Dose increase: by how much should I titrate?

itsmenotyou

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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?
 
Rely on your own assessment. Did the starting dose hit you hard, with rough side effects? In that case, take it slowly. At 1mg, my appetite came back around week 4, so I moved up to 2mg. Despite that bump, food still draws me in more than it did in that first week. The body seems to get used to it, I suppose.
 
Bioexplorer said:

Rely on your own assessment. Did the starting dose hit you hard, with rough side effects? In that case, take it slowly. At 1mg, my appetite came back around week 4, so I moved up to 2mg. Despite that bump, food still draws me in more than it did in that first week. The body seems to get used to it, I suppose.
Heartburn was the only issue I ran into — nothing that I'd call a serious side effect.

I appreciate the advice.
 
Hello. My starting point was 1 mg, and I raised it in 250mcg steps. Once I reached 2 mg, I had to reduce again. I suppose I’m lucky that big doses aren’t necessary for me. This approach has suited me, and I’ve now been doing it for 13 months.
 
Strawberry man said:

Hello. My starting point was 1 mg, and I raised it in 250mcg steps. Once I reached 2 mg, I had to reduce again. I suppose I’m lucky that big doses aren’t necessary for me. This approach has suited me, and I’ve now been doing it for 13 months.
 
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?

What is your current situation, and what outcome are you aiming for with Reta?
 
It's honestly pretty wild that my situation is the complete reverse of what you're describing. I've had reta in my system for 4 weeks now, began at 1 mg, and haven't moved past 1 mg. The strange part is that reta appears to be intensifying on its own somehow. I can't explain it. During week 1, the appetite suppression and quieting of food noise worked, though it would return for roughly two to three hours each day. Once week number two rolled around, though, hunger and cravings have completely vanished for me. On top of that, my side effects have been ramping up - my skin has become more sensitive, and the fatigue hits harder the day after I pin. The gastric emptying situation is also getting ridiculous, since I'm full the second I start eating. Seriously, 5 to 6 bites in and I'm finished, then I have to push myself to keep going, and I'm barely getting 1500 calories daily. Yesterday was especially absurd. I spent about an hour sitting there working through my Greek yogurt, my stomach was distended, and it honestly felt like I was bulking - which makes no sense since I'm running a cut and sitting in a huge calorie deficit. So titrating up has never been necessary for me because reta is working almost too effectively. As for your question, since the effects are fading for you, and everyone responds differently, you can raise the dose gradually. Meanwhile, it looks like I might need to step my dose down slowly.
 
A lot of what I read in this community sounds like it belongs on a daytime talk show. It honestly makes no sense to me. Where do all these side effects come from? Racing heart, brutal nausea, no appetite, no sleep, dropping 10lbs/week, plus plenty more, all while on starter amounts like .25, .5 and 1 mg, and people park at those doses for weeks instead of moving up.
 
.5 for 4 weeks

.8 for 1 week

1.0 this week

With tracking, weights and cardio, I'm dropping 2-3lbs weekly. Everybody responds differently. Pay attention to ur body and raise it gradually. There's no race. Take advantage of the slow titration to build new eating habits and choices. I made certain I wouldn't feel sick because I wanted to eat w fam, work out and stay productive.
 
Jumping from 1 to 1.5 works out to a 50% bump, while 1 to 2 means taking twice as much. If it were me, I'd go with the smaller option first and observe the result. Adopting a test-and-watch strategy only costs a bit of time, nothing more.
 
For the upcoming step, 1.5 is worth a shot; however, should that produce little effect, move up to 2 on the following occasion. Doing it this way lets you gauge your own reaction.
 
woundcarping 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?

What is your current situation, and what outcome are you aiming for with Reta?
In terms of weight? Right now I'm at 87 kgs, with a goal of 68 kgs, though I'm not hurrying.
 
anhydrous said:

Jumping from 1 to 1.5 works out to a 50% bump, while 1 to 2 means taking twice as much. If it were me, I'd go with the smaller option first and observe the result. Adopting a test-and-watch strategy only costs a bit of time, nothing more.
That's a solid suggestion!! I'll try 1.5mg first and see how it works out.
 
WLBLD said:

For the upcoming step, 1.5 is worth a shot; however, should that produce little effect, move up to 2 on the following occasion. Doing it this way lets you gauge your own reaction.
That’s helpful too — I’ll follow it.
 
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.
 
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.
 
WLBLD said:

For the upcoming step, 1.5 is worth a shot; however, should that produce little effect, move up to 2 on the following occasion. Doing it this way lets you gauge your own reaction.
Thanks — I went with 1.5 in the end
 
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