quick one nobody here can tell you what dose to be on and the ones who try get corrected
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#dosing-titration 2026-05-19
Tuesday48 messages9 participantstimes are UTC
Highlights from this day
- evidence_or_not — plateau versus set point is not answerable in under six months of data, for what its worth 17:24
- nausea_window — the trials escalated on a fixed schedule because a trial has to. you are not a trial 18:05
- nhs_pathway_nell — whats the longest anyone has stayed on one dose 18:23
- gradient_greg — unrelated but whats a sensible maintenance dose after a year at treatment dose 19:10
- lean_mass_lex — dose day drift is mostly harmless with a weekly compound, but pick a day and defend it 20:02
plateau versus set point is not answerable in under six months of data, for what its worth
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)i drifted from sunday to wednesday over a year and only noticed when i checked the log
thats noise
*that should say weekly
small steps are better than big ones and the only reason people take big ones is impatience
n of 1
hold
the trials escalated on a fixed schedule because a trial has to. you are not a trial
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i escalate on symptoms. if the current dose is still doing something i stay on it
whats the longest anyone has stayed on one dose
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you do not have to escalate at all. that is a real option that gets forgotten
*that should say weekly
genuine question how do you decide between holding and stepping when both feel wrong
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
not advice
half life is a week
| 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 |
if i took it 9 days late do i shift the schedule or go back to the old day
my titration ladder took 7 months to climb and i would do it slower again
the ladder in the trials is a starting point, not a schedule you owe anyone, ill dig out the number
update from 23 months ago: held at the same dose the whole time and still losing slowly
too early imo
is week 3 too early to be thinking about the next step
unrelated but whats a sensible maintenance dose after a year at treatment dose
coa-e-2205.pdf
1 page · 861 KB · not retained in the public archive
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has anyone gone up and then straight back down and been glad they tried
is there any actual reason to escalate every 4 weeks other than the trial did it
what does the room think about jumping a rung to catch up
how much does the last dose still matter 3 days later
held for months
do you count from injection day or from when you actually felt it
split dosing has no trial behind it. people here do it and report on it, thats all, i have it written down somewhere
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dose day drift is mostly harmless with a weekly compound, but pick a day and defend it
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does a missed week reset anything or do you just carry on
came down from a treatment dose to maintenance over about three months and it was uneventful
pick a day and stick to it
update from 21 months ago: held at the same dose the whole time and still losing slowly
do you escalate on the calendar or on how you feel
my rule: if a side effect is still there at day five, i hold. if it clears by day three, i step
stepping back down on purpose is a completely reasonable move and this channel should say so more often
the honest answer is that most of us are running protocols nobody has ever studied
no trial for that
anyone tracked whether a smaller more frequent dose changed their side effects
i hold for two months minimum before i decide a dose has stopped doing anything
appetite returning at the end of the week is extremely common and is not the dose failing
the people who do best here are almost always the ones going slowest
*Janoshik not the other one
anyone here split their weekly into two and would they do it again
two weeks is nothing
do you tell your prescriber you held or do you just hold
slightly off topic but i went up too fast and im paying for it, do i drop back or ride it out
i hold for two months minimum before i decide a dose has stopped doing anything