The slow GLP-1 titration, as people actually run it
Reach a tolerable dose of a GLP-1 without the gut side effects, or stay below the label dose on purpose
Patterns that circulate on peptide forums and in vendor dosing guides. Nobody measured anything systematically in any of these, and they are recorded here as reports rather than findings.
Not advice. This is a record of a schedule, not a dose for you.
The schedule, as reported
Each field below is what the source states, not a rounded version of it. Where the source does not publish a detail, the field says so instead of filling the gap.
- Amount
- Compounded vials drawn to amounts the pens do not offer. Starting points as low as 0.25 mg to 1.5 mg weekly of tirzepatide are described, against the 2.5 mg the label starts at.
- Frequency
- Once weekly
- Route
- Subcutaneous injection drawn from a compounded vial rather than a fixed dose pen
- Duration
- Each step held for four weeks or longer, and frequently held at a low dose indefinitely rather than escalated at all
What was measured
Body weight on a home scale, and how the person feels. Almost nobody running this pattern has any of the endpoints the trials used, and nobody is measuring what dose actually reached them from a drawn vial.
What was reported
Reports, not findings. Nothing below was produced by a controlled comparison.
People describe holding a low dose because it is enough for them, or because it costs less, rather than escalating toward the label maintenance dose.
Nausea is the reason most often given for holding a step longer than four weeks.
The approved escalation is treated as a ceiling on speed rather than a target to reach.
These are accounts of what people chose to do. No weight loss figure from any trial belongs to any of them.
Where this comes from
Compounded tirzepatide microdosing write-ups, and the practice usually attributed to r/tirzepatidecompound. The comparator is not in dispute: the approved schedule is 2.5 mg once weekly for four weeks, then increases of 2.5 mg every four weeks, which is the schedule SURMOUNT-1 ran.
Reddit blocks automated retrieval, so those threads could not be read for this entry. The sub-label starting amounts above come from published microdosing write-ups, several of which describe licensed prescribers using them off label. Nothing here establishes how many people run it or what happens to them.
What this protocol cannot tell you
Required on every entry in this registry, and never empty.
Every efficacy number that makes a person want a GLP-1 came from a trial that escalated to a maintenance dose and held it, so somebody who stops at a fraction of that dose has no number to expect. Nobody has trialled sub-label dosing against the label schedule, so whether a slower ramp reduces nausea across the whole course or only moves it later is unmeasured. Compounded vials are not tested for identity and content the way an approved pen is, and drawing a dose from a vial is a different accuracy problem from clicking a pen. Nobody is monitoring any of this.
The compounds in this protocol
Each profile carries the full evidence record, the legal status and what the trials did not show.
- Tirzepatide
A first-in-class dual GIP and GLP-1 receptor agonist with superior weight loss and glycemic control versus GLP-1 mono-agonists.
- Semaglutide
A long-acting GLP-1 receptor agonist approved for type 2 diabetes and chronic weight management, with proven cardiovascular risk reduction.