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c/semaglutide·posted 2 years ago by u/gustav_solberg

titration: the version I wish someone had shown me in week 1

Titration Long Haul ×2 Well Actually ×1

titration: the version I wish someone had shown me in week 1. This is a description of what happened to me and not a plan for anybody else.

What I would tell week-one me, in order of how much time it would have saved.

One: the first month is a tolerance check. You are finding out whether you can take this, not how much you will lose. Two: write down the dose, the day and the waist measurement. Three: a stall of under six weeks is weather, not climate. Four: nausea that arrives the day after the shot and fades by day four is the ordinary pattern and it usually settles at a stable dose.

None of that is advice about what you should do. It is the shape of the thing, which nobody explained to me and which the wiki explains better than I just did.

food noise made the first fortnight rough at each step up, then flattened out. Predictable enough that I started planning around it.

Sceptical readings welcome. The confident ones are the ones I distrust.

1,907 up / 702 down73% upvoted52 commentsid 54asf75 Aug 2023

52 comments

17 in this archive, depth 5

best — the order this archive was captured in

u/coa_janitormod · c/coa-22 points·2 years ago

On the "everybody ends up at 2.4" claim, which comes up every few weeks.

The escalation schedule in the trials was designed to get people to a fixed study dose. Real use is not a trial. The dose that keeps your appetite quiet with side effects you can live with is the dose, and for a lot of people on this board that has been 0.5mg for a very long time.

The counter-argument, which is fair: some people genuinely do need the top of the range, and staying low out of caution costs them months. That is a conversation with someone who knows your history, not with us.

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u/quiet_moderatorMOD72 points·2 years ago

Leaving this up. It is a check-in, it has numbers, and it is honest about being one person.

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u/rasmus_kimani18 points·2 years ago

The weekly interval comes out of the half-life — roughly a week — so you are on a smooth curve rather than a series of spikes. That is also why moving your day slightly does very little.

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u/gustav_solbergOP10 points·2 years ago

Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose. The distinction matters for anyone reading this later.

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u/salma_vasquez63 points·2 years ago

the ladder exists because the gut needs the time, not because the pharmacy likes paperwork

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u/nikhil_teixeira28 points·2 years ago

Correct, and worth adding: the trial average is an average. Half the people in it did worse than 15% and were still on the drug.

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u/units_not_mgsyringe math14 points·2 years ago

Strongly agree on protein. It did more for my injection-site soreness than any of the things I bought to fix my injection-site soreness.

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u/elodie_grimaldi19 points·2 years ago

Kept a log from week one and the single most useful column turned out to be waist, not weight.

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u/ffmi_watcher9 points·2 years ago·edited

protein first, then everything else gets easier

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u/test_it_yourselfvetting9 points·2 years ago

nausea that arrives on day two and fades by day four is the standard shape

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u/gustav_solbergOP35 points·2 years ago

What dose and how many weeks at it before this started?

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u/meta_analysis_mo43 points·2 years ago

the appetite signal and the scale move on different clocks

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[deleted]16 points·2 years ago

[deleted]

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u/reflux_report8 points·2 years ago

do not chase somebody else’s titration schedule, they are not you

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u/nadia_bakker5 points·2 years ago

I would push back gently. Going up because the scale paused is the single most common mistake described on this board.

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u/kavya_radich43 points·2 years ago

That figure is the 68-week trial mean, not a weekly rate. Dividing it by the weeks gives you a number that does not mean anything.

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u/vikram_mbeki10 points·2 years ago

STEP-1 averaged just under 15% at 68 weeks, so a 10% year is not a failure

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