PedsEndoPhilly said:

Dead space is the answer to the missing dose.

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

LondonLisa said:

Steady state is the thing most people miss.

Saving this. It is the first explanation that did not require me to already understand it.

PedsEndoPhilly said:

Dead space is the answer to the missing dose.

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

One concrete data point for the thread. The three numbers to write on the vial: total mg, total ml, and mg per ml. Everything else is division. And the sanity check is that dose volume times number of doses should be less than the volume you put in, because dead space takes the difference.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source.