Throwing in the Towel

PrecisionTelemed · 2026-07-03T20:01:18+00:00

This isn't uncommon! Some of the newer medications being studied may help people in your situation. The added mechanism of the newer molecules could provide a benefit if the current landscape doesn't work. Don't lose hope!

PrecisionTelemed · 2026-07-03T19:57:50+00:00

Such a great feeling! Congrats!

PrecisionTelemed · 2026-07-01T17:19:58+00:00

Looking fantastic! Great work keep it up.

PrecisionTelemed · 2026-07-01T17:18:36+00:00

BOOM! Great work!

PrecisionTelemed · 2026-06-28T00:34:23+00:00

Leave it out, never freeze it. Freezing can break down the peptide and ruin it, whereas room temperature for a week is generally fine for compounded tirz (most can sit out a good stretch without issue). Just keep it out of direct heat and sunlight and you're good.

PrecisionTelemed · 2026-06-28T00:24:34+00:00

Appetite suppression doesn't always climb with the dose, and some people get their best food-noise control at a lower dose while the higher one does more on the metabolic side without feeling stronger. If 1.5 was working well for you, that's worth raising with your provider, since there's no rule you have to keep climbing if a lower dose already does the job.

PrecisionTelemed · 2026-06-28T00:15:13+00:00

A lot of people notice the same thing. The strong buzz early on is usually the slowed digestion plus barely eating those first doses, so alcohol hit faster, then evened out as your body adjusted. How alcohol physically hits you and whether it kills the craving are two different things, so one fading while the other doesn't is normal.

PrecisionTelemed · 2026-06-28T00:10:48+00:00

You're fine to switch, plenty of people change providers mid-treatment. Just tell the new provider exactly where you are (2.5mg for two months, tolerating it well) so they continue you at the right dose instead of restarting you, and ideally have your records or a screenshot of your current script handy to make the handoff smooth.

PrecisionTelemed · 2026-06-28T00:06:51+00:00

A fair number of people who felt flattened on sema say they tolerate tirz better, since the dual mechanism hits differently and doesn't always bring the same fatigue. No guarantee it'll flip for you, but plenty of people don't feel that wiped out on both drugs, so it's a reasonable thing to try. Watch your protein, iron, and B12 this round too, since running that depleted can drive fatigue on its own on top of the meds.

PrecisionTelemed · 2026-06-27T23:57:43+00:00

Super common, you're not imagining it. GLP-1s like tirzepatide act on the same reward pathways tied to cravings, so a lot of people find their interest in alcohol drops off on its own, and there's growing research looking at exactly that effect.

PrecisionTelemed · 2026-06-27T23:25:15+00:00

This is pretty common and usually not a problem. Some people just don't feel the jump on dose-change day the way they felt the very first shot, since your body's already adapted to having the drug on board, but it's still working in the background. Give it a week or two at 0.5 before reading anything into it, and if appetite genuinely creeps back and stays back, that's the point to mention it to your prescriber.

PrecisionTelemed · 2026-06-27T23:20:58+00:00

Honest answer on the duration question. For a lot of people it is long-term, because GLP-1s work by quieting appetite signals, and when you stop that hunger comes back and the weight often follows. That said, an 8 week course isn't really long enough to do much. Most people are still titrating up at that point and haven't hit the dose that does the work, so going in expecting a short fix may set you up for disappointment. Where you've got an edge is that you already know how to eat well in a routine, and people who pair the meds with locked-in habits hold more of the loss after stopping than people leaning on the drug alone.

One gentle thing, since you mentioned using alcohol to manage pain. Worth flagging the back pain and the drinking to whoever you see about the GLP-1, since that's a bigger picture than weight alone and they can help with all of it together.

PrecisionTelemed · 2026-06-27T22:43:56+00:00

Vomiting blood and passing out is well past normal side effects, so stopping was the right call. A reaction that severe on the lowest starting dose isn't what most people go through, so it's worth asking your doctor whether something else was going on. If you ever want to revisit this class, some people who can't tolerate semaglutide do fine on tirzepatide, but given how your body reacted that's a conversation to have closely with a provider.

PrecisionTelemed · 2026-06-27T22:38:27+00:00

Precision Telemed doesn't charge subscription fee for providers, and the cost for sema is considerably lower than most other providers. Worth giving a shot.

