update from 21 months ago: held at the same dose the whole time and still losing slowly
#dosing-titration 2025-12-06
Saturday57 messages13 participantstimes are UTC
Highlights from this day
- noct.titrate — follow up i drifted from sunday to wednesday over a year and only noticed when i checked the log, ymmv 13:13
- impersonator_ip — the people who do best here are almost always the ones going slowest, ill dig out the number 15:20
- plateau_pen — my titration ladder took 4 months to climb and i would do it slower again, anyway 18:58
- turnaround_tam — is there any actual reason to escalate every 4 weeks other than the trial did it 19:50
steady state is 5 weeks
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if i hold at 0.5 indefinitely am i losing anything
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follow up i drifted from sunday to wednesday over a year and only noticed when i checked the log, ymmv
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coming down from 15 to 2.4, how bad is the appetite rebound
the honest answer is that most of us are running protocols nobody has ever studied
whats a sensible maintenance dose after a year at treatment dose
has anyone gone up and then straight back down and been glad they tried
Testing queue: 2 submissions open, 18 awaiting dispatch.
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came down from a treatment dose to maintenance over about three months and it was uneventful
the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess
thats noise
update question: did anyone who held for 10 months regret it
split dosing has no trial behind it. people here do it and report on it, thats all
do you escalate on the calendar or on how you feel
pick a day and stick to it
turnaround_tamupdate from 21 months ago: held at the same dose the whole time and still losing slowly
whats the longest anyone has stayed on one dose
sorry to jump in if you are going up because the scale stalled for two weeks, wait. two weeks is noise
go slower
is it normal for appetite to come back at the end of the week
anyone tracked whether a smaller more frequent dose changed their side effects
how do you tell a plateau from just being at your set point
if it "stopped working after four days" that is almost never pharmacokinetics
thats normal
do you tell your prescriber you held or do you just hold
what does the room think about jumping a rung to catch up
i would hold
anyone here split their weekly into two and would they do it again
the trials escalated on a fixed schedule because a trial has to. you are not a trial
you do not have to escalate at all. that is a real option that gets forgotten
quick one plateau versus set point is not answerable in under six months of data
how long did you hold at 7.5 before you moved up
i hold for two months minimum before i decide a dose has stopped doing anything
whats your rule for when a side effect means hold rather than push
my dose day has drifted 3 days later over 20 months, does it matter
the people who do best here are almost always the ones going slowest, ill dig out the number
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)a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
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whats the smallest step anyone has managed between doses
if i took it 4 days late do i shift the schedule or go back to the old day
if you are asking whether to go up, the fact you are asking usually means not yet
appetite returning at the end of the week is extremely common and is not the dose failing, someone check my working
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
stepping back down on purpose is a completely reasonable move and this channel should say so more often
is there a point where going up stops buying you anything
holding is not failing. most people here who lasted two years held at least one dose for months
no trial for that
the ladder in the trials is a starting point, not a schedule you owe anyone, i have it written down somewhere
i escalate on symptoms. if the current dose is still doing something i stay on it
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
i went from 15 to 12 and honestly could not tell the difference in appetite
is week 8 too early to be thinking about the next step
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after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice, your mileage will differ
my titration ladder took 4 months to climb and i would do it slower again, anyway
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end of week thing
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
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Digest for the week of 2025-10-12 has been published.
is there any actual reason to escalate every 4 weeks other than the trial did it
| Trial schedule | What most people here do | |
|---|---|---|
| Step interval | 4 weeks, fixed | 4-12 weeks, on symptoms |
| Holding | protocol deviation | normal and expected |
| Top dose | reached by design | often never reached |
| Coming down | not studied | common at maintenance |
too early imo