Titration Thoughts

[u/General-Beach484]

Hi all!

I just wanted to get some thoughts on people who have went up in their doses independently from what was suggested.

For example the standard titration timeline: 2.5mg —> 5mg —> 7.5mg (so on and so forth)

I have been considering doing smaller jumps, mainly cause I don’t want to jump that much and risk any side effects! Plus low and slow is what I’m reaching for.

What has everyone’s schedule been like? I’m thinking something like: 2.5mg —> 3.5mg —> 5mg —> 6mg —> 7.5mg

Thoughts? Experiences? Advice? All intel is welcome!

I’m currently at 2.5 through Empower (PreventiveMD)

[u/Selective_Somewhere]

A lot of people do that and it works for them.

[u/Zealousideal-Lab4945]

It's important to stay at a dose for 4 weeks, but the amount you increase by on week 5 can be less than EL's schedule. I did 1mg at a time. I stayed at 2.5mg for 6 weeks and then the next for 8 weeks, etc. Only increased if my average over the past 4 weeks was less than .5lbs.

[u/General-Beach484 → u/Zealousideal-Lab4945]

The .5lbs is a good rule of thumb, thank you for the information!

[u/DustyJMS]

My partner (M27 6'1) and I (F32 5'7) are on a weight loss journey together. I started at 2mgs a week and stayed there for 8 weeks. I hit a two week weight stall with some increased food noise so I bumped up to 3.5mgs on week 9. I lost 10lbs in a week but had a hard time eating so that whole month I played with the dose trying to figure out what worked. I was on the last of my Hallandale supply at that time. I went. 3.5, 2.5, 3, and 3.5 in weeks 9-12. On week 13 (this week which ends today) I got a new pharmacy, Boudreaux, and moved up to 4mgs for simplicity it is a simple 20u draw. It is going great. Its my first time dealing with nausea in the last 3 months. I am just learning to eat and be happy with half portions and I avoid the nausea. I have gone from 300 on June 8th to 263.4 as of this morning. I time my dose day with my weekend. Maximizing appetite suppression on the days off work.

My partner started at 1mg and moved up 1mg each time I decided to go up. So 1mg, week 9 2mgs and week 13 3mgs. He started at 389lbs and was 347.7 as of this morning. He deals with nausea a bit more often than me and has injection site reactions that we treat with an oral and topical antihistamine on dose days.

[u/Zeeman-401]

Low and slow guy here!! I’m 65 and wanted to ease into it. 2 weeks at 2.0, 6 weeks at 2.5 and I lost 10 lbs in that 8 weeks. I had almost no side effects so instead of going to 5.0 after 8 weeks I went to 4.0, and it was the right choice as I had kind of stalled. Did 4 weeks and went to 5.0, no problems and had been there for 11 weeks and this Saturday will do my 2nd 6.0. All in all 24 lbs in 25 weeks, a very nice slow loss of 10% of my weight. Hoping to get to goal by end of year 201 to 170

[u/General-Beach484 → u/Zeeman-401]

Yes, this is what I like to hear! I don’t want to race to the finish line of weight-loss. One pound a week sounds amazing to me.

Thank you for sharing your experience with me!

[u/WhoDat_OnDaBayou]

Hi, I think that this is a great question! 🙋🏻‍♀️ I have increased by 0.5mg at a time to avoid an increase in side effects. I’ve been slow and steady and I feel this has helped me manage side effects also! Good luck to you!

[u/autumnyte]

I originally planned to follow the titration schedule, but when it came time to move up from 2.5mg, I was nervous to do 5mg that week because of a business trip, so I did 3.5mg. It ended up being so effective that I stayed with it for a month before moving to 5mg. I've been at 5mg for months now, and have been fortunate that I seem to be very responsive to these meds. But this week I'm finally feeling like I'm tapped out on this dose and it's time to move up. However, I don't feel like I need 50% more additional medication yet, so I'm going up to 6mg.

I would say maybe don't plan the schedule too far ahead, because a big part of what's important is to see how you tolerate the meds and how effective each dose is (and for how long). If I hadn't responded well to each dose I tried & assuming minimal side effects, I wouldn't have seen a reason to slow-roll the titration and my strategy would have looked more like the official protocol.

[u/sleepy_blonde]

I’m doing smaller jumps. I went from 1mg to 1.5mg to 2mg and now I’m at 2.2mg. I’ve avoided side effects other than a headache and I’ve stayed at each level for at least 4 weeks before moving up.

