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ForumsDosing & ProtocolsDose escalation too fast? Recognizing over-titration symptoms — need advice Page 2

Dose escalation too fast? Recognizing over-titration symptoms — need advice

jennifer_SEA Sat, Dec 28, 2024 at 3:44 PM 12 replies 1,701 viewsPage 2 of 3
JennaRN
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Dec 28, 2024 at 7:54 PM#6
DataDave said:
Four weeks is the pharmacokinetics, not caution.

I disagree that the ladder is purely tolerability. The maintenance and regain data cluster at the top doses, so a ladder abandoned halfway leaves you outside the evidence base for the part that matters most — keeping it off.

Last edited: Dec 28, 2024 at 8:54 PM
50 20Dr.KarenChen, Dr.NateNeph, PharmD_Rodriguez and 47 others
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dan_philly
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Dec 28, 2024 at 9:32 PM#7
jennifer_SEA said:
I titrated faster than the label because I felt fine, hit a wall at the third step, and had to come back down — which I now think was the predictable…

PSA for titration users considering the 0.25mg starting dose: this dose is NOT intended for weight loss. It's a titration dose to let your body adjust. Don't be discouraged if you don't lose much in the first month.

The therapeutic dose for weight management starts at 1.7mg (semaglutide) or 5mg (tirzepatide). Be patient with the ramp-up.

Last edited: Dec 29, 2024 at 12:32 AM
49 19AmyNC_wife, SkepticalSean, Dr.CardioMD and 46 others
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lisa_labSD
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Dec 28, 2024 at 11:10 PM#8
JennaRN said:
I disagree that the ladder is purely tolerability.

Adding the part of the answer the thread has not reached. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.

48 18Dr.PulmRoch, maya_sedona, stefan_berlin and 45 others
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marcus_mpls
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Dec 29, 2024 at 12:48 AM#9

One thing that is still open after NicoleRaleigh’s answer:

Why the interval is four weeks rather than two, and whether a slower ladder gets to the same place?

47 17Dr.PathRoch, mona_PHX, andrew_nyc and 44 others
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jennifer_SEA
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Dec 29, 2024 at 8:38 AM#10

OP back with an update, since a thread like this is useless without one.

I held the step an extra three weeks instead of stepping back down, and it settled. Same dose, same everything, just more time — which is exactly what was suggested upthread.

47 20hyun_seoul, jim_asheville, matt_MKE and 44 others
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