Tirzepatide

Dual GIP and GLP-1 receptor agonist built on a 39-amino acid synthetic peptide backbone. Activates both incretin pathways simultaneously — GLP-1R for appetite suppression and insulin secretion, GIPR for enhanced beta-cell sensitivity and adipose tissue lipid metabolism. The GIP component differentiates it from pure GLP-1 agonists by engaging distinct metabolic signaling cascades in adipocytes.

Half-life

5 days (120 hours)

Bioavailability

80% (SC)

Route

subcutaneous

Evidence tier

T1 — Multiple RCTs

Optimization pillars

fat-loss · cellular-health

References

4 peer-reviewed

Dose ranges

Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.

conservative

2.5–5 mg/week SC

Titration initiation (weeks 1-8)

moderate

7.5–10 mg/week SC

Effective weight loss range

aggressive

12.5–15 mg/week SC

Maximum approved dose (Mounjaro/Zepbound)

Monitoring

fasting-glucose
hba1c
fasting-insulin
homa-ir
lipid-panel
thyroid-panel
alt
ast
triglycerides
creatinine

Contraindications

medullary-thyroid-carcinoma
men2-syndrome
pancreatitis-history
severe-gastroparesis

References

PMID:35658024Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1) — N Engl J Med, 2022
PMID:34170647Tirzepatide versus Semaglutide Once Weekly in Type 2 Diabetes (SURPASS-2) — N Engl J Med, 2021
PMID:37840095Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA) — N Engl J Med, 2024
PMID:33951535Tirzepatide versus Insulin Degludec in Type 2 Diabetes (SURPASS-3) — Lancet, 2021

Notes

Tirzepatide is what happens when you stop thinking about receptors individually and start thinking about systems. Dual agonism is not just additive — the GIP receptor contribution changes the metabolic calculus entirely. SURMOUNT-1 showed 22.5% body weight reduction at 15mg. That is surgical-tier weight loss from a weekly injection. The head-to-head against semaglutide in SURPASS-2 showed superior HbA1c reduction and weight loss at every dose tier. But the real signal is the lipid panel. Triglyceride reduction with tirzepatide exceeds what you see with most statins. This compound is a metabolic architecture reset.

This is not medical advice

Discuss with a licensed clinician before starting, stopping, or changing any compound. This page documents what the research literature describes — it is not a prescription.

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