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ForumsMASH / Liver DiseaseSemaglutide and MASH — liver fat reduction quantification Page 2

Semaglutide and MASH — liver fat reduction quantification

MASHdoc_SA Mon, Jun 8, 2026 at 3:08 PM 13 replies 146 viewsPage 2 of 3
PeptideChemSF
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Jun 8, 2026 at 4:45 PM#6

The figures, for anyone assembling their own picture. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

48 18steve_okc, dave_SLC, FDA_TrackerJim and 45 others
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DerekSJ_a1c
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Jun 8, 2026 at 5:24 PM#7

A narrower follow-up, since the general answer is now clear:

Whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg?

Last edited: Jun 8, 2026 at 10:24 PM
47 17Dr.SurgeonPGH, rachel_ABQ, traveltech_sara and 44 others
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claudia_zurich
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Jun 8, 2026 at 6:03 PM#8
PeptideChemSF said:
Worth knowing that the injection site changes very little.

There is a second half to this that has not been said yet. 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.

Ask again with the specifics and you will get a better answer than this one.

Last edited: Jun 9, 2026 at 12:03 AM
46 16Dr.LipidDallas, alex_tucson, kevin_tulsa and 43 others
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MASHdoc_SA
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Jun 8, 2026 at 6:42 PM#9

Closing the loop on my own question.

Update since I posted: I held at 1.7mg for a further twelve weeks and lost another 4kg slowly, which settles it for me. I was escalating because the number was available, not because I had stopped responding.

Last edited: Jun 8, 2026 at 9:42 PM
45 15LabKate, kate.chem, DataDave and 42 others
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lisa_labSD
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Jun 8, 2026 at 9:50 PM#10
claudia_zurich said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

claudia_zurich has the substance of this right. The condition it depends on is worth stating. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

Worth separating that from liver and MASH, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

7 5cory_ATX, lori_vegas, Dr.PulmRoch and 4 others
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