end of week thing
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#dosing-titration 2025-07-26
Saturday58 messages13 participantstimes are UTC
Highlights from this day
- nordic_price_nils — dose day drift is mostly harmless with a weekly compound, but pick a day and defend it 21:20
- rotate_the_site — plateau versus set point is not answerable in under six months of data, ill dig out the number 21:39
- meniscus_mel — i escalate on symptoms. if the current dose is still doing something i stay on it a missed week does not reset you, but going straight back to the top dose after a… 23:20
thats noise
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on, i could be wrong
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stepping back down on purpose is a completely reasonable move and this channel should say so more often
if i took it 2 days late do i shift the schedule or go back to the old day
whats the smallest step anyone has managed between doses
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
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the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess
steady state is 5 weeks
go slower
| 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 |
i went from 12 to 10 and honestly could not tell the difference in appetite
anyone tracked whether a smaller more frequent dose changed their side effects
plateau versus set point is not answerable in under six months of data, ill dig out the number
| 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 |
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the honest answer is that most of us are running protocols nobody has ever studied
small steps are better than big ones and the only reason people take big ones is impatience
thats anecdote
pick a day and stick to it
i hold for two months minimum before i decide a dose has stopped doing anything
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if you are asking whether to go up, the fact you are asking usually means not yet
the people who do best here are almost always the ones going slowest
is it normal for appetite to come back at the end of the week
i would hold
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
with a roughly seven day half-life you are near steady state after about five weeks at a dose, your mileage will differ
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
my dose day has drifted 5 days later over 4 months, does it matter
is there any actual reason to escalate every 4 weeks other than the trial did it
two weeks is nothing
if the current dose is still working, going up is spending headroom you might want later
split dosing has no trial behind it. people here do it and report on it, thats all
hold
coming down from 1 to 1.7, how bad is the appetite rebound
wk 1-4 2.5mg
wk 5-8 5.0mg
wk 9-20 7.5mg <- stayed here
wk 21-24 10.0mg (no extra benefit for me)
wk 25+ 7.5mg (came back down)do you tell your prescriber you held or do you just hold
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the trials escalated on a fixed schedule because a trial has to. you are not a trial
if i hold at 1 indefinitely am i losing anything
holding is not failing. most people here who lasted two years held at least one dose for months
whats the longest anyone has stayed on one dose
you do not have to escalate at all. that is a real option that gets forgotten
*that should say weekly
do you escalate on the calendar or on how you feel
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
i went up too fast and im paying for it, do i drop back or ride it out
appetite returning at the end of the week is extremely common and is not the dose failing, we shall see
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
if it "stopped working after four days" that is almost never pharmacokinetics
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step
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+ 2.40mgcame down, no regrets
if you are going up because the scale stalled for two weeks, wait. two weeks is noise
thats normal
i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat
i have been at 0.25 for 13 months and honestly i have stopped wanting to move
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thats normal
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n of 1
i escalate on symptoms. if the current dose is still doing something i stay on it
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
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+ 2.40mghas anyone gone up and then straight back down and been glad they tried
my titration ladder took 20 months to climb and i would do it slower again
nobody here can tell you what dose to be on and the ones who try get corrected
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