resistance_first

TL2 Regular · Belfast, UK

Strength coach. Programming for people in a large calorie deficit is its own problem.

Joined 29 January 2025 · last posted 2d

75 posts, newest first. Showing up to 150.

[2026 update] Antibiotics and a course of something with delayed emptying Replied, post #93 · Practice › Interactions · 26 Jul 2026 · 21 likes A pharmacist can answer most questions in this subcategory in a few minutes with access to a proper interaction database, and that access is the thing a forum does not…
Here for the analytics and not much else Replied, post #78 · Lounge › Introductions · 23 Jul 2026 · 7 likes What to include: your name or handle, how you found the community, what brings you here, maybe something about yourself that seems relevant (clinician, researcher,…
Aggregate verification data across the directory, with caveats Replied, post #57 · Sourcing › Independent verification · 19 Jul 2026 · 6 likes Where I part company with post #55, and it is a narrow parting. On aggregate verification data I would separate what is worth knowing from what is worth acting on. The…
Publication patterns in the BPC-157 literature, examined Replied, post #33 · Compounds › Repair & healing peptides · 11 Jul 2026 · 26 likes Everything in post #31 holds. The case it does not cover is the one I have. My experience of publication patterns contradicts the reply above. I am posting it as a data…
Selection into a registry and what it does to the estimate — a second dataset Replied, post #12 · Evidence › Study critique · 9 Jul 2026 · 0 likes Confirming post #9 from a second method, which matters more than confirming it from a second person. The version of Selection that circulates here is a simplification…
What a reversed-phase purity number actually is Replied, post #32 · Analytics › HPLC & UHPLC · 7 Jul 2026 · 16 likes Carryover from a previous injection shows up as a small peak at the same retention time in a blank. A method report that includes a blank injection is telling you the…
Carryover and the ghost peak from last week's standard — what changed since Replied, post #114 · Analytics › HPLC & UHPLC · 6 Jul 2026 · 10 likes The version of Carryover that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and those…
Coming back to: Where the four-week escalation interval comes from, and what it is not Replied, post #14 · Practice › Dosing & titration · 6 Jul 2026 · 2 likes Four-week escalation interval was covered in the wiki last year and the page has a review date on it, which is a better starting point than my memory of a thread.
Revisiting: Mobile reading experience on long topics Replied, post #12 · Meta › Site feedback · 30 Jun 2026 · 8 likes Picking up post #9: that is the part I would want checked first. Feature request framed as feedback: the category list is long enough that a first-time reader cannot…
Request: a per-category review queue Replied, post #58 · Meta › Feature requests · 25 Jun 2026 · 21 likes Where the per-category review queue reasoning breaks down for me is the step from the group result to the individual case. That step is almost never argued for.
Comparing my trajectory with the trial curves, carefully — a second dataset Replied, post #64 · Outcomes › Progress reports · 23 Jun 2026 · 7 likes This follows post #63 rather than contradicting it. Nothing here is medical advice and a progress report is a description of what happened to one person under…
Review: a draft on reconstitution arithmetic, with objections — what changed since Replied, post #28 · Documentation › Doc review · 23 Jun 2026 · 0 likes Draft on reconstitution arithmetic came up in a thread eighteen months ago and was answered well. I cannot find it, which is itself the problem, so here is the…
Pinch or no pinch, and how needle length changes the answer — what changed since Replied, post #45 · Practice › Administration · 21 Jun 2026 · 0 likes A methods point on Pinch rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.
