SHermansen

TL2 Member · Gdynia, PL

Keeps a personal log and shares the numbers when they are relevant, with the measurement caveats attached.

Joined 9 August 2025 · last posted 5d

85 posts, newest first. Showing up to 150.

Reading a rodent study on a secretagogue without over-extrapolating — the long version Replied, post #58 · Compounds › Secretagogues & GH axis · 23 Jul 2026 · 0 likes Answering the question post #54 raises rather than the one it answers. What a well-designed human trial of a secretagogue would look like: randomised,…
HbA1c lag and what it can and cannot tell you at eight weeks — one year on Replied, post #19 · Clinical › Bloodwork · 14 Jul 2026 · 6 likes Understood. Thank you for being specific about the limits of it.
An 18-month record including the parts that went badly Replied, post #67 · Outcomes › Progress reports · 12 Jul 2026 · 8 likes Thank you — that answers what I came here to find out.
What is genuinely unknown about long-term amylin agonism Replied, post #25 · Compounds › Cagrilintide & amylin analogues · 11 Jul 2026 · 1 like Amylin signalling is distinct from GLP-1 signalling. Amylin slows gastric emptying and promotes satiety through a different receptor and different neural pathways. The…
Immortal time bias in a claims-database study — one year on Replied, post #8 · Evidence › Study critique · 5 Jul 2026 · 9 likes I had written a reply contradicting post #6 and deleted it. Here is what survived. Statistical significance and clinical importance are different and both are needed. A…
Micro-titration: a disputed topic, argued properly Replied, post #87 · Practice › Dosing & titration · 10 Jun 2026 · 6 likes Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.…
Micronutrient adequacy at low total intake Replied, post #14 · Nutrition & Training › Protein & intake · 6 Jun 2026 · 0 likes I have no financial interest in anything named in this thread and I want to say so before I comment on micronutrient adequacy, because it is the sort of subject where…
An appeal that succeeded, with the letter structure — the long version Replied, post #41 · Access › Insurance & coverage · 2 Jun 2026 · 2 likes Appeal looks different depending on whether you are reading the primary literature or the summaries of it, and the difference is not in our favour.
Reading a trial's population section before its results Replied, post #66 · Evidence › Trials · 29 May 2026 · 1 like Nothing in a trial report is medical advice about an individual, and the gap between a population estimate and a person is exactly where clinical judgement lives. Not…
Revisiting: Primary endpoint hierarchies and why order matters Replied, post #21 · Evidence › Trials · 11 May 2026 · 29 likes Adding a small correction to the Primary endpoint hierarchies summary above rather than a disagreement with it. The substance holds; one of the figures is out by a…
Reimbursement variation across member states Replied, post #5 · Regional › European Union · 2 May 2026 · 16 likes Coming back to the opening post, because the follow-up matters more than the original answer. Spain: AEMPS is the regulator. Public reimbursement for weight management…
[2026 update] 0.3 mL versus 0.5 mL versus 1 mL barrels: resolution matters Replied, post #55 · Devices › Syringes & needles · 23 Apr 2026 · 0 likes That matches what I have seen, for whatever a single anecdote is worth.
Coming back to: Time to steady state after a dose increase Replied, post #33 · Pharmacology › Pharmacokinetics · 15 Apr 2026 · 3 likes Picking up post #32: that is the part I would want checked first. Washout after stopping takes roughly the same four to five half-lives as reaching steady state. A…
Coming back to: Solubility limits and what a cloudy solution is telling you Replied, post #14 · Pharmacology › Formulation chemistry · 9 Apr 2026 · 2 likes Small correction to my own earlier position on Solubility limits. I had the units the wrong way round, which changes the conclusion by an order of magnitude and…
Reading a home test result without over-claiming Replied, post #4 · Analytics › Home & field testing · 3 Apr 2026 · 8 likes Building on post #3 rather than restating it. Weighing vials against declared fill is the most underrated home check available. It needs a balance with adequate…
Pharmacy supply in the UK and the questions you will be asked Replied, post #95 · Regional › UK & Ireland · 28 Mar 2026 · 6 likes Post #91 describes the usual case. This is about the unusual one. I disagree with the framing of pharmacy supply above, and I think it is a substantive disagreement…
Second pass at: Adsorptive losses at low concentration, and why dilute solutions are… Replied, post #71 · Practice › Storage & stability · 23 Mar 2026 · 3 likes Clarity is a weak test. A solution can lose a significant fraction of its active content to degradation or adsorption while remaining perfectly clear. That has been…
Introducing myself: pharmacist, sceptic, reluctant participant Replied, post #10 · Lounge › Introductions · 17 Mar 2026 · 1 like Introductions are also a reasonable place to say what you are hoping to find, because somebody will usually know whether it exists here already. One case, stated as one…
Anaesthesia and elective surgery: the aspiration question Replied, post #44 · Practice › Interactions · 9 Mar 2026 · 24 likes That reframing is the whole thing. The facts I already had.
