Taking phentermine with lorsartan

Hey guys, I was diagnosed with PCOS last year I tried going on Metermine (phentermine) it like worked but not rlly I have stopped taking it bc it kinda made me feel sick.
Any suggestions on weight loss with PCOS I have the pcos characterised with insulin resistance and cysts mainly. I was looking at inositol but I don’t wanna buy it if it doenst rlly work.
Also does anyone just get random cramps in their lower stomach they feel like period cramps but not on their period?
Thanks guys ❤️

For three months I took phentermine and lost 30 pounds, after this initial success I transitioned over to 2.5mg of Zep and after 3 weeks I’ve lost an underwhelming 1.5 pounds. Neither medication is covered by my insurance, the phentermine cost $12 a month and the Zep is costing me $550. I’ve been doing everything I’m supposed to do food and exercise wise. When I was on the phentermine I wasn’t very interested in food but with the Zep I am way more interested in food than I expected. I know 3 weeks isn’t a long time but considering how difficult it is to find Zep, how much it costs me and how little success I’ve had it just doesn’t seem worth it. Anyone else having second thoughts about it?
Update: It’s not going to matter anyway because I can’t find the 5mg dose at all. For those that asked about staying on phentermine, after 3 months you’re supposed to take a break from it for a while because it loses its effectiveness.

Hi, new here. I've been on and off prednisone for about a year or a little over because I had insanely bad eczema. I've been working from home or at a Call center for about 2 years. I'm trying to get out for exercise more and hit the gym but it's hard because my muscles are literally sore for about a week to the point I can barely move (I was told weight lifting is the fastest way for women to lose weight, and no, I'm not lifting that much even lol) so I've been kind of on and off at the gym. Google says that prednisone weight can take up to 6-12 months to lose. I jumped from 160ish to 196, now that I've taken phentermine I'm about 184-187 depending on the day. I'm trying to watch what I eat and less calories in during the day, but with me working over nights it's hard to keep a balanced schedule. I try to eat at night within my work schedule period but I have to sleep during the day. I work 60hours a week now doing 2 jobs, so it's hard to kind of get out. Does anyone have any advice or share a similar experience? I don't want to wait 6 months to a year to get back to my old weight. Heck I'd even like to be 140 lbs. Also, I'm going on 25 and I'm 5'3ish. Thanks in advance!

Hi, I (28F) am 5'3 and weigh 212 pounds (fluctuating to 210 at times). I have a few conditions but the only relevant condition to what I need help with is GERD and my weight. I don't smoke, drink, or do any recreational drugs. I'm in the US. Sorry for making the background info so long, just wanted to give the full picture. The question is down below if you want to just jump to it.
In 2019 I ended up gaining a lot of weight. This was surprising to me because I was always 125 pounds. I ended up getting to over 230 pounds in 2 years. I thought it was my birth control because I had just gotten on a new one (Nexplanon) at that time. During this time I developed a bad case of GERD, and had to get on both Lansoprazole and Famotidine. As time passed, in early 2022, I would get bad stomach pain and ended up getting what ER doctors believed to be infections: colitis and on another occasion ileitis. My gastro at the time was confused because I wasn't showing signs of infection. He told me he didn't think I had any infections and set up an MRI Enterography in 2023. By 2023 I was down to 221 pounds.
In 2022, I had met with a Rheumatologist who has honestly been amazing. The Rheumatologist identified my Psoriatic Arthritis in my first visit, well before my first Psoriasis patch ever showed. Treatment has been going pretty well. During that first visit I told him about my infections earlier that year and he stated that he believed I have IBD. He says in all his time working (he is an older doctor), I'm presenting clear signs of it but they probably won't catch it any time soon as it's hard to catch. Fast forward to the MRI Enterography, they catch nothing. Everything is fine. Time passes, the pain comes back, and I get scheduled for a Colonoscopy and Endoscopy. Both came back fine, just evidence of mild chronic gastritis comes back. Eventually, that gastro decides I'm too complicated and drops me, passing me on to a nurse practitioner who is only there to refill my GERD meds.
In late 2023, the pain gets worse. Nothing touches it, and only opioids manage some of the pain until even they stop working. I get in a stat laparoscopy to see if I have endometriosis and they saw none so they send me home. Things are sort of okay until they weren't again and this time I see a new gastro. They schedule me for a Colonoscopy/Endoscopy for December. During the end of 2023 I lost 11 pounds. I went from 221 pounds to 210 pounds. I was so nauseous I couldn't eat anything. I was dizzy to the point that I couldn't drive or walk well. My stomach was in so much pain and felt "paralyzed". I just felt awful.
The colonoscopy/endoscopy showed, once again, nothing but mild chronic gastritis. On December 24th, I started Phentermine. With Phentermine, my issues went away. Everything from the nausea to the pain and paralyzed stomach went away. I stopped it for a week to see if the symptoms came back and they did. Once I started again the symptoms went away. It was like a miracle medicine. I went from taking 4 acid reflux pills to 1. My nausea went away and everything felt good. I'm just so confused...Actually, I have stopped taking Phentermine as often because I keep forgetting to take it. My nausea, dizziness, and stomach pain have all come back. I went to the ER a week ago for intense stomach and kidney pain. They did a CT scan and the kidney pain was due to a kidney stone, but they also told me that I had inflammation in my intestines that showed some kind of chronic inflammatory disease occurring. They just couldn't tell or see more details.
Here's the question: Why would Phentermine help with all of these issues? Is it the Phentermine? Just today I was eating lunch and suddenly got extremely nauseous. I remembered I hadn't taken Phentermine and took it. Within 30 minutes my nausea was completely resolved. Is it just me? Am I making it into some kind of placebo that I think cures me but doesn't actually? I'm unsure and I need someone to explain why it could or couldn't be it.
My primary and gastro are so confused by this but they're encouraging me to continue on the Phentermine as it's helping my symptoms. My primary is concerned because it isn't meant to be used long-term and wants this issue resolved. My Rheumatologist is still certain I have IBD and my gastro is still confused because nothing has come up on colonoscopies/endoscopies. Is IBD really that hard to catch? If so what other tests or bloodwork should I be doing to check for IBD?

