update from 17 months ago: held at the same dose the whole time and still losing slowly
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#dosing-titration 2026-05-10
Sunday75 messages12 participantstimes are UTC
Highlights from this day
- vat_on_import — my titration ladder took 3 months to climb and i would do it slower again 20:34
- fasting_insulin — small steps are better than big ones and the only reason people take big ones is impatience 22:18
- invoice_mismatch — if the current dose is still working, going up is spending headroom you might want later 23:26
nobody here can tell you what dose to be on and the ones who try get corrected, someone check my working
*Medutest not the other one
ok so if it "stopped working after four days" that is almost never pharmacokinetics, we shall see
steady state is 5 weeks
no trial for that
the honest answer is that most of us are running protocols nobody has ever studied
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*that should say weekly
slightly off topic but my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step, ask me again in a month
has anyone gone up and then straight back down and been glad they tried
my titration ladder took 3 months to climb and i would do it slower again
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go slower
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is it normal for appetite to come back at the end of the week
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if you are going up because the scale stalled for two weeks, wait. two weeks is noise
split dosing has no trial behind it. people here do it and report on it, thats all
pick a day and stick to it
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quick one whats your rule for when a side effect means hold rather than push
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my dose day has drifted 2 days later over 26 months, does it matter
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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
half life is a week
if you are asking whether to go up, the fact you are asking usually means not yet, someone check my working
thats normal
do you tell your prescriber you held or do you just hold
i drifted from sunday to wednesday over a year and only noticed when i checked the log
is there a point where going up stops buying you anything
stepping back down on purpose is a completely reasonable move and this channel should say so more often
whats the smallest step anyone has managed between doses
right so the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess
anyone here split their weekly into two and would they do it again
whats a sensible maintenance dose after a year at treatment dose
small steps are better than big ones and the only reason people take big ones is impatience
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if the current dose is still working, going up is spending headroom you might want later
i would hold
what does the room think about jumping a rung to catch up
quick one stepping back down on purpose is a completely reasonable move and this channel should say so more often
do you count from injection day or from when you actually felt it
if i hold at 7.5 indefinitely am i losing anything
came down, no regrets
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anyone tracked whether a smaller more frequent dose changed their side effects
held for months
while im here how do you decide between holding and stepping when both feel wrong
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the people who do best here are almost always the ones going slowest
if i took it 8 days late do i shift the schedule or go back to the old day
you do not have to escalate at all. that is a real option that gets forgotten
not advice
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i log dose, day, weight and one line about how the week felt. thats enough to make decisions on
thats noise
ok so holding is not failing. most people here who lasted two years held at least one dose for months
a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
appetite returning at the end of the week is extremely common and is not the dose failing
too early imo
the trials escalated on a fixed schedule because a trial has to. you are not a trial
*Janoshik not the other one
small steps are better than big ones and the only reason people take big ones is impatience
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i went from 1 to 7.5 and honestly could not tell the difference in appetite, ask me again in a month
thats anecdote
is week 10 too early to be thinking about the next step
dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
i hold for two months minimum before i decide a dose has stopped doing anything
update on the earlier thing with a roughly seven day half-life you are near steady state after about five weeks at a dose, ask me again in a month
how much does the last dose still matter 8 days later
i have been at 7.5 for 24 months and honestly i have stopped wanting to move
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two weeks is nothing
i escalate on symptoms. if the current dose is still doing something i stay on it, happy to be corrected
stepping back down on purpose is a completely reasonable move and this channel should say so more often
i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat, i have it written down somewhere
whats the longest anyone has stayed on one dose
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
end of week thing
[edited]plateau versus set point is not answerable in under six months of data
the ladder in the trials is a starting point, not a schedule you owe anyone
came down from a treatment dose to maintenance over about three months and it was uneventful
if the current dose is still working, going up is spending headroom you might want later
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no trial for that
if the current dose is still working, going up is spending headroom you might want later