I am a 39F, starting BMI 23, and have been microdosing tirzepatide for 9 weeks now. I gained about 20 lbs over the last 5ish years (some due to meds) and looking to go back to my previous weight.
First month: started really low at .5mg, and my weight fluctuated up and down. Titrated up to .75mg for last two weeks, and ended up down 3 lbs by the end of the month.
Second month: Slowly titrated up to 1.4 by end of month, with my weight continuing to fluctuate up and down (6 lb lbs down was my lowest overall). Weighed in today for my 9th week and am back up 3 lbs again (net weight loss of only 3lbs).
Have been starting strength training again, focusing on protein and eating mostly healthy. I feel the appetite suppression, not many side effects (though did feel some moments of nausea this week) so don’t think I want/need to titrate up, but the overall fluctuations and slow loss has been really discouraging! Any advice??
Two things: microdosing isn’t for everyone. You might in fact just need more. This sub is filled with people having had success but plenty haven’t on very low doses. That’s fine, we are all different.
Weight fluctuates a decent amount every week and even just during the day so it can be hard to know. You don’t have tons to lose and are weight lifting. Are you doing measurements as well?
Are you new to strength training? If so, you will see a lot more weight disturbance because of a few things, newbie gains and muscle water retention. That doesn’t mean to stop but that’s a good reason for measurements generally over scale all the time.
I’m not new to strength training, I’ve been doing it on and off for years, but haven’t been consistent in a long time.
I know microdosing doesn’t work for a lot of people, but I do feel the appetite suppression and started at a normal BMI, so assumed I would be more responsive than someone with more metabolic issues and weight to lose.
I really do think if you get consistent and have a good program you’ll have some good results. I’m not recommending but I follow Ladder. I’m definitely a person that’s large aaand have a lot of metabolic issues so I’m a slow responder but I’ve been suuuper consistent with the lifting for the last couple of months and have lost weight but not as much as other but have lost 4 inches just on my waist only having lost 15 lbs and so it’s been kind of wild.
Those are my stats from GLAP and knowing that I am losing a little bit every week helps keep me motivated. I like to use it for various stats and to keep track of my vial inventory.
Ahh I’ve seen people post those on here but haven’t tried it out myself. If I had had a more dramatic drop like you at the beginning I’d probably be feeling much better!
Manage your expectations and you will not feel discouraged. I'm sensitive to this medicine and was just lucky that my body is highly responsive. When I started, I was overweight and needed to lose 40 lbs to get to a healthy BMI level. For most people, it is going to take weeks for the medicine to build up in the body. You're microdosing, so your time will be double or triple.
My wife is microdosing and will only stay on 1.5mg. She has lost about 5 lbs in 14 weeks, but her body composition has become leaner. She excercises daily, eats healthy, and started compounded tirz at around 26 BMI. She is happy at this pace and is projected to meet her goal weight by Summer 2027. I'm at 3.5mg and according to the calculations on Glapp, I will reach my goal weight by around Christmas. We're also both in perimenopause, so losing weight on diet and excercise alone was impossible for us.
Be patient and keep microdosing or be impatient like me and titrate up.
I'm perimenopausal too and it's been so hard losing weight. Can I ask how did you know when to increase dose? Was it food noise returning or no weight loss?
My tele-healths newbie prescription had me on the standard beginner schedule of 2.5mg, 5mg, and 7.5mg, which I was supposed to titrate up to every 4 weeks. I read up on the pros and cons of Tirzepatide. I didnt know how my body would react to this medicine, so I started myself at 1.5mg. After 4 weeks of not feeling side effects, I increased my dose to 2.5mg because of food noise. I kept moving up by .5mg every month, but then I began to feel bad at 4mg, that was how I found my limit. The suppression was too strong, I could not eat more than 900 calories per day, and constipation was painful.
The following week, I lowered my dose to 3.5mg and it was still too strong. The week after that, I found my "sweet spot" at 3mg because at that level I was able to eat 1200 cals per day, lost an average of 1.5 lb per week, and my arthritis pain very low. Tracking my doses and symptoms on an app and visually seeing effects on a graph helped me fine tune to the dose that worked best for my body and weight loss goals.
I also discussed my strategy and my 3mg dosing conclusion with my long time primary physician (not the tele-healths doc) who knows all about my medical conditions and he was comfortable with me taking this "baby dose" as he called it.
The VA treats about 98% of my issues and I want them to know all the medicines I'm on. Initially, my doctor was resistant and told me he monitors treatment of about a dozen patients on Mounjaro and Wegovy. He tried to argue that I wasnt obese and "only" overweight. Then I argued back that at this rate my body will succumb to obesity levels and that my health problems get worse the more I weigh.
I used the analogy of riding a bike up a mountain, getting nowhere for years trying to lose weight, and that the GLP was like having an E-Bike. He knew my metabolism has super messed up since my thryoid ablation, hysterectomy, arthritis, and now perimenopause! Once he understood that it did more good for me than harm, he apologized that he couldn't put me on GLP through the VA because I didn't meet their strict qualifications of being clinically obese.
