Giant Semaglutide Thread (and other GLP-1 / GIP agonists)

[Doodle]

Wanted to create a thread where everyone can post their experiences with different sourced Semaglutide.

Who are you using?
Pharma vs non?
Dosage?
How long have you been taking it?
What are your thoughts?
Have you lost weight?
Side effects?
Oral vs injection?
Tests?

 

[fit2beking]

I'm honestly surprised how easy it was to get prescribed and prior auth submitted via teledocs. I simply said i was obese with high lipids and the provider prescribed and submitted my p.a. No verification or labwork was needed at all. You could be underweight and they'd still prescribe it...

I'm planning to finish up my UGL Reta, will keep escalating reta till ~25mg then probably switch over to Tirz 15mg US Pharma. I've been upgrading most of my stuff from India/CN PCT -> US Pharma. If i knew it was so easy, i would have done it much sooner lol.

Mind sharing which service you used?

 

[Ghoul]

Mind sharing which service you used?

Just FYI, you qualify for a prescription of your BMI is 30 (@6' 221lb) or 27 (@6' 199lb) if you have one other condition (Blood pressure >130/80, high cholesterol, sleep apnea, heart disease, pre-diabetes, Non-alcoholic fatty liver) and can get it from your regular doctor. You can see those weights aren't particularly high.

If you don't qualify based on the above, you can just lie about your weight via telemedicine.

The rest is dependant on your insurance. If your insurance doesn't cover it I think it's down to $499/mo for Zepbound for cash payers now.

You can check insurance coverage with this tool from Ro.

Ro GLP-1 Insurance Checker Signup

Sign up for the GLP-1 Insurance Checker to understand your insurance coverage for drugs like Ozempic, Wegovy, and Zepbound.

ro.co

 

[nullandvoid]

I am up to 12.5mg of UGL Tirz. Always a nontrivial amount of overfill it seems, so may be closer to 15mg. It's interesting to see an almost linear response. As body fat decreases at a certain dose, I get to a point where appetite suppression fades and have to increase Tirz. It's been stated many times; I just think it's an interesting mechanism and not "desensitization" as I would have deduced otherwise. I can't really go by impedance scanners now, so I gauge it by vascularity on thighs and stomach. My estimate is I will top out at around 15mg UGL at around the 6-8% range.

 

[SubparMarioBro]

Just FYI, you qualify for a prescription of your BMI is 30 (@6' 221lb) or 27 (@6' 199lb) if you have one other condition (Blood pressure >130/80, high cholesterol, sleep apnea, heart disease, pre-diabetes, Non-alcoholic fatty liver) and can get it from your regular doctor. You can see those weights aren't particularly high.

If you don't qualify based on the above, you can just lie about your weight via telemedicine.

The rest is dependant on your insurance. If your insurance doesn't cover it I think it's down to $499/mo for Zepbound for cash payers now.

You can check insurance coverage with this tool from Ro.

Ro GLP-1 Insurance Checker Signup

Sign up for the GLP-1 Insurance Checker to understand your insurance coverage for drugs like Ozempic, Wegovy, and Zepbound.

ro.co

Not sure if I could’ve gotten my insurance to cover. Possibly, but the plan is very much set up to not cover GLP-1s.

Either way, I think that being told it wouldn’t be covered and being pushed into this world led to me learning a lot and getting much better results than I would have if my doctor had just prescribed Wegovy.

 

[Iksrohcic1]

1 month on Reta dosing 2, 4, 4, 6 currently. Went from 255lb to 237 lb at 6’4. Currently on 175mg weekly of test. 18 lbs in one month unheard of or what? I’m eating 3 meals a day still and working out 5-6 days/week.

 

[Ghoul]

1 month on Reta dosing 2, 4, 4, 6 currently. Went from 255lb to 237 lb at 6’4. Currently on 175mg weekly of test. 18 lbs in one month unheard of or what? I’m eating 3 meals a day still and working out 5-6 days/week.

A little above average, but you titrated up fast (and actually exercise unlike the typical user). Average loss after 4 weeks on Tirz starting dose (2.5mg) is 5%. So 13lbs.

 

[TheBeast1]

Before I lose track where im at in the thread, Iv been experiencing orthostatic hypotension for months and mostly just ignored it/blamed it on the deficit, but its progressively gotten worse so I started looking around here and see you have gotten the same from reta. Hearing that it kind of clicked that I started getting it around the time I started increasing above 2mg of reta.

My question is did increasing daily salt intake make symptoms disappear? Or have you discontinued reta and symptoms resolved themselves?

Hey bud sorry I missed your reply.
Yes, supplementing salt 100% fixed the problem.

I take salt, magnesium, and potassium before bed as well. I haven't noticed a change in blood pressure and more importantly the black outs stopped.

