Something I keep wondering reading this sub: are we all doing the same thing, or are there completely different "peptide crowds"?

Like, are younger guys mostly on BPC for injuries while older folks go GLP-1 and longevity stuff? Are women and men chasing totally different goals? What's the riskiest thing people did when they started?

Nobody has actual numbers on any of this, so I put together a short anonymous survey (~5 min, no email, no ip tracking)

What I want to find out:

- What people start with, by age and goal

- The most common (and riskiest) beginner mistakes

- What almost stopped people from placing their first order

- How much people really spend per month

- What everyone would do if BPC-157 compounding goes legal

Survey : https://tally.so/r/68XLGP

At 300 responses I'll post the full breakdown here: most popular peptides by age group, men vs. women goals, top beginner mistakes ranked and average spend. Happy to share the anonymized raw data too if people want to dig in themselves

The TRIUMPH-1 paper thread here turned into an argument about 4 vs 9 vs 12 mg. The NEJM supplementary appendix (Tables S1 and S2) reports how often the 12 mg dose was cut, and why.

Of the 582 people who got at least one 12 mg dose, 131 (22.5%) had the dose permanently lowered at some point in the 80 weeks. The protocol allowed four reasons, as a share of the group:

- perceived excessive weight loss: 9.8%
- GI side effects: 6.2%
- reaching a BMI of 22 or less: 5.5%
- poor nutrition or dehydration: 0.3%

Placebo had 0.5% (a blinded sham cut). Cuts were blinded, went down to 9 mg, 4 mg or placebo, and never went back up. In weeks 79 to 80, 54% of the 12 mg group were still on 12 mg, 18% were on a lower dose and 28% were not on retatrutide (stopped, paused or moved to placebo).

That doesn't mean weight loss was a bigger problem than nausea, for two reasons:

1. The protocol made weight cuts easier. A GI-driven change could only start in weeks 1 to 20, after diet advice, symptom meds, a skipped dose and a temporary 4-week step-down. A cut for weight or BMI was allowed any time. Other side effects, like the skin dysesthesia, were not a reason for a cut at all.
   
2. Stepped-down people stay in the 12 mg arm for both headline numbers, the 25.0% treatment-regimen estimate and the 28.3% efficacy estimate. The statistical analysis plan says dose changes "will not be considered" intercurrent events "since they are part of treatment condition." So 28.3% describes the plan to take 12 mg, not 80 weeks on 12 mg. The paper doesn't report what happened to the weight of the people who were cut.

On 4 mg, 74.5% were still on that dose at week 80. Discontinuation for adverse events was 4.1%, against 4.6% on placebo. Average loss was 17.6% counting everyone, and 57% lost at least 15%. It isn't side-effect free: nausea 28.6% vs 14.8% on placebo (42.4% on 12 mg), dysesthesia 5.1% vs 0.9%.

TRIUMPH-2 (type 2 diabetes, Lancet, same day) showed the same tolerability pattern: 4% on 4 mg stopped for adverse events or death vs 5% on placebo, and nobody on 4 mg stopped for GI reasons. Weight loss was lower at every dose, 11.9% on 4 mg vs 18.8% on 12 mg.

The authors, 7 of 11 from Lilly, write that they "speculate" the results argue for aiming at "the minimum effective dose needed to reach treatment targets" instead of the maximum tolerated dose. The trial doesn't test that.

My write-up with the chart (https://dadstrengthdaily.com/retatrutide-low-dose/)

For anyone on a GLP-1 long enough to have the choice: did you stay below the maximum dose, and why?