Storing lyophilised material long term: what governs the shelf life Replied, post #84 · Practice › Storage & stability · 27 Feb 2026 · 0 likes I keep a log for storing lyophilised material long term specifically because my memory of it turned out to be systematically wrong in one direction. Six weeks of notes…
About the How to Ask category Replied, post #9 · Start Here › How to Ask · 8 Feb 2026 · 2 likes This is the sort of exchange that makes the archive worth searching.
Measurement error in home scales, with a worked standard deviation Replied, post #2 · Research Methods › Statistics · 2 Feb 2026 · 1 like Adding the measurement that the opening post says would settle it. Number needed to treat: how many people need to be treated to prevent one bad outcome or achieve one…
Travelling with an injectable: documentation and practicalities Replied, post #8 · Access › International · 30 Jan 2026 · 0 likes Post #6 and I disagree about the size of the effect, not about the direction. Regulatory position dates: a regulatory position is only current as of when it was…
Adolescents: a distinct evidence base — one year on Replied, post #58 · Clinical › Special populations · 27 Jan 2026 · 8 likes Adolescents: a distinct evidence base exists. The compounds are not approved for routine adolescent obesity but are being studied. Adolescent physiology and psychology…
Dead volume across syringe and needle combinations Replied, post #58 · Devices › Syringes & needles · 21 Jan 2026 · 20 likes Picking up post #55: that is the part I would want checked first. Drawing through a wider needle and injecting through a thinner one is a reasonable approach for a…
Coming back to: What the published dose-response for semaglutide actually looks like… Replied, post #6 · Compounds › Semaglutide · 15 Jan 2026 · 11 likes Building on post #3 rather than restating it. The STEP programme populations were selected: enrollment criteria required baseline body mass index over 30, no recent…
Coming back to: Washout: how long is long enough, and for what purpose Replied, post #5 · Pharmacology › Pharmacokinetics · 30 Dec 2025 · 0 likes Building on post #4 rather than restating it. The documentation on Washout is better than this thread and I say that as someone who has posted in the thread.
A history of disordered eating: proceeding carefully Replied, post #44 · Wellbeing › Mental health · 30 Dec 2025 · 23 likes Motivation and expectation: starting with clear motivation and realistic expectations about what will happen and when helps with psychological adjustment. If the…
Vomiting: when it is expected and when it is a reason to stop Replied, post #39 · Practice › Side effects · 27 Dec 2025 · 0 likes On post #36 — agreed on the reasoning, with one qualification. The published rates come from populations that were titrated on a defined schedule with clinical…
Reused chromatograms across lots: how to spot it Replied, post #9 · Analytics › COA interpretation · 20 Dec 2025 · 5 likes Trying to state the reused chromatograms across lots position in a way that someone who disagrees would recognise as fair, because I do not think the version in this…
Second pass at: The topic list is dense — is that deliberate? Replied, post #16 · Meta › Site feedback · 9 Dec 2025 · 1 like Worth separating two things that post #12 runs together. On topic list I would separate what is worth knowing from what is worth acting on. The first list is long and…
Temperature loggers worth the money — the long version Replied, post #86 · Devices › Cold chain · 3 Dec 2025 · 0 likes Temperature logging: devices that record temperature over time let you confirm cold chain was maintained. Useful if a shipment was delayed or if you are concerned about…
Older adults, sarcopenia risk, and the trade-off nobody quantifies — the long version Replied, post #58 · Clinical › Special populations · 28 Nov 2025 · 5 likes Post #55 put the caveat in the right place and I want to underline it. Post-surgical populations, particularly after procedures affecting the gastrointestinal tract,…
[2026 update] What a good consultation looks like from the other side Replied, post #5 · Clinical › Prescriber conversations · 26 Nov 2025 · 20 likes My understanding of good consultation is a few years old and may have been superseded. If it has been, I would genuinely like to know rather than keep repeating it.
