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

my ApoB moved and I cannot work out whether SURPASS is why

Discussion Slow Clap ×4 Sourced ×3 Well Actually ×2

my ApoB moved and I cannot work out whether SURPASS is why. Change my mind, genuinely — I have no stake in being right about this.

Switching from semaglutide, since three people asked in this thread alone.

There is no published dose equivalence between the two. The conversion tables that circulate are somebody’s arithmetic, not data. What people report here is that the first month after a switch is often flat, that the appetite effect feels differently shaped rather than simply stronger, and that starting at the bottom of the ladder again is the common approach.

None of that is a recommendation. It is what the threads say, and the threads are not a clinic.

Week 60 was the first time the scale moved after a five-week stall. I changed nothing in that window.

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

Not medical advice, obviously, and nothing here is approved for human use. One person with a spreadsheet.

3,693 up / 585 down86% upvoted50 commentsid 18g7qf24 Jul 2024

50 comments

21 in this archive, depth 4

best — the order this archive was captured in

u/zaid_balogun685 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/amara_halonen0 points·2 years ago

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

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u/noor_hovland515 points·2 years ago

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/mikkel_kimani572 points·2 years ago

week 5 is early to draw any conclusion at all

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u/alcohol_aversionOP992 points·2 years ago·edited

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/dario_vermeulen462 points·2 years ago

hold the dose that works, the ladder is not a leaderboard

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u/dexa_twice_yearlyMOD328 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/certified_referenceQC250 points·2 years 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/georgi_chowdhury107 points·2 years ago

sulphur burps are the signature complaint and they are not dangerous

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u/zeynep_zielinski100 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 40 is not a fair reading.

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u/matias_salgado25 points·2 years ago·edited

Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.

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u/two_mil_or_one19 points·2 years ago

if 7.5 is working, 10 is not automatically better

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u/certified_referenceQC49 points·2 years ago

Agree. The GIP component is the interesting half and it barely gets discussed outside c/glp1science.

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u/hub_opssite staff175 points·2 years 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/coring_the_stopper146 points·2 years ago

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

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u/hair_shed_hannah109 points·2 years ago

Yes. I stepped to 12.5 because the calendar said so, not because anything needed fixing, and I regretted it for a fortnight.

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u/slow_logbook_ftw71 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/alcohol_aversionOP47 points·2 years ago

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

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u/yusuf_ramos56 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/quiet_moderatormod135 points·2 years ago

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

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u/samir_falk40 points·2 years ago

Correction to my own post above — I said 10mg and I have been on 5mg since the spring. Same argument, wrong number.

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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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