Search filters: what is missing Replied, post #68 · Meta › Site feedback · 12 Jun 2026 · 3 likes Confirming post #67 from a second method, which matters more than confirming it from a second person. Navigation problems: if you cannot find something you expected to…
Why fasting instructions for oral semaglutide are not optional advice Replied, post #25 · Compounds › Oral incretins · 3 Jun 2026 · 10 likes Answering the question post #21 raises rather than the one it answers. Missed doses behave differently for a daily oral than for a weekly injection. With a short…
Blinding yourself: practical methods and their limits Replied, post #30 · Research Methods › N-of-1 designs · 31 May 2026 · 27 likes Order effects matter. If you always try A before B, you cannot separate the treatment from the sequence, and alternating is cheap. Adding the caveat now so it does not…
Personal import allowances, compared — a second dataset Replied, post #122 · Access › International · 13 May 2026 · 3 likes Two sentences on Personal import allowances and then I will stop, because the rest is speculation and the thread is better without mine. What is documented is narrow.…
Follow-up: Tirzepatide and nausea: is the profile genuinely different or just… Replied, post #44 · Compounds › Tirzepatide · 12 May 2026 · 7 likes Tirzepatide and nausea has been discussed here with more heat than it deserves, mostly because two definitions have been in play the whole time.
Prescription requirements and telehealth models — a second dataset Replied, post #19 · Sourcing › Regulatory · 4 May 2026 · 8 likes I had written a reply contradicting post #15 and deleted it. Here is what survived. Counterpoint on Prescription requirements and telehealth models, offered without…
A site rotation scheme that is easy enough to actually follow Replied, post #52 · Practice › Administration · 30 Apr 2026 · 32 likes Building on post #50 rather than restating it. If you have to inject at a different time of day than usual, that is a much smaller perturbation than it feels for a…
[2026 update] A vial that will not fully dissolve: what to check and in what order Replied, post #25 · Practice › Reconstitution · 25 Apr 2026 · 0 likes Taking post #22 at face value and following it one step further. Dead volume is the part nobody mentions until it costs them a dose. A fixed-needle insulin syringe…
The best-written scientific paper you have read Replied, post #14 · Lounge › Off topic · 22 Apr 2026 · 15 likes Marking my uncertainty on best-written scientific paper explicitly. I am confident about the direction, much less confident about the size, and not confident at all…
A 10 mg vial reconstituted three different ways, compared Replied, post #14 · Practice › Reconstitution · 13 Apr 2026 · 3 likes Concentration is total mass divided by total volume, and everything else follows from that. Ten milligrams into two millilitres is five milligrams per millilitre, and…
Follow-up: State-level differences that actually matter Replied, post #15 · Regional › North America · 4 Apr 2026 · 22 likes Reframing State-level differences slightly, because I think the disagreement is about the question rather than the answer. If the question is "does it happen", yes. If…
Half-life, steady state, and accumulation worked through — a second dataset Replied, post #117 · Pharmacology › Pharmacokinetics · 28 Mar 2026 · 15 likes Answering the question post #116 raises rather than the one it answers. I have three months of notes on Half-life and the honest summary is that the trend is real and…
Why a compound being unapproved is not the same as being illegal to possess Replied, post #65 · Sourcing › Regulatory · 5 Mar 2026 · 3 likes I read the earlier replies on compound being unapproved twice before writing this, because I had assumed the opposite and wanted to be sure I was disagreeing with what…
Preprint servers and what screening they do Replied, post #77 · Evidence › Preprints · 5 Mar 2026 · 3 likes Confirming post #74 from a second method, which matters more than confirming it from a second person. Where numbers change between preprint and published version, the…
Why the timeline is on the right and not the left — what changed since Replied, post #2 · Meta › Site feedback · 1 Mar 2026 · 31 likes Timeline is a question about a distribution, not about a value, and treating it as a value is what produces the confident wrong answers.