28 (F) 5’2” SW:212 CW :203.7 Goal: 170
So today is day 5 of phentermine and I am 8.3 pounds down. Only side effects I’ve had so far is dry mouth and constipation. I haven’t really had much of an appetite but I try to at least eat something full of protein and drink a protein shake. I began weight lifting and 30 min cardio Friday. Constipation was the biggest con with not passing any bowls for 4 days. I tried magnesium citrate and threw it up about an hour after taking it . I tried milk of magnesia yesterday afternoon and it got the job done !!! I went to the bathroom 7-8 times and every time I felt more and more relieved. The dry mouth is a little annoying and makes me feel like I have to cough so I’m constantly drinking water but other than those two side effects I feel great and can’t wait to see the scale move more!

I have struggled so badly this weekend with constipation. On Friday night I had really bad stomach issues, I thought I ate too much or it was something I ate. I barely slept Friday night. On Saturday morning I took pepto and ate plain oatmeal. I felt so much better. I drank miralax later in the day, but drinking plain water was making me nauseous. I didn’t eat much on Saturday but I didn’t take my phentermine either. On Sunday, I didn’t take my phentermine and I ate a bit more but stayed below 2000 calories. Water still made me feel nauseous but I added water flavors. I did not drink miralax. I woke up this morning 5 pounds heavier and my stomach is so freaking big. I’m contemplating taking a laxative tonight and seeing how I can clear this out, I hate laxative but I am so freaking uncomfortable.

I have been taking 15mg Phentermine and Topiramate for a month and lost a few pounds so far!
But i felt my appetite coming back so my doctor has prescribed me the higher dosage - 37.5mg.
When i first started 4 weeks ago i went through some pretty intense side effects the first week: - insomnia - nausea - dry mouth - lightheadedness/dizziness
Most of these have gone away except for the dry mouth (which i don’t mind because it helps me drink water).
But I am worried that i’ll experience these side effects again.
My doctor also suggested maybe easing my way into the higher dose by taking one every 2 days if i feel like my appetite is okay, has anyone tried this? did this help with side effects?
I’m also very close to my goal weight, so i’m planning on trying to easy my way off of. Is the best way to do this, get to my goal weight and then ease my way off (one every two days, one every three days, etc.)

Update: I’ve noticed a lot of side effects and not much weight loss. I’m currently taking 15 mg of Lexapro along with the Phentermine (15mg). My anxiety shot up very badly when starting the phentermine, I couldn’t breathe and couldn’t sleep. I powered through it until last week it subsided. I started the 37.5 mg and anxiety has risen but not as bad as before. My issue is I’ve only lost 4-5lb. I’ve been walking about 1-2 miles a day and going to Pilates 3x a week but still only 4lb loss on the 15mg for 45 days. Hoping that starting the 37.5 will jump start some more weight loss, but also unsure if the lexapro is making it harder for my body. Anyone else on lexapro with this medication? My starting weight was 189 and I’m at 184, and I’m a 5’5” female, 30 yrs old.

I'm on day 2 of paxlovid, had my second dose at 12 because i didnt get my medications until late last night. i know wveryone says they get diarrhea but im having the opposite problem. i was already struggling w this because im on phentermine, but now im so full because of paxlovid side effects. the bloating is insane, and i cant poop. can i take miralax? i cant even drink anymore fluids or eat food because it just makes me bloat even more and im in so much pain. how the fuck am i supposed to take another dose after this when i can barely get water in me without feeling like im going to stuff myself until i puke?
for reference, i havent really been hungry at all while ive had covid, thats aside from t he phentermine because i still get hungry on it. i had been drinking lots of water and tea (before i started pax) to stay hydrated. all i eat with pax is a bowl of soup and a piece of bread. why do i feel like i ate a well done filet minion please someone help me bc i wont be able to take my third dose or drink water anymore if this fullness doesnt go away

20m, 5’11”, 316
diagnosed GAD taking unprescribed Testosterone Cypionate @ 100mg/week
i had an ER visit last friday (may 10th) since i had taken 35.7mg Phentermine that morning to try it out. it made me feel good and then it began to wear off after a few hours and some extreme anxiety issues and heart palpitations set in. the veins in my hands began to darken and my fingers started to get a light purple hue that spread onto my palms. seeing this made me freak out and overthink so i got up slowly and just walked around for a bit and it subsided. when i got home, i did some light cardio which made my lips turn red. it looked like i was wearing lipstick or something and they also felt tingly. that’s when i decided that i needed to go to the ER just to be safe. around the same this same time i began to feel light headed and i was getting random sharp pains in my right forearm and right neck (which might’ve been placebo since i was overthinking all of this)
when i got to the ER they did an EKG on me and said everything was fine, on the copy of results i got back it did say something about a left ventricular conduction delay but it had a line through it where the doctor wrote “normal/(his name)MD”.
next they did blood work to check liver function and CBC. liver came back elevated but not dangerous, everything else came back normal besides CK enzymes. 1455 U/L is what the marker was.
i do strenuous 1hr workouts 3 times a week with a personal trainer lifting weights. i don’t ever really feel sore from them and i really had no muscle pains that would’ve helped me guess CK elevation. i’ve been working out for the past 3 months. dr said discontinue the steroids and rest, come back to check bloods in a few days to see if it went down.
i do have rest days, i’m not sure what could cause CK elevation. i have a theory that it’s because i’m not taking in enough protein to sustain muscle repair so i’m just sitting with the microtears and they aren’t healing, since i really don’t get enough protein in. would that be a reasonable cause for CK elevation? any thoughts or advice is greatly appreciated.

