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Something Ive been seeing with my patients lately, a very few but a legitimate number of my patients, is allodynia, Rosen (@drdanielrosen) told his 70,000 followers
56 However, if the patient continues to present evidence of liver dysfunction beyond persistent ALT elevation (satisfying KCH criteria of acidosis, elevated creatinine, hyperbilirubiniemia, coagulopathy and encephalopathy), then NAC therapy should be continued as these indicators portend a poor prognosis regardless of transaminase levels
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Lower cagrilintide doses in combinations When combining, can reduce cagrilintide: 1.8mg cagrilintide + 2.4mg semaglutide: Still very effective (14-18% weight loss estimated) Better tolerated than both at 2.4mg Cost savings on cagrilintide Consider if GI-sensitive 1.2mg cagrilintide + 2.4mg semaglutide: Modest benefit from cagrilintide addition Minimal GI side effects from cagrilintide Semaglutide does heavy lifting May still achieve 12-15% total weight loss Testing approach: Start with standard doses (both 2.4mg) If intolerable, reduce cagrilintide first Maintain semaglutide at 2.4mg (well-tolerated, established) Find optimal cagrilintide dose for your tolerance Maintenance dosing after weight loss Strategies to sustain results long-term