When a dose reduction is the correct response to a side effect — a second dataset Replied, post #2 · Practice › Dosing & titration · 24 Nov 2025 · 5 likes Narrowing the opening post, because the general version has more than one answer. Concentration and dose get conflated constantly in this subcategory. Changing how much…
What "marked as solution" means and who gets to mark it — does this still hold? Replied, post #11 · Start Here › Welcome · 13 Nov 2025 · 7 likes Trust levels accumulate over time and they give you access to small things like the ability to edit your own posts without a timestamp. They are not a status symbol and…
What a confidence interval means, from scratch — the long version Replied, post #10 · Research Methods › Statistics · 25 Oct 2025 · 26 likes A request rather than an answer: could whoever has the primary source for confidence interval post it? I have seen the claim three times this month and each version had…
SURMOUNT-4 and what withdrawal data does and does not tell an individual — one year on Replied, post #73 · Compounds › Tirzepatide · 22 Oct 2025 · 19 likes Post #71 and I disagree about the size of the effect, not about the direction. Small methodological point on SURMOUNT-4: repeating a measurement is cheap and resolves…
Why an oral GLP-1 agonist is a formulation achievement more than a chemistry one Replied, post #8 · Compounds › Oral incretins · 17 Oct 2025 · 0 likes Fasting instructions are not optional advice. Taking the tablet with food or with more than a sip of water measurably reduces absorption. This is the one compound in…
Follow-up: The decimal-point error, and the habit that catches it Replied, post #63 · Practice › Reconstitution · 20 Sep 2025 · 1 like Decimal-point error is a question about a distribution, not about a value, and treating it as a value is what produces the confident wrong answers.
What the GIP component of tirzepatide is thought to contribute, and how confident we can… Replied, post #41 · Compounds › Tirzepatide · 17 Sep 2025 · 0 likes Appreciated. The plain phrasing does more work here than a longer post would.
Biological variation versus analytical imprecision — does this still hold? Started this topic · Clinical › Bloodwork · 16 Sep 2025 · 56 likes The question in the title: Biological variation versus analytical imprecision — does this still hold? I will give what I have already checked below so nobody repeats…
Titles that describe the question, not the situation Replied, post #87 · Start Here › How to Ask · 3 Sep 2025 · 31 likes Coming back to post #85, because the follow-up matters more than the original answer. A question about somebody else's post should be a reply to that post, not a new…
A preprint whose numbers changed substantially at publication Replied, post #24 · Evidence › Preprints · 20 Aug 2025 · 20 likes What changes between preprint and publication: authors respond to reviewer comments, re-analyse data, correct errors found in peer review, and sometimes report…
BPC-157: what the rodent literature actually shows, and what it does not Replied, post #32 · Compounds › Repair & healing peptides · 19 Aug 2025 · 0 likes Coming back to post #28, because the follow-up matters more than the original answer. The pentadecapeptide sequence is short and stable enough to survive conditions…
EU-wide position versus national implementation Replied, post #24 · Regional › European Union · 9 Aug 2025 · 19 likes Narrowing post #23, because the general version has more than one answer. Practical note on eu-wide position versus national implementation: write down what you expect…
Travel coolers and how long they really hold Replied, post #69 · Devices › Cold chain · 7 Aug 2025 · 0 likes Distinguishing three things in the travel coolers discussion that keep getting used interchangeably: the observation, the proposed mechanism, and the recommendation…
A request that was declined, and the reasoning — a second dataset Replied, post #8 · Documentation › Wiki requests · 5 Aug 2025 · 26 likes Picking up post #5: that is the part I would want checked first. The most useful requests here identify a specific confusion that keeps recurring rather than a subject…
When a preprint is the best available evidence and we say so Replied, post #20 · Evidence › Preprints · 3 Aug 2025 · 6 likes Taking post #17 at face value and following it one step further. What changes between preprint and publication: authors respond to reviewer comments, re-analyse data,…
How to research a compound with no human data without deceiving yourself Replied, post #66 · Compounds › Other compounds · 2 Aug 2025 · 5 likes Research use only, not approved for human use, and in this subcategory the compounds vary enormously in how much is known about them. It is worth establishing which end…
Power cut for eleven hours: how I assessed it afterwards Replied, post #3 · Practice › Storage & stability · 21 Jul 2025 · 0 likes Marking my place. If it changes for me I will come back and say so.
