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ForumsSemaglutide (Ozempic / Wegovy)Heart rate increase on sema — what worked for you?

Heart rate increase on sema — what worked for you?

GraceAZ_72 Fri, Apr 5, 2024 at 2:21 AM 66 replies 3,533 viewsPage 1 of 14
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GraceAZ_72
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Apr 5, 2024 at 2:21 AM#1

I moved from brand to compounded semaglutide at the same nominal dose and cannot decide whether what changed is the material, my titration, or my expectations.

What I actually want to know is whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg.

I have searched first, so if this is covered somewhere point me at it and I will read it.

17 12MariaRD, AussieAnna, BethLabQueen and 14 others
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NeuroNate
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Apr 5, 2024 at 2:26 AM#2

Answering the narrow version, because the broad one does not have a single answer. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

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RetaRick_CA
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Apr 5, 2024 at 2:31 AM#3
NeuroNate said:
The dose-response is real but shallow at the top.

No disagreement with NeuroNate. One condition attached. 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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mark_tokyo
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Apr 5, 2024 at 2:36 AM#4
GraceAZ_72 said:
I moved from brand to compounded semaglutide at the same nominal dose and cannot decide whether what changed is the material, my titration, or my…

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.

That is the short version; the long version is somebody else's post.

Last edited: Apr 5, 2024 at 5:36 AM
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DeniseRN_TPA
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Apr 5, 2024 at 3:02 AM#5

Clinical perspective, offered as context rather than as advice.

GraceAZ_72 said:
...but the FDA says semaglutide...

Interesting point. I want to add some regulatory nuance: the FDA labeling reflects the specific clinical trial data submitted for approval. Real-world clinical practice often extends beyond the FDA label based on emerging evidence and clinical judgment.

Example: semaglutide was first approved for diabetes (Ozempic), then obesity (Wegovy). The molecule didn't change — our understanding of its applications expanded. Similarly, semaglutide may evolve as more data accumulates.

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