Congrats Dr.EM_Chicago!! You should be so proud of yourself. 🎉 👏

Clinical perspective on Tirzepatide titration:

I have managed over 200 patients on GLP-1 therapy and this topic comes up frequently. What the data shows — and what I see in practice — is that the medication works best as part of a comprehensive approach.

For this specific question, I would recommend: getting comprehensive baseline labs first.

kevin_tulsa said:

You should be so proud of yourself

I respect kevin_tulsa perspective but I think this oversimplifies things a bit. Re: Tirzepatide titration — the subgroup analyses show meaningful heterogeneity.

I am not saying kevin_tulsa wrong entirely — just that the picture is more nuanced than a blanket statement. The SUSTAIN data specifically shows different outcomes in different metabolic phenotypes.

Can confirm — exactly what happened to me.

Want to share my personal experience related to Tirzepatide titration since I think it might help others in a similar situation.

I started my GLP-1 journey in March 2025 at 285 lbs with metabolic syndrome. My telehealth provider prescribed semaglutide 0.25mg to start.

Now, 12 months later: I am down 85 lbs, my labs have normalized, and my sleep apnea has improved dramatically. The Tirzepatide aspect specifically was something that made a big difference in my journey.

This forum was my go-to resource throughout.