Dr.CardioMD said:Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.
Pushing back on Dr.CardioMD here. Two drugs, two side-effect profiles, one price. The efficiency argument only works if the tolerability really is better than dose-escalating a single agent, and I have not seen that demonstrated head to head.
Adding the numbers, since they settle part of this. 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.
Dr.GastroMayo said:Two drugs, two side-effect profiles, one price.
Coming at Dr.GastroMayo’s question from a different direction. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.
I would rather be corrected than agreed with, if it comes to it.
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Shop Reference StandardsFollowing on from Dr.EndoEP — and this may be the naive question:
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?
Reporting 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.