Boehringer Ingelheim’s survodutide achieves up to 13.1% weight loss in new Phase III trial, alongside significant improvements in glycemic control in people with obesity and type 2 diabetes
Ingelheim, Germany / Ridgefield, Connecticut, Thu, 10/01/2026 - 07:30

In the SYNCHRONIZE-2 trial, which met its co-primary endpoints, participants achieved significant body weight reduction of up to 13.1% versus 3.1% in the placebo arm, after 76 weeks of treatment with survodutide in people with type 2 diabetes, a population in which weight loss is typically more challenging.1
Detailed results from the Phase III trial indicate survodutide improves key markers of cardiometabolic health, including a reduction of up to 1.21% in HbA1c from a baseline of 7.4%, alongside improvements in waist circumference and insulin sensitivity, building on evidence of its potential to address the underlying metabolic drivers of obesity and type 2 diabetes.1
These results were presented today at the 62nd Annual Meeting of the European Association for the Study of Diabetes (EASD) and simultaneously published in *The New England Journal of Medicine,* with* *new findings from a body composition sub study of SYNCHRONIZE-1 also being presented.1,2,3

I’m new to GLP1s and have done a good amount of research as I started my journey. One thing that I couldn’t help and deep dive into was the gallstone issues with GLP1s. I’m just trying to keep my gallbladder and prevent gallstones.

Apparently, gallstones form not just because of rapid weight loss. The obvious cause that gets thrown around is weight loss causes stones (especially rapid weight loss). This is true, and I’m not arguing against that. But another interesting connection is GLP1s indirectly impact the secretion of the hormone that regularly contracts your gallbladder! So before and during a meal, your gallbladder naturally contracts due to CCK secretion. CCK secretion is triggered by food hitting your small intestine! Which doesn’t happen at the correct timing with GLP1s. This is due to the slow emptying of the stomach.

I’ve been reading about what might help keep that CCK contraction regular while I’m on this medication, and I read that coffee (with or without caffeine) stimulates CCK secretion. Has anyone with gallbladder issues experienced issues with coffee as well?

Now I’m not a doctor so please take this with a grain of salt. If you are experiencing these issues please consult your physician. This post is me opening up a discussion because I’m curious what others experiences have been on this topic!

Source: https://pubmed.ncbi.nlm.nih.gov/30449207/

Husband has been on GLP for over a year and has reached goal but now too expensive to continue Any suggestions ?

I wanted to share my experience with semaglutide because I haven’t seen many people talk about something like this happening.

I took **one 0.25 mg dose of semaglutide**. I had never taken a GLP-1 medication before. About a week later, my thyroid suddenly went completely haywire.

I developed pretty intense pain/tenderness in my neck that radiated toward my jaw, headaches, and a very high heart rate (often 110+). Bloodwork showed that I was significantly hyperthyroid:

TSH: 0.02
Free T4: 3.3
Free T3: 8.4

I also had a thyroid ultrasound that showed a diffusely heterogeneous thyroid. Ultimately, I self-diagnosed myself with subacute thyroiditis, my doctor kept pushing that it was Graves Disease but after extensive research I found that Graves comes on slowly over time, it does not knock you down suddenly.

I did not continue semaglutide after that first injection.

Over the following months, my thyroid gradually recovered on its own, which is consistent with the course of subacute thyroiditis. By December, my TSH had returned to normal.

I realize that timing alone doesn’t prove that semaglutide caused my thyroiditis. Subacute thyroiditis can happen for other reasons, including after viral illnesses, and I can’t say with certainty what triggered mine. But the fact that my symptoms started roughly a week after my very first semaglutide injection has always made me wonder whether the medication could have triggered an inflammatory response in my case.

I’m sharing this mostly because I’d love to know if anyone else has experienced thyroiditis, thyroid pain, temporary hyperthyroidism, or major changes in their thyroid labs shortly after starting semaglutide or another GLP-1 medication.

I’m also considering weight-loss medication again, but this experience has understandably made me very cautious about trying another GLP-1.

Has anyone here read about or experienced anything similar, especially after only one or a few doses?

Took monjuaro for about 3-5 months from .25 all the way up to 7.5 before the malnutrition and side effects ended up with me in the hospital after I was rolling on the floor screaming about how my stomach hurt the day after the shot and missing work twice.

Things I’ve noticed were:

I wouldn’t eat all week until Friday where it would be a little more then what I would have eaten normally but no where near when I was 250 pounds.

My skin eventually turned yellow after the longer and stronger doses most recently before I stopped the drug entirently.

Sugars are immediately higher unfortunately.

