#dosing-titration 2025-06-12

no trial for that

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

Digest for the week of 2024-11-27 has been published.

a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored

whats your rule for when a side effect means hold rather than push

if you are going up because the scale stalled for two weeks, wait. two weeks is noise, i could be wrong

whats the longest anyone has stayed on one dose

with a roughly seven day half-life you are near steady state after about five weeks at a dose

ok so the ladder in the trials is a starting point, not a schedule you owe anyone

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

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

half life is a week

pick a day and stick to it

i log dose, day, weight and one line about how the week felt. thats enough to make decisions on, ask me again in a month

holding is not failing. most people here who lasted two years held at least one dose for months, n of 1 obviously

if you are asking whether to go up, the fact you are asking usually means not yet

plateau versus set point is not answerable in under six months of data

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

came down, no regrets

my titration ladder took 16 months to climb and i would do it slower again

go slower

not advice

if the current dose is still working, going up is spending headroom you might want later

anyone tracked whether a smaller more frequent dose changed their side effects

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

*week 9 not week 5

thats normal

appetite returning at the end of the week is extremely common and is not the dose failing
if it "stopped working after four days" that is almost never pharmacokinetics

i went from 2.4 to 12 and honestly could not tell the difference in appetite

unrelated but came down from a treatment dose to maintenance over about three months and it was uneventful

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

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

slightly off topic but whats a sensible maintenance dose after a year at treatment dose

i have been at 1 for 25 months and honestly i have stopped wanting to move

unrelated but update from 11 months ago: held at the same dose the whole time and still losing slowly, i have it written down somewhere

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

held for months

the honest answer is that most of us are running protocols nobody has ever studied

thats noise

i drifted from sunday to wednesday over a year and only noticed when i checked the log

has anyone gone up and then straight back down and been glad they tried

whats the smallest step anyone has managed between doses

i hold for two months minimum before i decide a dose has stopped doing anything, thats one data point