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Semaglutide or Tirzepatide?


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Does anyone here have any experience with either of these? My understanding is that these these are medications that are approved for treating Type 2 Diabetes, but many doctors are prescribing them off label for weight loss.


My fasting glucose and A1c levels are borderline pre-diabetic and have been steadily getting worse despite improving my diet. My doctor is open to trying either of those medications. I have inappropriate sinus tachycardia (treated with Ivabradine (Corlanor) and low dose Bystolic), and I’ve also noticed that my symptoms seem to get worse if I eat anything that causes my blood sugar levels to bounce.  I’m wondering whether my heart rate (and related symptoms) might be better controlled if my glucose metabolism were better controlled.

My insomnia (related to the tachycardia) has gotten worse over the years as my fasting glucose and A1c levels have deteriorated. This is my primary motivation for looking into this.  It’s a serious issue for me and affects every aspect of my life. 


One concern is that both of those meds can slow stomach emptying. I already have mild (stage 1) gastroparesis, and this may make it worse.

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Have not taken either of these but i can tell you that metformin was a no go for me. big show stopper was bad cramping. from what i have read it's a mixed bag for folks taking either of these drugs. some do ok with little side affects some with mild and others just can't tolerate the meds. my Endo takes Ozempic and only thing he deals with is a bit of burping.

50 minutes ago, Jason_X said:

and I’ve also noticed that my symptoms seem to get worse if I eat anything that causes my blood sugar levels to bounce.

I am a diabetic as well. I can tell you for sure when my blood glucose levels get high or out of control i am very symptomatic orthostatic as well as mild tachycardia among other issues. can't say i have insomnia but i do get up multiple times in the night to relive myself when my BG has been high (diabetic pee).

There is a pill form of Ozempic (Rybelsus) that maybe more tolerable. for the gastroparesis i would take to your doc. only reason i have not tried these drugs is that my Endo suspects some sort of pancreas/malabsorption issues so we are sorting that out first.

Just a friendly reminder eating low carb helps.

Good Luck! and keep us posted.  

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Thanks for the info! I tried Metformin years ago and it seemed to aggravate my tachycardia and insomnia. However, I'm on Berberine now and I'm tolerating it fine. I keep lowering my carbs, but I haven't tried going completely carb-free. More exercise would be great, but I can't tolerate more than a little exercise these days without increased heart rate for 12-24 hrs and certain insomnia. I've tried some mild intermittent fasting and find it very unpleasant.

If I try one, I'm leaning towards Tirzepatide over Semaglutide since it seems to be more effective with slightly reduced side-effects.

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@Jason_X I have read that Tizepatide does come with fewer side effects as well. Do expect some weight loss with the drug. It's also advised to take on more fluid.

I do the intermittent fasting and have been good with it. seems like every time i try the 6 meals a day or a normal 3 meal a day i just end up with higher glucose levels and start feeling sick. Stick with what works for you for sure.


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