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Blood levels take about four weeks to settle after a step. The stomach-slowing effect that drives early nausea builds and then adapts over roughly the same window. And gut symptoms cluster at the first dose and at each increase, then ease with time on a held dose. The label waits for the last step to settle before adding the next

Dose escalation is occasionally used in longer protocols (8+ weeks) where initial high-dose loading aims to saturate tissue receptors, followed by lower maintenance doses to sustain gene expression changes

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