does a missed week reset anything or do you just carry on
#dosing-titration 2026-06-23
Tuesday62 messages13 participantstimes are UTC
Highlights from this day
holding is not failing. most people here who lasted two years held at least one dose for months
i jumped a rung once to catch up after a supply gap and it was a bad week. would not repeat
whats the longest anyone has stayed on one dose
| 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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whats the smallest step anyone has managed between doses
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if i hold at 0.5 indefinitely am i losing anything
i escalate on symptoms. if the current dose is still doing something i stay on it, still working it out
how do you tell a plateau from just being at your set point
whats your rule for when a side effect means hold rather than push
the trials escalated on a fixed schedule because a trial has to. you are not a trial
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two weeks is nothing
i went up too fast and im paying for it, do i drop back or ride it out
i went from 1.7 to 0.25 and honestly could not tell the difference in appetite
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right so anyone here split their weekly into two and would they do it again
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whats a sensible maintenance dose after a year at treatment dose
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)the people who do best here are almost always the ones going slowest
[edited]update from 18 months ago: held at the same dose the whole time and still losing slowly
do you count from injection day or from when you actually felt it
steady state is 5 weeks
| 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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dose day drift is mostly harmless with a weekly compound, but pick a day and defend it, ask me again in a month
if you are going up because the scale stalled for two weeks, wait. two weeks is noise
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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
if i took it 5 days late do i shift the schedule or go back to the old day
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my titration ladder took 10 months to climb and i would do it slower again
i escalate on symptoms. if the current dose is still doing something i stay on it
i have been at 5 for 21 months and honestly i have stopped wanting to move
update from 22 months ago: held at the same dose the whole time and still losing slowly
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is it normal for appetite to come back at the end of the week
you do not have to escalate at all. that is a real option that gets forgotten
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half life is a week
i log dose, day, weight and one line about how the week felt. thats enough to make decisions on, your mileage will differ
pick a day and stick to it
held for months
how much does the last dose still matter 8 days later
split dosing has no trial behind it. people here do it and report on it, thats all
unrelated but do you tell your prescriber you held or do you just hold
how long did you hold at 12 before you moved up
came down, no regrets
Purity check: no report on file for lot E-2205. Nothing logged either way.
coming down from 0.25 to 1.7, how bad is the appetite rebound
my dose day has drifted 3 days later over 14 months, does it matter
hold
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the honest answer is that most of us are running protocols nobody has ever studied
for the archive a missed week does not reset you, but going straight back to the top dose after a gap is how people get floored
the ladder in the trials is a starting point, not a schedule you owe anyone
i drifted from sunday to wednesday over a year and only noticed when i checked the log, your mileage will differ
the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess, anyway
came down from a treatment dose to maintenance over about three months and it was uneventful
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
anyone tracked whether a smaller more frequent dose changed their side effects
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thats normal
with a roughly seven day half-life you are near steady state after about five weeks at a dose
after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice
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appetite returning at the end of the week is extremely common and is not the dose failing
thats noise
i would hold
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go slower
is week 34 too early to be thinking about the next step
n of 1
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)plateau versus set point is not answerable in under six months of data
thats anecdote
nobody here can tell you what dose to be on and the ones who try get corrected
is there a point where going up stops buying you anything
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not advice
if you are asking whether to go up, the fact you are asking usually means not yet