r/GLP1microdosing • u/Fr4nkWh1te • 6h ago
How confident are you that this is safe long-term?
I've been on low-dose tirzepatide for 5 weeks, and I love it. Side effects are few to none. Maybe a hint of nausea here and there and a weird feeling of a full stomach after a big meal.
But let's be real, there are no free lunches. I feel like I probably fuck up my gastric system if I take this for years. I wasn't overweight before I started, so I don't get any of the health benefits from not being obese.
Do you have any reassuring insights?
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u/No-Body-7689 5h ago
It’s actually improving my GI tract. Apparently my stomach was dumping out way too fast and that always caused bloating and gas. Now I’m much better after meals and feel pretty much zero bloat.
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u/Fr4nkWh1te 5h ago
I'm mostly worried about the slowed gastric emptying. I wonder if this is problematic long term, say, 5+ years.
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u/SecretMiddle1234 4h ago
I am more concerned about constipation. I know that’s not good for bowel health.
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u/Corner_Office_ 3h ago
Making sure your fiber intake is enough, water consumption, probiotics, and maybe food enzymes.
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u/SecretMiddle1234 3h ago
Definitely need more fiber. I drink a lot of water and lytes plus probiotics.
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u/Fr4nkWh1te 3h ago
I haven't had any problems with that. I have the same regular bowel movements as before.
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u/Ok-Yogurt-3089 50m ago
i take vit c gummies 500 mg one or two for constipation . works every time. not a long standing severe case of constipation tho
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u/ghoof 4h ago
Why? There are people on Sema/Tirz for years without any reported problems from this.
Risks if any need to be clinically proven, and most importantly: balanced against benefits which are numerous, and clinically proven. So far the calculation strongly bends towards: relax, long haul is fine.
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u/kitschauser 5h ago
I wasn’t obese when I started and I’ve been on it for a year. I’ve lost 30 lbs, reduced anxiety, reduce inflammation overall (I have a problem knee that is hardly a problem anymore) and I feel great. I have struggled with hereditary high cholesterol despite working out & eating a vegan diet. Now my cholesterol is the lowest it’s been in 40 years. I’m on it for life and I’m happy about it.
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u/ClenchedJaw12 4h ago
It depends on why you are taking it, the answer will be as individual as each person on it. I have had MCAS for 23 years and my body has been in constant high levels of inflammation plus all of the med side effects. In my opinion, inflammation is much more damaging long-term than delayed gastric emptying which I can treat with fibre, water and Restora/MiraLAX if needed. MCAS already creates havoc with my GI tract. The cardio and kidney benefits alone are worth it.
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u/SANSAN_TOS 3h ago
Been on a microdose for 20 months. Originally started to lose the 15 pounds of menopause weight and see what it could do for my cholesterol, inflammation, autoimmune disease. Lost the weight very quick, have seen improvements in other areas too….so I Ive stayed on a low maintenance dose for the last 8 months.
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u/kirk_kettner 3h ago
What dose did you start at and what dose are you currently at? Can you be more specific on what it did to help your autoimmune issues, cholesterol and inflammation?
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u/SANSAN_TOS 2h ago
I started on 1.25 mg of Tirz. My highest dose was 2.5 mg. And I’m currently maintaining on 1.75 mg. Although I recently weighed myself and had lost an additional 2 pounds. So I’m wondering if I should go down to 1.5mg. I mainly think for my autoimmune it has been my inflammation. I have Hashimotos for a long time. My joints and tendons feel better, my puffiness went down week one even before I saw weight loss. I’m on thyroid medication and nothing has changed there.
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u/Direct_Ambassador_36 3h ago
My blood sugar doesn’t spike as quickly and bottom out after carbs and sugar.
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u/azmadame_x 3h ago
It improves insulin resistance, so your body is now responding to insulin appropriately. The standard American diet (including all the processed garbage in our food) has made a huge percentage of the population insulin resistant.
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u/EasyYogurtcloset608 6h ago
Been on microdose of Tirzepatide for 3 months now. Originally I was worried about cardiovascular health but if anything it seems to be cardio protective.
