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[Discussion] the GIP advice in here is 2 years out of date

Discussion Clean Column ×8 Cold Box ×1 Slow Clap ×1

Posting this as a discussion rather than a claim: the GIP advice in here is 2 years out of date.

To save the first four comments: 2 years.

The step schedule question, answered properly, because it comes up weekly.

The label sets a minimum interval of four weeks between increases. That is a floor on how fast you may go, and it exists because tolerability, not efficacy, is what limits most people. There is nothing in the pharmacology that says you must increase at four weeks, or at eight, or ever.

What decides it in practice is whether the effect you want is still there. If appetite is quiet and the trend is going the right way, the dose is doing its job. If both have genuinely gone flat for six weeks or more, that is a conversation worth having with someone who knows your history.

Week 9 was the first time the scale moved after a five-week stall. I changed nothing in that window.

Research-use-only material is not approved for human use and nothing here should be read as a recommendation to use it.

21,613 up / 15,730 down58% upvoted48 commentsid 18q7c46 Aug 2024

48 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/tidy_vialdrawer_pls819 points·1 year ago

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

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[deleted]588 points·1 year ago

[deleted]

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u/throwaway_wl2026154 points·1 year ago

Cosigning the four-week thing. It is a minimum interval, and treating it as a schedule to keep up with is how people end up miserable at 12.5.

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u/mod_cold_roommod · c/coldchain-3 points·1 year ago

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

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u/ferran_mensah404 points·1 year ago

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

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u/dario_stanescu0 points·1 year ago

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

Agreed, with one qualifier: that is the mean of the top arm and the spread around it was enormous.

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u/gentle_correctionnice about it189 points·1 year ago·edited

The thing nobody warned me about was how much of this is logistics — storing it, remembering it, the same day every week.

ferran_mensah is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.

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u/quiet_moderatorMOD397 points·1 year ago

Removed the conversion table. There is no published equivalence between the two molecules and posting one as fact is exactly the kind of thing that gets copied for years.

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u/customs_seizure_sid143 points·1 year ago

Careful with "everyone tolerates it better". The people it did not suit stop posting, which makes this board look calmer than the drug is.

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u/georgi_chowdhury41 points·1 year ago

sulphur burps are the signature complaint and they are not dangerous

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u/titration_marshalmod · c/semaglutide59 points·1 year ago

the four-week step schedule is the label, not folklore

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u/tidy_vialdrawer_plsOP44 points·1 year ago

the four-week step schedule is the label, not folklore

Saving this one. It is the clearest statement of the stall problem I have read here.

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u/tarek_kirchner71 points·1 year ago

Careful with "everyone tolerates it better".

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

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u/copay_card_cc234 points·1 year ago

The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.

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u/marit_sandvik80 points·1 year ago

a lot of people plateau nicely at 10mg and never need 15

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u/laila_yilmaz70 points·1 year ago

hold the dose that works, the ladder is not a leaderboard

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u/tidy_vialdrawer_plsOP56 points·1 year ago

SURMOUNT-1 landed around 21% at 72 weeks on the top arm

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u/emil_barros28 points·1 year ago

Agree. The GIP component is the interesting half and it barely gets discussed outside c/glp1science.

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u/graph_it_gary15 points·1 year ago

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

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u/gustav_vermeulen186 points·1 year ago

zepbound and mounjaro are the same compound with different labels

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u/yusuf_ramos51 points·1 year ago

Yes — 10mg being a genuine landing place for a lot of people is underrated. There is no medal for 15.

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u/incretin_ivypharmacology17 points·1 year ago

week 8 is early to draw any conclusion at all

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u/hair_shed_hannah128 points·1 year ago

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.

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u/laila_wikstrom118 points·1 year ago·edited

Research-use-only material is not approved for human use. Anything in this thread about how a research vial "should" titrate is a discussion about chemistry, not a plan.

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u/hassan_nilsen91 points·1 year ago

22kg over 59 weeks, never went past 10mg, and food noise stayed mild the whole way. Posting because the loud threads are all 15mg.

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u/coring_the_stopper47 points·1 year ago·edited

That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.

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u/crosspost_bot_no34 points·1 year ago

Pen or vial? The step sizes available differ and it changes this answer.

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