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Evidence-based GLP-1 & peptide discussion since 2023
ForumsTirzepatide (Mounjaro / Zepbound)5mg doing nothing - should I ask to go up?

5mg doing nothing - should I ask to go up?

nick_newbie Mon, Apr 13, 2026 at 3:31 AM 10 replies 770 viewsPage 1 of 2
nick_newbie
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Apr 13, 2026 at 3:31 AM#1

Fourteen months on tirzepatide, currently 10mg, and I stopped escalating because 10mg is doing the job and 15mg made me feel flat rather than full.

So the question, as narrowly as I can put it: whether anyone has held 10mg long term rather than climbing, and what happened over the following year.

If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

25 20robert_kc, dan_philly, MeganSA_TX and 22 others
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RetaRick_CA
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Apr 13, 2026 at 4:26 AM#2

This one has a reasonably settled answer, so here it is. Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five. That matters when you are deciding whether a dose step has finished expressing itself.

24 19AmyNC_wife, SkepticalSean, Dr.CardioMD and 21 others
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tane_welly
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Apr 13, 2026 at 5:21 AM#3
RetaRick_CA said:
Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of people never reach the dose the headline number came from.

23 18DanielChem_CHI, marco_milano, pam_columbus and 20 others
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FranDenver
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Apr 13, 2026 at 6:16 AM#4
nick_newbie said:
Fourteen months on tirzepatide, currently 10mg, and I stopped escalating because 10mg is doing the job and 15mg made me feel flat rather than full.

This matches mine closely enough to be worth saying so. SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1. Different trials, different populations, so the comparison is indicative rather than decisive — but SURPASS-2 was a genuine head-to-head and it pointed the same way.

Last edited: Apr 13, 2026 at 12:16 PM
22 17MASHdoc_SA, GenomicsKate, Dr.ObesityMed and 19 others
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hans_munich
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Apr 13, 2026 at 11:31 AM#5

Adding the clinical framing, because it changes how the question reads.

Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows:

Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill coefficient ≈ 1.3
Tirzepatide: ED50 ≈ 6mg, Emax ≈ -25%, Hill coefficient ≈ 1.5

Clinical implication: most patients achieve >80% of maximal response by the mid-range dose (1.7mg sema, 10mg tirz). Going to the maximum dose provides diminishing returns — possibly not worth the additional side effect burden for some patients. Individualize dosing based on response vs tolerability.

21 16emma_london, tammy_FL, Dr.LipidDallas and 18 others
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