From what everyone has told me, the manufacturer’s recommended titration schedule should be disregarded. Instead, I have been told to increase the dosage slightly once the nausea is not as bad, and you may continue that adjustment process over time – don’t let someone rush you into it. Also, I agree with Emily in that several people, including doctors, have said that the full dosage may not be necessary for all people with type 1.
According to Dr. Steven Edelman, assistant professor of medicine at the U.C. San Diego School of Medicine, “I always tell my patients that the ‘perfect’ dose of Symlin is the dose that induces satiety but does not cause nausea.” In his experience, the nausea is not really as big an issue in type 2s - most likely because most type 2s are still producing some amylin and so the “return” of the hormone to their system isn’t so jarring. But in type 1s, the nausea can be acute, and Dr. Edelman may recommend a slightly different titration schedule to reduce it.