I started this medication in October of 2023! height - 5'2, starting weight - 245 pounds, shirt size - 2xl, pant size - 2xl - 16\18.
currently - 180 pounds, shirt size - medium, pant size - Lg - 10/12,
total loss of 65 pounds !!
I have noticed my hands appear smaller, and my shoes fit more comfortably, I get colder a lot easier, I have not noticed any loose skin, I am taking just the topiramate (50mg), no phentermine. I try to go to the gym atleast 5 days a week, for an hour at most, sometimes less. I switched out the food in my house for the lowest sugar, highest protein, lowest calorie options I could find within my budget, I have found that preworkout helps get me into the gym (always monitor your heart rate with this medication & avoid anything that will help raise your body temp) I have found that the easiest machine for me since the beginning of my journey has been the elliptical, and of course weights!

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Old-Scool Diet 2.O
"A comprehensive article on bodybuilding diet minutiae - and SO MUCH MORE
What follows is my version of an old school (mid-80s to early 90s) bodybuilding fat-loss diet/regimen, with an updated (2020's) dietary supplementation plan. This type of diet was very popular when I was a child and produced results for many who used it. I was reminded of such diets by bodybuilding writers such as John Romano, who wrote about the basic bodybuilding diet in an issue of Muscular Development sometime around 2008.
Although renowned for its simplicity, it can become somewhat monotonous. The key tenets of this type of fat loss diet are 1) being in a slightly negative caloric balance, 2) using a simplified shopping list of 15 or fewer items, and 3) taking in large amounts of protein, a moderately large amount of carbohydrates, and a small/modest amount of dietary fat.
You will consume 3-4 "whole-food" meals per day along with 1-3 protein shakes (more on workout days and less on off days). You should drink at least 1 gallon worth of calorie-free liquids per day.... the closer you get to 1.5 gal and even 2 gal (if you're really big) the better.
The Shopping List
So, you're at the grocery store and you're in and out within 10 minutes. You don't care about the weekly sales (unless they involve one of your "weekly 15" items). Thus, grocery shopping becomes a snap.
As for the items themselves, a basic "old school" bodybuilding diet would likely contain:

1. Eggs
2. Milk (skim or 2% or UF/CFM)
3. Chicken Breast (boneless and skinless)
4. Tuna chunk light, canned
5. Cottage Cheese (2-4%) & red-fat cheese
6. Lean Gr Beef or Sirloin, NY strip, etc Steak
7. Rice
8. Oatmeal
9. Whole wheat (or white) Bread
10. Apples
11. Oranges
12. Pasta
13. Frozen Berries
14. Bananas
15. Broccoli