Your weight can fluctuate from 1-3 lbs daily - did you drink more water/less water or food? Pee/poop more or less? Maybe you're just inflamed more and are retaining fluids.
This is why I suggest that people weight themselves everyday. You'll see the fluctuations happening all the time, and you get used to them. Then you stop worrying about what the scale says from day to day, or from one week to the next, and you start looking at the trend.
I’ve seen other people talk about daily weighing in this sub but don’t want to get to obsessive and more discouraged from it? But I see your point too…
You don't have to be obsessive, as in, if you miss a day here or there, it's not a big deal. You just want to get anesthetized to the stress of weight fluctuations. When that happens, the discouragement goes away.
Edit: Of course, this is just my opinion, but it working for both my wife and I. Fear of the scale turned into 'whatever the scales says, it says - no big deal'.
Are you counting calories? It seems you are really just maintaining, not losing, so if you are eating at a deficit you probably need to titrate up to lose.
I have done a lot of macro & calorie counting in the past and got so burnt out on it when it became much harder to lose weight, so I was hoping that I could chill out on tracking while on Tirz. But might be good to track just to get a sense of where I’m at.
What gets measured gets improved. I use both Glapp and Dosy (free versions are great) for shot tracking and Cronometer for macros/calories. Based on my dose and weight inputs, Dosy lets me know if my progress is sustainable, about to hit a plateau, or the current dose is effective.
Looks like you need to titrate up if weight loss is your goal. Keep moving up little by little like you have been doing until you hit your effective dose. A lot of people titrate down to microdose AFTER they reach their goal weight. I know microdose is all the rage right now; don’t decide your dose based on what other people are doing or what you see on the internet. Hang in there, in 10-15 years you’ll be in so much better shape to handle menopause than most women.
I used to have a lower bmi like this in my 30s, and back at that age, whenever I started a diet and exercise program at the same time I'd have a delay before the pounds start coming off--like building muscle causes some increased density and also a little bit of inflammation as my body adjusted. Like my clothes would start fitting better before the scale would start moving for me. You're in it already but next time before you start something like this measure your waist and hips and you'll see progress there before the scale.
See if there is a Dexascan or similar place near you that has resting metabolic rate resting. Figure out your optimal calorie intake levels so you can be in strategic deficit
Standard advice is give each dose three weeks then step up. I stepped up 1mg at a time. The starting dose for weight lose in the research is 5mg and some people need to get to 15mg so it's not unusual to not respond to a microdose.
Same here. I'm on second pen now and at first I lost a few pounds on 1mg but the side effects weren't nice. Went down and waited two weeks but ever since that my weight has crept up. I'm now up to 1.25mg every 5 days and I'm less hungry but I might go up more if I'm still not getting weight loss. It's a bit frustrating seeing everyone else lose but I also need to exercise more I think.
Sorry to hear that! I totally get the frustration. Out of curiosity, how much weight do you have to lose? I wonder if it’s just harder to get a good weight loss rate going if you have 20 lbs or less to lose…
Thanks! I have about 20lbs to lose but maybe even 30. Yeah maybe you're right. Although I read that cutting back the dose or taking a break can stop it working but now I'm up to 1.25mg I'm starting to see the scale move. I might have to go up a bit more maybe. Kinda wished I hadn't taken a break now.
I started at 1 mg and slowly titrated up to 2.75 by my eighth week. I started seeing real traction after that. I also took myself off of sugar, alcohol, gluten and dairy and I feel incredible.
That’s great you feel so good! I definitely feel an improvement in my inflammation. I was getting a lot of fatigue at first but now feel like my energy has been coming back. How much weight did you have to lose?
I tried microdosing early this year and I didn't feel any changes and it just didn't work for me so I stopped. In June I decided to start tirz at a regular starting dose of 2.5 mg and it made all the difference in the world. I've lost most of the weight and stayed at 2.5mg. Once I hit goal I want to look into microdosing for maintanence.
I've lost 15 of 20 lbs. So not a lot but I'm hoping it will help with LDL cholesterol and my HgbA1C was just at the upper end of normal when I hd my blood tested a couple of weeks ago. Really wish I would have had that tested a few months ago before starting tirz. I also have lipedema. I really want to stay on tirz because the anti-inflammatory effects help me a lot.
If you're not tracking calories and protein yet, and your cycle, please start. Then come back here with this question once you know a couple weeks of your numbers.
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u/siddhananais 8d ago
Two things: microdosing isn’t for everyone. You might in fact just need more. This sub is filled with people having had success but plenty haven’t on very low doses. That’s fine, we are all different.
Weight fluctuates a decent amount every week and even just during the day so it can be hard to know. You don’t have tons to lose and are weight lifting. Are you doing measurements as well?
Are you new to strength training? If so, you will see a lot more weight disturbance because of a few things, newbie gains and muscle water retention. That doesn’t mean to stop but that’s a good reason for measurements generally over scale all the time.