Just get some salt tablets on Amazon. 1g will do

 

[Gatman]

I started taking prescription tirzeparide in January…continuing until may of this year….plateaud at a weight loss of 15 pounds…started ugl Reta 12mg in August

I feel like I’m the man in the movie “thinner” now

 

[SnowyMiami]

Given what I recently learned about Glucagon agonism's links to cardiac remodeling (hypertrophy, fibrosis, collagen), and the fact there's a pile of drugs involving glucagon that were killed in development because of this, I'm not comfortable suggesting it be combined with anything. If Reta proves to be the safe exception to all the others, which included dual (Glucagon/GLP) and triple (Glucagon/GLP/Tirz) drugs, then it's specific balance between the three agonists is likely key to that long term safety,

I don't think it's even safe to assume there's a good sized dose "safety margin" above 12mg like there is with old GLPs.

Tirz and Sema don't have this problem. In fact they protect the heart against harmful remodeling, and can even reverse it in some cases.

IMO, if you're looking for strong appetite suppression, switch to Sema. For slow/non responders, Sema is safe all the way up to 7.2mg per Novo Nordisk's extended trials for larger doses than the original limit of 2.4mg, By 7.2mg there were NO non-responders. Everyone lost substantial amounts of weight (of course most people don't even need 2.4mg to get to their goal weight, but we're talking about the small genetic subset of those who don't respond strongly to GLP class drugs).

Thats a little scary considering everyone gets the resting heart rate increase with reta.

 

[Ghoul]

Thats a little scary considering everyone gets the resting heart rate increase with reta.

Yeah that's part of the recipe of cardiac danger signals to me.

I had been troubleshooting some minor "reactive hypoglycemia" that kept setting off my continuous glucose monitor alarm. (I've been on a Tirz maintenance dose for over a year).

Any high glycemic index meal that caused a spike in glucose resulted in a rapid crash into low blood sugar that took longer than it should to recover, leaving me with brain fog and fatigue for ~90 minutes, when it should be closer to 30.

TLDR, the instant crash is the result of excellent insulin sensitivity and Tirz's boosting of insulin release, causing an "overcorrection" in response to a blood sugar spike. That's mostly a positive thing, and also seen with highly trained athletes too.

The issue is that what should happen in response is the liver releases glucose to restore normal blood levels. When Alpha cells in the pancreas detect low blood sugar they release Glucagon, which is the signal that triggers the liver to release sugar, so you recover from hypoglycemia.

Sema and Tirz suppress Glucagon release, so the liver responds to low blood sugar more slowly.

Reta continuously stimulates glucagon receptors in the liver. It also enhances Alpha cell glucagon release. This means blood sugar is continuously higher (not desirable when using rHGH or with pre-diabetes), and because the liver is "primed" by Reta to release glucose, the post high glycemic meal sugar crash is recovered from much faster. Reta's overall effect is to effectively neutralize GLP induced Glucagon suppression, or even enhance it (for a faster than natural recovery from low blood sugar).

Anyway, Reta's end result from constantly stimulating the liver to release glucose is higher baseline calorie burn, much less of the fatigue that people sometimes experience on Sema or Tirz (though that can be avoided via food choices), possibly INCREASED overall energy (from glucose being continuously dumped into blood by glucagon stimulation of the liver) but also more cardiac stress, along with the "permissive" harmful cardiac remodeling factors we discussed. If anything adds to the stress on the heart (like heavy workouts), the likelihood of heart damage becomes higher than it would without Reta.

These effects are most pronounced at higher Reta doses. At 4mg or below, the glucagon activity is so weak Reta is more like Tirz, with most of the effects coming from GLP/GIP.

One other note on Reta. Because the liver uses amino acids to synthesize glucose, and it's doing so continuously with Reta, in a calorie deficit the risk of muscle catabolism is higher than it is with Sema/Tirz. So increased protein intake on Reta is even more important than usual to prevent potential lean mass loss in a deficit.

 

[The Answ3r]

Mini update after week one on Reta, switched over from Tirz 15 mg, with the last two weeks before starting Reta being 10 mg. Started low at 2 mg, and honestly, no sensitive skin, no fatigue, none of that “Tirz tired” feeling. Hitting 350g carbs is suddenly way easier, and it’s like my brain’s got a built-in switch, once I hit my macros, it’s like “yep, we’re done here.”

Energy-wise, nothing crazy to report, but I feel fantastic overall. Plan is to stay at 2 mg for the next three weeks, then bump the dose every month until I hit 6 or maybe 8 mg. So far, so good.

 

[Infernalmango]

Hey bud sorry I missed your reply.
Yes, supplementing salt 100% fixed the problem.

I take salt, magnesium, and potassium before bed as well. I haven't noticed a change in blood pressure and more importantly the black outs stopped.

