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Two common adjustments include stepping down, where the dose is gradually lowered while monitoring for cravings, or stretching out, which involves extending the time between doses (e.g., moving from weekly to every 1014 days)
Some compounded providers offer aggressive escalation
[15] Hjerpsted JB, Flint A, Brooks A, et al
Xu Q, Park Y, Huang X, Hollenbeck A, Blair A, Schatzkin A, et al
In L-cells of the lower intestine and colon the proprotein convertase subtilisin/kexin type 1 (or PCSK1/PC1) cleaves after single or double basic amino acids to liberate glicentin (amino acids 21-89 in proglucagon), oxyntomodulin (amino acids 53-89 in proglucagon), GLP-1 (amino acids 92-128 in proglucagon), and GLP-2 (amino acids 146-178 in proglucagon) (see UniProt P01275)
