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ForumsOral GLP-1 AgonistsOral semaglutide bioavailability optimization — 12 month update Page 5

Oral semaglutide bioavailability optimization — 12 month update

jim_asheville Wed, Feb 7, 2024 at 4:58 PM 58 replies 3,516 viewsPage 5 of 12
JakeSmashed95
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Feb 15, 2024 at 12:02 PM#21
DeniseRN_TPA said:
The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either.

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.

Worth separating that from semaglutide, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

44 19Dr.PainCLE, mike_mealprep, NicoleRaleigh and 41 others
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lucas_SP_BR
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Feb 17, 2024 at 11:16 PM#22

Adding the numbers, since they settle part of this. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

43 18Dr.ObesityLA, NurseKim_ATL, paul_denver and 40 others
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newstart_MO
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Feb 20, 2024 at 10:31 AM#23

Following on from DeniseRN_TPA — and this may be the naive question:

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

42 17HPLC_Greg, LibrarianMeg, bri_stats and 39 others
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fiona_VT
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Feb 22, 2024 at 9:47 PM#24
lucas_SP_BR said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

Ask again with the specifics and you will get a better answer than this one.

41 16chris_chi24, tampaLisa73, KarenAZ_mom and 38 others
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RickReta_CO
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Feb 25, 2024 at 9:05 AM#25
lucas_SP_BR said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

Last edited: Feb 25, 2024 at 2:05 PM
40 15LindaRN_retired, tommy_boulder, hyun_seoul and 37 others
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