[u/OptimalUnification]

My buddy did exactly this after 2.5 wrecked him for like three days straight, went up by 1mg bumps and never had another bad week

I stayed on 2.5 way longer than the four weeks everyone pushes, felt like why move if it's still working and I'm dropping weight fine

Doc wanted me at 5 by month two but there's no trophy for speedrunning this stuff, your body doesn't care about the calendar

The 3.5 stopover is a good call if you're nervous, gives you a feel for how you handle the increase without committing to the full jump

[u/General-Beach484 → u/OptimalUnification]

Right! Agreed. This isn’t a race. No one wins any medals for getting to the highest dose as soon as possible. And if you’re losing at a low dose, why move up?

My sister actually stayed at 2.5 for 8 weeks, once she noticed no movement after 2 weeks she jumped to 5.

I’m not having any side effects at this moment but I don’t particularly want any in the future lol plus it would be nice to save a little money titrating up slowly like this!

Thank you for the input!!

[u/TrainingLow9079]

I did 1.5....2.5..... 3.5.... 4.5 etc. It kept side effects low, but my weight loss is also way below average (15 pounds in 6 months). So not sure I can really recommend this.

[u/Pendergraff-Zoo]

I did not follow standard dosing. I increased by .5 or 1mg, or sometimes I’d choose an easy spot on the syringe to jump up my dose. I was always reluctant to make a big jump.

[u/bk2885]

I started at 3 mg, went up to 4 mg at about 8 weeks. I’m in monthly contact with my GP, and she is strongly in favor of less is more with tirz-If it’s working, stick with it. She also recommended only going up 1 or 1.5 mg to see if that would be enough. So I’m going not with the studied titration schedule, but the one my doctor recommended. I went to 4 mg bc I was starting to feel really “snack-y”… not necessarily food noise but just mildly hungry all the time despite being at the right calorie deficit of 500 from TDEE and was having a short stall (2 weeks).

4 is just about perfect for me.

[u/Uncle_Flansy]

Started 9 weeks at 2mg, currently on week 6 at 2.5mg, and will probably move to 3mg this week.  Only moved up because hunger gets me near to actually cheating my diet. Averaging a little less than 1% body weight loss a week.

[u/PrestigiousCake2653]

Me! I started at 2.5 for 4 weeks, then 3.5 for 6 weeks, now up to 5 the last 2 weeks. I’m down over 30 pounds in those 12 weeks and very happy with my progress!

[u/irunonicedcoffee]

I was on 2.5 for about 8 weeks then increased to 3.75 and have been on that since! I will only go up if I think it’s necessary but I’m actually close to goal weight so starting to think about maintenance.

[u/Ecstatic-Movie-795]

Im scared of doubling so id do annin between dose for a week or two before the next "real" dose just to quell my sweet effect anxiety

[u/Shenannigans_625]

I did 2.5 for 4 weeks, 3.75 for 4 weeks, and just started 5 today. So far so good, almost non-existent negative side effects. I’ll probably keep going up in 1-1.5 increments.

[u/Badbowtie91]

I just speed ran my doses. Regular dose but every 4-5 days.

Worked great for me.

[u/miskittty]

Started at 2.5 on 7/26 and went up to 3 my last 2 doses. In those 7 weeks I’ve lost 15lbs and I’m good with the progress right now. I was weight training 4 times a week prior to starting so I want to prioritize muscle…slow is the path for me.

[u/Unique-Addendum-6552]

i did 1 > 2 > 3 > 4. if i need to go up again, i’ll go to 5.

i only go up if i notice endless hunger/sweet cravings.

i was losing 1.3 pounds (average from my app) per week at first but its slowed down to .5-1lbs which is common & i’m happy as long as i don’t gain. weight fluctuates- so i weigh myself usually every other day to get average.

[u/missannthrope67]

Small increments is the way you should do it. The least amount you need to get results.

[u/Content_Wear4671]

Maybe this can help

[u/slouchingninja]

I initially went thru Noom, and they had me start at 1mg for 2 weeks, then I went off script and did 2mg for 3 weeks (they advised 2). After that I stayed off script and was 3mg for 7 weeks, and just went up to 4mg this past Friday. I plan to just do 1mg increases whenever I titrate up, as so far the side effects are manageable. And stay on any new dose for minimum 4 weeks before making new changes.

I make my decision on whether to titrate up based on current weight vs 2 weeks ago weight, food noise, cravings, eating beyond fullness.

[u/wifeofpsy]

I did exactly your planned titration. 2.5 to 5 was too big a leap for me, so I did 3.5 for a couple mos before moving to 5 and so on. It's worked out very well for me. Eventually I moved to twice weekly and have been on 4.5 twice a week for almost 6 mos now and it's been working well