Apr 1, 2026 at 8:33 PM#6
Regarding your sulfur burps — this is much more common with tirzepatide than semaglutide in my clinical experience. The GIP component seems to slow gastric emptying in a way that promotes fermentation and H₂S production.
If you do switch back to sema and the sulfur burps resolve, that'll be telling. But in the meantime, some patients get relief from:
- Bismuth subsalicylate (Pepto)
- Simethicone with meals
- Reducing high-sulfur foods (eggs, cruciferous veg, red meat)
- Smaller, more frequent meals
The injection site reactions are also more commonly reported with tirz — the formulation and injection volume may play a role.
Last edited: Apr 1, 2026 at 10:33 PM
36 6julia.endo, JessicaM_2024, TomFromTexas and 33 others
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Apr 2, 2026 at 1:16 AM#7
the data comparison is eye-opening. 5.7% vs 3.0% is nearly double. Even accounting for greater weight loss on tirz, that's notable.
the sulfur burps are literally affecting my work life. I'm in sales and I've had to excuse myself from client meetings. It's mortifying. Pepto helps somewhat but isn't a real solution.
I think I'm going to talk to my doctor this week about transitioning back. The extra weight loss isn't worth the quality of life hit.
35 5kim_atl_prep, sarah_TO, wendy_avl and 32 others
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Apr 2, 2026 at 5:59 AM#8
One more thing to consider for the transition: timing. You'll want to coordinate the switch so there's minimal gap. Most commonly:
1. Take your last tirz dose
2. Wait one week (your normal injection schedule)
3. Start semaglutide on what would have been your next tirz injection day
4. Begin at the agreed-upon sema dose
Some doctors prefer a two-week washout between the two medications. Ask yours what they prefer. Either approach is used in practice.
Also make sure your insurance/prior auth situation is sorted before switching. Going FROM tirz TO sema should be straightforward from a coverage standpoint but always verify first. Nothing worse than a gap in medication because of insurance admin. 📋
Last edited: Apr 2, 2026 at 8:59 AM
34 4marcus_mpls, DeniseRN_TPA, SandraNC_45 and 31 others
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View ResultsApr 2, 2026 at 10:41 AM#9
Great point about insurance. I'll call them first. My original Ozempic PA might still be on file actually.
Thanks everyone. I'll update this thread after I make the switch. I know most people here are going sema→tirz so hopefully this reverse perspective helps someone else who's struggling on tirz and feeling like they can't "go back." You absolutely can. ✌️
Last edited: Apr 2, 2026 at 2:41 PM
33 3tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 30 others
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