Of course, you can rotate in other vegetables such as corn on the cob, salad greens, and lettuces (with light balsamic or low-carb vinaigrette dressing if a salad) etc etc.
Eating a variety of wholesome foods that are (by and large) as unprocessed (aside from rice and oatmeal which must be processed as well as some dairy items) as possible typically means you'll be getting a wide spectrum of nutrients, including both macro and micronutrients. A daily multivitamin/mineral tablet can ensure you're filling any gaps in micronutrient needs (vitamins and minerals). As for macronutrients, this diet provides the bulk of its calories as protein and carbohydrate with only about 10% of the daily calorie allotment being reserved for fats.
What is the logic behind the macronutrient breakdown?
You'll be eating about 45-50 percent of your calories as carbohydrates and 40-45 percent as protein with only 10-15% as fat.
Why 45-50% as carbohydrate? Carbohydrate is stored in the liver and muscles as a substance called glycogen. For every gram of glycogen stored within the body, there are 2.7 grams of water attached. This gives the muscles a pumped appearance and feeling. This also means the muscles are well stocked with stored energy. The majority of your weight training sessions will involve anaerobic exercise. This type of exercise utilizes the glycolytic energy pathway to generate ATP or Adenosine Tri Phosphate.
(Note: The amino-acid-based dietary supplement Creatine also supports ATP synthesis by donating Phosphate to ADP).
Having adequate amounts of both calories and carbohydrates helps prevent dietary-induced drops in TSH.... or Thyroid Stimulating Hormone. This, in theory (and empirical practice) keeps one's metabolism humming and prevents one from "drying out." Simply put, you'll get great pumps in the gym thanks to all that stored water (remember 2.7 grams of water is stored per gram of glycogen).
Energy-rich carbohydrates (grains and fruits) differ from fiber-rich vegetables. Not only do energy-rich carbohydrates provide far more calories but the calories they supply raise blood glucose levels markedly and rapidly. These types of carbohydrates are more easily broken down into simple sugars (glucose etc). Simple sugars and carbohydrates such as rice and white bread are termed high-glycemic (they spike serum blood sugar and insulin levels) while whole wheat or rye bread and things like oatmeal and non-starchy vegetables are deemed low-glycemic.
To be completely forthright and technical all carbohydrates and macronutrients provide energy. The phytonutrients, micronutrients, and fiber aside, carbohydrates simply provide a "higher octane" energy (than protein or fat). ATP is regenerated via the glycolytic energy pathway; carbohydrates stoke the glycolytic energy pathway most efficiently. Despite this, carbohydrates are technically unessential.
Fat and in particular protein can both be used to create carbohydrates. And both fat and protein can supply energy. But fat and protein contain essential nutrients the body cannot manufacture. These essential nutrients are essential fatty acids (EFAs) and essential amino acids (EAAs).
What about Protein?
Because you're getting roughly half of your calories from carbohydrates the protein you take in will likely be spared from providing energy - at least that's what we're hoping for. You're going to shoot for 1 gram of protein per pound of body weight. The actual range of values would be between 0.8g/lb to 1.4g/lb (grams of protein per pound).
You're going to want to consume high-quality, complete protein from sources such as meat, poultry, fish, and dairy. If you have 4 meals and a shake and are taking in let's say 225 grams of protein per day that works out to 45 grams per "feeding." To be more realistic we'll simply say take in between 40-50 grams of protein per feeding.
Protein supplies nitrogen and the "building blocks" of skeletal muscle tissue (amino acids). Protein is essential because 8-10 amino acids are considered essential (other amino acids can become essential in certain situations or circumstances, they are called conditionally essential amino acids).
If you're 200 lbs taking in 1.25 grams protein per pound of bodyweight you're consuming 250 grams of protein per day. Protein contains 4 calories per gram. Thus you'd be consuming 1,000 calories of protein. At 45-50% of total daily calories, carbohydrates would comprise app 1.25x worth of calories as compared to protein. Thus, carbohydrates would come to 1,250 calories. Total daily calories would thus far be 2,250.
2,250 divided by 0.9 yields 250 calories, and at 9 calories per gram that would afford us a mere (roughly) 25 grams of fat. I would at least double this figure (not counting supplemental fats). 50 grams of fat adds 450 calories. 450 plus 2,250 yields 2,700 calories total. Thus, your diet breakdown will be closer to 16-20% fat (20% when including supplemental EFAs), 40% protein, and 40-45% carbohydrate).
Note: If need be, you can cut down carbohydrates by a few hundred calories and increase your protein consumption. This would change the dietary breakdown to roughly 40/40/20 (popularized by Barry Sears as the Zone diet).
You'll want to stay on this diet for a week and record how you felt, what you ate, and how well you slept. Every other day weigh yourself after your morning shit, shower and shave. If you maintain your weight the 2,700 calorie mark is your body's "set-point target." To reduce excess weight (fat) reduce your total daily calories by roughly 10-15 percent and exercise 3-5 days per week. Include cardiovascular training in addition to your weight lifting to further speed up your fat loss efforts. You can do LISS (low-intensity steady state) cardio (walking) or you can do HIIT (High-intensity interval training) cardio 2-5 times per week. Personally, I would choose 5 45-minute leisurely walks over other forms of cardio.
What about "fat burners?"
When people say "fat burners" they're referring to thermogenic agents which speed up the body's metabolism by some 5% or so (5-8% for an hour or two). In the 90s both Phentermine and the ECA stack were popular. These catecholamine-based compounds were potent appetite suppressants, particularly phentermine. The ECA stack was/is also a beta-adrenergic agonist. Since then a host of other supposedly "thermogenic" compounds and preparations have come into the limelight. Yerba Mate comes to mind, as do the popular OTC products Xenadrine and Hydroxycut. Even plain old caffeine is sometimes considered a first-rate "fat burner."
The truth is these products barely increase metabolic rate enough to make much of a difference. Most of their worth comes from their appetite-suppressant effects. Now, I'm not saying if you're suddenly prescribed Adderall or start smoking ice you won't lose weight - you will. It's simply that most weight loss, even from strong stimulants, comes from their appetite-suppressant effects.
The only "fat burners" that truly increase fat burning without the need for appetite suppression are L Carnitine and Cardarine. Cardarine is a peroxisome proliferator-activated receptor-delta agonist. Cardarine enhances lipolysis during exercise. Training increases energy availability by promoting catabolism of proteins, and gluconeogenesis, whereas GW501516 enhances specific consumption of fatty acids and reduces glucose utilization. L Carnitine can be beneficial to exercise performance and fat loss; paradoxically it also suppresses T3, or active thyroid hormone.
T3 or Cytomel can be used to markedly increase resting metabolic rate, but "T3 burns through muscle and fat indiscriminately." You can reduce the amount of muscle tissue being burned and attenuate the reductions in "muscle pump" experienced when supplementing with extra T3.
To do so you'll need to drink water like a camel and supplement your diet with beetroot crystals and citrulline malate. You'll also want to utilize Tadalafil or Cialis. Surprisingly, aside from increasing the pump one experiences from lifting weights Cialis also increases fat burning and creates more BAT (Brown adipose Tissue as compared to WAT... white adipose tissue), relatively speaking. BAT is metabolically active and behaves more like muscle in this respect.
To reduce muscle loss while on higher doses of T3 nothing short of AAS (@ least 200-300 mg/wk, if not 400mg + per week) will truly help. SARMS such as RAD-140 may be of some (yet limited) value. To be honest I would avoid T3 supplementation unless also using Testosterone (Enanthate 400mg/wk) or other AAS.
As for fats, their consumption is largely incidental on this diet and comes from the dairy, red meat, poultry, occasional salad, or handful of mixed nuts one might expect to consume if adhering to the aforementioned dietary principles .
This means the amount of saturated fat as compared to MUFAs or PUFAs will be somewhat high. To remedy this one can consume tuna packed in soybean oil as well as by supplementing 3x per day with triple concentrated, enteric-coated, fish oil capsules. These fish oil capsules break down in the small intestine and there are no fishy burps with them thanks to that enteric coating. They are extremely rich in the special fatty acids EPA and DHA, Eicosapentaenoic acid and Docosohexanoic acid.
One might also supplement with an Udo's Omega 3:6:9 blend of daily supplemental oil.
As for specialty fats, one must purchase the next two in supplement form. CLA is conjugated linoleic acid and it helps improve body composition over time by increasing muscle mass and decreasing fat mass. Sesamin has a host of potential health benefits. Together these two designer fats can markedly improve physical aesthetics, health, and overall well-being.
Finally, there is GLA or gamma linoleic acid. Unless you eat a lot of cashews you'll want to get this fatty acid in supplement form as well.
Note: You needn't supplement every specialty fatty acid mentioned to reap benefits from each fatty acid you choose to use.
The GOLDEN RULE of DIETING: CICO
Calories in vs. calories out. It's so simple yet so misunderstood. When you reduce dieting down to its least common denominator it's CICO you're left with. If you aren't gaining or losing weight you're at an established set-point. You're at current equilibrium. It also means you're essentially burning just about every calorie you take in (burning every single calorie to be more precise, it's just the body's ebbs and flows and an equilibrium setpoint is usually somewhat elastic ).
If you begin to regularly consume more calories than your BMTMR allot (and than you burn via daily movement and exercise), you will put on additional body mass (including both fat and skeletal muscle). If you begin to consume less than your BMTMR allot, and/or begin exercising yourself into a negative caloric balance, you will lose weight, typically a combination of fat and muscle (but usually far more fat than muscle, particularly if one lifts weights throughout).
Note: BMTMR = Basal & Total Metabolic Rate
So are all macronutrients equal then? I mean, do all macronutrients convert into ATP at the same efficiency rate?
Technically no they do not. Protein is far less efficient in its conversion to ATP as compared to fat or carbohydrate. Thus, it takes MORE protein to create "x" amount of ATP. Remember, ATP stands for adenosine triphosphate. It is the body's preferred cellular fuel for high-intensity, high-octane activities. In this sense, protein's inefficiency in converting to ATP means a calorie really isn't a calorie after all. (Because) It takes more protein calories to create "x" amount of ATP than if one were creating that same "x" amount of ATP from carbohydrate or fat calories.
Now that that anomaly is out of the way it's best to simply memorize CICO, calories in vs. calories out, irrespective of macronutrient source. This is the most practical, tried and true way to diet scientifically.
So you've established your caloric allotment for metabolic equilibrium and lowered that figure by 10-15%. You've added in 3-4 30-minute LISS cardio sessions per week in addition to 4 weight-lifting workouts. You're beginning to lose weight week in and week out and then your progress slows and eventually stalls. Your body has become accustomed to the lower calories and the extra workload. Unfortunately, aside from supplementing your diet with substances such as Cardarine or Clenbuterol, there is little more you can do outside of dropping calories once more.... (or adding even more cardio).
Over time these successive reductions in calorie allotment lead to a reduction in TSH, or thyroid stimulating hormone. It's the body's way of slowing things down in an effort to maintain homeostasis. To continue improving body composition one mustn't merely lose as much fat as possible, but also must maintain the muscle mass one has - or even build a bit. Now I'll come right out and say it, if you're 6-10 weeks into a strict fat loss diet you're not going to be concerned with building additional muscle unless you're using Testosterone and/or other AAS and PEDs. Even then, if juicing quite a bit, at some point building muscle transitions into preserving muscle. No matter how much you're pinning if you aren't eating enough calories you simply cannot (physiologically) add appreciable lean fat-free body mass.
To boost the body's T3 levels one can supplement directly with T3 (Cytomel) or with pro-active-thyroid T4 (converts to T3 in body; Synthroid). There is supplemental T2 but I advise readers to steer clear of this thyroid analogue. Another way of boosting T3 levels, and a legal, natural way to boot, is by having periodic carbohydrate-rich refeeds and higher calorie days. Have a carbohydrate-rich meal every 3 days if on a lower carbohydrate diet as well as a higher calorie day once every seven to ten days whether on a mixed macronutrient or a lower carbohydrate type diet.
How many meals do you need to eat per day?
While there is potentially some slight advantage to eating several smaller to moderately sized meals spaced evenly throughout the day the science says "when you eat the bulk of your calories makes little to no difference." So if you'd rather have two larger-sized 1,350 calorie meals and then intermittently fast for the rest of your wake-sleep cycle (or "day" whether a 1st, 2nd, or 3rd shifter etc) go ahead. That said, I would personally recommend at least 2-3 whole food-based meals and 1-3 protein shakes per day for best results in the gym. As for weight loss, remember it boils down to CICO: whether you have 10 270-calorie mini-meals or one 2,700-calorie smorgasbord makes practically no difference.
