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ForumsTirzepatide (Mounjaro / Zepbound)Tirzepatide and cholesterol — LDL/HDL ratio improvements Page 2

Tirzepatide and cholesterol — LDL/HDL ratio improvements

Dr.LipidDallas Sat, May 23, 2026 at 8:05 AM 12 replies 374 viewsPage 2 of 3
SleepFixSam
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Hawaii
May 23, 2026 at 10:55 AM#6

For what it's worth, there was a retrospective analysis (Rubino et al., presented at ObesityWeek 2024) looking at patients who switched from semaglutide to tirzepatide. The cohort that did accelerated titration (2wk/2wk through starter doses) had comparable GI adverse event rates to the standard titration group. N was small though (~180 patients).

The more interesting finding was that 73% of sema "plateau" patients resumed weight loss within 8 weeks of reaching tirz 7.5mg or higher.

47 23pete_nash, hank_denver, carlos_SATX and 44 others
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MarkLI_maint
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May 23, 2026 at 11:12 AM#7

following this thread! im in the exact same boat. stalled on wegovy 2.4 for almost 4 months now 😩

46 18TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 43 others
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MASHdoc_SA
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May 23, 2026 at 11:29 AM#8
SleepFixSam said:
For what it's worth, there was a retrospective analysis (Rubino et al., presented at ObesityWeek 2024) looking at patien...

73% resumed weight loss — that tracks with what I've seen anecdotally on here and on the Discord. The other 27% probably needed 10mg+. Have you seen any data on what happens to that remaining group at higher tirz doses?

27 14JennaRN, LabKate, kate.chem and 24 others
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PeptideSynthNJ
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May 23, 2026 at 11:46 AM#9

UPDATE — Week 2:

Ok so I'm finishing my second week on 2.5mg and here's what I'm noticing:

  • Appetite suppression is milder than what I had on Wegovy, but it's... different? Hard to explain but food doesn't look as "exciting" if that makes sense
  • Zero nausea so far (I had horrible nausea on sema for the first 2 months)
  • Energy is UP. Like noticeably. I thought people were exaggerating about the tirz energy boost but no, it's real
  • Down 2.1 lbs already after 4 months of nothing on sema
  • No sulfur burps yet 🤞

Moving to 5mg next week per my endo's accelerated plan. Will keep updating!

SW: 247 | CW: 206.9 | GW: 165

Last edited: May 23, 2026 at 3:46 PM
49 0MikeKY_noInsulin, Dr.RaviCardio, jennifer_SEA and 46 others
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JenPlateau
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May 23, 2026 at 12:03 PM#10

The energy increase you're describing is something I hear from probably 60% of my patients who switch. There's some mechanistic basis for it — GIP receptor activation in the brain may have distinct effects on perceived energy vs pure GLP-1 agonism. It's not well studied yet but it's a very consistent patient-reported outcome.

Glad the transition is going smoothly! 🙌

50 16sarah_nash92, FitDadDave, RunnerRach and 47 others
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