I've been on tirzepatide for 3 months and I have these firm, pea-sized lumps under my skin at previous injection sites. They're not painful, not red, not warm — just... there. Like little marbles under my skin. I have about 4-5 of them across my abdomen.

Is this normal? Will they go away? I'm running out of real estate for new injections because I don't want to inject near the lumps. 😬

What you're describing sounds like subcutaneous nodules at injection sites, which can represent a few things:

1. Lipohypertrophy — localized fat tissue buildup from repeated injections in the same area (more common with insulin but can occur with any subcutaneous injection)
2. Granulomatous reaction — a mild immune response to the injected medication or carrier
3. Residual medication depot — especially possible if injection technique resulted in too-shallow placement

The good news: if they're non-tender, non-erythematous, and non-warm, infection is very unlikely. These typically resolve on their own over weeks to months, though some can persist.

Key management points:

• Rotate injection sites systematically — use all approved areas: abdomen, front of thighs, back of upper arms (if someone else can inject). Within each area, move at least 1 inch from the previous site.
• Do NOT inject into existing lumps — absorption may be erratic
• Ensure proper technique: 90-degree angle for subcutaneous injection, don't inject too shallow
• Let the medication come to room temperature before injecting — cold medication may cause more local reaction

I had the same thing! About 6 lumps at their peak, all on my belly. A few things that helped:

• Switched to injecting in my thighs and the lumps in my abdomen slowly resolved over about 2-3 months
• Started letting the pen sit out for 20-30 minutes before injecting (room temp vs. fridge cold)
• Inject SLOWLY — I used to rush it and I think that contributed. Now I inject over 10 seconds, count to 10 after the plunger is down, then remove
• Gentle massage of the area for 30 seconds after injecting (some sources say don't massage, but my nurse practitioner recommended it and it seems to help prevent lumps for me)

The existing lumps do go away, just slowly. Like a month or two per lump.

I'm a nurse and inject medications all day. A couple of practical tips:

• Use a rotation chart — literally draw a grid on a piece of paper with zones on your abdomen and mark where you injected each week. Sounds excessive but prevents clustering.
• Pinch up adequately — you need a good fold of subcutaneous tissue to ensure you're in the fat, not too shallow (intradermal) or too deep (intramuscular)
• If you're lean, your thigh outer aspect is often a better site than the abdomen — more subcutaneous fat for most people
• Don't rub the site vigorously after. Gentle pressure with a cotton ball is fine.

Those nodules are almost certainly benign but mention them at your next appointment so your provider can document and examine them.

wait should I NOT be injecting in the same spot every week?? I've been doing the same exact area on my left belly every time for 6 weeks... is that why I have one big lump there? 🤦‍♀️