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c/tirzepatide·posted 1 months ago by u/adnan_nascimento

dual agonist — my 18-week log, condensed into one table

Side Effects Clean Column ×4 Well Actually ×3

Something I keep coming back to: dual agonist — my 18-week log, condensed into one table.

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.

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.

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.

Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.

2,164 up / 225 down91% upvoted49 commentsid qmfw3p22 Jun 2026

49 comments

17 in this archive, depth 4

best — the order this archive was captured in

u/sanne_novak171 points·1 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/bastian_eriksen128 points·1 months 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/signe_villalobos59 points·1 months ago

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

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u/forest_plot_fionastats65 points·1 months 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/mikkel_kimani59 points·1 months 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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u/ewan_marchand14 points·1 months ago

The distribution matters more than the mean.

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

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u/zeynep_zielinski9 points·1 months 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/fatima_wojcik-9 points·1 months ago·edited

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

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u/zeynep_ndiaye0 points·1 months ago

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

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

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u/laila_yilmaz45 points·1 months ago

week 4 is early to draw any conclusion at all

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u/marit_sandvik22 points·1 months 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/search_before_post10 points·1 months ago·edited

Appetite effect for me is flat across seven days.

marit_sandvik 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/ewan_marchand8 points·1 months ago

The 21% figure is a 72-week mean on the highest arm. Quoting it as what someone should expect by week 27 is not a fair reading.

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u/b12_baseline0 points·1 months ago

Correction to my own post above — I said 15mg and I have been on 2.5mg since the spring. Same argument, wrong number.

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u/sofia_nascimento4 points·1 months ago

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

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u/sten_palacios18 points·1 months 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/adnan_nascimentoOP8 points·1 months ago

Which week did the appetite change actually land for you?

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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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