PeptideChemSF said:

The line between titrate-through and stop is not severity, it is trajectory and what else is present.

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.

The figures, for anyone assembling their own picture. For anyone reading later: the numbers in this thread are worth checking against a primary source before you act on them, including mine. Half the figures circulating in this community trace back to a secondary summary that dropped a qualifier.

Dr.SleepRoch said:

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

Coming at Dr.SleepRoch’s question from a different direction. There is a difference between no evidence and evidence of no effect, and this subject is one where the two get swapped freely in both directions.

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

What distinguishes the nausea you can titrate through from the nausea that means stop?

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

Holding the step for six weeks instead of four did it. Same dose, same food, and the nausea that had felt like a wall turned out to be a timing problem.