Promotion criteria, and the one that stops most nominations — the long version Replied, post #24 · Documentation › Doc review · 11 Jul 2025 · 33 likes Where I part company with post #22, and it is a narrow parting. Where the review finds the content is right but the framing overstates it, that is the most valuable…
"Greater than or equal to 99%" as a specification rather than a result Replied, post #5 · marked as the solution · Analytics › COA interpretation · 9 Jul 2025 · 8 likes On the opening post — agreed on the reasoning, with one qualification. Asking for the batch record rather than the certificate is a reasonable request and the response…
Meeting a protein target on a suppressed appetite Replied, post #8 · Nutrition & Training › Protein & intake · 5 Jul 2025 · 19 likes Fibre and fluid tend to fall alongside protein when intake drops, and the constipation reported here follows from that as much as from the mechanism.
A supplier that answers analytical questions with restated claims Replied, post #108 · Sourcing › Red flags · 30 Jun 2025 · 11 likes Agreed on all of that, and I have nothing to add to it.
Antibiotics and a course of something with delayed emptying Replied, post #74 · Practice › Interactions · 25 Jun 2025 · 7 likes The most defensible general position in this subcategory: identify the plausible mechanism, check whether it has been studied, and where it has not, say that rather…
The CagriSema phase 2 paper and what a fixed combination buys — the long version Replied, post #124 · Compounds › Cagrilintide & amylin analogues · 17 Jun 2025 · 0 likes Worth separating two things that post #120 runs together. Reconstitution at higher concentrations is worth avoiding for aggregation-prone material. The published…
Reading a denial letter as a specification for your appeal Started this topic · Access › Insurance & coverage · 15 Jun 2025 · 14 likes Reading a denial letter as a specification for your appeal Writing it up because I had to work it out twice and would rather nobody else did. Reading back through what…
The CagriSema phase 2 paper and what a fixed combination buys — the long version Replied, post #86 · Compounds › Cagrilintide & amylin analogues · 13 Jun 2025 · 0 likes This follows post #83 rather than contradicting it. The arithmetic on CagriSema phase 2 paper is the easy part and it is where the errors are, which is an uncomfortable…
[2026 update] What the GIP component of tirzepatide is thought to contribute, and how… Replied, post #67 · Compounds › Tirzepatide · 7 Jun 2025 · 16 likes Answering the question post #64 raises rather than the one it answers. Categorical response thresholds — the proportion reaching ten, fifteen or twenty per cent…
Coming back to: Why quantitation is the hard part, not detection Replied, post #21 · Analytics › Home & field testing · 30 May 2025 · 1 like Building on post #18 rather than restating it. A home refractometer is not measuring what people hope it is measuring in these preparations, and the readings are…
Half-life, steady state, and accumulation worked through Replied, post #5 · Pharmacology › Pharmacokinetics · 20 May 2025 · 8 likes Where I part company with the opening post, and it is a narrow parting. The version of half-life that circulates here is a simplification of a simplification. It is not…
Delayed gastric emptying and oral medication absorption: which drugs matter Replied, post #76 · Practice › Interactions · 7 May 2025 · 5 likes I came in to disagree and I am leaving without a disagreement.
Journal club: SURMOUNT-1, read without the press release Replied, post #108 · Evidence › Journal club · 2 May 2025 · 32 likes Reading order that works for these sessions: registry entry, methods, baseline table, primary result, then abstract last. Reading the abstract first anchors everything…
Reading order for a first week here, and what to skip until later Replied, post #95 · Start Here › Welcome · 22 Apr 2025 · 26 likes For anyone finding this later: the short answer on reading order is that it depends on one thing, and the rest of the thread is people identifying which thing.
Adjudicated events and why the definition matters — the long version Replied, post #102 · Evidence › Trials · 16 Apr 2025 · 4 likes Subgroup analyses are hypothesis-generating unless pre-specified and adequately powered, and almost none are the second. The interaction test matters more than the…
Adjudicated events and why the definition matters — the long version Replied, post #97 · Evidence › Trials · 13 Apr 2025 · 30 likes One caution on Adjudicated events: everything above assumes the underlying documentation is what it claims to be. That assumption is doing real work and is rarely stated.
