stepping back down on purpose is a completely reasonable move and this channel should say so more often
#dosing-titration 2026-02-01
Sunday67 messages12 participantstimes are UTC
Highlights from this day
- nhs_pathway_nell — has anyone gone up and then straight back down and been glad they tried 17:15
- nhs_pathway_nell — small steps are better than big ones and the only reason people take big ones is impatience 17:46
- VialBot — New independent result logged — CPC, lot SG-1177, purity 98.1% (Medutest). 19:47
my titration ladder took 2 months to climb and i would do it slower again
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored, ymmv
i escalate on symptoms. if the current dose is still doing something i stay on it
anyone tracked whether a smaller more frequent dose changed their side effects
my dose day has drifted 5 days later over 8 months, does it matter
plateau versus set point is not answerable in under six months of data
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holding is not failing. most people here who lasted two years held at least one dose for months, your mileage will differ
came down from a treatment dose to maintenance over about three months and it was uneventful, anyway
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
has anyone gone up and then straight back down and been glad they tried
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with a roughly seven day half-life you are near steady state after about five weeks at a dose
if the current dose is still working, going up is spending headroom you might want later
the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess
i went up too fast and im paying for it, do i drop back or ride it out
update on the earlier thing does a missed week reset anything or do you just carry on
the honest answer is that most of us are running protocols nobody has ever studied
i went from 15 to 5 and honestly could not tell the difference in appetite
i escalate on symptoms. if the current dose is still doing something i stay on it
do you escalate on the calendar or on how you feel
small steps are better than big ones and the only reason people take big ones is impatience
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half life is a week
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split dosing has no trial behind it. people here do it and report on it, thats all, still working it out
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
if you are asking whether to go up, the fact you are asking usually means not yet
[edited]update from 2 months ago: held at the same dose the whole time and still losing slowly, n of 1 obviously
is there any actual reason to escalate every 4 weeks other than the trial did it
is there a point where going up stops buying you anything
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steady state is 5 weeks
whats a sensible maintenance dose after a year at treatment dose
the ladder in the trials is a starting point, not a schedule you owe anyone
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+ 2.40mgif it "stopped working after four days" that is almost never pharmacokinetics
the trials escalated on a fixed schedule because a trial has to. you are not a trial
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the people who do best here are almost always the ones going slowest
is there a trial anywhere that studied twice weekly, or is it all anecdote
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
held for months
| 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 |
while im here i hold for two months minimum before i decide a dose has stopped doing anything
how much does the last dose still matter 3 days later
go slower
i have been at 10 for 15 months and honestly i have stopped wanting to move
On this day 2 years ago this channel logged 128 messages.
appetite returning at the end of the week is extremely common and is not the dose failing
New independent result logged — CPC, lot SG-1177, purity 98.1% (Medutest).
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what does the room think about jumping a rung to catch up
not advice
right so i drifted from sunday to wednesday over a year and only noticed when i checked the log
thats anecdote
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step
thats normal
you do not have to escalate at all. that is a real option that gets forgotten
sorry to jump in how do you tell a plateau from just being at your set point
n of 1
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
pick a day and stick to it, someone check my working
end of week thing
[edited]lot-log.csv
183 rows · not retained in the public archive
i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat
i hold for two months minimum before i decide a dose has stopped doing anything
is it normal for appetite to come back at the end of the week
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came down, no regrets
thats noise, thats one data point
hold
coming back to this pick a day and stick to it
nobody here can tell you what dose to be on and the ones who try get corrected
two weeks is nothing
i would hold
do you tell your prescriber you held or do you just hold
too early imo
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice