This is the most defensible version of alternating, but it requires a provider willing to manage the complexity and a patient committed to meticulous tracking and communication
The lift seems to come straight from the weight loss. Current Research on GLP-1 and Testosterone A SMALL STUDY published in Endocrine Abstracts showed that semaglutide was more effective than testosterone replacement therapy in improving body composition and increasing testosterone for men with type 2 diabetes

Common Side Effects (Both Medications): Gastrointestinal Side Effects (Most Common): These typically occur when starting treatment or increasing doses, and often improve over time: Nausea: Most frequent side effect for both medications Semaglutide: 44% of participants in clinical trials Tirzepatide: 30-37% depending on dose Usually mild to moderate Most common in weeks 1-8, improves with continued use Diarrhea: Semaglutide: 30% of participants Tirzepatide: 19-23% depending on dose Often resolves within a few weeks Staying hydrated helps manage symptoms Constipation: Semaglutide: 24% of participants Tirzepatide: 10-17% depending on dose Can alternate with diarrhea Fiber and hydration help Vomiting: Semaglutide: 24% of participants Tirzepatide: 9-17% depending on dose More common at higher doses May require dose reduction Abdominal Pain: Semaglutide: 20% of participants Tirzepatide: 8-11% depending on dose Usually mild, related to slower stomach emptying Other Common Side Effects: Appetite Changes: Decreased appetite (desired effect) Food aversions or taste changes Reduced interest in previously enjoyed foods Early satiety (feeling full quickly) Fatigue: Semaglutide: 11% of participants Tirzepatide: Similar rates Often related to reduced calorie intake May improve as body adjusts Injection Site Reactions: Mild redness, swelling, or itching at injection site Usually resolves within a few days Rotating injection sites helps minimize Headache: Occurs in 10-14% of participants with both medications Usually mild and temporary Often related to dehydration Side Effect Comparison: Why Tirzepatide May Have Fewer GI Side Effects: Despite being more potent, tirzepatide appears to cause slightly less nausea and GI distress

Semaglutide Has been around longer, so there may be more coverage options
Some questions to consider include: What are the potential benefits and risks of semaglutide for my specific situation