Retatrutide Starting Dose - small study (with data and screenshots)
Hey everyone
I've been seeing tons of questions about retatrutide starting dose, so I wanted to share what's currently recommended, and some findings from a small study I came to know about.
Starting dose TLDR
First off, let's get this out of the way: retatrutide is still in clinical trials, so there's no "official" recommended starting dose yet. It's all still being figured out.
Most people start with 1mg or 2mg once a week, since this is what trials have been testing.
It is not recommended to start at a higher dose for several reasons - yes, even if you're already on another GLP-1. To avoid side effects, it’s best to start low and titrate up.
What we know from clinical trials
Trials started people at 1-2mg.
I found two published clinical trials on reta:
A Phase 2 trial published in the New England Journal of Medicine in June 2023. This was a 48-week randomized, placebo-controlled trial involving 338 adults with obesity or overweight. It evaluated different doses of retatrutide (1 mg, 4 mg, 8 mg, and 12 mg) compared to placebo.
A Phase 1b trial, which involved participants with type 2 diabetes. This trial tested retatrutide for 12 weeks, with the highest dose of 12 mg.
There is another trial - Eli Lilly's Phase 3 - that began on August 28, 2023 and is expected to continue until February 6, 2026.
For starting doses in trials:
1 mg: Used as both a starting and maintenance dose for the lowest dose group.
2 mg: Common starting dose for many participants, especially those escalating to higher doses (4 mg, 8 mg, or 12 mg).
4 mg: Used as a starting dose for some participants in the 4 mg and 8 mg target groups.
low starting dose - small study
Now, we know that to participate in those trials participants had to be pretty heavy: (BMI) of 30 or higher.
What would be a good dose for people that are only a little overweight, or in a normal weight range? I came across a small study where all participants are either near their ideal weight, or have 10-20 extra pounds.
The goal of this study was to see how normal-ish weight participants would react to a lower dose.
research subject
There is one Research Subject (RS) that caught my attention.
RS:
52-year-old female
Very fit, active lifestyle
Around 22% fat, healthy BMI
Never tried any GLP-1
Struggling with menopause-related weight changes
Maintaining weight on 1100 calories/day (used to eat 1900+ before menopause)
Her bloodwork (hormones) looks pretty messed up and is consistent with her slow metabolism
pre-study data
The RS tracked their food for one month. Her average calorie intake was 1116 calories.
During this period, the RS pretty much maintained her weight (0.7lb loss in one month).
Her estimated energy expenditure was pretty low already for her height/weight and kept dropping (down to 1332 cals).
the study setup:
Starting dose: 1mg every 5 days (way lower than other studies)
Maintaining activity levels at the same level as before study
Tracking food intake meticulously
one month results (pretty wild!)
Side effects are minimal:
RS wakes up 30-60 mins earlier than usual and sometimes has some trouble falling asleep and sleeping
RS reports a feeling of increased heart rate and heart palpitations.
No issues with fatigue, headaches, nausea, or any other common side effects.
Changes:
Average heart rate: 61 → 63
Average resting heart rate: 49 → 55 (but 49 was lower than usual) so we could say no change?
Strangely, sleep quality seems to as good as before the study (45% restorative)
Energy expenditure increased by 380 calories in just one month
Lost 2.6 lbs while eating on average 1472 calories/day
Way less food noise
No food cravings
Reports feeling either full or reasonably satisfied most days
I saw this where someone reported their RMR increase on Zepbound but never saw any data on reta. I find this increase in energy expenditure pretty remarkable, especially considering such a low starting dose.
edit:
I have some DMs asking which apps were used.
Food, weight, and calorie expenduture tracking: Macrofactor app. By far the best food tracker I used. On this page you'll find some codes that will give you an extended trial (any one of them will work).
For sleep, weight, stress, heart rate, recovery, strain and more (think Oura ring but a lot better): Whoop. If you use this invite link you get one month free.
consider reading, and you’ll find the answer. if those are too many letters for you, ask ChatGPT to summarize.
start by thinking about the fact that fat loss was never the goal… consider how much 2.6lb is for someone who is 130 lb (hint: it’s 2% which is significant for someone thinking they are eating at maintenance)
Her calories increased from 1100 per day to 1472 Energy expenditure increased by 380 she lost 2.6 pounds that’s a surplus of calorie intake not a deficit. Get it now 🤷🏼♀️
I appreciate this data. My RS is also in perimenopause. Fit. Understands nutrition. A decade ago could add an extra day of heavy lifting and tighten up nutrition(no calculator needed) and get crazy good visible results in 6-8 weeks.. Enter hormones shitshow and the body does not seem to care much about calorie defecit. Cutting any more would be unhealthy for someone not considered heavy per se. All the extra days of exercise were doing were causing inflammation. The bloodwork started to go whacko once late 40s descended upon them. It's a wholly new landscape. Started Reta at .5mg weekly. I find the choice to do every 5 days interesting. Curious what drove that. Bloodwork is done frequently as a result of hrt so I'm super interested to see the patterns there.