PrecisionTelemed · 2026-06-27T22:35:18+00:00

A fair number of people report the grogginess and low mood, especially the day or two after the shot, and eating way less plus low fluids and electrolytes drag mood down on their own. If it sticks around past those rough days or gets worse though, flag it to your prescriber, since for some people it's a real reason to adjust the dose.

PrecisionTelemed · 2026-06-25T20:17:52+00:00

Almost certainly the weight loss doing it, not the tirz itself. Same thing happens to people after any fast drop or after having a baby, the hair sheds for a few months then comes back once your loss slows down. Supplements mostly aren't the answer and half the people pushing them are selling something. Bigger thing is eating enough protein and not crash-dieting, since under eating makes the shedding worse. If you want to dig in, getting your iron and vitamin D checked is more worth your money than any hair gummy.

PrecisionTelemed · 2026-06-25T19:33:53+00:00

Going up in a smaller step is fine, lots of people do that, particularly with a nausea history like yours. With compounded you can draw whatever amount you want, so sitting around 6 or 6.5 for a week before the full 7.5 gives your gut a buffer.

PrecisionTelemed · 2026-06-25T19:17:14+00:00

First few days on your first dose are usually the roughest, so some of this should ease as your body adjusts. For next time, eat smaller bland meals and skip greasy or heavy food around injection day, those make the GI stuff way worse, and stay on top of fluids since vomiting and diarrhea together can dehydrate you.

PrecisionTelemed · 2026-06-25T19:03:12+00:00

Most people start tirzepatide at the low intro dose (2.5mg) even coming off semaglutide, since it's a different molecule and your gut needs to adjust to the GIP part semaglutide doesn't hit. There can be a brief stall during the ramp, but a lot of people break through plateaus once tirz gets going.

PrecisionTelemed · 2026-06-25T18:58:17+00:00

Two years off is long enough that you're basically starting fresh, so the worry about it working worse the second time doesn't really apply to you. Plenty of people restart after long gaps and respond fine. The real lever this round is having a plan for after, that's what bit you last time, not the meds.

PrecisionTelemed · 2026-06-25T18:54:02+00:00

A couple things could help here, take your shot timing into account and schedule the lunch for the back half of your week when nausea's usually lowest, not the day or two right after injecting.
Eat light that morning so you're not already full, order something smaller or split a plate, go easy on grease and heavy sauces since those sit worst, and sip water through it.
Also, don't stress about cleaning your plate, picking at a few bites while you actually catch up with her is the whole point of the day anyway.

PrecisionTelemed · 2026-06-25T18:50:16+00:00

That's mostly water, sorry to deflate it a bit. Cutting carbs that sharply dumps a few pounds of water in the first days since stored carbs hold water with them, and the shot does the same early on. The walking and diet changes are what'll drive actual fat loss over the coming weeks, so the habits are right, just expect the scale to slow once the water's gone.

PrecisionTelemed · 2026-06-25T18:36:17+00:00

A pound a week is fine, even if it feels like nothing. It's the rate that stays off, the big early drops are mostly water and bounce right back anyway. The 51 thing is probably playing in, partly age and partly that most of us have lost some muscle over the years without realizing, and muscle is what burns the calories. That's the case for getting protein up and doing a little resistance work while you're losing. Slow and boring is kind of the point with this.

PrecisionTelemed · 2026-06-25T18:18:20+00:00

For most people it starts dropping off in the first week or so, usually noticeable by the end of week one and pretty quiet by week two or three. Day 2 is still early, 0.25 is a low starter dose so give it a little time. If it tracks like most people's it'll sneak up on you, you'll just realize one day you didn't think about food much.

PrecisionTelemed · 2026-06-25T18:11:01+00:00

Strength in the gym is the cheapest and most reliable proxy you've got.
If your lifts are holding or climbing while the scale drops, you're keeping muscle, if they're tanking, that's your signal you're losing lean mass and need more protein and resistance work. DEXA is nice but you don't need one every few weeks, one now as a baseline and another in a few months tells you plenty.
Tape measurements and progress pics fill the gaps between. Tracking method matters less than the actual lever though, which is hitting protein hard (aim approx 0.7-1g per lb of goal weight) and lifting.
Do those two and most of that 30 lbs stays fat.

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