What about enhancing insulin sensitivity and improving glucose metabolism while imparting a nutrient-partitioning effect?
I first learned of the term Glucose Disposal Agent while reading Dan Duchaine's Underground BodyOpus. Dan was recommending an isocaloric diet at one point but I believe he'd moved onto cyclical ketogenic-type dieting by the early to mid-90s - and obviously by the time he wrote Underground BodyOpus. Because catecholamines work better in low (serum) insulin environments and because high levels of insulin in the blood render fat-burning enzymes such as HSL largely inert, it is a good idea to release as little insulin as is necessary/possible. Postprandial serum insulin concentrations share a direct correlation with postprandial (after a meal) blood glucose levels. To help optimize glucose metabolism and loweoptimize postprandial glucose numbers far more efficiently - while also driving nutrient partitioning by enhancing the selective expression of GLUT 4 (on muscle cells and not fat cells), one should consider the use of glucose disposal agents such as Na R ALA and Berberine HCL.
Over time the use of GDAs improves insulin sensitivity markedly, assisting in the significant attenuation of metabolic syndrome. Berberine alone has been shown in some clinical trials to perform as good or better than the popular diabetic medication Metformin. Na R ALA is the most bioavailable form of alpha lipoic acid and you need only 250mg 2-3x/day to reap major benefits. If you use the cheaper form of alpha lipoic acid use 400-700 mg 2-3x/day.
To these two GDAs I would recommend a form of Vanadium, Vanadyl Sulfate. I would also add a form of chromium, either chromium picolinate or chromium polynicotinate. There are scores of various GDA or GDA-like compounds to choose from. For the most bang for your buck start and stick with this 4 part GDA stack before adding additional GDA compounds into the mix.
Note: If you combine the regular use of GDAs with a modified lower or low-carb diet one can literally reverse Type 2 Diabetes, particularly if the disease is in its early onset stage(s).
Maintaining Energy (to train intensely) while on a reduced-calorie diet
When you lift weights getting that all too familiar "pump" feels amazing. Arnold Schwarzenegger once compared it to sexual release - even going so far as to claim the "pump was better than cumming." I would have to disagree with Mr. Schwarzenegger on that, but I will concede that getting a vein-bursting, skin-splitting pump (obviously I'm embellishing: no pump bursts veins or splits the skin) gives one a major short-term motivational boost as well as an endorphin rush. It also feels great and makes one look more muscular and vascular. But getting a great pump while in a major caloric deficit, particularly if one is restricting carbohydrates, becomes difficult to say the least. So how does one boost the body's high-octane "energy" source, ATP, without taking in extra calories?
If you were unaware that ATP can be supplemented directly (orally), now you know. PEAK ATP is a well-known ATP supplement. In addition to supplementing directly with ATP one can also utilize Creatine Monohydrate (or other forms of creatine) to behave as a Phosphate donor. Creatine is stored within the body as creatine phosphate. Creatine phosphate donates its phosphate ring to ADP, or Adenosine Di-Phosphate, creating ATP, or Adenosine Tri-Phosphate. As you know ATP is the body's preferred "high-octane" cellular-energy-medium. Creatine and ATP are both important to high-intensity anaerobic exercise. But what about boosting the glycolytic energy pathway?
The body utilizes glucose and stored glycogen to replenish ATP. When glucose/glycogen is in low supply the body will utilize glycogenic amino acids (in a process called gluconeogenesis) to boost serum glucose concentrations, especially while involved in intense exercise such as weight lifting (bodybuilding). Supplementing (pre-workout) with whey protein isolate and/or EAA/BCAA+Glutamine can help prevent the body from utilizing its muscle tissue as a donor source for gluconeogenically-derived "energy."
Note: Glutamine can increase both hepatic and skeletal muscle glycogen stores (without carbohydrates).
Another thing you can do to enhance fat burning is to increase the proportion of fuel burned as fat during exercise. To achieve this supplement with the PPAR delta agonist Cardarine. Cardarine markedly increases cardiovasculaendurance capacity as well as muscular endurance. You'll be getting a few more reps per set on your higher rep sets and increasing the amount of fat (instead of blood sugar) your body is using while doing so.
Note: Stacking Cardarine with the infamous lipotropic L Carnitine may further enhance each supplement's effects.
Note: I have a separate article written on L Carnitine. See this article to learn everything you would ever want to know about L Carnitine in less than 5 minutes.
What about maintaining the muscle mass you built while in a caloric surplus after you diet your way into a significant negative caloric balance?
The supplement HMB, Beta Hydroxy Methyl Butyrate was over-hyped in the 90s. Everybody was looking for the "next creatine." And HMB showed promise. Then the research trickled in. Initially, HMB appeared to be of little value. Then more and more research poured in. Today we know HMB is most effective as an anticatabolic supplement.
HMB helps ensure the body remains in a positive nitrogen balance, but not by increasing protein synthesis. Rather, HMB reduces the breakdown of muscle mass (protein), and is particularly useful in lower-calorie settings, and/or high-stress situations (including recovery post-surgery and healing from serious burns).
You'll want to use a minimum of 3 grams of HMB per day. Amounts as high as 10 grams or more daily can be costly but are safe (and more effective than lower dosages, which does not necessarily hold true for other dietary supplements).
A second anticatabolic supplement you might consider is Phosphatidylserine or PS. The use of PS is reportedly effective in reducing excessive serum cortisol concentrations. Cortisol, a glucocorticoid, increases protein catabolism. This supplement can be costly to use, however.
Some trainees, gurus and gym pundits firmly believe the conditionally essential amino acid Glutamine is a potent anti-catabolic substance. The research on Glutamine's efficacy for athletes isn't clear; some studies show benefit(s) while others clearly do not.
If you're using appreciable amounts of protein powder (Whey Protein Isolate, Pea Protein Isolate, Caseinate, Milk Protein Isolate) you'll be getting about 4-5 grams of Glutamine (and precursors) per scoop (app 25 grams of protein. Most protein rich whole foods are also rich in Glutamine.
If you're in a caloric surplus (off season mode) then additional Glutamine is essentially a waste of money. Glutamine is best utilized while in the throes of strict dieting, when muscle mass losses are most likely. Glutamine can contribute to the Amino Acid Pool and act as a gluconeogenic donor if need be. Glutamine can also help restock both hepatic and skeletal muscle glycogen stores INDEPENDENTLY of carbohydrates (Glucose). To enhance glycogen replenishment, particularly in the peri-workout period, Glutamine must be taken in very large doses (up to 15-20 grams pre/intra workout & post workout).
Another thing you can do to reduce the loss of muscle mass while dieting is to raise your protein consumption to as high as 1.5 grams per pound of body weight. Of course, you'll have to have a commensurate reduction in calories from carbohydrates and/or fat.
And remember, while dieting to maximize fat-loss your goal isn't to build muscle, but instead to maintain that muscle which you've already built. This means you must take care to avoid overtraining. Not only is overtraining unnecessary at this stage, but it can be extremely damaging to one's physique. You run the risk of injury anytime you step foot in a gym but the probability of injury is geometrically increased if one is overtraining, particularly while on a low-calorie diet. Limit your weekly lifting sessions to no more than 5. Don't go crazy on the volume (# of sets) and stay in the 8-12 rep range most of the time (you can do more or fewer reps but 8-12 is a great rep range for most). You aren't going to be setting any PRs here.
Can you tell us what a sample day of eating might look like?
Let's say you decide on 3 whole-food meals, 2 shakes, and a snack every day. Let's assume your shakes are composed of ultrafiltered skim milk (12 g protein and 8 grams carbohydrate w/ 0g fat per 8oz), 2 scoops whey isolate (40 g protein), a small banana, and 1/2-1 cup frozen strawberries. By themselves, the two protein shakes will supply 130 grams of protein. And remember, at the beginning of this article we said our hypothetical dieter was 200 pounds. Thus your total daily protein goal in grams was 250 grams per day. Hence, you need only consume 120 more grams of protein, divided between 3 whole food meals and your optional snack.
Your total daily calorie and macronutrient allotment breakdown:
Calories: 2,700 Protein: 250 grams, 1,000 Cal Carbohydrate: 310 grams, 1250 Cal Fat: 50 grams, 450 Cal
Note: the caloric/macro breakdown above yields appx 37% protein, 46% carbohydrate, and 17% fat. This differs slightly from the 40/50/10 breakdown we began with but the actual percentages are simply a guide post. If you're more endomorphic you should probably drop the carbohydrates to 37% and raise the fat to make up the difference (or add protein for the same reason). If you're an ectomorph or mesomorph you can handle the 46% carbohydrate level without missing a beat.
Note: Supplemental fats do add additional fat grams (and calories to your daily totals). Thus, your total fat intake will likely be closer to 80 grams per day. You may also take a shot glass or two of extra virgin, cold-pressed organic olive oil 3-5 times per week to increase MUFAs in your diet.
Removing the protein shakes' nutritional values (130 grams protein, 0 grams fat, and roughly 60-120 grams of carbohydrates: one protein shake may be simply protein powder with milk or water and ice) leaves 120 grams of protein, 50 grams of meal-derived fats (excluding supplemental fats) and approximately 190-250 grams of carbohydrates for the remainder of the day. These figures will be spread (evenly or unevenly) over 3 whole-food meals and one snack. This works out to 40 grams of protein, 80 grams of carbohydrates, and about 15-20 grams of fat per meal. Under this scenario, your snack would have to be something like sugar-free jello which has practically no calories whatsoever.
As for how you put together your meals....
Because your list of foods was basic and limited to 15 items you'll have an easy time putting potential menus together. Choose foods from your list and match up their nutritional values to fit the macronutrient and caloric allotment for each of your 3 whole-food meals.
Note: If you need more variety go ahead. The number of different foods you eat has no intrinsic bearing on the results you'll achieve from dieting. I give the 15-item limit to reflect the authenticity of old-school bodybuilding dieting as told by John Romano, the famous bodybuilding author, and for simplicity's sake.
Look up the nutritional value of the various 15 (or more) foods you chose for your diet and write them down on the front page of your diet journal. You're going to want to make use of nutrition labels anytime you deviate from your list of foods. And if you're not accurately eyeing up proper portion sizes you'll want to invest in a food scale. Studies have shown that people who didn't record what they ate often overate far more than what they self-reported they'd eaten. The same goes for people commonly overestimating portion sizes. That's why you're going to record everything you eat and weigh out or measure proper portion sizes.
So how do you know how many calories you should begin the diet with?
There are many useful diet and macro calculators available online. One figure I've come across quite a bit is 15-17 calories per pound of body weight as a good, "average" starting point. For a 200 lb person, this works out to between 3,000 and 3,400 calories per day, which might be a bit high. If consuming even 1.25 grams of protein per pound of body weight that 15-17 cal/lb figure leaves 2,400 "energy" calories to come from carbohydrates and/or fats. Our hypothetical diet above was 2,700 calories with 250 grams of protein for a 200-lb individual.
So the two figures (2,700 cal and 3,000- 3,400 cal are close enough to be compatible and would likely fit any 200 lb hard training individual quite well - but we can't be certain. The only way to do that is to keep a diet journal for a minimum of 7 days where you record every morsel of every foodstuff you consume, each and every day and night. You also tally up your macronutrient totals for each of the seven days. At the end of those seven days, if your weight has remained the same, you have found your homeostatic caloric setpoint.
Add up the total amount of calories consumed over the seven days and then divide the resultant figure by seven. You now have your starting caloric allowance. If you want to gain quality mass you would increase your calories by 10-15%. But, we want to lose fat, so we will cut out starting caloric allowance (homeostatic-setpoint) by 10-15%.
If you simply don't have the discipline to keep a food journal you'll also have trouble keeping track of calories later on in the diet and end up overeating, even if unintentionally. That said, 15-17 cal/lb of body weight is a good average starting range for most lifters.
If you'd like, I'm open for consultations.
Contact me for nutritional, dietary supplementation, and exercise regimen consulting.
Mike Renteria BigMikeRenteria@gmail.com BPVA Summer 2024
Photo: Gunter Schlierkamp, IFBB LEGEND, 2002 GNC SOS CHAMPION (Defeated Reigning Mr Olympia Ronnie Coleman)