Reference intervals: how they are constructed and why one in twenty flags Replied, post #56 · Clinical › Bloodwork · 26 Feb 2026 · 0 likes I had written a reply contradicting post #54 and deleted it. Here is what survived. Lipid panel interpretation: total, LDL, HDL, triglycerides all on one panel. Reading…
[2026 update] Storing lyophilised material long term: what governs the shelf life Replied, post #59 · Practice › Storage & stability · 31 Jan 2026 · 0 likes Door storage in a refrigerator is the warmest and most variable position in the appliance. A shelf at the back is a materially different environment. I would rather be…
Batch date after test date, and other internal inconsistencies Replied, post #30 · Analytics › COA interpretation · 24 Dec 2025 · 0 likes Narrowing post #27, because the general version has more than one answer. A certificate of analysis is a statement by its issuer that a defined test was performed on a…
Documentation that materially improves an appeal's chances Replied, post #86 · Access › Insurance & coverage · 2 Dec 2025 · 1 like An update on my earlier documentation post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.
Pen dose counters: what a click does and does not guarantee Replied, post #60 · Devices › Pens & autoinjectors · 16 Nov 2025 · 5 likes Reading the dose window rather than the dial position is worth the habit. On several devices the two do not correspond in the way you would guess.
About the Pharmacokinetics category Replied, post #5 · Pharmacology › Pharmacokinetics · 12 Nov 2025 · 2 likes Volume of distribution: the theoretical volume the drug distributes into. For albumin-binding compounds, volume is reduced compared to drugs that do not bind protein.…
Coming back to: Semaglutide in people without diabetes: what the evidence base looks like Replied, post #8 · Compounds › Semaglutide · 9 Nov 2025 · 6 likes Semaglutide in people without diabetes is well covered in the tag pages, and the older discussions are better than the recent ones because they were argued out…
Where to report an adverse event officially, by region — a second dataset Replied, post #57 · Safety › Adverse events · 26 Oct 2025 · 19 likes Nothing here is medical advice, and in this subcategory the phrase is doing more work than in any other on the site.
A 40-week log with the measurement method stated Replied, post #50 · Outcomes › Progress reports · 22 Oct 2025 · 0 likes Longitudinal report with the method stated: same scale, same time of day, same conditions. A scale is a tool; use the same one each time. Consistency matters more than…
Promotion criteria, and the one that stops most nominations — the long version Replied, post #78 · Documentation › Doc review · 20 Oct 2025 · 9 likes The most useful review comment names a sentence and says what is wrong with it. General approval and general concern are both hard to act on. I would put a moderate…
Sleep tracking data and its considerable limitations Replied, post #4 · Wellbeing › Sleep · 14 Oct 2025 · 0 likes A sleep diary with times rather than impressions is the only way to tell a real change from a remembered one, and it takes a minute a day. It is worth checking rather…
Half-life, steady state, and accumulation worked through — a second dataset Replied, post #2 · Pharmacology › Pharmacokinetics · 8 Oct 2025 · 0 likes Half-life is a question about a distribution, not about a value, and treating it as a value is what produces the confident wrong answers.
Temperature loggers worth the money — the long version Replied, post #50 · Devices › Cold chain · 3 Oct 2025 · 23 likes Suppliers that reship after a documented excursion without argument are doing something commercially costly, and it is worth recording when they do.
Waist circumference technique and its repeatability Started this topic · Outcomes › Progress reports · 16 Sep 2025 · 31 likes Waist circumference technique and its repeatability — setting out what I have, and where I think it stops being reliable. I have spent a fortnight trying to pin waist…
Follow-up: Why the titration planner refuses to produce a schedule below a floor Replied, post #97 · Data & Tools › Calculators · 28 Aug 2025 · 11 likes Post #96 is right about the mechanism and I think understates the practical bit. Mass error checking: enter your observed mass and theoretical mass and check whether…
Cost per delivered dose, which is the number that matters Replied, post #4 · Access › Pricing · 26 Aug 2025 · 10 likes Cost per milligram is the only comparison that survives format differences, but even then it needs care. A pen and a vial are not the same product and cannot be…
Revisiting: German, French and Dutch differences, compared Replied, post #63 · Regional › European Union · 25 Aug 2025 · 0 likes Reading back through, this was answered upthread and I missed it. My fault.
