Adding the numbers, since they settle part of this. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.
One thing that is still open after Dr.KarenChen’s answer:
What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?
stefan_berlin said:For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…
Coming at stefan_berlin’s question from a different direction. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.
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View ResultsReporting back.
Update. I did go to 2.4mg in the end, and the honest report is that it bought me less than the step before it and cost me two bad weeks. Worth knowing rather than worth repeating.
DeniseRN_TPA said:The mechanism that matters here is not stomach emptying, it is central.
No disagreement with DeniseRN_TPA. One condition attached. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.
I would rather be corrected than agreed with, if it comes to it.