NeuroNate said:

Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts.

I dislike how confidently this board tells people to push through. Incidence figures around 20 to 25% at the higher doses are class-typical, but the trials also had a discontinuation column, and "manageable with protocols" is not the same as manageable for everyone.

One concrete data point for the thread. Worth stating the units and the reference range whenever you post a number here. A large fraction of the apparent disagreement in these threads is two people using different units and both being right.

MikeFit_NJ said:

I dislike how confidently this board tells people to push through.

There is a second half to this that has not been said yet. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.

One thing that is still open after steph_laguna’s answer:

Whether holding at a lower dose for longer actually reduces total side-effect burden or just spreads it out?

Reporting back.

Follow-up: smaller meals, less fat in the two days after dosing, and not lying down afterwards. Unglamorous, and it worked within a fortnight.