Is 2.5mg/week tirzepatide too low to start? I've seen people running 5mg first dose

Start at 2.5. The people saying "just start at 5" are the same people ending up on the couch for 4 days with GI nausea hell. The titration schedule exists for a reason — tirz has a 5-day half life so even 2.5 accumulates over the first 2 weeks. You will notice appetite reduction at 2.5.

+1 to above. I work with patients on tirz/sema daily. The people who jump to 5mg first dose account for a disproportionate share of "I had to stop, couldn't tolerate it." Slow is fast here.

@slow_lose yes, that's literally what the syringe math is for. If you reconstitute a 10mg vial with 2mL bac water, that's 5mg/mL. 5 units on a U-100 syringe = 0.05mL = 0.25mg. Units on the syringe = mg with predictable math once you set your concentration.

Ran 2.5 for 6 weeks before moving to 5. No drama, appetite dropped week 2. Your A1c is gonna love you.

@microdose_glp1 wait so you can split a 2.5 dose? how do you know you're getting the right amount

You can even go slower than 2.5 if you're sensitive — I did 1mg for the first two weeks, then 2.5. some people microdose tirz long term at 1.25-1.75. Works.

Also — don't skip the "boring" stuff. hydration, protein at 0.8-1g per lb bodyweight, electrolytes (especially sodium) first 2 weeks. The nausea people blame on tirz is often just dehydration + low sodium.

^^^ this. I had zero nausea on tirz and I credit electrolytes + eating slowly.

The name checks out for me — tirz made me stop eating without realizing it. Set alarms to eat protein. Muscle loss on these drugs is real if you're not paying attention.

thanks everyone. starting 2.5 this weekend. will probably repost in a few weeks.

Just noting for the record that "2.5mg does nothing" is a thing people say who don't keep a food log. The pharmacokinetics do not lie — you have drug in your system at 2.5. If "nothing happens" it's because you weren't tracking.

^ second on reta for the future. tirz is the right first-timer choice though, learn the routine first.

If you're considering other options long-term, reta has a cleaner side-effect profile for a lot of people at comparable fat loss. But tirz is totally fine to start, well-characterized, and the research supply is better.

Update week 3 on 2.5: down 6lb, appetite definitely reduced, mild nausea day after dose which goes away by day 2. electrolytes helped a lot. Going to do one more week at 2.5 and then titrate to 5.

@slow_lose great start. Tip: when you bump to 5, don't be surprised if the appetite effect feels "same" for a week — that's normal because the accumulation is what matters not the step. Let 5 run 4 weeks before deciding whether you need 7.5.

Love to see it. Get a DEXA around month 3-4, you want to confirm you're losing fat not muscle.

Update week 8: on 5mg for 3 weeks now, total loss 14lb. No issues. Eating more protein than I ever have. Thanks to everyone in this thread.

^ hi yes DEXA gang checking in. Book it.

Reading this thread a month after posting my own tirz question — this is the template. Thank you OP for updating.