#dosing-titration 2024-10-24

Thursday25 messages6 participantstimes are UTC

Highlights from this day

nhs_pathway_nell — you do not have to escalate at all. that is a real option that gets forgotten 07:02
week_zero — anyone here split their weekly into two and would they do it again 07:46
bpc_sceptic — stepping back down on purpose is a completely reasonable move and this channel should say so more often 08:41
ten_of_ten — small steps are better than big ones and the only reason people take big ones is impatience 09:23

how do you decide between holding and stepping when both feel wrong

nobody here can tell you what dose to be on and the ones who try get corrected

you do not have to escalate at all. that is a real option that gets forgotten

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follow up whats the smallest step anyone has managed between doses

the people who do best here are almost always the ones going slowest

dose day drift is mostly harmless with a weekly compound, but pick a day and defend it

anyone here split their weekly into two and would they do it again

wk 1-4    0.25mg
wk 5-10   0.50mg   (held 2 extra weeks)
wk 11-14  1.00mg
wk 15-26  1.70mg   (held, long)
wk 27+    2.40mg

i escalate on symptoms. if the current dose is still doing something i stay on it

i log dose, day, weight and one line about how the week felt. thats enough to make decisions on

whats the longest anyone has stayed on one dose

update question: did anyone who held for 10 months regret it

[edited]

coming back to this update from 25 months ago: held at the same dose the whole time and still losing slowly

stepping back down on purpose is a completely reasonable move and this channel should say so more often

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if it "stopped working after four days" that is almost never pharmacokinetics, for what its worth

pick a day and stick to it

is there a trial anywhere that studied twice weekly, or is it all anecdote

hold

unrelated but if i hold at 2.4 indefinitely am i losing anything

appetite returning at the end of the week is extremely common and is not the dose failing

after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice

split dosing has no trial behind it. people here do it and report on it, thats all

held for months

small steps are better than big ones and the only reason people take big ones is impatience

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i have been at 1.7 for 16 months and honestly i have stopped wanting to move

thats noise