Adding Tirz to reduce Reta side effects

There were entire days my heart rate stayed above 100 bpm. I stopped Reta completely and moved over to Tirzepatide instead.

Once I reached my first goal weight I paused dosing until the 8 mg level had cleared after eleven days. The main aim was to let my system settle, especially resting heart rate. Sleep has improved and resting heart rate has eased a little. I’ve been combining with Sema but am considering switching that to Tirz. Might try adding elora depending on how the coming week goes.

Yes, I’m running Tirz and Reta on alternating days and using more Tirz than Reta because of the heart-rate problem. The combination has worked well for me.

My average resting heart rate over the five years before Reta was 63 according to Apple data. Last full dose was 8/3 and a reduced one on 8/14. Only once did the resting heart rate feel bothersome, on a stressful workday with extra caffeine, 8/6. You can basically see the stress spike in the numbers.

I’ve gone back and forth between Reta alone and Tirz alone a few times. On Reta I still feel some hunger but get full after a normal portion, which I think helps preserve muscle. On Tirz I feel calmer and sleep better, yet food can seem almost repulsive. That lack of interest was great at first, but at maintenance it matters not to push calories too low and slow metabolism. Stacking might offer a middle ground, though I’ve kept things simple so far.

One thing worth watching as it becomes available is eloralintide. One reported effect is a reduction in resting heart rate, so pairing it with Reta could help balance things nicely.

Adding Tirz while keeping the same Reta dose may ease some GI sides thanks to stronger GIP activity, but it won’t change the heart-rate effect coming from Reta. That would need a lower Reta dose swapped for a comparable or slightly higher Tirz dose. GIP itself doesn’t appear to affect heart rate, GLP-1 raises it modestly, and glucagon raises it more, though individual responses vary widely. Tirz produces similar lipid changes, but Reta seems better at cutting liver fat. Stacking the two is fairly common for balancing benefits and sides. No published research exists on the combination, yet nothing obvious suggests a problem. Plenty of people online are already doing it, which at least hints that any unusual rare effects aren’t widespread. I did well on Tirz at 15 mg and appreciated the lack of sides after a year of nausea on lower doses.