21f, 5’2, sw-155 gw 130
For reference, I got put on phentermine to help me shed this birth control weight that I cannot seem to get rid of since i’ve quit taking bc. Post birth control I was always 130-135. I never changed my diet or exercise routine while on it but I did change it to a stricter level after birth control because I could not figure out why I wasn’t losing this weight. On May 3rd I weighed 155lbs and today (May 10th), I am 148lbs! For reference, I drink A LOT of water on this pill.
Side effects day one and two: extreme energy spikes, could not sit down. Deep cleaned my apartment top to bottom, like a maniac lol. No appetite at all, everything tasted gross, I did not want to eat but forced myself. Dry mouth, bad taste in my mouth. Did not sleep well, but still woke up early ready to go.
Side effects day three and four: those energy spikes were still there, but only for an hour or two after the pill kicked in. Still no appetite. I had a weird pressure in my head, like a constant tiny migraine. Tingly and cold fingers and toes and my heart would randomly start racing. I talked myself into a near panic attack but went on a walk and felt better. Still dry mouth. Did not sleep well still, but continued to wake up with energy.
Side effects day 5-now: All of those negative side effects I was having, have vanished. I have steady energy throughout the day, no crazy highs and no crazy lows. My appetite has come back a little bit, although I wish it hadn’t because I was fine eating without one and it helped me manage what and how much I ate. I have found that phentermine helps me fall asleep faster and I am now sleeping SO good and wake up feeling great.
I get extreme anxiety when starting new medications so I kind of blame that on a lot of the bad feelings I was having on day 2-3. But if you are anything like me, this is your sign to keep it pushing!

