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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMetabolic Health & DiabetesSUSTAIN-6 to SELECT — what worked for you? Page 6

SUSTAIN-6 to SELECT — what worked for you?

fiona_VT Sat, Aug 16, 2025 at 4:04 PM 38 replies 1,492 viewsPage 6 of 8
VendorMark
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Nov 9, 2025 at 1:16 AM#26
DebRD_ATL said:
Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…

Same experience, arrived at from the opposite direction. Nothing to add that would improve it.

29 2DebRD_ATL, KristenIndy, MarkLI_maint and 26 others
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KristenIndy
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Nov 19, 2025 at 10:57 PM#27
DebRD_ATL said:
Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…

There is a second half to this that has not been said yet. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

Last edited: Nov 20, 2025 at 3:57 AM
30 3amsterdam_pete, LondonLisa, mike_nyc and 27 others
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Dr.AddMedPHL
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Nov 30, 2025 at 8:32 PM#28

The figures, for anyone assembling their own picture. 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.

Last edited: Nov 30, 2025 at 10:32 PM
31 4mike.trainer_LA, sarah_nash92, FitDadDave and 28 others
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GraceAZ_72
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Dec 11, 2025 at 6:00 PM#29

A narrower follow-up, since the general answer is now clear:

How much of the between-person variation is pharmacokinetic and how much is just adherence measured badly?

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fiona_VT
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Dec 22, 2025 at 3:22 PM#30

OP back with an update, since a thread like this is useless without one.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.

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