ago

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

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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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