Just get some salt tablets on Amazon. 1g will do

All good brother, I got sodium, potassium, and magnesium powders from bulk supps and since adding those in twice a day my symptoms have started disappearing for sure. I also skipped my weekly reta shot, along with most everything else besides test and bpc/tb. Was not feeling good at all for a second lol. Thanks for getting back to me! Was considering restarting the reta but lower like 2mg. I was up to 8mg a week and the symptoms really kicked in hard at that point. Glad to get some reassurance it was most likely electrolytes related.

 

[Gatman]

Mini update after week one on Reta, switched over from Tirz 15 mg, with the last two weeks before starting Reta being 10 mg. Started low at 2 mg, and honestly, no sensitive skin, no fatigue, none of that “Tirz tired” feeling. Hitting 350g carbs is suddenly way easier, and it’s like my brain’s got a built-in switch, once I hit my macros, it’s like “yep, we’re done here.”

Energy-wise, nothing crazy to report, but I feel fantastic overall. Plan is to stay at 2 mg for the next three weeks, then bump the dose every month until I hit 6 or maybe 8 mg. So far, so good.

What I have noticed on Reta in my case…..if I eat a meal of chicken breast ,eggs.. or all protein around 7pm at night the next day I can eat my normal 4 eggs with egg whites at around 630am

But if I eat a higher carb meal the night before …it’s impossible for me to eat in the a.m.

 

[Photon]

Mini update after week one on Reta, switched over from Tirz 15 mg, with the last two weeks before starting Reta being 10 mg. Started low at 2 mg, and honestly, no sensitive skin, no fatigue, none of that “Tirz tired” feeling.

I'm planning to do the opposite lol.
Reta -> US Pharma Tirz.
Just need to finish up my Reta vials first.

I only just got it approved so it'll take awhile to get my prescription to 15mg.

 

[Ghoul]

I'm planning to do the opposite lol.
Reta -> US Pharma Tirz.
Just need to finish up my Reta vials first.

I only just got it approved so it'll take awhile to get my prescription to 15mg.

You could start collecting pens now for a little stockpile. Usually the titration is one box of four pens per dose. So you've got 6 months to hit 15. Since you're already using a GLP, 2.5mg may not do anything at all. Even 5mg.

Once you get to 15mg, ask for an 84 day (3 month) prescription). Then it's a $25 copay for 3 boxes with the Eli Lilly discount card.

 

[Earthworm Jim]

Two weeks on tirz and it gives me such lethargy. Was not expecting that coming from reta which felt stimulating. I don't like this lol. But the weight keeps dropping.

 

[Ghoul]

Two weeks on tirz and it gives me such lethargy. Was not expecting that coming from reta which felt stimulating. I don't like this lol. But the weight keeps dropping.

If you get a CGM, wear it for a week or two, you'll be able to see exactly which foods are triggering the reactive hypoglycemia (low blood sugar) causing the lethargy and work around it.

 

[TheBeast1]

All good brother, I got sodium, potassium, and magnesium powders from bulk supps and since adding those in twice a day my symptoms have started disappearing for sure. I also skipped my weekly reta shot, along with most everything else besides test and bpc/tb. Was not feeling good at all for a second lol. Thanks for getting back to me! Was considering restarting the reta but lower like 2mg. I was up to 8mg a week and the symptoms really kicked in hard at that point. Glad to get some reassurance it was most likely electrolytes related.

I was doing 10mg a week during heavy maitanance and that electrolyte combo was managing it perfectly. But yeah you should be fine continuing to do that. The reddit subs discussing reta mention this as a side effect so I'm glad upping the salts was the solution.

I'm down to 2 mg a week now on a bulk to keep me from getting too happy and still taking it which I've noticed is definitely helping. I'll be keeping up with it.

 

[keengkong]

I've attached prescribing information for mazdutide. I attached two documents because one is for diabetes; the other is for obesity. I'll offer the disclaimers advising you of things that you likely already know or suspect: (1) Maz has not been approved in the US; (2) It has been approved in China; (3) I'm submitting translated versions of the prescribing information to you; (4) I don't speak Chinese; (5) I used ChatGPT in order to translate the prescribing information; and (6) while AI can do many things great, when it gets things wrong, it usually sounds like it is right.

Considering that Eli Lilly hasn't decided to move on to its own stage three trials of mazdutide (as opposed to Lilly's licensed partner in China, which conducted such trials and got it approved there), I estimate that there is at most a 50 percent change that mazdutide will ever be approved for the US market considering that Eli Lilly would probably like to focus on its other weight loss drugs.

 

[Earthworm Jim]

If you get a CGM, wear it for a week or two, you'll be able to see exactly which foods are triggering the reactive hypoglycemia (low blood sugar) causing the lethargy and work around it.

Thank you. Didn't know it was hypoglycemia