[2026 update] Journal club: is percentage weight change the right endpoint? Replied, post #104 · Evidence › Journal club · 24 Aug 2025 · 16 likes This follows post #101 rather than contradicting it. Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded…
Sequence verification for an obscure compound: how it is done Replied, post #102 · Compounds › Other compounds · 23 Jul 2025 · 0 likes On post #98 — agreed on the reasoning, with one qualification. Sequence verification is one of those subjects where the general answer and the answer for a specific…
Which panel is worth repeating and which is worth ignoring Replied, post #59 · Clinical › Bloodwork · 13 Jul 2025 · 0 likes Lipid panel interpretation: total, LDL, HDL, triglycerides all on one panel. Reading them together is more informative than reading one value in isolation. An elevated…
Sodium, potassium and magnesium when intake drops Replied, post #50 · Nutrition & Training › Hydration & electrolytes · 9 Jul 2025 · 5 likes Post #48 describes the usual case. This is about the unusual one. My experience of sodium contradicts the reply above. I am posting it as a data point rather than as a…
Hepatic steatosis: what the MASH trial evidence supports Replied, post #56 · Clinical › Comorbidities · 4 Jun 2025 · 12 likes I keep a log for hepatic steatosis specifically because my memory of it turned out to be systematically wrong in one direction. Six weeks of notes cost nothing and…
Pregnancy as an absolute contraindication Replied, post #30 · Safety › Contraindications · 17 May 2025 · 21 likes Adding the measurement that post #27 says would settle it. Pregnancy appears in the labelling for this class and the position is stated explicitly rather than left to…
Reading a trial's population section before its results — does this still hold? Replied, post #50 · Evidence › Trials · 29 Apr 2025 · 29 likes Funding and trial conduct should be stated and are a weak predictor of anything on their own. Design quality is the stronger signal and it is checkable. Scoping that to…
How Janoshik, Medutest, PeptideMeter and VendorInvestigate differ Replied, post #25 · Sourcing › Independent verification · 29 Apr 2025 · 0 likes PeptideMeter: purity analysis plus structured, dated supplier verification records. Produces both individual analytical results and verification records assessed over…
Amylin analogue mechanism: satiety signalling separate from GLP-1 Replied, post #104 · Compounds › Cagrilintide & amylin analogues · 25 Apr 2025 · 19 likes On post #100 — agreed on the reasoning, with one qualification. Trying to state the amylin analogue mechanism position in a way that someone who disagrees would…
Research-use-only labelling: what it means and what it does not — the long version Replied, post #131 · Sourcing › Regulatory · 17 Apr 2025 · 18 likes Building on post #130 rather than restating it. Adding the boring version of Research-use-only labelling, because the interesting version keeps getting posted and the…
Shakes versus food: a pragmatic assessment — the long version Replied, post #3 · Nutrition & Training › Protein & intake · 17 Apr 2025 · 10 likes Post #2 is the version of this I will quote in future. One addition. I would rather this thread reach "we do not know" about Shakes versus food than reach a confident…
Asking about a compound your prescriber has not heard of Replied, post #18 · Clinical › Prescriber conversations · 16 Apr 2025 · 10 likes Saving this. It is the version I will quote when the question comes round again.
Splitting a vial for two laboratories: how to do it without ruining both Replied, post #18 · Sourcing › Independent verification · 12 Apr 2025 · 12 likes Agreed, and I will stop repeating the version of this I had been repeating.
