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

[Vendor] QST vs WWB on the same compound, same month — both cleared 99.0%

Discussion Clean Column ×6 Sourced ×2 The Quiet One ×1

Filing this under things worth writing down: QST vs WWB on the same compound, same month — both cleared 99.0%.

Figures up front so nobody has to dig: 99.0%.

Went 10 to 12.5 on the calendar and had the worst fortnight of the whole run. Dropped back to 10 and everything settled.

41kg over 86 weeks, never went past 10mg, and nausea stayed mild the whole way. Posting because the loud threads are all 15mg.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

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61 comments

27 in this archive, depth 5

best — the order this archive was captured in

u/quiet_moderatormod899 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/incretin_ivypharmacology-3 points·2 years 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/taper_off_tabithaOP0 points·2 years ago

2.5mg is a four-week starting dose, not a maintenance dose. Worth being precise since people search these threads.

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u/emil_barros1 point·2 years ago

Does injection-site soreness follow the day after the shot, or is it spread across the week?

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u/gentle_correctionnice about it1 point·2 years ago

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

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u/taper_off_tabithaOP1 point·2 years ago

What is the waist doing? That is usually the number still moving during a scale stall.

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u/endpoint_creep1 point·2 years ago·edited

What is the waist doing?

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

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u/tarek_lokken728 points·2 years ago

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

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u/hugo_bergstrom445 points·2 years ago

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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u/elin_ferrari98 points·2 years ago

week 10 is early to draw any conclusion at all

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u/marta_dziedzic418 points·2 years 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/two_mil_or_one283 points·2 years ago·edited

Week 80 was the first time the scale moved after a five-week stall. I changed nothing in that window.

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u/rania_marchand204 points·2 years 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/piotr_nascimento192 points·2 years ago

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

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u/ghrp_history90 points·2 years ago

Not sure that follows. You went up a step and changed your training in the same fortnight.

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u/taper_off_tabithaOP53 points·2 years ago

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

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[deleted]21 points·2 years ago

[deleted]

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u/certified_referenceQC129 points·2 years ago

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

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u/line_petrov188 points·2 years 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/gustav_vermeulen88 points·2 years ago

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

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u/emil_okwuosa95 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 63 is not a fair reading.

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u/dexa_twice_yearlyMOD34 points·2 years 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/ignacio_vanhecke55 points·2 years 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/amara_halonen19 points·2 years ago

stepping every four weeks is a ceiling on speed, not a schedule you must hit

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u/elin_ferrari16 points·2 years ago

Careful with "everyone tolerates it better". The people it did not suit stop posting, which makes this board look calmer than the drug is.

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u/sanne_novak10 points·2 years ago

Correction to my own post above — I said 12.5mg and I have been on 10mg since the spring. Same argument, wrong number.

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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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