So I’ve had my Mirena since March 4 . I just recently stopped with the bleeding but went from 195 to 212 almost overnight . I’m in the military and workout and eat fairly healthy . Nothing was working so I was placed on phentermine, I’m on day 2 and now I can barely eat . I have no appetite AT ALL . I know that’s the point of the meditation and everything I researched people lost 15-30 pounds in 3 months on it which would be great for me . Anyone ever take this medication while on birth control and seen good results?

Hi all, wanted to share some good news/feedback re: Lexapro since there are a lot of newbies.
I have always had generalized anxiety disorder but after I had my first kid (quite frankly, even when I was pregnant) I became more obsessive and I developed severe intrusive thoughts and PPA with some PPD. My OB started me on an ultralow dose of Lexapro at 8 months post partum to "take the edge off"(2.5 MG) over the next year, I upped to 5 MG. Then covid hit, I got pregnant again, and after baby no. 2 I upped to 10 MG. I've been stable ever since (3 years). The intrusive thoughts have subsided, I'm far less anxious, and I'm a better mom.
It's not without side effects though - I did gain weight (almost 20LBs - started Phentermine today) and it's *very* noticeable if I forget to take it for a few days (has only happened a few times, but the brain fog, headaches, and nausea from withdrawal are very very real).
All this to say - it takes about 4-6 weeks to really notice a change in how you feel and stabilize. I promise it can get easiebetter when you find your perfect dose. Hugs to all of you as you navigate this journey.

