small steps are better than big ones and the only reason people take big ones is impatience
#dosing-titration 2025-06-06
Friday54 messages11 participantstimes are UTC
Highlights from this day
- transit_degrade — how much does the last dose still matter 7 days later 22:07
- back_from_away — how do you tell a plateau from just being at your set point 22:15
- pharmac_pen — if i took it 7 days late do i shift the schedule or go back to the old day 22:51
- five_mg_ml — i log dose, day, weight and one line about how the week felt. thats enough to make decisions on 23:18
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step
not advice
[edited]how much does the last dose still matter 7 days later
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half life is a week
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steady state is 5 weeks
hold
held for months
how do you tell a plateau from just being at your set point
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thats anecdote
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
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if it "stopped working after four days" that is almost never pharmacokinetics
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no trial for that
end of week thing
thats noise
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
my titration ladder took 18 months to climb and i would do it slower again
appetite returning at the end of the week is extremely common and is not the dose failing
nobody here can tell you what dose to be on and the ones who try get corrected
is there a point where going up stops buying you anything
pick a day and stick to it
two weeks is nothing
if the current dose is still working, going up is spending headroom you might want later
thats normal
i drifted from sunday to wednesday over a year and only noticed when i checked the log
do you tell your prescriber you held or do you just hold
whats a sensible maintenance dose after a year at treatment dose
i went from 12 to 10 and honestly could not tell the difference in appetite
if i took it 7 days late do i shift the schedule or go back to the old day
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update from 6 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
coa-d-0718.pdf
1 page · 856 KB · not retained in the public archive
i hold for two months minimum before i decide a dose has stopped doing anything
came down, no regrets
wk 1-4 2.5mg
wk 5-8 5.0mg
wk 9-20 7.5mg <- stayed here
wk 21-24 10.0mg (no extra benefit for me)
wk 25+ 7.5mg (came back down)go slower
holding is not failing. most people here who lasted two years held at least one dose for months
update question: did anyone who held for 12 months regret it
the people who do best here are almost always the ones going slowest
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split dosing has no trial behind it. people here do it and report on it, thats all
[edited]coa-sg-1177.pdf
1 page · 617 KB · not retained in the public archive
follow up the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess
i went to the top of the ladder, felt no better than two rungs down, and came back. that is data for me and nobody else
came down from a treatment dose to maintenance over about three months and it was uneventful
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
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plateau versus set point is not answerable in under six months of data
the trials escalated on a fixed schedule because a trial has to. you are not a trial
[edited]i would hold
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
if you are going up because the scale stalled for two weeks, wait. two weeks is noise
with a roughly seven day half-life you are near steady state after about five weeks at a dose
held for months
i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat
is week 4 too early to be thinking about the next step
i went up too fast and im paying for it, do i drop back or ride it out
you do not have to escalate at all. that is a real option that gets forgotten