Switching from sema to tirz and WOW the difference — what worked for you?

There's no official dose conversion table between tirzepatide and semaglutide, but here's what's commonly used in clinical practice: Approximate conversions (not official guidelines): - Tirz 5mg → Sema 0.5-1mg - Tirz 7.5mg → Sema 1-1.7mg - Tirz 10mg → Sema 1.7-2.4mg - Tirz 12.5mg → Sema 2.4mg - Tirz 15mg → Sema 2.4mg Coming from tirz 10mg, your prescriber will likely start you at sema 1mg or 1.7mg depending on their comfort level. Some prefer to be conservative and start at 1mg to re-establish tolerability. The GIP component of tirzepatide is what makes direct conversion imprecise — you're not just switching GLP-1 doses, you're removing a second mechanism of action entirely.

I did this exact switch about 4 months ago! Went from tirz 7.5mg back to sema (Wegovy 1.7mg). My experience: Week 1-2: Felt "off" — like the medication wasn't doing much. Appetite was noticeably higher than on tirz. Week 3-4: Sema kicked in more fully. Appetite suppression returned but it's definitely less intense than tirz. Month 2-3: Stabilized. Losing about 0.5 lb/week (was losing 1.2 on tirz). Month 4: Steady state. Side effects are basically zero, which was the whole point. The trade-off is real: tirz was more effective but sema is more tolerable FOR ME. Everyone's different. My hair stopped falling out about 6 weeks after switching, which was the main reason I switched back. I regret nothing. 💇‍♀️

thank you for the conversion guide. I'll bring this to my doctor. your timeline is really helpful. The hair thing is a big concern for me too — I'm a guy and it's already thin to begin with. Did your doctor think the hair loss was from the tirz specifically or from the rate of weight loss?

Jumping in on the hair question. Telogen effluvium (TE) is associated with rapid weight loss regardless of the mechanism. However, there's emerging discussion in dermatology about whether the dual agonism (GIP+GLP-1) of tirzepatide may contribute to a slightly higher rate of TE compared to semaglutide alone. From the SURMOUNT trials: > Alopecia was reported in 5.7% of participants on tirzepatide 15mg vs 1.0% on placebo From the STEP trials (semaglutide): > Alopecia was reported in 3.0% of participants on semaglutide 2.4mg vs 0.9% on placebo Whether this difference is due to the drug itself or simply the greater rate of weight loss on tirzepatide is unclear. But switching to a medication with potentially less hair impact is reasonable, especially if you're already experiencing TE. Consider adding biotin, iron (if deficient), and ensuring protein intake stays above 0.8g/lb during the transition.