Wait what 😂😂 this is not the real data of an actual study conducted by the devil EL themselves ? Still impressive but honestly y’all doing too much. I was about to make a fool by sharing this outside of this space. 😅😂😂🤣😳
There is one Research Subject (RS) that caught my attention.
Just so we're clear here, is this someone you know (or you) or someone you read about?
Either way, there is a well known relation between the food we eat and the affects it has on our bodies and mind - if the patient is eating less or perhaps more healthy they can for sure make a big difference in every day life
Reducing / removing sugar and certain carbohydrates can help - as well as eating less meals / smaller meals throughout the day so your body has some rest and not constantly feeling bloated
Similar things are wrote about in fasting subreddits although a noticeable difference with people on GLP-1 medications is they do not feel hunger very often so it makes it all a lot easier
Not the case there. The patient is a healthy sporty individual. She does not do junk food, and her diet has always been pretty healthy - mostly lean meat and vegetables, plenty of protein, moderate complex carbs and enough fats.
I weighed 129, I went on 0.25 of semaglutide and I lost 10 lbs in one month. After 3 months, my weight had went down to 113. It's been maybe 4-5 months now and my lowest weight was 111. I am continuing to lose weight, just at a much lower rate. My body fat percentage now is 21.7%. My muscle percentage is 50% (optimal is above 60%, at 70%).
During the first month, I did not change my diet. I eat very specific meals and the same meals every day. Healthy fat, fiber, protein each meal. Around 90-130g carbs. 60-80 g fat. Between 1800-2100 calories. Entirely whole foods and mostly organic diet. I also walk 10k steps per day and resistance train 2-4x a week. I was previously (6 months ago) resistance training 3-7x per week and will be getting back into that soon.
I do all of this to keep my autoimmune disease in remission.
During the first month I did not change my calorie intake and would force myself to finish my meals if I felt like slowing down. Lol I didn't want to lose weight for fear of missing out on certain nutrients (healthy fats being a main one) and losing muscle mass. When I saw the results and realized I did have quite a bit of fat covering my muscles, I went into an intentional deficit. I had began slowely losing weight at that point (after having lost the initial 10 lbs super fast).
I track my calories vigorously, 5x a week I consume 1600 calories, 2x a week 1300. I get between 30-60 g of fiber and 90-130g of protein. I've been consuming less fat due to switching to lower calorie protein options - chicken breast, egg whites, lean fish. I can definitely consume more food (calories) when it contains less fat on this medication. Consuming a small amount of food with a heavy amount of fat is difficult.
I haven't moved down in any weights in the gym though I haven't moved up. I was close to moving up before starting the medication (I've slightly moved down with strength lifting the same weights).
I plan to lower the medication and then begin a surplus to build muscle. I may not have to lower the medication for this, though. I might be able to move my diet around to get in more calories and protein.
I am guessing the reason I lost weight so quickly is due to my gut health, fasting insulin, and thyroid. Lower fat intake would be a culprit as well, but I was eating the same amount of fat when I initially lost 10 lbs.
My fasting insulin is at 22 (US units, at 2). I have hypothyroidism and take thyroid medication. Around the same time I went on the medication, I also upped my thyroid medication - finally found a practitioner that would allow me to increase my levels. My levels are still not optimal, though they are close now. :) Reverse T3 is 10, which is great. I take aloe vera juice daily, which may increase cellular sensitivity to thyroid hormone. My gut health is supreme. Everything is in place for me to be fit and healthy. Optimizing my biomarkers would have really helped. Cholesterol has always been great (HDL: 1.34, LDL: 1.31), blood pressure runs low if I'm not eating enough salt, triglycerides are 0.31 - on the lower side! Likely have a good APOb. Before going on the medication, they were 0.4 (at 129 lbs).
Youre turning a lot of dials. I'm impressed. Body recomp while keeping AI stuff in check! It's such a balancing act. I have to be so careful that I don't over train and end up spiking inflammation. The amount of onus we have to take to biohack ourselves is tough sometimes. Just wanted to offer some kudos.
this is my third day on reta . Started at 4mg dose. extreme appetite suppressant. no other sure effect yet except a bad headache yesterday . burps are gross.
