#semaglutide 2024-11-19

Tuesday42 messages9 participantstimes are UTC

Highlights from this day

slow.taper — went 1 to 1.7 too fast and spent two weeks regretting it, dropped back and repeated the step, still working it out 17:41
half_life_hal — £120 a month for compounded against what brand costs locally is why most people here use vials the appetite effect faded for me around 10 months and going up fixed it… 18:04
salt_bridge — five week steps worked better for me than four, purely on how the second week felt 18:54
pbs_pip — licensed ceiling for weight is 2.4 weekly, anything above that is not a licensed dose 20:54

slow.taper 17:41

went 1 to 1.7 too fast and spent two weeks regretting it, dropped back and repeated the step, still working it out

🙏4👀13

SELECT wasnt weight

plateau_pen 17:45

2.4 is the ceiling

Cited study

Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1)

New England Journal of Medicine · 2021

68 weeks, semaglutide 2.4mg weekly against placebo, with lifestyle intervention in both arms.

held there too

im at 1.7 and stuck, did anyone break a plateau without going up

🎉4

vials not pens here

half_life_hal 17:53

STEP 4 had the withdrawal arm, thats the one people quote when they talk about stopping

half_life_hal 18:03

while im here how long did the first 16kg take for people at the low doses

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£120 a month for compounded against what brand costs locally is why most people here use vials
the appetite effect faded for me around 10 months and going up fixed it for a while

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+    2.40mg

half_life_hal 18:14

my dose day drifted from friday to sunday, does that reset anything

Cited study

Semaglutide vs Liraglutide for Weight Loss in Adults with Overweight or Obesity (STEP 8)

JAMA · 2022

Weekly against daily, head to head.

half life is about a week so youre roughly four to five weeks to steady state on any new dose

the plateau hit me at 34 weeks and moved again about a month later without a dose change

brand vs compounded, is there a difference people can actually feel

[edited]

half_life_hal 18:29

my Medutest report on the CPC vial came back 99.4 against a certificate saying 99

VialBotbot18:31

Verification log updated: BCH — evidence added, status unchanged.

area_percentlab18:43

steady state is the bit people skip, judging a new dose after eight days tells you almost nothing, i could be wrong

salt_bridgelab18:54

five week steps worked better for me than four, purely on how the second week felt

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taper_tess 18:57

dose day is sunday for me only because thats when i remember, not because sunday matters

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for the archive i held at 1.7 for 5 months and it was the best decision i made, not advice obviously

was STEP 4 the one that ran to 68 weeks or am i mixing them up

salt_bridgelab19:03

how long till steady state, ive read the half life is about a week

plateau_pen 19:04

how did people handle the jump from 1 to 1.7

meal_prep_mick 19:06

moving my dose day by a day or two never did anything noticeable for me, ymmv

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slow.taper SELECT wasnt weight

meal_prep_mick 19:16

SELECT was cardiovascular outcomes in people with overweight and existing disease, not a weight trial

slow.taper 19:18

vial units and pen clicks are different systems, mixing the two is how people end up wrong

meal_prep_mick 19:26

seven days ish

slow.taper 19:43

held at 2.4 and lost 89lb over 14 months, slower than the trials and fine by me

half_life_hal half life is about a week so youre roughly four to five weeks to steady state on any…

slow.taper 20:00

the long half life flattens the trough more than people expect, i never felt a day seven dip

pbs_pip 20:02

changed my mind on the four week rule, i think it depends entirely on how the current dose feels
dose day is sunday for me only because thats when i remember, not because sunday matters

pbs_pip 20:08

i dont think the plateau is a dose problem most of the time, but i cant prove that

lost about 38kg on the low doses before i even got to 1, which surprised me

area_percentlab20:10

i was wrong about the ceiling for a year, i thought 3 existed. it doesnt for the weight indication

salt_bridge how long till steady state, ive read the half life is about a week

area_percentlab20:12

restarted after 4 months off at a low dose and the nausea arrived exactly like the first time, your mileage will differ

going slow cost me nothing except time and saved me two bad weeks, thats my whole contribution

my 5 vial in 5ml gives 2.5mg/ml so 2.5 lands on 20 units, thats why i picked that volume

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taper_tess 20:16

is 2.4 the top or do people go past it

taper_tess dose day is sunday for me only because thats when i remember, not because sunday matters

pbs_pip 20:19

sorry to jump in FLOW was the kidney outcomes trial and it gets quoted in here for things it didnt measure

pbs_pip 20:51

not the same trial

licensed ceiling for weight is 2.4 weekly, anything above that is not a licensed dose

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back after 20 months off, do i restart at 0.25 or somewhere higher

STEP is several trials, so saying STEP said x is usually wrong without a number after it
i held at 15 for 6 months and it was the best decision i made

im 15 months in at 0.25 and the appetite effect faded, is that a thing