pick a day and stick to it
#dosing-titration 2025-11-22
Saturday66 messages11 participantstimes are UTC
Highlights from this day
- fake_tracking — update from 2 months ago: held at the same dose the whole time and still losing slowly 19:56
- sunday_shot — if i took it 8 days late do i shift the schedule or go back to the old day 20:05
- declared_value — if it "stopped working after four days" that is almost never pharmacokinetics 21:54
- declared_value — is it normal for appetite to come back at the end of the week 22:10
the ladder in the trials is a starting point, not a schedule you owe anyone
end of week thing
thats normal
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stepping back down on purpose is a completely reasonable move and this channel should say so more often
held for months
i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat
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*week 22 not week 3
the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess, anyway
two weeks is nothing
thats noise
do you count from injection day or from when you actually felt it
i would hold
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Assay note: WWB lot A-2418 reported at 99.4% of label content.
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
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i went up too fast and im paying for it, do i drop back or ride it out
the trials escalated on a fixed schedule because a trial has to. you are not a trial, your mileage will differ
if you are asking whether to go up, the fact you are asking usually means not yet
is there any actual reason to escalate every 4 weeks other than the trial did it
update from 2 months ago: held at the same dose the whole time and still losing slowly
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with a roughly seven day half-life you are near steady state after about five weeks at a dose, still working it out
slightly off topic but came down from a treatment dose to maintenance over about three months and it was uneventful, ill dig out the number
*Janoshik not the other one
if i took it 8 days late do i shift the schedule or go back to the old day
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n of 1
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
whats your rule for when a side effect means hold rather than push
right so coming down from 0.5 to 15, how bad is the appetite rebound
the people who do best here are almost always the ones going slowest
steady state is 5 weeks
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whats a sensible maintenance dose after a year at treatment dose
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too early imo
is there a trial anywhere that studied twice weekly, or is it all anecdote
[edited]thats anecdote
if the current dose is still working, going up is spending headroom you might want later
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
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anyone here split their weekly into two and would they do it again
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step, i have it written down somewhere
i went from 2.5 to 0.25 and honestly could not tell the difference in appetite
you do not have to escalate at all. that is a real option that gets forgotten
plateau versus set point is not answerable in under six months of data
the honest answer is that most of us are running protocols nobody has ever studied
while im here my titration ladder took 6 months to climb and i would do it slower again
go slower
hold
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
if it "stopped working after four days" that is almost never pharmacokinetics
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if you are going up because the scale stalled for two weeks, wait. two weeks is noise
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+ 2.40mgi hold for two months minimum before i decide a dose has stopped doing anything, for what its worth
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
came down from a treatment dose to maintenance over about three months and it was uneventful
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nobody here can tell you what dose to be on and the ones who try get corrected
not advice
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
split dosing has no trial behind it. people here do it and report on it, thats all
is it normal for appetite to come back at the end of the week
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i drifted from sunday to wednesday over a year and only noticed when i checked the log
how long did you hold at 7.5 before you moved up
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whats the longest anyone has stayed on one dose
no trial for that, ask me again in a month
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
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holding is not failing. most people here who lasted two years held at least one dose for months
do you tell your prescriber you held or do you just hold
does a missed week reset anything or do you just carry on
| 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 |
came down, no regrets