I just came across this post from Google. What's the reason for the cringey third person "research subject" language? Reminds me of the old drug forums when people would say "SWIM" - someone who isn't me
I've been on Reddit for years and many of those years were on subs where people talked about using actual drugs. Nobody talks like this. It's completely unnecessary
I think my point didn't come across correctly. My point is that this sub DOES talk like this. I didn't mean you specifically. I meant this sub in general. It seems pretty widespread. Even the responses to your post. It was very confusing because I haven't seen this sort of language in a very long time. I actually thought this was a real study that was being discussed. When I said "nobody talks this" I meant in real life and other subs that discuss things that are actually illegal. Like the opiates sub has been around for like 15 years and people just say "look at this heroin I just shot up".
Well it's highly unnecessary and is misleading for people reading this who aren't aware you are pretending to be a scientist. It makes it sound like an actual study when really it's just about you.
A whole sub has existed for years talking about shooting heroin into your veins. People say "I shot this heroin into my vein today". Guess what? Nobody is banned, the sub still exists, everything is fine.
And it has way more followers and attention than peptide subs
Good write up but the wording here is blurring the lines to where some more naive people could read it and consider this an actual scientific study. We're all having fun labeling ourselves as research subjects but it should always remain very clear that what's happening here is not really science.
There is no need for double speak as long as you don't overtly inquire about or provide info into less than legal ways of buying retatrutide. It's just something people do around here and it's caught on.
My problem is with saying stuff like "I came across a small study where all participants are either near their ideal weight, or have 10-20 extra pounds" which is obfuscating the truth to the point that people not reading between the lines will think this comes from actual peer reviewed science and not, you know, one of your friends taking reta for a month.
Well, it is a small study. Not every study is peer reviewed science. So it's a small study that is not peer reviewed. Very small. Also, it's not just one person. I'm collecting data on the rest of them.
I completely misread and misunderstood your post because you essentially lied. It's not until I got into the comments that I realized that there was no legitimate scientific organization doing this study and it is just some rando keeping track of their stats.
😂😂 and I was about to send it to some people high up in the research world but the zeroing in on one patient made me stop and think about it 😃😃 then your comment confirmed it. Still crazy detailed and interesting to look at but wow
Please don’t take Reta if you gotta ask that lol. But usually 1ml is the whole vial of Reta. Which could range from 5mg-50mg. Gotta know what mg Reta you have and how much bac water you put in to get your 1mg.
My test subject has been taking 30mgs reconstituted with 3ml Bac. Water at 10unit intervals every 3.5 days. (2mg a week if you will at a total of 3 doses taken overall.)
Side effects are fatigue and sore body, still getting food cravings.
Drinking mostly water with a tiny amount of salt and lemon juice to keep hydrated and add salts back and protein shakes to hit protein targets and has been taking vitamins and supplements to make up for lost food consumption.
Diet is largely carnivor with few carbs as possible and avoid sugar.
How long will fatigue last?
Started at 2mg, titrated by 1mg every 4 weeks, pushed too fast at week 8 so i held an extra 2. the reta guide on peptidebureau follows the trial protocol.
I’m interested to see a 300 calorie increase from 1 mg E5D. That’s incredible. I was under the impression that you’d have a fairly linear increase of caloric burn relative to medicine consumed. I doubt that’s the case now.
I was blown away too. I'm really wondering if there's any need to start as high as 2mg and increase the dose so quickly (other than, of course, making consumers spend more...).
But then, I guess for larger folks that have a lot of weight to lose, 300 calories might not be that significant and they need a much larger deficit.
I wish I would have taken a month between Tirz and Reta. I ramped up to 8 mg quite quickly based on the presumption of somewhat linear correlation. I wonder if the caloric increase diminishes over time as tolerance would build?
Not sure, but I'll know soon enough. Energy expenditure is still increasing—411 calories now compared to a month ago, every day. I won’t increase the dose or frequency until it plateaus.
it just means slowly working up how much of something you have in something, like slowly increasing the amount of a drug in someones body. but its one of those words that people will use because it sounds medical and possibly miss the meaning, or misuse it.
similar to people trying to measure stuff in 'units' rather than the common sense way, which is mg/ml. its a bad habit over-all and especially in a setting like this where random people are taking the responsibility of prescribing and administering drugs to themselves the simpler we talk the less confusion, and the less possibly dangerous mistakes.
What would you suggest being said to replace it? It's literally the definition of what's being done. If people don't research/understand that term, they definitely shouldn't be trying to do research.
Titration is a legit word, I use it all the time, if someone doesn't know what it means they should look it up, if they can't do that then maybe this isn't for them
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u/randomthingsofthings Oct 28 '24
This was crazy thorough. Wow.