My doctor wants to keep me on 0.5 but I want to go up — January 2024

PeptideChemSF said:

Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

This is where I part company with the consensus forming above. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.

One concrete data point for the thread. 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.

Dr.ObesityLA said:

The trial means are being read too generously in this thread.

There is a second half to this that has not been said yet. The mechanism and the magnitude are separate questions. Agreeing that something happens says nothing about whether it happens enough to act on.

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

What did you change at the same time, and can you separate the two now?

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

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.