Revisiting: Absolute versus relative contraindications — setting out what I have, and where I think it stops being reliable.
A narrow question about Absolute versus relative contraindications, deliberately narrow, because the broad version has been asked here four times and produced four long threads and no answer.
One question, stated units, stated method, and what I have already ruled out.
Summarising the Absolute versus relative contraindications thread so far, since it is long and the answer is buried: the first reply has the method, the fourth has the correction to it, and the rest is people agreeing at length.
Narrowing post #3, because the general version has more than one answer.
I would call the community position on Absolute versus relative contraindications likely rather than established, and I would be comfortable defending that hedge.
Where a contraindication is relative rather than absolute, the reasoning usually appears in the assessment report rather than the labelling.
I would not lead a decision with this, but I would not ignore it either.
I read post #3 twice before replying, because I had assumed the opposite.
Adding a reference point for Absolute versus relative contraindications. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.
That is clearer than the version I had in my head. Thank you.
The section of the product information covering special warnings is usually longer and more useful than the contraindications list itself.
Picking up post #9: that is the part I would want checked first.
I have no financial interest in anything named in this thread and I want to say so before I comment on Absolute versus relative contraindications, because it is the sort of subject where it matters.
Picking up post #9: that is the part I would want checked first.
I disagree with the framing of Absolute versus relative contraindications above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.
The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.
Somebody's condition being on a list does not settle the decision, and somebody's condition being absent from one does not either.
On reflection I would soften that slightly.
Medullary thyroid carcinoma (personal or family history) or multiple endocrine neoplasia type 2: absolute contraindication. The rodent preclinical signal is real enough to exclude this population.
The evidence for this is thinner than the way I have phrased it suggests.
Disordered eating history: appetite suppression can trigger relapse in people with history of anorexia, bulimia, or other eating disorders. This is a relative contraindication requiring specialist input.
It is the sort of thing that seems obvious in retrospect and was not at the time.
Adding the measurement that post #12 says would settle it.
Concurrent insulin or sulfonylureas: not an absolute contraindication but requires dose adjustment and close monitoring for hypoglycemia. The combination is used with caution, not avoided.
Post #14 describes the usual case. This is about the unusual one.
Two things can be true about Absolute versus relative contraindications at once: the mechanism is plausible and the evidence for the size of the effect is thin. Most of the argument here is people defending the first against attacks on the second.
History of pancreatitis: these compounds can rarely trigger pancreatitis. History of pancreatitis increases relative risk. That is a relative contraindication, not absolute, but requires monitoring.
A modest claim, modestly supported.
Gastroparesis or severe delayed gastric emptying: these compounds slow gastric emptying. Pre-existing severe gastroparesis can be worsened. That is a relative contraindication depending on baseline severity.
I would treat the number as indicative rather than as a measurement.
Research-use-only material has no labelling and therefore no contraindications listed, which is not the same as having none.
This follows post #19 rather than contradicting it.
Two people in this thread mean different things by Absolute versus relative contraindications and are disagreeing about the definition while believing they are disagreeing about the facts. Worth pausing to define it.
If someone has run Absolute versus relative contraindications properly I would rather read that than my own reconstruction of it. Posting mine only because the thread has gone quiet.
Taking Absolute versus relative contraindications seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.
Post #27 describes the usual case. This is about the unusual one.
Allergy to the specific compound: true allergy is rare but possible. Any prior allergic reaction to the same compound or to structurally similar peptides warrants caution.
I would rather post the uncertainty than round it away.
One more thing on Absolute versus relative contraindications that took me far too long to see: the two figures people quote are not measuring the same quantity. Once you notice that, the apparent contradiction disappears.