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10.1056/NEJMoa2403347 48 PessoaT
Protocol 1: the gentle start (for GI-sensitive individuals) Goal: Minimize side effects completely while building to a therapeutic dose Best for: People with histories of medication sensitivity, IBS, acid reflux, or those who tried standard tirzepatide and could not tolerate it Complete schedule: Weeks 1-2: 0.125 mg weekly Weeks 3-4: 0.25 mg weekly Weeks 5-6: 0.5 mg weekly Weeks 7-8: 0.75 mg weekly Weeks 9-10: 1.0 mg weekly Weeks 11-14: 1.5 mg weekly Weeks 15-18: 2.0 mg weekly Weeks 19-22: 2.5 mg weekly Weeks 23-26: 5.0 mg weekly Time to therapeutic dose: 22-26 weeks Expected results: Minimal GI discomfort, gradual appetite reduction beginning around weeks 7-10, meaningful weight loss starting around weeks 15-18 This protocol takes nearly six months to reach 5 mg, but for someone who previously abandoned treatment due to side effects, six months on treatment beats three weeks of misery followed by quitting
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Furthermore, hepatic insulin sensitivity was only compromised in obese individuals ( n = 20) when NAFLD was present [66]
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