coming down from 1 to 5, how bad is the appetite rebound
#dosing-titration 2024-08-05
Monday40 messages9 participantstimes are UTC
Highlights from this day
- quiet.hours — ok so my titration ladder took 15 months to climb and i would do it slower again 18:33
- slow.taper — small steps are better than big ones and the only reason people take big ones is impatience 18:55
- slow.taper — update from 10 months ago: held at the same dose the whole time and still losing slowly 19:02
i went up too fast and im paying for it, do i drop back or ride it out
how long did you hold at 2.4 before you moved up
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice, from memory
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whats a sensible maintenance dose after a year at treatment dose
quick one i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat
ok so my titration ladder took 15 months to climb and i would do it slower again
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i escalate on symptoms. if the current dose is still doing something i stay on it
the ladder in the trials is a starting point, not a schedule you owe anyone
not advice
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n of 1
hold
small steps are better than big ones and the only reason people take big ones is impatience
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i drifted from sunday to wednesday over a year and only noticed when i checked the log
pick a day and stick to it
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update from 10 months ago: held at the same dose the whole time and still losing slowly
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if it "stopped working after four days" that is almost never pharmacokinetics
the people who do best here are almost always the ones going slowest
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step
what does the room think about jumping a rung to catch up
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no trial for that
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19:23quiet.hours pinned a message to this channel
for the archive anyone here split their weekly into two and would they do it again
for the archive the people who do best here are almost always the ones going slowest, i have it written down somewhere
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
anyone tracked whether a smaller more frequent dose changed their side effects
thats anecdote
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the honest answer is that most of us are running protocols nobody has ever studied
while im here the trials escalated on a fixed schedule because a trial has to. you are not a trial
i escalate on symptoms. if the current dose is still doing something i stay on it
whats the longest anyone has stayed on one dose
split dosing has no trial behind it. people here do it and report on it, thats all
slightly off topic but the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess, take that with a pinch of salt
| 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
Digest for the week of 2024-04-30 has been published.
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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
thats noise
do you tell your prescriber you held or do you just hold
nobody here can tell you what dose to be on and the ones who try get corrected
thats normal
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you do not have to escalate at all. that is a real option that gets forgotten
stepping back down on purpose is a completely reasonable move and this channel should say so more often