two weeks is nothing
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#dosing-titration 2025-12-07
Sunday52 messages14 participantstimes are UTC
Highlights from this day
sorry to jump in i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
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while im here you do not have to escalate at all. that is a real option that gets forgotten
coming down from 7.5 to 0.25, how bad is the appetite rebound
the trials escalated on a fixed schedule because a trial has to. you are not a trial
is it normal for appetite to come back at the end of the week
came down, no regrets
is week 13 too early to be thinking about the next step
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my titration ladder took 2 months to climb and i would do it slower again, i could be wrong
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update from 12 months ago: held at the same dose the whole time and still losing slowly
end of week thing
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+ 2.40mgsplit dosing has no trial behind it. people here do it and report on it, thats all
nobody talks about going down. is there a taper or do you just stop
you can just stop, nothing withdraws in the classic sense. but almost nobody who just stops likes what happens next
i stepped down over four months and it was much less disorienting than the friend who stopped in a week
disorienting how
appetite arriving back all at once versus arriving back gradually. same destination, very different month
and thats a real distinction even though the endpoint is identical
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the other option is stretching the interval instead of reducing the draw
i went weekly, then 9 days, then 10, then fortnightly. never changed what i drew
thats the one i recommend to nobody but do myself, which is where this channel lives
the two routes are not the same thing
| Route | What changes | Peak/trough | Suits |
|---|---|---|---|
| Reduce the dose | the amount drawn | both fall together | people who want a smooth glide down |
| Stretch the interval | the gap only | peak stays, trough falls | people who dose from vials and hate half units |
| Both at once | everything | unpredictable | nobody, do one at a time |
the both at once row is doing a lot of work there
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its the mistake i see most often. change one variable
and if coming down is happening because of a side effect rather than a plan, that is a doctor conversation, not a chat one
agreed. mine was a plan, and i said so badly above
whats a maintenance dose look like in practice
wildly variable. in the long logs here it ranges from the full loss dose down to about a third of it
im on 1.0 sema having lost on 1.7. two years, stable within about 2kg
im on 5mg tirz fortnightly having lost on 10 weekly. thats a quarter of the weekly exposure and it holds
a quarter?
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maintenance and loss are different jobs. holding a weight needs less signal than moving one
which is a very common pattern in the logs and has basically no trial evidence behind it, so treat it as folklore with a lot of witnesses
folklore with a lot of witnesses is the best description of this archive anyone has produced
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my actual maintenance maths since people always ask
loss phase: 10mg tirz weekly = 10mg / 7 days
maintenance: 5mg tirz every 14 days = 5mg / 14 days
weekly-equivalent = 2.5mg/wk vs 10mg/wk
so roughly a quarter of the exposure
30mg vial in 3ml = 10mg/ml
5mg = 0.5ml = 50 units on a u100, dead easy to draw
and appetite doesnt come back at day 12 or 13
a bit. i notice it. its manageable and it is genuinely the trade i chose
thats the honest version. maintenance is not the same as being on a full dose forever, it just costs a little vigilance
the people who struggle most are the ones who expected maintenance to feel like the loss phase
worth reading #maintenance properly, there are people three years out in there
will do. thanks all, this channel is a lot
one more — the third of the loss dose figure. is anyone lower than that and still stable
two people i know of, both on very stretched intervals rather than tiny draws. and both of them changed a lot else about how they eat
which is the confounder nobody can remove from any of these logs. it is still worth writing them down
go slower
how much does the last dose still matter 9 days later
came down from a treatment dose to maintenance over about three months and it was uneventful
came down from a treatment dose to maintenance over about three months and it was uneventful
thats normal
Digest for the week of 2025-02-25 has been published.
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my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step
whats your rule for when a side effect means hold rather than push
i escalate on symptoms. if the current dose is still doing something i stay on it, n of 1 obviously
the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess
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