jim_asheville said:Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.
This is exactly what I could not find anywhere else. Printing the relevant bit and taking it with me.
Clinical perspective, offered as context rather than as advice.
Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows:
Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill coefficient ≈ 1.3
Tirzepatide: ED50 ≈ 6mg, Emax ≈ -25%, Hill coefficient ≈ 1.5
Clinical implication: most patients achieve >80% of maximal response by the mid-range dose (1.7mg sema, 10mg tirz). Going to the maximum dose provides diminishing returns — possibly not worth the additional side effect burden for some patients. Individualize dosing based on response vs tolerability.
hyun_seoul said:The GIP arm is doing real work rather than padding the label.
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.
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Shop Reference StandardsOne concrete data point for the thread. The arithmetic in one line: half-life about a week, so steady state at four to five weeks, so a four-week interval is one steady state per step. Two-week intervals mean every step is dosed onto a rising curve.
Correct me if the detail matters more than I have assumed.
Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. No action needed from anybody.