Dose increase: by how much should I titrate?

JCO79 said:

If you're not in a hurry, I'm with you that going until you feel ill isn't sensible. Nothing I've come across suggests a gradual ramp-up costs you anything beyond taking longer to get there.
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Appreciate the perspective — I went with 1.5 in the end
 
lessthanhalf said:

Based on what I've read here on the forum — though the studies don't back this up — it appears that individuals aiming to shed fairly modest amounts of weight, who weren't severely obese to begin with, tend to experience stronger side effects and stronger effects at lower doses than I'd anticipate. The research isn't very illuminating either, since the study populations were generally more overweight. It's certain that the metabolic state in severe obesity differs in many respects, so this pattern isn't entirely surprising.

I raised my tirz dose from 1mg to 15 within a single month without any problems — no, I'm not suggesting anyone do that — but by then I had already lost 70 kg.

As for the OP: the fact that your calorie intake fell to 600/day when you began at 1mg indicates you're quite sensitive to the medication, so proceeding cautiously is likely wise. More severe side effects can always occur with any dose increase at any point, but going up gradually probably makes them less abrupt or intense. If you didn't feel the effects growing over the past 4 weeks, then should you move to 1.5mg and still have no side effects while remaining hungry, you likely don't need to wait 4 weeks before going to 2mg — 2 weeks is probably sufficient, since 2mg is the standard starting dose and the manufacturer doesn't consider it risky.
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Appreciate it!! I went with 1.5mg earlier today - plan is to stay at that for 2 weeks, then reassess and move up to 2 if necessary
 
On Friday I moved up to 8mg using a fresh batch of MLB R50. This one is hitting me in several ways, and they are positive. What the scale showed after 4 days caught my attention.
 
BNLFL said:

On Friday I moved up to 8mg using a fresh batch of MLB R50. This one is hitting me in several ways, and they are positive. What the scale showed after 4 days caught my attention.
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8mg—that's a massive jump! Good to hear it's doing the job for you.
 
Turnus said:

Just wondering, did the higher dose cause any problems?
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I moved up to 1.5mg and the food noise faded - though the past few days brought heartburn and an upset stomach... still, it hasn't kept me from getting through my day.
 
I had been considering raising my reta dose from 2mg all the way to at least 4mg, but in the end I chose to go up by just .5mg. I'm really relieved I didn't go higher. It hit me like a brick wall: food noise suppression, heartburn, and dopamine blocking. It seems I'm sensitive to this stuff.
 
msyntakz said:

I had been considering raising my reta dose from 2mg all the way to at least 4mg, but in the end I chose to go up by just .5mg. I'm really relieved I didn't go higher. It hit me like a brick wall: food noise suppression, heartburn, and dopamine blocking. It seems I'm sensitive to this stuff.
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At night the heartburn gets really bad.. it's like being pregnant all over again!

the dopamine blocking is real. there were a few days where i could barely do anything except doomscroll.. happy that phase has passed...
 
itsmenotyou said:

I've been at 1mg for 6 weeks now. Dose day is tomorrow, and I'm leaning toward bumping it up. Over the past week or so, food noise has come back strongly and I'm consuming far more than in earlier weeks. (At the start, getting 600 calories down in a day was a struggle; these days 2000 goes down with no effort at all.)

So which step makes sense - 1.5mg or 2mg? And on what reasoning do you pick between them?
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My approach is to bump it by just 1.25mg at most--I raise it by a single unit each time--so if 10u equals 2mg for me, then I add 1 unit gradually across several weeks.
 
domin8brix said:

itsmenotyou said:

I've been at 1mg for 6 weeks now. Dose day is tomorrow, and I'm leaning toward bumping it up. Over the past week or so, food noise has come back strongly and I'm consuming far more than in earlier weeks. (At the start, getting 600 calories down in a day was a struggle; these days 2000 goes down with no effort at all.)

So which step makes sense - 1.5mg or 2mg? And on what reasoning do you pick between them?
Click to expand...
My approach is to bump it by just 1.25mg at most--I raise it by a single unit each time--so if 10u equals 2mg for me, then I add 1 unit gradually across several weeks.
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Appreciate it — I bumped my dose from 1.0 up to 1.5, and I'll stick with that for a few weeks to see how things go!
 
itsmenotyou said:

I've been at 1mg for 6 weeks now. Dose day is tomorrow, and I'm leaning toward bumping it up. Over the past week or so, food noise has come back strongly and I'm consuming far more than in earlier weeks. (At the start, getting 600 calories down in a day was a struggle; these days 2000 goes down with no effort at all.)

So which step makes sense - 1.5mg or 2mg? And on what reasoning do you pick between them?
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happy to have come across this thread — I’m in week 5 at 1mg (the starting dose), and compared with the first 4 weeks, this week I’ve been clearly hungrier with more food noise. Because of that I was considering an increase and was torn between 1.5 and 2. I’m leaning toward 1.5 and seeing how it goes from there.

Do you have any update on your side?
 
IMT11 said:

itsmenotyou said:

I've been at 1mg for 6 weeks now. Dose day is tomorrow, and I'm leaning toward bumping it up. Over the past week or so, food noise has come back strongly and I'm consuming far more than in earlier weeks. (At the start, getting 600 calories down in a day was a struggle; these days 2000 goes down with no effort at all.)

So which step makes sense - 1.5mg or 2mg? And on what reasoning do you pick between them?
Click to expand...
happy to have come across this thread — I’m in week 5 at 1mg (the starting dose), and compared with the first 4 weeks, this week I’ve been clearly hungrier with more food noise. Because of that I was considering an increase and was torn between 1.5 and 2. I’m leaning toward 1.5 and seeing how it goes from there.

Do you have any update on your side?
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I'm in the same boat — 3 weeks at 1mg, and the appetite is slowly returning. So, like you, I'm moving up to 1.5mg. Best to go gradually.

Back when I used Tirz, I jumped from 2.5 to 5 and it hit me hard! I increased by too much at once, so now I know to take it easy and step up slowly.
 
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