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ForumsPublic SquareGLP-1 receptor desensitization and tachyphylaxis — why plateaus happen Page 2

GLP-1 receptor desensitization and tachyphylaxis — why plateaus happen

NeuroNate Thu, Apr 16, 2026 at 9:52 PM 16 replies 611 viewsPage 2 of 4
labquiet_amy
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Apr 16, 2026 at 11:21 PM#6
NeuroNate said:
The mechanism is more central than most summaries suggest.

Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest trajectory ever seen for an anti-obesity agent[1].

Amylin receptor agonism enhances satiety signaling through the area postrema and reduces glucagon secretion. Combined with GLP-1R agonism, this dual mechanism may produce even greater efficacy than current agents.

Early-stage data — interpret with caution. But the trajectory is extraordinary.

References:
[1] Novo Nordisk investor presentation, September 2023.
Last edited: Apr 17, 2026 at 1:21 AM
30 0TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 27 others
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AmyNC_wife
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Apr 16, 2026 at 11:55 PM#7

A narrower follow-up, since the general answer is now clear:

How to distinguish a genuine plateau from measurement noise and creeping intake, before changing anything?

29 24julia.endo, JessicaM_2024, TomFromTexas and 26 others
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Dr.SportsMedIN
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Apr 17, 2026 at 12:29 AM#8
labquiet_amy said:
Amycretin (AMY/GLP-1 dual agonist) emerging data relevant to the pharmacology: Phase 1 showed -13.1% body weight at only 12 weeks, the fastest…

Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%), creating a depot effect with a ~168-hour half-life enabling weekly dosing[1].

Tirzepatide is a dual GIP/GLP-1R agonist with higher GIP affinity (5:1 GIP:GLP-1 potency ratio). The GIP component may enhance beta-cell function and adipocyte lipid metabolism beyond what GLP-1 alone achieves.

For the pharmacology, the pharmacology explains the clinical differences between these agents.

References:
[1] Lau J, et al. J Med Chem. 2015;58(18):7370-7380.
Last edited: Apr 17, 2026 at 5:29 AM
28 23adam_van, Dr.SurgeonPGH, rachel_ABQ and 25 others
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NeuroNate
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Apr 17, 2026 at 1:03 AM#9

OP back with an update, since a thread like this is useless without one.

Update — tachyphylaxis to the gastric effect, persistence of the appetite effect. Two curves, and I had been watching the wrong one.

Last edited: Apr 17, 2026 at 7:03 AM
27 22kim_atl_prep, sarah_TO, wendy_avl and 24 others
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chris_chi24
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Apr 17, 2026 at 3:48 AM#10
Dr.SportsMedIN said:
Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%),…

PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:

  • Tmax: 24-72 hours post-injection
  • T½: ~168 hours (7 days) — enables weekly dosing
  • Steady state: reached at 4-5 weeks
  • Bioavailability (SubQ): ~89%
  • Volume of distribution: ~12.5L (primarily plasma)

The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.

41 14SleepFixSam, PurityPaulOR, MaxMetOK and 38 others
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