Sema Weight Management Protocol

What This Protocol Is For

This protocol is designed to help you lose a meaningful amount of weight — and keep it off — when diet and exercise alone haven't been enough. Sema works by quieting the food-noise in your head, helping you feel full sooner, and making it easier to stick with reasonable portions without constant willpower battles.

Beyond the number on the scale, most people notice their energy steadies out, cravings shrink, and clothes start fitting better within a couple of months. Many also see improvements in blood sugar, blood pressure, and cholesterol along the way.

This is a slow-and-steady protocol. We start low, go up gradually, and pay close attention to how you're feeling. Rushing the dose usually just means more nausea, not faster results.

What You'll Be Taking

• Sema (low-dose vial, 15 mg total) — Your starter and titration vial. You'll use this for the first several weeks while your body adjusts. One injection per week.
• Sema (higher-dose vial, 30 mg total) — Your maintenance vial once you've worked up to a steady dose. Same routine: one injection per week.

How to Use It

Reconstitution (mixing your vial): Your vial comes as a dry powder that needs to be mixed with bacteriostatic water (sterile water with a tiny preservative) before use. The office will walk you through the exact amount of water to add and show you how the first time. If you ever forget the mixing ratio or your syringe markings look off, call the office before you inject — don't guess.

The injection:

• Sema is given subcutaneous (just under the skin, not into muscle).
• Rotate sites: belly (avoiding the area right around your navel), upper thigh, or back of the upper arm.
• Same day each week — pick a day that works (Sunday mornings are popular because they're predictable).
• Time of day doesn't matter. Food doesn't matter. Just be consistent.

Typical titration (your doctor may adjust this):

• Weeks 1–4: starting dose
• Weeks 5–8: step up
• Weeks 9–12: step up again
• Then hold at whatever dose gives you steady progress with side effects you can live with.

Storage:

• Unmixed vial: refrigerator.
• Mixed vial: refrigerator, and use within the timeframe the office tells you (usually about 4 weeks).
• Never freeze it. If it freezes by accident, don't use it — call us.

If you miss a dose:

• Within 2 days of your usual day: take it when you remember, then go back to your regular schedule next week.
• More than 2 days late: skip it and take your next dose on your normal day.
• Missed more than 2 weeks in a row? Call the office before restarting — you may need to drop back down to a lower dose.

What to Expect

Week 1–2: You'll likely notice you're not as hungry, and you feel full faster. Some people get mild nausea or a "blah" stomach feeling for a few days after the injection. Weight may not move much yet — that's normal.

Week 4: Food noise is usually quieter. You may have lost a few pounds. Cravings for sweets and snacks tend to fade. Side effects from the first weeks should be settling down.

Week 8: Most people are down 5–10% of their starting weight by now. Energy feels more stable. You may notice you're choosing smaller portions without thinking about it.

Week 12 and beyond: This is where steady, real progress shows up. Some people lose 10–15% of their starting weight by month 4–6 and continue gradually after that. Give it the full 12 weeks before judging how well it's working for you.

A note on the scale: weight loss isn't linear. You'll have flat weeks and even small bumps up. That's biology, not failure.

Common Side Effects

• Nausea or upset stomach — Most common in the first 1–2 weeks after starting or stepping up. Eat smaller meals, stop when you feel full, and skip greasy or very rich foods for a few days. Usually settles within a week or two.
• Constipation — Drink more water than you think you need, add fiber (vegetables, berries, chia, or a fiber supplement), and stay active. If nothing in 3 days, call us.
• Heartburn or burping — Smaller meals, don't lie down right after eating, and skip carbonated drinks for a bit.
• Fatigue, especially early on — Often tied to eating much less than before. Make sure you're getting enough protein (aim for a serving at every meal) and drinking plenty of water.
• Injection site itching or a small red bump — Normal, fades in a day or two. Rotate sites.

Most side effects ease up as your body adjusts. If they don't, tell us — we can slow the titration or hold a dose longer.

When to Call the Office

Call us (or seek urgent care) if you have:

• Severe belly pain that doesn't go away, especially if it wraps around to your back
• Vomiting that won't stop, or you can't keep fluids down for more than 24 hours
• Signs of dehydration: dizziness, dark urine, headache, racing heart
• Yellowing of your skin or eyes
• A new lump in your neck, hoarseness, or trouble swallowing
• Severe constipation (no bowel movement in 3+ days with pain or bloating)
• Any allergic reaction: rash, swelling of lips or tongue, trouble breathing — this is a 911 call

Also call (not urgent, just let us know) if you've lost more than 2% of your body weight in a single week, or if you're so not-hungry that you're skipping meals entirely.

A Note About This Protocol

Sema is supervised through Peptide Pure's research network, and while the active ingredient is well-studied, this specific compounded version is not FDA-approved for weight loss. Your doctor is monitoring you closely throughout — this works best paired with reasonable food choices, protein, movement, and sleep, not as a replacement for them.

Questions for Your Next Visit

• "Based on how I'm responding, should we move up to the next dose or hold steady?"
• "What's our long-term plan — how long do you expect me to stay on this, and what does coming off look like?"
• "Am I getting enough protein and nutrients given how much less I'm eating? Should I add anything?"
• "What can I do now — strength training, habits, food choices — to protect the results when I eventually taper off?"