Titrate - How much to increase?

[itsmenotyou]

Currently on 1mg - have been for 6 weeks. Tomorrow is dose day and I am thinking I should increase. This last week or so I have had a lot of food noise and eating way more than I had done the weeks before. (When i first started I was struggling to eat 600 calories a day now I could easily eat 2000 without thinking).

My question is - should I go to 1.5mg or 2mg? And what is the basis for deciding?

 

[Bioexplorer]

Use your judgement. Were you very sensitive to the initial dose and experience unpleasant side effects? If so, be gradual. I noticed increased appetite after 4 weeks at 1mg and increased to 2mg. Even with the dose increase, food is more attractive than it was during the initial week. I guess the body acclimates.

 

[itsmenotyou]

Use your judgement. Were you very sensitive to the initial dose and experience unpleasant side effects? If so, be gradual. I noticed increased appetite after 4 weeks at 1mg and increased to 2mg. Even with the dose increase, food is more attractive than it was during the initial week. I guess the body acclimates.

I didn't have any "bad" side affects except heartburn.

Thanks for your insight.

 

[Strawberry man]

Hello. I went from 1 mg and increased by 250mcg. When I got to 2 mg I had to back off. Fortunate I guess I don’t need large doses. This has worked for me and I have been on 13 months.

 

[BNLFL]

2mg. I started at 2mg myself.

 

[itsmenotyou]

Hello. I went from 1 mg and increased by 250mcg. When I got to 2 mg I had to back off. Fortunate I guess I don’t need large doses. This has worked for me and I have been on 13 months.

Interesting that is a small increase! Lucky you are so receptive!

 

[itsmenotyou]

2mg. I started at 2mg myself.

Thanks for your feedback.

 

[Strawberry man]

I had heart rate issues in the beginning which were very uncomfortable. That is why I increased by only 250mcg . Good luck!

 

[woundcarping]

Currently on 1mg - have been for 6 weeks. Tomorrow is dose day and I am thinking I should increase. This last week or so I have had a lot of food noise and eating way more than I had done the weeks before. (When i first started I was struggling to eat 600 calories a day now I could easily eat 2000 without thinking).

My question is - should I go to 1.5mg or 2mg? And what is the basis for deciding?

Where are you and where are you trying to get Reta to take you?

 

[Crowreap]

That's actually kind of crazy, because what's going on with me is the opposite of your experience. I've been on reta for 4 weeks, and I started at 1 mg, and I'm still at 1 mg. And what's going on is, reta is actually somehow getting stronger. I don't know how. In my first week, food noise and appetite suppression was gone, but it would kind of come back for like two to three hours of the day. But then after week number two, I haven't felt hunger or had any cravings ever since. And also my side effects seem to get worse, because my skin is getting more sensitive, and I'm feeling more fatigue after my pinning day. And also, the gastric emptying is getting pretty insane, because I get full instantly. I'm not even kidding, after 5 to 6 bites, I'm completely done, and then I have to force it down, and I'm only eating 1500 calories a day. It actually got so crazy yesterday. I was sitting there eating my Greek yogurt for like an hour straight, and my stomach was all bloated, and I genuinely felt like I was bulking, but its so weird because I'm in a massive calorie deficit because I'm doing a cut right now. So I've never actually had to titrate the dosage up because reta is doing its job a bit too well. and to answer your question, everyone's different so slowly you can up the dosage since it's effects on you are wearing off. I am may to slowly lower my dosage it seems.

 

[BNLFL]

So many of stories here seem like they need to be evaluated by Dr Phil. I just don't understand it. How can y'all have so many side effects. Heart rates, crazy nausea, can't eat, can't sleep, losing 10lbs/week and many others on these baby doses of .25, .5 and 1 mg and you're staying on it for weeks without titrating up.

 

[gimmeshelter]

.5 4 weeks

.8 1 week

1.0 this week

Losing 2-3lbs a week w tracking, weights and cardio. Everyone is so different. Listen to ur body and go up slowly. It's not a race. Use the slow titration to train urself on new food habits and choices. I made sure i was not gonna feel ill because I wanted to be able to eat w fam, exercise and be productive.

 

[anhydrous]

Going from 1 to 1.5 is a 50% increase in dose and going from 1 to 2 is doubling your dose. Of the two I'd choose the lesser and see what happens. It costs you nothing but a little time to take a try it and see approach.

 

[WLBLD]

You can try 1.5 for your next but if it doesn't do much just go to 2 the next time. That way you make sure how you respond to it

 

[itsmenotyou]

Where are you and where are you trying to get Reta to take you?

Weight wise? 87 kgs at moment want to get to 68kgs but not in a rush…

 

[itsmenotyou]

Going from 1 to 1.5 is a 50% increase in dose and going from 1 to 2 is doubling your dose. Of the two I'd choose the lesser and see what happens. It costs you nothing but a little time to take a try it and see approach.

Good advice!! I’ll start with 1.5mg see how that goes.

 

[itsmenotyou]

You can try 1.5 for your next but if it doesn't do much just go to 2 the next time. That way you make sure how you respond to it

Also good advice I’ll do this.

 

[lessthanhalf]

From what I have seen on this forum, and I have seen no evidence of this in the studies, people trying to lose relatively small amounts of weight, who are not severely obese at the start , seem to get more side effects and more effects at lower doses , than I would expect. And the research is not that helpful as most people were more overweight in the studies. There is no doubt at all that the metabolic state in severe obesity is quite different in a lot of ways , so it sort of makes sense.

I cranked the dose of tirz from 1mg to 15 in a month, without issues, no I am not recommending it, but I had already lost 70 kg at that point.

For the OP the fact that calorie intake dropped to 600 /day when you started at 1mg suggests you are pretty sensitive to the drug, so being more careful is probably sensible. Worse side effects are always possible with any dose increase at any stage, but increasing slowly probably is likely to make them less sudden or severe. If you did not notice the effects increasing over the last 4 weeks, then if you increase to 1.5mg and you still have no side effects and are still hungry then you probably do not need to wait 4 weeks to increase to 2mg, 2 weeks is probably fine, given that 2mg is the standard starter dose and not thought by the company that makes the drug to be risky.

 

[JCO79]

I agree that pushing it to the point of feeling sick doesn’t make sense if you aren’t in a rush. I haven’t seen anything to convince me that a slow escalation has any other trade off than slower progress.

 

[itsmenotyou]

You can try 1.5 for your next but if it doesn't do much just go to 2 the next time. That way you make sure how you respond to it

THanks i ended up doing 1.5