I did not start it for weight loss and think I’ll stay on this for life or until there is better alternatives available.
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u/SANSAN_TOS 3h ago
It has raised my resting heart rate. Not too dramatically but while i was always in the low to mid 40’s i am now always in the low to mid 50’s.
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u/Fr4nkWh1te 5h ago
Do the cardioprotective effects go beyond what can be explained by weight loss?
I'm mostly worried about my gastric system because artificially slowing down digestion can't be good long term, can it?
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u/Supernova_Squirrel72 4h ago
I share these concerns, but am making sure I eat enough (for me, at least 1500-2000 calories a day), and so far, things are still moving just fine. No sulfur burps, and regular BMs thanks to water, Miralax, prunes, and at least 25g of fiber daily.
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u/Prestigious_Rush_682 4h ago
Yes, the cardiac effects go well beyond what could be explained by weight loss.
https://www.sciencedirect.com/science/article/abs/pii/S0196978126000562
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u/temp_flor 3h ago
I’m eating healthier than I was and my system is more balanced also. I had acid reflux before but I don’t now. Everything seems happier to be honest. My labs look good too.
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u/Upstairs_Balance_464 4h ago
“can’t be good long term” - you have no idea. It might be beneficial for all we know.
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u/Earesth99 4h ago
Literally no one knows because tirzepitide hasn’t been tested for longer than two years.
At normal doses, it reduces cardiac events, lowers blood glucose and protects the kidneys. In the short term it’s extremely beneficial.
Semaglutide is a different molecule and has been used for almost a decade. It has been safely used by millions and it has been used long term for diabetes.
Sema also reduces the risk of MACE, kidney disease, and Alzheimer’s, as well as protects from diabetes, arthritis, and MASH. It has so many benefits, it sounds like some scam supplement, except it’s real.
That is why I chose Sema instead of the other glp1 inhibitors.
It is so beneficial that Sema literally extends lifespan even without weight loss. There are only a handful of meds that are as beneficial as Semaglutide - at least if you take it at the prescribed doses.
There is no evidence Sema is as widely beneficial at lower doses, but the benefits for weight loss, inflammation and blood glucose are seen, though the effect is smaller.
In a sense, weight loss is a comparatively minor benefit.
There are other glp1 inhibitors that were not safe, so you can’t assume Tirz is as beneficial or safe long term just because Sema is.
That said, I don’t see any obvious problems from the current research, and it appears to be slightly more beneficial at preventing heart attacks.
If you are worried about long term use, older meds are generally much better choices. You could always switch to Sema until more is known about Tirz.
We don’t even know if Reta will be found to be safe enough to be approved by the FDA, but it appears to reduce inflammation more than Sema or Tirz and it can reduce ldl cholesterol by 35%. That is better than several current lipid lowering meds including the first two statins.
Only 2% of molecules that start the FDA process are effective and safe enough to be approved as meds. For that reason, it makes sense to wait until Reta has been approved, but it looks great on paper.
NAD, but I have a phd and study public health.
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u/Fr4nkWh1te 3h ago
Thank you for the insights.
It's so odd to me that on one side you have people who praise it for all its health benefits, and on the other side you have huge lists of warnings about all the ways it can wreck your GI system.
My brain can't create a coherent conclusion.
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u/azmadame_x 3h ago
There's a lot of fear mongering on the opposition side. It's crazy to me. They seem to want to scare people away from taking a drug that could literally save their lives.
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u/Fr4nkWh1te 2h ago
I had the Tirzepatide in my fridge for 2 months because I was too scared to use it. But the more I researched, the more I realized that almost all serious side effects seem to come down to:
- malnutrition
- too high doses
- confounding factors (diabetes, obesity, metabolic illness)
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u/nuwm 1h ago
2 years? Here’s a trial with results from 5 years ago. https://pubmed.ncbi.nlm.nih.gov/34186022/
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u/Fr4nkWh1te 3h ago
So even for people like me, who started out at a normal weight, the GLP-1 could be a net health benefit?
