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Abnormal Gut Flora Abnormal gut flora pertains to an imbalance between the protective, good bacteria, and the pathogenic, bad bacteria in the gut
As you move into higher doses, tolerance becomes less frequent because the medication effects are stronger and longer lasting
An elegant data analysis of the STEP-2 protocol shows the temporal dynamic of this effect, where the incidence of nausea grew from ~5% at the beginning of the dose escalation period (week 1
The 4-week interval exists because shorter intervals (2 weeks) produce more side effects without additional efficacy, and longer intervals (6 to 8 weeks) allow too much receptor adaptation
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