I started taking phentermine about 2 weeks before my period started last month. I didn’t have big cravings but this month they are TERRIBLE. I cannot get enough chocolate. I’m staying in my calories but this cannot be healthy for me. Has anyone else figured out a way to curb cravings once your body has adjusted to phentermine? I’m not struggling with over eating on meals or anything like that, just constantly wanting chocolate.

Hi, im currently on day 6 of phent and i was wondering if i should mention to my DR at the one month apt about Topiramate. Im curious if taking it without will give me the same results im looking for.
Is there a different in just taking phent only?

I’m generally a laid back person. I’m on week 7 of taking phentermine & finding myself increasingly annoyed with people in my life. I think I have legitimate reasons but usually I’m able to let stuff roll off of my back. I don’t know if this is a common side effect of this medicine or if I’m just particularly stressed out lately.

Been slowly dieting from around (M27) 280 since January 1st, down to 254 today, GW: 200. Currently on just phentermine at 37.5mg, one month and 2 weeks in and about 12 pounds down. Doc said at first we will stop after 3 months per FDA guidelines, but let them know about the updated long term use. They read up on it and now say we can do the 3 months in a row, stop for 15-30 days, then start again for another 3 months, see if we get any results. Has anyone had success with this taking a break and starting back up or does it really lose effectiveness after the first 3 months?

First time poster to this thread. I’m literally to the point I’m out of options. I have been seeing my pcp for over a year for various symptoms I keep bringing to his attention. Often times he says it’s because I’m a mom of 5 kids and I’m tired, or I’m not taking care of myself. He’s in CrossFit, and I’m, well, very obviously not into CrossFit (or being fit, for that matter. Sometimes he will do a lab test to shut me up. I’m not a complainer. I’m not making up symptoms to get attention. I feel he thinks I do both of these things. Here are my symptoms: Regular migraines, once a week (on topiramate and imatrex) Consistent joint pain and swelling in hands. Sausage digits occasionally in pointer fingers. Worse in the right hand. (Now on celebrex) Blurred vision Extreme fatigue BMI of 37 Random patches of red itchy skin with white/silver scaley patches (given triamcinolone cream) Muscle weakness Brittle nails Hair loss
These symptoms have gotten progressively worse over the last year. My pcp tested me for autoimmune and celiac disease and he said it’s fine. He says I’m fat and my problems would be fixed if I lost weight. I am on my 6th month of phentermine, and it’s no longer working. I’m more hungry now than I was before I started. I’m on 37.5mg now. He made a note in my chart 2 weeks ago that if I don’t lose weight in the next two months, he will discontinue weightloss efforts. Thanks, guy. He wants me to workout 45 minutes a day. I live an hour from the gym. I drink protein coffee in the morning with 2 eggs and sometimes sausage. I’m drinking over 100 oz of water daily. I’ve gained 11 lbs in 3 weeks. He’s maxed my Zoloft. I also take omeprazole 40mg. Just checked thyroid and it’s “normal”
If he’s right and doing what he can, I’m fine with it. Seriously I don’t want to make things harder than they are. I just don’t like feeling dismissed. Any advice would be appreciated even if it’s to tell me to suck it up.

Hi all, wondering if anybody has had good luck with phentermine after being a non-responder to semaglutide medication ( i.e. Ozempic, Rybelsus) and/or metformin. I've currently on both Rybelsus and Metformin 1500mg with no effect.
My endocrinologist just prescribed, but I am nervous to take it and feeling so hopeless since nothing has been working for me.