DanielChem_CHI said:The mechanism that matters here is not stomach emptying, it is central.
I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.
The figures, for anyone assembling their own picture. 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.
SarahChen_PharmD said:I will push back on the "any working dose is fine" framing.
Coming at SarahChen_PharmD’s question from a different direction. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.
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Shop Reference StandardsOne thing that is still open after fiona_glasgow’s answer:
How to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases?
Closing the loop on my own question.
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.