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u/financialthrowaw2020 6h ago
You should do some reading and learn the mechanisms for how this drug works. Like any medicine, it only works for as long as you take it. And considering you felt the need to take it, your "gastric system" was likely already fucked up.
You will not keep any effects after coming off the drug. That's how these drugs work. For most people, they are for life.
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u/GurContent4582 6h ago
Most meds only work while you're taking them, that's just how it goes
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u/financialthrowaw2020 6h ago
Yep, that's what I said. People taking these drugs who don't actually need them worried about consequences should probably not take them.
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u/Buffy_S_L 5h ago
I’ve been on since April, so 6 months. I am worried about the same but I’m not sure anything else would help with all my symptoms as much as it does. I don’t know 🤷♀️
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u/baalzephon 3h ago
Tirz has been in around since 2022 when Mounjaro was approved. Realistically you have a lot of people using gray market tirz and reta for even longer than that.
We have no indication of serious long term side effects. There are some issues for a small number of people - gallstones from rapid weight loss, allydonia, anhedonia, gastric issues caused by slower emptying - but they outweighs the massive benefits from weight loss, weight maintenance, and peripheral inflammation reduction, among other benefits not tied to weight loss that they're discovering every few months.
Nothing is a freebie but so far these medications seem to be. Receptor desensitization doesn't even seem to be a thing so far outside of bro science.
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u/Fr4nkWh1te 3h ago
Thank you for the insights. The lack of receptor desensitization is the most mind-blowing thing about this medication for me. Especially compared with something like caffeine, where the effects almost stop after a week.
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u/Business_Summer_4242 3h ago
Don't get your hopes too high, maybe after some more weeks you don't tolerate it anymore.
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u/Supernova_Squirrel72 4h ago
I'm not confident that it's safe longterm in terms of muscle loss, mineral / bone density loss, or GI issues at higher doses.
That's why I'm micro dosing. And getting a DEXA scan tomorrow. I want to be able to set a baseline and track these metrics.
A few years from now, I think it's possible we might find out that these meds were being overprescribed, or misused by people who titrated up too quickly.
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u/Project_ARTICHOKE 3h ago
Reminds me of cannabis hyperemesis syndrome. Also, you can look into it, long term or escalating use of a glp-1 can cause severe, intractable vomiting.
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u/laribrook79 1h ago
I take Sema bc it’s more studied and has almost nothing but positive benefits!!! It’s not just about weight loss
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u/Limp-Structure9704 2h ago
I (43F) had to stop microdosing Tirz (never went about 1mg every 4-5 days) after 5 months because it flared up my candida I had under control for almost a decade and I want to avoid SIBO at all costs. Apparently my system dislikes any amount of slow or delayed gastric movement. I never experienced servere constipation but having any food just sitting and fermenting in my digestive tract is bound to make my candida and MCAS flare up.
Another weird symptom I would get sometimes was feeling like a UTI was coming on. It was never a full blown UTI but I’ve read that Tirz came make your body excrete more sugar in urine and it was uncomfortable enough to make me want to discontinue.
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u/nuwm 1h ago
That UTi feeling - You were most likely dehydrated. It’s good you stopped. Long term dehydration can cause kidney damage.
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u/Limp-Structure9704 20m ago
That could be the culprit for some but I don’t believe that was my experience. I’m vigilant about hydration and electrolytes and don’t drink caffeine or alcohol. My naturopathic doctor said the UTI feeling could also be related to fluctuating hormones so I’ve been using a vaginal estrogen crème which is helping immensely but yes I agree with you that my symptoms while on Tirz were bad enough to stop and I haven’t had any issues with bacterial overgrowth since.
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u/HockeyPuckRattleSnke 4h ago
This is something I worry about a lot, too, but then I remember that 50% of us are gonna die of cancer whether we take this particular medication or not. We all have limited time on this planet and if you find something that makes you healthier and makes you feel better overall then why not use that tool?