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Sometimes we need to also improve GI transit at the smooth muscle level (by utilizing the serotonin precursor 5-HTP for example.) As mentioned, hormones need to be normalized as well
The dose is then increased to 0.5 mg weekly, with possible further escalation to 1 mg or 2 mg weekly if needed for glycaemic control
doi:10.1002/j.1875-9114.1985.tb03413.x
doi:10.1006/jsre.1996.0364.[Crossref], [PubMed], [Web of Science ] , [Google Scholar])
Starting at the standard initiation dose is still recommended, but extending each escalation step to 6-8 weeks instead of 4 weeks is a common clinical adjustment
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