Dr.ObesityMed said:The dose-response is real but shallow at the top.
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.
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.
I would rather be corrected than agreed with, if it comes to it.
PharmacoVig_BOS said:I will push back on the "any working dose is fine" framing.
There is a second half to this that has not been said yet. There is a difference between no evidence and evidence of no effect, and this subject is one where the two get swapped freely in both directions.
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View ResultsA 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?
Reporting back.
Following this thread I went back and re-read the extension data properly. The point about trough rather than peak explains the pattern I was seeing on day six, which I had been blaming on the vial.