Not sure where to go from here, advice appreciated

Increase the dose and probably both compounds. Avoid another break. Consider adding another option for appetite control. Someone else here has experience with quicker increases and higher amounts.

Sorry this phase is rough. I would titrate tirzepatide back up. I recently added another compound but it is too soon to judge results. It is relatively inexpensive compared with the main options and might be worth trying. I have heard good reports about one other option but it costs more and sources are inconsistent.

I have come across articles indicating tirzepatide provides stronger appetite suppression than retatrutide though I do not recall all the specifics.

You moved from the highest tirzepatide dose straight to the lowest retatrutide dose. That transition is difficult because fast increases with retatrutide bring side effects. Appetite control from retatrutide is also weaker at comparable doses though the glucagon action can still support weight loss once you reach higher amounts since it has a threshold around 4 mg. You could add another compound for appetite help but some of those carry possible mood or motivation side effects.

I would hold retatrutide at 5 mg for now and raise the tirzepatide since you already know how it affects you and it should manage hunger better. After a few weeks without progress you could slowly lower the tirzepatide while increasing retatrutide. Do not rush the higher retatrutide amounts and pay attention to how you feel rather than just the scale.

This approach makes sense.

You might want to look into PAM gene variants. Research from Stanford indicates they influence response in around 10 percent of users.

I recognize my own early experience in your post. Insurance stopped covering the branded version so after a two month gap I switched to another source and worked up to the maximum dose with little effect. You have to give the medication time. Two weeks is not enough. Choose one approach and follow the dosing schedule. This is a marathon not a sprint. Everyone here is eager for results but it will come. Stop trying everything at once. There are many adjustments possible to find what works. Most people here want others to succeed.

He would just send it back unopened. Everyone knows that person uses only retatrutide.

You have staff.