I initially gave it some thought but Dr. Kevin Joseph on YT mentioned splitting the dose can desensitize the receptors faster. Adding Sema might not be the best idea either, but Sema only affects 1 pathway, while Reta affects 3 pathways.
Watching his video
here, mainly the part on split dosing this time, I've watched the video before.
Split dosing dose not affect your average exposure, but it absolutely suppresses peaks and raises troughs. I posted about the math
here showing average exposure is the same, but peaks and troughs are less extreme.
"-If you take the 1mg twice a week, you end up with a peak of 3mg, trough of 2mg, and average of 2.5mg.
-If you take .285mg daily, the peak is 2.62mg, trough is 2.33mg, and the average is still 2.5mg.
-If you take 4mg every other week, the peak is 5mg, the trough is 1mg, and the average is still 2.5mg."
He says split dosing sends more receptors to the lysosome because they get burnt out, but doesn't go on to explain that logic. We agree the average concentration is the same. There is an argument that lower troughs between doses allows them time to replenish, but what about the higher peaks "burning them out" (if that's a thing)... still, the steady state/average exposure isn't different.
I've said that symptoms track peaks and troughs determine efficacy. By split dosing, so far, I have kept my adverse side effects minimal to non existent. I've controlled appetite (less of a problem for me), food noise (more of a problem for me), showing solid weight (presumably fat) loss, still eating generally appropriate macros without undue struggle, and maintaining enough capacity to burn at least 500 calories a day exercising on top of my general daily life.
I am transitioning from Tirz to Reta. I started split dosing 3.5 weeks in to my Tirz 2.5mg dose when food noise came back mid week, I took the 4th dose then and started my move to 5mg/week split dosing before starting the transition to Reta. My highest peak on Tirz has been 5.6mg, my highest peak on Reta has been 5.7mg. I'm currently down 18lb in 40 days which is slightly ahead of my intended slope but well within the tolerance of the range. I anticipate being off Tirz injections sometime next month, but I'm just along for the ride.
What is your current Reta dose and levels?