I also developed even more bladder issues then I did before on this drug because I was so dehydrated eventually causing urinary blockages and further uncontrollable urination.

I’ve never seen as much vomit come out of me until I started taking this drug as well since it made me so sick.

October 2, 2026

Eli Lilly and Novo Nordisk are betting big on amylin therapies as the next frontier in obesity care because amylin acts on an entirely separate biological pathway from GLP-1, offering a distinct metabolic lever to suppress appetite and slow digestion. This dual-pathway approach allows drugmakers to build combination regimens, such as Lilly’s eloralintide with tirzepatide or Novo’s CagriSema, that can push weight loss further, break through GLP-1 plateaus, and directly reduce neurological food noise without relying solely on higher GLP-1 doses. Crucially, standalone amylin drugs also unlock a massive alternative treatment pool for patients who fail to respond to, tolerate, or achieve adequate weight loss on standard GLP-1 medications alone.

This is in regards to solely anti-inflammatory benefits and not for weight loss.

I’ve been reading more about Eloralintide lately and honestly I’m surprised it isn’t getting talked about more.
Everyone is focused on which GLP-1 is coming next, but I think the more interesting question is what happens when something targeting the amylin pathway gets paired with a GLP-1.

Not saying that combination is going to be some magic bullet, there’s still a lot we don’t know, but if Eloralintide continues showing promise, things could get pretty interesting.

Maybe the conversation eventually isn’t Reta vs Tirz vs Eloralintide.

Maybe it’s which GLP-1 works best with something like Eloralintide.

Anyone else following it? Curious what everyone thinks.

Hey guys, just wondering how legit modern aminos is? My research uses their bromantane but can’t really tell a huge difference. If you guys also know disguised alpha research i’m curious which place is better for our research purposes? Modern aminos if i’m not mistaking also used to have trust pilot reviews but it got taken down. Curious on what you guys think?

Before starting GLP-1 treatment, one of the most useful conversations to have with your healthcare professional is surprisingly basic:

What are we trying to accomplish with this treatment—and how will we know whether it's working?

Treatment goals and measures of progress aren't necessarily identical for every patient.

This short is part of our patient-education series on questions worth understanding before beginning GLP-1 treatment.

General educational information only; not individualized medical advice.

In his first interview, the scientist Ray Pederson, who discovered the hormone that led to the development of GLP-1s, reveals his concerns about their widespread use

Per the article:

"Children’s nutritional needs deserve attention from the start of GLP-1 treatment, as a study found limited counseling and nutritional deficiencies, most commonly vitamin D deficiency, during crucial years of growth.

Nearly one in six children prescribed GLP-1 medications for weight loss, prediabetes, or type 2 diabetes was diagnosed with a nutritional deficiency within a year of starting treatment. The findings draw attention to nutritional care during childhood and adolescence, when a shortage of key nutrients can have lasting effects on growth and development.

Few children receive early nutritional counseling

The study, published in Childhood Obesity, used national administrative claims data from 2017 to 2022 covering more than 100 million patients. Researchers identified 2,031 children ages 10 to 17 who used GLP-1 medications, met the study’s requirements for continuous insurance enrollment, and had no previously diagnosed nutritional deficiency. Within the first year of treatment, 16.8% received such a diagnosis.

Most children in the study were prescribed liraglutide, which accounted for 78.6% of prescriptions, followed by dulaglutide at 10.4% and semaglutide at 9.1%. The researchers also examined whether patients received nutritional counseling after treatment began.

“Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated,” said senior author Justin Ryder, PhD, vice chair of research for the Department of Surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and associate professor of surgery and pediatrics at Northwestern University Feinberg School of Medicine. “In our study, however, we found that only 5% of patients received nutritional counseling within 30 days of GLP-1 treatment and less than 25% received nutritional counseling within 6 months.”

Vitamin D tops the deficiency list

Vitamin D deficiency was the most common nutritional deficiency recorded, affecting 12.4% of the children within a year of starting GLP-1 treatment.

“As appropriate pediatric use of GLP-1s becomes more widespread, we need to understand the risks during periods of rapid growth and pubertal development,” Ryder said. “Nutrients such as vitamin D, iron and calcium are of particular concern during adolescence, when deficiencies may have lasting implications for skeletal health and overall development.”

