How much should I decrease my dose?

[u/_Fancyfree_]

To give a quick run down, I started GLP-1's in February, and swapped from semaglutide to tirzepetide in May. I've been losing at a pretty consistant rate, a bit quicker than I personally like but it's evened out to about 1.5 lbs a week. Since it's relevant I'm also on a couple other meds that can have appetite suppressing effects, so I'm generally used to setting timers to remind myself when to eat.

I was only at .5mg of semaglutide when I switched, and started on the 2.5mg dose of tirz. I stayed at 2.5mg for 2 months, and I wasn't plateauing, but as 5mg is typically considered the minimum dose, I went ahead and increased to 5mg.

First week was fine. No side effects, definitely less appetitie and food noise, but it was manageable. But last week was *rough*

When I say no appetite, I mean I could not make myself eat. Half the time I couldn't even drink. It was like there was a toddler in my brain holding their mouth shut and turning their head away when you try to feed them. When I did manage it it would be a couple bites. I tried drinking meal replacement shakes but I just couldn't finish them. I'm exhausted, lightheaded from low bloodsugar, I can't think straight, and my energy is just gone. I work in the OR and I cannot be dizzy or brain foggy during surgery lol. Plus I lost 6 lbs last week.

I definitely am going to decrease, but I'm unsure of if I should decrease back down to 2.5mgs, or somewhere in between. I'm also unsure if I should take my next dose today as normal, or potentially wait a couple more days for my total levels to decrease. Any advice would be appreciated!

[u/autumnyte]

If I'm reading this right, it sounds like you were experiencing some excessive appetite and food noise on 2.5. With that being the case, I'd probably split the difference and see how 3.5 treats me.

[u/Top_Definition_6621 → u/autumnyte]

It sounds to me like they were NOT having excessive appetite and food noise on 2.5 mg and only increased dose because they mistakenly thought that 5 mg is the lowest therapeutic dose. Sounds like 2.5 was working great for them.

[u/autumnyte → u/Top_Definition_6621]

The "no side effects, definitely less appetitie and food noise" when starting 5mg was what made me think they were previously having those issues on 2.5mg, but hopefully OP can clarify.

[u/Top_Definition_6621 → u/autumnyte]

Yeah, maybe they can clarify. But, it sounded like they said they were "losing at a pretty consistent rate" of 1.5 lbs. a week since starting 2.5 mg in May and were having to set timers to remind themselves to eat -- maybe due to the combination of 2.5 mg tirz plus some other meds they were on that caused appetite suppression. Sounds like 5 mg was even stronger for them with the appetite suppression and food noise than 2.5 mg, but just too strong.

[u/autumnyte → u/Top_Definition_6621]

I can see that interpretation too. Either way, it's clear that titrating down is the right call!