5mg -> 10mg -> 15mg on tirze — how long at each step, who held where

Held at 7.5 for 11 months. Lost 48lb. Side effect profile at 7.5 is the best risk/reward in my experience — the appetite suppression is real but the GI stuff is manageable. Pushing higher gave me nausea that wasn't worth the extra loss rate.

Made it to 15. Had to. 7.5 and 10 were fine for the first few months but loss flattened hard around month 7. 12.5 added a small push. 15 is where the food noise finally shuts up completely. I'm 5'11" 225lb trying to get under 200 for the first time in 15 years. For some body types you need the top dose.

Sema 2.4 felt like my stomach was 30% smaller all the time. Tirze 10 feels different — less 'stomach is full,' more 'I just don't think about food.' The GIP component seems to be doing cognitive/appetitive work that GLP-1 alone doesn't do. Anyone else feel this?

@sema_saturday yes — that matches my experience exactly. Sema was 'I'm full after 2 bites.' Tirze is 'I forgot to eat lunch.' Qualitatively different mechanism hitting.

Important nuance: tirze has a 5-day half life and the 'peak' effect day is more spread out than sema's 2-4 day window. Titration tolerability is actually easier on tirze because the drug level plateau is smoother across the week.

Pro tip — when you step up on tirze, the nausea window is actually days 3-5 post first higher dose, not days 1-2. Plan the step-up injection for early in the week if you have a weekend obligation. Opposite of what people expect.

People who need 15: typically higher start weight (>280lb), older (>50), or with significant insulin resistance. The GIP component is doing a lot of work on IR specifically, and at max dose you're saturating both receptors. If you don't have that pattern, 10 is usually plenty.

The titration question is really a stopping-rule question in disguise. 'Should I go to 15?' = 'Is my current loss rate achieving my goal within my timeline?' If yes, don't. If no, and side effects are tolerable, yes. Stop asking 'which dose is best' and start asking 'which dose closes the gap to my goal.'

Held at 5 for my entire run. Lost 34lb over 14 months. Slow and boring but zero side effects at any point. If time isn't your constraint, low and slow on tirze is an extremely clean protocol.

Titrated even slower than label — 6 weeks per step. Hit max 30 weeks in. No nausea at any transition. Felt like cheating to have almost no side effect profile. 'Go slower than you think' is the single best piece of advice on this drug.

Two weeks into 2.5mg. Barely feel anything. Is that normal or should something be happening?

@wanderlite totally normal. 2.5 for most people is subclinical — it's a tolerability stepping stone, not a therapeutic dose. Real movement typically starts at 5.

The dose-response curve on tirze is not linear. 2.5 is near-placebo. 5 is real. 10 is meaningfully more than 5. 15 is incrementally more than 10 for most. Don't evaluate the drug at 2.5.

DEXA at start (2.5), at 5, at 10, at maintenance dose. LBM loss as % of total loss was 18% at 5, 14% at 10, 22% at 15 (last 8 weeks). The 15 jump coincided with my protein intake dropping because appetite got too suppressed. Top dose requires more, not less, food discipline.

@dexa_devotee that's a really clean dataset. The 'more food discipline at higher dose' framing is underrated. Higher dose doesn't mean you eat less and it's fine — it means you have to actively engineer intake because autopilot will underfeed you.

Also worth noting — reverse titration off tirze takes longer than sema in my experience. The 5 day half life plus longer receptor adaptation means coming off 15 is a 4-6 month project if you want to do it right.

SURPASS and SURMOUNT trials showed max weight loss continuing to accrue through week 72 on 15mg. So if you're going to use top dose, plan for 18+ months to see the full benefit. Most stop too early.

This thread is what makes me pay for this forum. Real N-of-many data from people who've actually run it.