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Description

Standard semaglutide titration: Weeks 1-4: 0.25 mg weekly Weeks 5-8: 0.5 mg weekly Weeks 9-12: 1.0 mg weekly Week 13+: 1.7 mg or 2.4 mg weekly (target dose) Hashimoto's-adjusted approach: Weeks 1-6: 0.25 mg weekly (extended to allow thyroid monitoring at week 6) Weeks 7-12: 0.5 mg weekly (TSH check before increasing) Weeks 13-16: 1.0 mg weekly Week 17+: Assess whether higher doses are needed The extended timeline allows for thyroid function checks at each step, ensuring levothyroxine doses are adjusted proactively rather than reactively

The review revisited SUSTAIN-6, where semaglutide-treated patients showed a hazard ratio of 1.76 for retinopathy complications compared with placebo. The discussion has since shifted toward whether rapid metabolic changerather than direct retinal toxicitymay explain the signal

Early data are promising: retatrutide, a leading candidate in this class, produced 24.2% average weight loss at 48 weeks in a Phase 2 trial, exceeding results seen with current medications

Retatrutide pricing is speculative since it is not yet approved, but analysts estimate it will launch at $1,100-1,400 per month, roughly competitive with semaglutide