When "no data" is the complete and final answer Replied, post #143 · Compounds › Other compounds · 9 Apr 2025 · 24 likes Thymosin alpha-1 has a regulatory history in several jurisdictions and a real clinical literature, which puts it in a different evidential category from most of its…
Delayed gastric emptying and oral medication absorption: which drugs matter Replied, post #40 · Practice › Interactions · 8 Apr 2025 · 2 likes Post #38 is right about the mechanism and I think understates the practical bit. The claim about delayed gastric emptying and oral upthread is stronger than its source…
Reaching a dose and staying there for a year: a longitudinal note Started this topic · Practice › Dosing & titration · 6 Apr 2025 · 0 likes Reaching a dose and staying there for a year: a longitudinal note Writing it up because I had to work it out twice and would rather nobody else did. I have read the…
Retatrutide dose escalation in the published trials Replied, post #51 · Compounds › Retatrutide · 26 Mar 2025 · 3 likes The reason retatrutide dose escalation keeps being re-asked is that the answer is conditional and people quote it without the condition. It is not that the answer is…
Why cagrilintide alone is discussed so much less than in combination Replied, post #3 · Compounds › Cagrilintide & amylin analogues · 21 Mar 2025 · 0 likes Reconstitution at higher concentrations is worth avoiding for aggregation-prone material. The published formulation work generally uses lower concentrations than people…
An orphaned page with no inbound links Replied, post #18 · Meta › Wiki maintenance · 16 Mar 2025 · 17 likes Orphaned page: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know…
Journal club: SURMOUNT-OSA and a hard endpoint in a soft field Replied, post #44 · Evidence › Journal club · 15 Mar 2025 · 12 likes This settles it for me, at least until somebody posts a reason it should not.
Reconstituting a multi-strength kit without mixing yourself up Replied, post #33 · Practice › Reconstitution · 15 Feb 2025 · 2 likes Preservative effectiveness is tested against a defined microbial challenge under defined conditions. It is not a licence to treat an entered vial as sterile…
Follow-up: Individual participant data versus aggregate data Replied, post #78 · Evidence › Meta-analyses · 11 Jan 2025 · 17 likes Study quality and weighting: some meta-analyses weight all studies equally; others weight by study size or study quality. The choice affects the result and should be…
What changed in 2026, by region Replied, post #69 · Access › International · 10 Jan 2025 · 0 likes Regional practice around what a pharmacy will and will not do varies enormously and is not deducible from the regulatory position. I have changed my mind on this once…
[2026 update] Step therapy requirements and how to satisfy them Replied, post #109 · Access › Insurance & coverage · 7 Jan 2025 · 7 likes This follows post #108 rather than contradicting it. I would put moderate confidence on the mainstream reading of Step therapy requirements and no more. That is not…
Books and papers worth reading that are not about this at all Started this topic · Lounge › Off topic · 26 Dec 2024 · 0 likes On the subject in the title: Books and papers worth reading that are not about this at all Working notes rather than a conclusion. Reading back through what has been…
Reading a preclinical wound-healing model and its relevance to a human tendon Replied, post #144 · Compounds › Repair & healing peptides · 25 Nov 2024 · 13 likes Dose-response is unstudied in humans for essentially everything in this family, which means the confident numbers in circulation came from somewhere other than a trial.…
Tracking semaglutide's approved indications across jurisdictions, dated — does this… Replied, post #19 · Compounds › Semaglutide · 10 Nov 2024 · 3 likes Post #18 put the caveat in the right place and I want to underline it. On formulation: the licensed product is buffered and includes a preservative in the multi-dose…
Gallbladder disease risk with rapid weight loss Replied, post #10 · Clinical › Comorbidities · 17 Sep 2024 · 0 likes Everything in post #6 holds. The case it does not cover is the one I have. Reading back through the gallbladder disease risk threads from last year, the same three…
Semaglutide half-life: where the 165 to 184 hour figure comes from — what changed since Replied, post #6 · Compounds › Semaglutide · 3 Sep 2024 · 0 likes On post #2 — agreed on the reasoning, with one qualification. On the "does it stop working" question: tolerance in the pharmacological sense is not what the withdrawal…
The topic list is dense — is that deliberate? Replied, post #13 · Meta › Site feedback · 11 Aug 2024 · 31 likes Two people in this thread mean different things by topic list and are disagreeing about the definition while believing they are disagreeing about the facts. Worth…