Karin,

You wrote: If we cut the dose down further, and she keeps having those symptoms, would it be on to the next LM?

Which symptoms do you mean by "those symptoms"? If you mean the aggravation symptoms after taking the dose, I would modify the dosage in one or some of the ways listed above.

If she is overly hypersensitive she may not be 'ready' for the LM potency scale. A general rule is if the patient can tolerate up to 30C then they may be considered suitable for the LM scale especially in chronic cases of long-standing illnesses. Hahnemann often used olfaction in his hypersensitive cases where the 3rd, 4th, 5th dilution cup still did not prevent aggravations.

If you mean after modifying the dose to avoid those aggravating symptoms after taking the dose, the original complaints are progressing too slowly, or not at all, then yes, you need to step up to the next potency level. I have not found refilling the remedy solution bottle of the same potency to be as effective as moving up to the next potency level. When you have the correct remedy you should be able to move up the potency scale to promote rapid, gentle healing and cure.