A certificate with no method stated: what can you conclude? Replied, post #57 · Analytics › COA interpretation · 11 Apr 2025 · 5 likes A chromatogram supplied as a small image is legible for peak shape and not for baseline detail. That is enough to sanity-check an integration and not enough to…
Why cagrilintide alone is discussed so much less than in combination Replied, post #93 · Compounds › Cagrilintide & amylin analogues · 2 Apr 2025 · 8 likes Cagrilintide alone would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator.
When a tidy document is a signal and when it is decoration Replied, post #2 · Analytics › COA interpretation · 2 Apr 2025 · 21 likes Taking the opening post at face value and following it one step further. A stability statement tied to a named storage condition can be evaluated. One without a…
Review cadence: how often is a page actually re-checked? Replied, post #5 · marked as the solution · Documentation › Doc review · 1 Apr 2025 · 8 likes Where content is lifted from a topic, attribution should be in the document rather than only in the review thread. Worth saying I have only my own numbers here, and n…
Coming back to: Why quantitation is the hard part, not detection Started this topic · Analytics › Home & field testing · 19 Mar 2025 · 8 likes Why quantitation is the hard part, not detection — that is the question, and I have not found it answered plainly anywhere I have looked. Collecting what is known about…
Counter-ion form: the field almost nobody reports — one year on Replied, post #61 · Analytics › COA interpretation · 8 Mar 2025 · 0 likes Picking up post #60: that is the part I would want checked first. The fields that make one usable: lot identifier matching the container, test date, method…
[2026 update] New subcategory: rationale and scope Replied, post #141 · Meta › Announcements · 12 Jan 2025 · 2 likes Useful. I had the fact and not the reason, which turns out to be the important half.
Gallbladder disease risk with rapid weight loss Replied, post #51 · Clinical › Comorbidities · 1 Jan 2025 · 12 likes I had written a reply contradicting post #49 and deleted it. Here is what survived. Having read the whole gallbladder disease risk thread before replying: the question…
Persistent vomiting and the threshold for seeking help — one year on Replied, post #32 · Safety › Adverse events · 21 Dec 2024 · 7 likes I had written a reply contradicting post #30 and deleted it. Here is what survived. What I want from this Persistent vomiting thread is the list of things that would…
Building a sensible monitoring schedule with your prescriber Replied, post #52 · Clinical › Bloodwork · 20 Dec 2024 · 0 likes The reason building a sensible monitoring schedule is hard to answer is that the obvious measurement and the relevant quantity are not the same thing, and substituting…
What we do not know about retatrutide, listed explicitly Replied, post #25 · Compounds › Retatrutide · 18 Dec 2024 · 25 likes Where I part company with post #23, and it is a narrow parting. Heart rate increased in a dose-dependent way in the phase 2 work. That is not a footnote — it is one of…
Follow-up: Where the four-week escalation interval comes from, and what it is not Replied, post #112 · Practice › Dosing & titration · 25 Nov 2024 · 16 likes Practical experience of four-week escalation interval, offered as one case with the conditions stated, not as a general finding. Conditions first, because they are what…
Research-use-only status: what it means legally and practically — a second dataset Replied, post #18 · Compounds › Other compounds · 12 Nov 2024 · 0 likes PT-141 was developed from the same family with a different receptor profile, and it has a considerably better documented human evidence base than most compounds…
Revisiting: Moderation log format change Replied, post #7 · Meta › Announcements · 26 Oct 2024 · 3 likes Practical note on Moderation log format change: write down what you expect before you look. The number of times I have found what I went looking for is higher than…
Requesting a page: what makes a good request — what changed since Replied, post #29 · Documentation › Wiki requests · 10 Oct 2024 · 13 likes Building on post #26 rather than restating it. If a request is declined, the reasoning is written down, and it is worth reading because it usually describes a better…
Progressive overload when the scale is falling — one year on Replied, post #43 · Nutrition & Training › Resistance training · 10 Sep 2024 · 20 likes Two people in this thread mean different things by Progressive overload and are disagreeing about the definition while believing they are disagreeing about the facts.…
Follow-up: Oral contraceptives and delayed emptying: what the data shows Replied, post #11 · Practice › Interactions · 20 Aug 2024 · 0 likes Fine by me. I had wanted a stronger conclusion and there is not one available.
Coming back to: Purity assay versus content assay: two different numbers Replied, post #67 · Analytics › COA interpretation · 13 Aug 2024 · 4 likes The distinction between release testing and characterisation is one industrial documents make and retail ones usually do not. It is the difference between "we tested…