[PSA] the escalation schedule everyone quotes is a floor, not a finish line
Getting asked this every single week so putting it in one place.
The labelled schedule (roughly: 0.25 for a month, then step up every 4 weeks) is the fastest the trials tested, not the recommended pace. It's a minimum interval, not a target you should be racing to hit.
| Step | Labelled interval | Common "low and slow" interval |
|---|---|---|
| 0.25 → 0.5 | 4 weeks | 6–8 weeks |
| 0.5 → 1.0 | 4 weeks | 6–10 weeks |
| 1.0 → 1.7 | 4 weeks | 8–12 weeks |
| 1.7 → 2.4 | 4 weeks | rarely rushed at all |
None of the right-hand column is a rule. It's just what a lot of people in here report doing after learning the hard way. Whether and when you step up is between you and whoever prescribes it — this is just "here's the range people describe," not a schedule to copy.
best — the order this archive was captured in
this table is basically my last 22 months. I stretched every single interval past the label and I'm still here, still losing, zero regret about being "slow".
you're kind of the poster child for the right-hand column honestly
happy to be. 31kg down, no crash, no regret. slow is not the same as slow-to-work.
the number of people who think slow = not working is way too high in this community honestly
because the scale is noisy week to week and slow titration makes the noise louder relative to the trend. a 7-day average fixes most of that panic.
this comment should be pinned somewhere, it's the actual mechanism of the confusion
Pinning this. Good, well-hedged post — describes ranges people report rather than telling anyone what to take, which is the standard we want. edit: fixed a typo in the 1.0→1.7 row, it originally said 8 weeks not 8–12.
worth noting SUSTAIN 6 and the STEP trials used faster escalation than most of this "low and slow" folk wisdom and still had meaningful discontinuation from GI side effects. the label pace isn't invented, it's just aggressive.
right, and that's kind of the whole argument for stretching it if your body's not cooperating — the trial pace optimised for trial length, not for any one person's stomach.
my pharmacist looked at me like I was unwell when I asked about a slower step-up. this table would've saved that conversation.
one thing this doesn't cover: skipping a dose entirely doesn't reset your tolerance, it just resets your escalation clock. worth its own line maybe.
fair, adding a line about that, good catch
this is basically the wiki page but readable, linking both
- 1this table is basically my last 22 months. I stretched every single interval…6 comments in this branch · started by u/TitrationTortoise