[redacted at member request] · archive policy
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
#dosing-titration 2024-12-02
Monday39 messages8 participantstimes are UTC
Highlights from this day
- void_volume — this is the single best argument for logging and it has nothing to do with data 21:33
- lean_mass_lex — mine from 2024, and i deviated from it twice which is the point 21:48
- blank_slate_bo — seeing the plan and the actual next to each other is the whole thing isnt it 21:51
- void_volume — for anyone who wants the generic skeleton rather than a specific drug 22:48
appetite returning at the end of the week is extremely common and is not the dose failing
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored, thats one data point
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pick a day and stick to it
two weeks is nothing
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i would hold
if i took it 4 days late do i shift the schedule or go back to the old day
unrelated but anyone here split their weekly into two and would they do it again
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
21:16pinned: write your ladder down before week one. the pinned unit explainer is directly above this
is there any point planning a ladder in advance if youre going to change it anyway
the point is that you notice when you change it
if you never wrote a plan down, every escalation feels reasonable in the moment
this is the single best argument for logging and it has nothing to do with data
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mine was three columns. planned dose, actual dose, and one word about how the week went
the one word column turned out to be the useful one
what does a plan actually look like
mine from 2024, and i deviated from it twice which is the point
PLAN (written before dose 1)
step 1 0.25mg 4 wks escalate only if <=2 bad days/wk
step 2 0.5mg 4 wks same rule
step 3 1.0mg 5 wks review at 4, decide at 5
step 4 1.7mg 5 wks hard stop and reassess here
step 5 2.4mg open only if slope has flattened 6+ wks
ACTUAL
step 1 0.25mg 4 wks fine
step 2 0.5mg 6 wks held, week 5 was rough
step 3 1.0mg 9 wks held twice, losing well, no reason to move
step 4 1.7mg ongoing 14 months, never went to 2.4
seeing the plan and the actual next to each other is the whole thing isnt it
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yes. and the deviations were both downward in speed, which surprised me
thats the usual direction for people who write a plan. the people who dont write one deviate upward
is that a real observation or a nice sounding one
nice sounding. i cannot prove it from this archive and i should not have said it as flatly as i did
respect
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whats the escalate only if two bad days rule about
i needed a number, so i picked one. its arbitrary and it worked because it was written down
which is more honest than most protocols people post in here
for anyone who wants the generic skeleton rather than a specific drug
| Element | What to decide up front | Why |
|---|---|---|
| Step length | minimum weeks per dose | stops you reacting to one bad week |
| Escalation trigger | a symptom threshold, not a date | makes the decision reviewable |
| Review point | a week before the step ends | gives you time to hold instead |
| Hard stop | a dose you will not pass without a rethink | the only real brake most people have |
| Exit plan | what coming down looks like | almost nobody writes this one |
nobody writes the exit plan?
i didnt. see #maintenance, thats where everybody finds out they should have
template version of mine, blanked out. steal it
ladder-plan-vs-actual.csv
22 rows · 3 KB · not retained in the public archive
thank you, genuinely
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you asked me to remind you: @blank_slate_bo set a ladder review for today. planned step ends in 6 days.
i set that four weeks ago and completely forgot
and thats what the bot is for
the noticing when you change it thing — i get it now. i almost moved up last week for no reason i could write down
and you didnt, because you had to write it down. thats the entire mechanism
good week for this channel
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