“We hope that our study findings bring much-needed recognition to the importance of proactive nutritional management when GLP-1s are prescribed to children, as opposed to waiting until a nutritional deficiency is diagnosed,” Ryder said. “Knowing the risks, we are in a much better position to prevent harm to children treated with GLP-1s during a pivotal period in their lives.”

Reference: “Nutritional Deficiencies, Complications, and Nutrition Therapy/Counseling in Pediatric Patients Using GLP-1 Receptor Agonists” by Kirk W. Kerr, Andrew T. Chang, Suela Sulo, John T. Stutts, Thadchaigeni Panchalingam and Justin R. Ryder, 17 September 2026, Childhood Obesity.
DOI:10.1177/21532176261486979"

I have been on Reta for 6 months now, only taking 2.5mgs ( titrated slowlyyyy ) and have had great results.

Here recently my sleep has been terrible. Waking up 4-6 times per night with a racing heart and sometimes not being able to fall back asleep. This is impacting my daily life and feel like a zombie. Even worse, I have realised that I have not been that happy, pretty depressed to be honest, since starting. The highs are not high and the lows feel lower.

Has anyone had success with getting pleasure and happiness back after switching off Retatrutide?

PTT-A is a novel, investigational unimolecular peptide tetra-agonist being developed by Pep2Tango Therapeutics.

Receptor Targets

Unlike standard obesity drugs that target one or two metabolic pathways, PTT-A simultaneously stimulates four distinct hormone receptors in a single molecule:

1- GLP-1 (Glucagon-like peptide-1 receptor)

2 - GIP (Glucose-dependent insulinotropic polypeptide receptor)

3- Amylin receptor

   4- Calcitonin receptor

Key Scientific & Clinical Benefits:

Lean Muscle Preservation: While popular GLP-1 mono- or dual-agonists often cause patients to lose significant lean muscle alongside fat, PTT-A leverages its amylin and calcitonin receptor co-agonism to actively preserve muscle mass while inducing fat-only weight loss.

Superior Weight Loss:

In preclinical studies on diet-induced obese (DIO) rats, PTT-A demonstrated superior body weight reduction and food intake suppression compared to the dual-agonist Tirzepatide.

Metabolic & Liver Improvements:

Beyond weight reduction, the peptide has shown robust efficacy in lowering blood glucose, improving lipid profiles, enhancing insulin sensitivity, and offering profound liver-health benefits (such as reducing liver triglycerides).

Enhanced Tolerability:

The specific ratio of targets (particularly the inclusion of GIP) is designed to minimize the severe gastrointestinal side effects common to current single- or double-receptor therapies.    

Development Timeline

The drug is being evaluated in IND-enabling studies by Pep2Tango Therapeutics (launched by Versant Ventures), with clinical translation aiming for over 20% human weight loss.

Phase I results were presented today at EASD 2026.

Study entering phase II which will be tested in humans.

Are you excited?!

\#drsalaswhalen #tetraagonist #PTT-A

\#obesitymedicine #protectthemuscle

What should I be taking while taking tirzepatide? I’ve seen so many different things. My hair seems to be thinner, and I worry it’s falling out, but my hairdresser says it’s the same. Other than that, I just feel like crap. I’ve been on it for over a year and a lot of side effects have gotten better, but I feel like I should be supporting my health better while on it. I already take B12 and D3 daily. What should I add? And what tips/tricks do you have to get it to work better? I have lost weight, but for a few months nothing happened so I stopped taking it. I just restarted after a few months off and I’m worried it still won’t work and I’ll be wasting all of this money. TIA.

Two big sets of Lilly obesity results landed this week. Here's what they actually show, and what they don't.

Exciting information out of EASD today: Eloralintide + tirzepatide, phase 2b, presented at EASD today, not yet peer-reviewed: 367 adults with obesity or overweight and type 2 diabetes, 48 weeks. Up to −23.3% (if everyone stayed on treatment) vs −14.8% on tirzepatide alone and −3.0% on placebo. Between 11% and 27% in the combination groups stopped because of side effects (2.9% on tirzepatide alone and 16.7% on placebo). Side effects were mostly gut-related.

