Adding the numbers, since they settle part of this. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.
Correct me if the detail matters more than I have assumed.
Following on from traveltech_sara — and this may be the naive question:
What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?
DataDave said:Worth knowing that the injection site changes very little.
There is a second half to this that has not been said yet. Steady state is the thing most people miss. The terminal half-life is about a week, so every dose step takes four to five weeks to fully express itself. Judging a step at day ten is judging the ascent, not the plateau, and it is the single commonest reason people escalate before they needed to.
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Browse GL BiochemOP back with an update, since a thread like this is useless without one.
Following this thread I went back and re-read the extension data properly. The point about trough rather than peak explains the pattern I was seeing on day six, which I had been blaming on the vial.
lisa_labSD said:Steady state is the thing most people miss.
That is correct as far as it goes, and here is where it stops going. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.