vialroom

#dosing-titration 2026-04-07

Tuesday61 messages13 participantstimes are UTC
Highlights from this day
  • oli_orals — if i took it 4 days late do i shift the schedule or go back to the old day 13:09
  • oli_orals — my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step 13:13
  • sol_sends — the honest answer is that most of us are running protocols nobody has ever studied 14:12
  • per_mg_pete — the trials escalated on a fixed schedule because a trial has to. you are not a trial 15:48
  • noct.titrate — plateau versus set point is not answerable in under six months of data, ymmv dose day drift is mostly harmless with a weekly compound, but pick a day and defend it 21:38

came down from a treatment dose to maintenance over about three months and it was uneventful

my dose day has drifted 9 days later over 24 months, does it matter

OO

how do you tell a plateau from just being at your set point

DV

the ladder in the trials is a starting point, not a schedule you owe anyone

[edited]
BB

ok so is there a point where going up stops buying you anything

BB

while im here how much does the last dose still matter 5 days later

VB

Archive lookup: wrong_network first appears in this channel on 2026-01-09.

BB

right so update from 8 months ago: held at the same dose the whole time and still losing slowly, ymmv

VB

Batch lookup C-4402: 8 independent reports on file, earliest 2025-05-14.

BB

if the current dose is still working, going up is spending headroom you might want later

if it "stopped working after four days" that is almost never pharmacokinetics

OO

i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat

NT

is there a trial anywhere that studied twice weekly, or is it all anecdote

RR

the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess

NT

whats a sensible maintenance dose after a year at treatment dose
with a roughly seven day half-life you are near steady state after about five weeks at a dose

my titration ladder took 10 months to climb and i would do it slower again

OO

if i took it 4 days late do i shift the schedule or go back to the old day

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my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step

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RR

you do not have to escalate at all. that is a real option that gets forgotten

OO

thats noise

Cited study
Semaglutide vs Liraglutide for Weight Loss in Adults with Overweight or Obesity (STEP 8)
JAMA · 2022
Weekly against daily, head to head.

i would hold

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i hold for two months minimum before i decide a dose has stopped doing anything

WN

if you are asking whether to go up, the fact you are asking usually means not yet

SS

the honest answer is that most of us are running protocols nobody has ever studied

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nobody here can tell you what dose to be on and the ones who try get corrected, n of 1 obviously

anyone tracked whether a smaller more frequent dose changed their side effects

GV

update on the earlier thing dose day drift is mostly harmless with a weekly compound, but pick a day and defend it

GV

i drifted from sunday to wednesday over a year and only noticed when i checked the log, anyway

slightly off topic but whats your rule for when a side effect means hold rather than push

holding is not failing. most people here who lasted two years held at least one dose for months

has anyone gone up and then straight back down and been glad they tried
if the current dose is still working, going up is spending headroom you might want later

if you are going up because the scale stalled for two weeks, wait. two weeks is noise

while im here update question: did anyone who held for 21 months regret it

medutest-report-c-4402.pdf
3 pages · 310 KB · not retained in the public archive
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PM

genuine question split dosing has no trial behind it. people here do it and report on it, thats all

PM

i escalate on symptoms. if the current dose is still doing something i stay on it

sorry to jump in stepping back down on purpose is a completely reasonable move and this channel should say so more often

VB

Archive lookup: reship_rita first appears in this channel on 2026-01-11.

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GV

appetite returning at the end of the week is extremely common and is not the dose failing

WN

i have been at 5 for 12 months and honestly i have stopped wanting to move

MP

the people who do best here are almost always the ones going slowest

WN

after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice

Cited study
Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1)
New England Journal of Medicine · 2022
72 weeks, tirzepatide 5, 10 and 15mg against placebo.
RR

i log dose, day, weight and one line about how the week felt. thats enough to make decisions on

RR

ok so 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 i hold at 0.5 indefinitely am i losing anything

GV

do you escalate on the calendar or on how you feel
nobody here can tell you what dose to be on and the ones who try get corrected

NT

i went up too fast and im paying for it, do i drop back or ride it out

NT

plateau versus set point is not answerable in under six months of data, ymmv
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it

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