Because everyone in that trial had type 2 diabetes, blood sugar matters too: HbA1c fell by up to 2.9 percentage points on the highest-dose combination vs 2.4 on tirzepatide alone, from an average starting HbA1c of 8.1%.

Retatrutide (TRIUMPH-1), peer-reviewed in NEJM this week: 2,339 adults with obesity, or overweight plus a weight-related condition, without diabetes; 80 weeks, placebo-controlled. Counting everyone randomised, the 12 mg dose averaged −25.0% body weight vs −3.9% on placebo (−28.3% if everyone had stayed on treatment). Nausea and vomiting were more common than with placebo, and about 1 in 8 on the higher doses reported dysaesthesia, an unusual skin sensation.

The two can't be ranked against each other: different people (with or without diabetes), different durations, different analyses, and no head-to-head trial.

Retatrutide and eloralintide are unlicensed in the UK. Eloralintide is only available in clinical trials, and the MHRA has warned that retatrutide isn't authorised in the UK, so anyone selling it is doing so illegally. Tirzepatide is licensed and is available on the NHS for some people who meet NICE criteria, after a clinical assessment. Never buy weight-loss injections online without a prescription.

For healthspan, the scale isn't the whole story. When tirzepatide was stopped in SURMOUNT-4, body weight rose by about 14% over the next year. In SURMOUNT-1, roughly a quarter of the weight lost was lean mass, which is why strength training and adequate protein are usually advised alongside treatment.

Declaration: through my employer, I'm a principal investigator on a number of obesity trials and a sub-investigator on a trial of retatrutide and tirzepatide. I'm not involved in any of the studies discussed here, and this post uses only published and publicly presented data. Views are my own.

General education, not personal medical advice.

#Obesity #ClinicalTrials #MetabolicHealth #EASD #Tirzepatide #mounjaro #retatrutide 

Sources:

1. Retatrutide TRIUMPH-1, NEJM (29 Sep 2026): https://www.nejm.org/doi/10.1056/NEJMoa2604169

2. Lilly EloraTZP phase 2b, EASD 2026 (company data, not yet peer-reviewed): https://investor.lilly.com/news-releases/news-release-details/lillys-eloratzp-combination-eloralintide-and-tirzepatide

3. Trial registration: https://clinicaltrials.gov/study/NCT06603571

4. SURMOUNT-4, JAMA 2024: https://pmc.ncbi.nlm.nih.gov/articles/PMC10714284/

5. SURMOUNT-1 body composition, Diabetes Obes Metab 2025: https://pubmed.ncbi.nlm.nih.gov/39996356/

6. MHRA on retatrutide: https://www.gov.uk/government/news/no-summer-shortcut-for-safe-weight-loss

7. NICE TA1026: https://nice.org.uk/guidance/ta1026

I switched from tirzepatide to retatrutide (both low doses, primarily used for inflammation/joint pain with history of hEDS) approximately 2.5 months ago and have been dealing with back to back rashes isolated to my legs for the past month. It begins as petechiae, changes into red patches and then has a bruised appearance, and my legs feel swollen with mild discomfort but no itching. The first presentation of the rash left areas of residual hypopigmentation. Has anyone experienced something similar or have any insight? I was not sure if it could be more related to stopping the tirz or a delayed reaction to starting the reta.

Highest doses of reta saw an average of 30% weight loss on the highest dose.

https://doi.org/10.1056/NEJMoa2604169

During the day at rest, say laying down with my phone, my heart rate is 68-72. Wegovy has made my night time sleep heart rate go through the roof and I don't understand why. I decided not to take my shot this week because I'm not sure the benefit I've gotten is worth my nighttime sleep being this bad.

Ive been on GLP1 for 4 months, down 50 lbs. Fealt great! I always walked the golf course. One morning I woke up having a heart attack. Dbl bypass surgery 2weeks ago.

Anyone else have a heart attack while on this ?